The URL can be used to link to this page

10020072 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10105 DE ANZA BLVD CONTRACTOR:ALL SEASONS ROOFING PERMIT NO: 10020072 S 3RVICES `iER'S NAME: PONDEROSA ASSOC LLP 1 120 SMITH AVE DATE ISSUED:02/12/2010 OwNER'S PHONE: 5103770077 SXN JOSE,CA 95112 PHONE NO:(408)971-4455 ❑ LICENSED CONTRACTOR'S DECLARATION 13 UILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# 7 �9� F F MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF COATING OVER 1 LAYRER OF (commencing with Section 7000)of Division 3 of the Business&Professions CAPSHEET Code and that my license is in full force and effect. & INSTALLING I.V.60 MIL PVC(120SQ)CLASS I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this S 1.Ft Floor Area: Valuation:$66300 permit is issued. APPLICANT CERTIFICATION A PN Number:35909017.00 Occupancy Type: I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. / h;sued by: " Date:2--� Z---CO 5 ---ature �r Dat ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: it stalled without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: !' GLfiL 1,as owner of the property,am exclusively contracting with licensed contractors to — construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. (alifornia Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by c)mpliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. c mtaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's L ei�lth&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must C wnor suthori,4d agent: forthwith comply with such provisions or this permit shall be deemed revoked. —�7¢� �'!'r� ?wa_kDate: /..V l� APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name the above mentioned property for inspection purposes.(We)agree to save .nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. // 1 understand my plans shall be used as public records. Signature Cal/V Date B l 4GLicensed Professional CITY OF C JPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 35909017 .00 DATE ISSUED. . . . . . . : 02/12/2010 RECEIPT #. . . . . . . . . BS000009744 REFERENCE ID # 10020072 SITE ADDRESS . . . . . : 10105 DE ANZA BLVD SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER PONDEROSA ASSOC LLP ADDRESS 10105 S DE ANZA BLVD CITY/STATE/ZIP CUPERTINO, CA 95014 RECEIVED FROM ALICIA SALAS CONTRACTOR GOR3HTEIN, VLADISLAV LIC # 21035 COMPANY ALL SEASONS ROOFING SERVICES ADDRESS . 172 ) SMITH AVE CITY/STATE/ZIP SAN JOSE, CA 95112 TELEPHONE (403) 971-4455 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- -- 00 1BCBSC VALUATION 66, 300 .00 3 . 00 0 .00 3 . 00 0 . 1BSEISMICR VALUATION 66, 300 .00 6 . 70 0 .00 6 .70 0 . 00 1REROOFRES SQ FEET 120 . 00 1560 . 00 0 .00 1560 . 00 ------0_00 ---------- ---------- ---------- TOTAL PERMIT 1569 . 70 0 .00 1569 .70 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER --------------- ------------------- CREDIT CARD 1, 569.70 MC --------------- TOTAL RECEIPT 1, 569. 70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- _ - ------ ------------------- ------- - -- ---------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO Na.1, RER.00F CUPEkTiNO PERMIT APPLICATION APN# Date: Building Address: -� I Vd Owner's Name: Phone#: Contractor: •(N.tk J Phone#: Ltb Fax#:408 .61.3�&- L� t -1 Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles Other(Specify)Ckrc ,, v) C Q OkZL� Other(Specify) b dtiI q �X, Number of existing coverings \ ❑ Provide I.C.B.O. Report#_SI-i Q m'To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: _T001 0�-k-3 0-v,--L, L kc_vat- Ob Cz C1' Residential ❑ Commercial Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable,include in plan set & the sheet Inde K. I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 6/16/08 CITY OF CUPERTINO RER.00F CUPE�TINO FEE SC14EDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Re3idential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08 Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the Ci-.y of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 2. New roof coverings shall not be applied•without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any s oofing installation. 4. To receive a final sign off from the City,+he following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed,a plywood nail ilspection is required. 6. Any roofing which is applied without fi-st obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: if you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: mum of 1/4" per foot slope and demonstrate 1. Flat roofs must have a mini that there is no ponding. 2. An I.C.B.O.report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: iliwkus��I� ]�0 G i oc -V_S C� Job Site Address: � � �� 7 Roofing Company Name: n 0 (`)k 4 Applicant's Signature: Date: Greg Casteel Building Official ReviE ed 11/2/04 M.Indoor Air Quality and Finishes 1-UW Laaii WVOC Pak# 1 IAQ/Health pts y=yes p 2.Use Low VOC,Water-Based Wood Finishes ?IAQ/Health pts y=yes p 3.Use Low lk VOC A 3 IAQ/Health pts y=yes p 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 31AQ/Health pts y=yes p p 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7.%W Ar 1 IAQ/Health. is P Y=Yes 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes p N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Ma#srials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl FIAQ/Health pts y=yes p 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 ■ i i f Total Points Available: 1401 1301 57 Total Points Project Received: _� 01 0 0 4 G:date/progs/greenl iuildingguidelines/remodelers/greenpointsfinal212.04protected.zls Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY OF .;UPEkTINO Buildir",j artmenl OB ADDRESS: d Q S> r RMIT #J 011 �OWNER'S NAME: i®' vt ONE # p�' 7/GENERAL CONTRAC OR: /-� l Sea. o� X a - l 77 I am not usingan subcontractors: _ l�— /Q�e P� y Date Signature Please check applicable subcontractors and comp'FFI! � USINESS LICENSE # BUSIN Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date