06090246CITY OF CUPERTINO ��1lss,,��T
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QIfA 1L��i'OTiQL`
'BUILDING DIVISION PE1�1Y111
5�o�Vs.
kli.:_.r
6UILDINC ADDRESS:
DAN ELLIOTT'S ROOFING CO
�R"dnNO06090246
10177 BYERLY CT
OWNER'S NAME:
PI]U11T LSSUE DATE
SABANOVICH STEPHEN
2669 COIT DR
09/26/2006
NE:
SANITARY NO. CONTROL NO.
(408)559-7327
ARCHITEC MNO1NEER:
BUILDING PERMrr INFO
BIRO ELECT PLUMB MECH
0
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 br dby srfirm Ws I m li.rmd ndc' pmvlaan. or CEsgv 9 (®merlin[
with Sccdw 700Mof Diibmn 30flhe Basins ad Profedmu Code.W my 1r h
inrYllm at.
3
-
REROOF- REMOVE SHAKES, INSTALL 1/2" CDX, 2 LAYE
'9 L'
30LB, 1 X 2 X 48 BATTENS, INSTALL T E COMPLET
—rertead
D.aw.aa
IT
ARCNECTSCDECLI on
ALL NEW METAL, 32 SQUARES, CLASS A
1 undmsuN my plw YW I Ec usd u psbUc nada
/
Lfv'nmd Plo(cstioul
O.,NEn,BURDBR D, lba C AMN
n,.a tya fnm the
1 hacby Cm 1.
2`/�
Z
Any
COMAny oilyaloudly
and Cm
. (SccMlm m 7 1.. Bon s Pr
f 70 1.5.
/
-dooau
hix:hin[moon..(Sanaa
which rryu m -lat. a mpab mY suocmrt
4 ala+, i1allra
6
four Nranith,
loan O.al. uirOt t Kof faf mChp flL' L..(ChtamCN
pr,Cr Yl iLL,S.d ...ISa R
m,
Sq. Ft. Floor Area
Valuation
W',
,nnnabrcanmape�,nlmumnl,m.;.Ian.alnccam,mY.�tLiaa,:I,wla,.plR9
a prone
,mdPmrasmadCn )«
$20977
(c.,mncmLW;thSm)an7")ofDlwpa3oflaOil
dw M Is acmpt omoaf, m ad Ne buts for de alk[cd emmpdm Any wobtion of
APN Number
Occupancy Type
Sadon 7031.5 by my appBoat (a a Permit mbjms do appbont 10 a cull pam.lry of
nm vtore Nan Rw hudscd dolWrs (S5001
❑ 1, n Oxon of Ne propcmy, a my emplaycu wflh nLo a de'u mk o n llawlm.
Required Inspections
9 P
will do thc wvh, sod the wvcMe is ant it d dmaBacd lar We(S .7044, Buabev
and Planula. Code The Caouarors TJv4sse Law don not apply n m . of
proputy who Wilda mimpo,v 1Eama, adwho dousmb w mmml(ar thrvo[b his
owm anployen, poridcd the once Impattnenu =mt udraMd or aBcd f" Rio. B,
haw . the Waill[ m impmsemenl u sold Um. areywNmrv,laion.do, aron-
Wildc wIB Mdo badcn of pm.vL tht1 be did m1 Wild or'ooprme for pod o of
.le-).
I. n ow11a of the pr.Plm. w cachelvely canusain[ wdb Iktasd ldann s n
caavua and Pojca (Svc. 70 W. Basiaw W Ra(®wu Cdc)Tho Caolmors Li-
iuric
.U. duo sotaWY at m vwnn ar 7OPrxtY wba builds or tmp thvcon, and.
wbo conuacLLfar lab pm)ects with •canlranar(s) kllb4A iasunt an Ne Caatta -
I i ._ few.
❑lam.aamnd asc ,Ba PCfm Ni.
Due
WORKERS COMPENSATION DECLARATION
1 bartbY 0bm undcr N1W ty a( Nrpmy mad of the folbxia[=�
Ihaw ad Will mtlnuin• ccd.of Cl On mlf.W for Watcrs CnoPa.
vim, n XaMc cd for by Sudan 3700 d me Libor Code for Na Nrformm a Ne
fa wbiri This permit Is Wood.I
Zwak
ham aM wir m ob,,,a WWWs ComPmuion lasunnm, u TotImad by Section
3 Nc Ltbor Coda, for thc Nrformmcc of the w fa Which Nis pmmb b i1
My Worker Campuouloala appy� and Polity nwoba am:
c.vier. An2GlfYi'cf� /APa'y No.: /9 !f
COMFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(@b radon and am be c0mpked If Ibe NmOt Is facdnc bundmS dadns ($100)
err les)
1 laic,, lion in Nc Psformsax of the w for which thispermit is Invcd. l "I na
a.'nplor any pavan in my anal., m u W bxome mbja.T toIAC WortaY Cmlpm Wer
IzWs a 'form.. Dau
Appeo s
NOTICE TOAPPLJOANT:if, .ft, errE C tyoushould
cattHin PCcniO a
m Warccra Canpcnatais Pwit 00 M Ne lu tkll Code muu
d .
faNwith rnmply w'uh wch provbioruathb pam;tNJl bcdmadlmvtcd
fotar i Garro ii
J
CONSra AGENCY
is a c,ONLtianN a[cmy for Nc purarnuam of
I Worley Ibu L a on I
ctvm
d (SO,. . C11.
s Nc wort fa.hch 16ia Pamlt b lvaE 13a. )lyTl. Civ. C.)
mil
� Lsdvrs N.
'
r<deraAamw
j 1 v,emiry'. Nat 1 lute rid Kia an and salt thou td,mto idarol.da
ad .
I Orn m comply with all c;tY and county ottan es.d sue Ian mbdnL to
city and O
Wilding-.UoutclinaN,ty MrtbY wNan scuti�cs ofNb lily mc�ur upon de
ianpa
bvvc-mcnomcd for iaspccum purposes. -
Ul
in aM 4,P the Dllr a(Cupmnmid
(,jd, bc. iM
,in City
and caprn=•White vuyin myny wrneaLaiwavd Gly
t,.
rLj Iiacoascgj
of the
in ca ICAN-Tx of l6c RS'T n[ of Nb D WILL
APPLICANT UNDERSTANDS AND WILL COMPLY WrIH ALL NONPOBrf
Issued by: Date
CE REOVIATI
Re-roofs
Type Roof
Si[n.1urt of AppUca.cln Due
HA].bRD0U6 MATERIALS DISCLOSURE
HAZAR
of
mea ba chawdavnwclvl
WIBdeappliovlafMort bp.1
Cooaopua
u dcfued by Ue CupW no Municiryl Code. Chagcr 9.12, W the IIcaIN sd S.fay
Cie. S.W. 25572(07/j
All roofs shall be inspected prior to any roofing material being installed.
❑y�[\
If a roof is installed without first obtaining an inspection, I agree to remove
Will Ne aPplicml or rmam wBdin[ aavgnl ac egdpnlmt a aNvLL Wbicn
Qusllty Man.t
rtdnn &UW by thA. e B.y AAb [cmcn
conn huudom air cmuuts
all new materials for inspection.
Db1ria1
❑ rn
Ihvtc and de hvarGu. maarWa rtyuimmcu urutr Clup1a6.95 of Ne Cali(er-
�
ni. HUINaSafclyCodc,S vau25505,255JJ and 213]4.1 WcrrarL NiifNe hNY6n[
A�/O, f/ ii C9 C/ (D
dao m1 cum:mly lust • iaaac Nat It b my rupOruiNlilY n lwfy Nc vpmt of Nc
�C�-/�—
xr yp g yam gcpfac mmeoro ap
Signature of Applicant Date
9=,76 -e
a�`��-/—
All roof coverings to be Class "B" or better
r m mlbm>cd aLcn1 Dau
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
*CIOF Telephone: (408) 777-3228
Fax: (408) 777-3333
CUPEkTINO
Building Department
Subject: Re -roofing policy for the City 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 roofing installation.
4. To receive a final sign off from the City; he followingsteps 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: inspection is required.
6. ..:.Any_ roofing which is applied without first obtaining an inspection,
willrequire the removal of all new material down to the slieathing,
so a proper City inspection can be'performed:
7. NOTE: If you call for a' plywood nail4nspectidn 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:
1. Flat roofs must have a minimum of 1/4 " per,foot slope and demonstrate
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:. V Ci is * A tlou I Cb
1 �
Job Site Address: �� 1 l 1 �iU�11ICf u� 1CI�I �'teAsnri lyx�
Roofing Company Name:
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
s
S�
CM OF
UPEkTINO
Community Development
10300 Torre Avetme
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS:
/G er
PERMIT #
OWNER'S N
PHONE # -3-
-GENERAL
GENERAL CONTRACTOR
FAX #
I am not using any subcontracto
Signature Date
Please check applicable subcontractors and complete the following information
Owner/ Contractor Signature
pay` o�
Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
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
pay` o�
Date
0m 1 of 1
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 34212085.00
DATE ISSUED.......: 09/26/2006
RECEIPT #......... 36212
REFERENCE ID # ...: 06090246
SITE ADDRESS .....: 10177 BYERLY CT
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: amyw
COPY # : 2
OWNER ............: SABANOVICH STEPHEN
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-5647
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
------------
290.46
290.46
NUMBER
-----------------
12682
RECEIVED FROM ....:
DAN
ELLIOT ROOFING
CONTRACTOR .......:
DAN
ELLIOTT
LIC #
21466
COMPANY ..........:
DAN
ELLIOTT'S
ROOFING
CO
ADDRESS ..........:
2669
COIT_DR
CITY/STATE/ZIP ...i
SAN
JOSE,'CA
95124
TELEPHONE ........:
(408)559-7327
PD
THIS REC
NEW BAL
FEE ID
UNIT QUANTITY
AMOUNT
-TO -DT
----------
BPERMFEE
-----------------------
VALUATION 21,000.00
----------
----------
288.36
0.00
----------
288.36
----------
0.00
BSEISMICRE
VALUATION 21,000.00
2.10
0.00
2.10
0.00
TOTAL PERMIT
----------
----------
290.46
0.00
----------
290.46
----------
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
------------
290.46
290.46
NUMBER
-----------------
12682
0
0
0
Ll
CITY OF CUPERTINO Ob --'AS
REROOF
PERMIT APPLICATION FORM
APN# 1�Wn—IZC7_J rOnG
L
Date: -ZS–O ID
Building Address:
Owner's Name: IjPhone
#:
0— q
Contractor:
Phone #:
License #:
11,P o (b
(1oB-SSq--1'3'z
33�
Contact:
Go
Phone #:
Cupertino Business License #:
is
5Sq--nz_1
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Asphalt Shingles
❑ Built -Up roof
m Wood Shakes
'
❑ Asphalt Shingles ❑ Wood Shakes rnpp1er
M
❑ Wood Shingles -
❑ Other(Specify)
Number of existing coverings oyg7
❑ Wood Shingles
O Other (Specify)_Lgkv-W,D1ej�-i- �1 s
Q To be Removed
❑ Provide I.C.B.O. Report # C 1Z Z p 3
❑ Provide Mfgr. Installation Specs.
I Have Read Understand and Will om2ly
Job Description::
With Cii ertino's Tear Off Plic
o
i�Rvts 1ZFinoVe 'e -P in
lI �Iz1��DXl�Wa � s� #30l x 48
2 , llMW
Residential COMM' ercial.0.rNAO
...
Fire Zone: Yes ❑ No
Confirmed With Planning Dept. if
there
Cost of Project:
Type of
are any restrictions: U
Construction:
Z a1 Occupancy group:
F
Qty. if
Fee ID
Plan
Fees
License