08080164 CITY OF CUPERTINOwsr..4..i ^f'� ,a f" .Rk' .A4y .a'S7r
•BUILDING DIVISION PERMIT CONTRACTQINFORMATIOR
BUILDING ADDRESS: PERMIT NO.
0913 CANYON VISTA DR DRAEGER CONSTRUCTION INC 11114ERE NAME: PERMIT ISSUE DATE
RANCHO DEET? CLIFF HOA 605 COMMERCIAL ST 08/22/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
ROOF OVER LAY W/DURO— LAST BLDG ELECT �O 0
000 LICENSED CONTRACTORS DECLARATION SINGLE PLY MEMBRANE•
ItiE with Ihereby affirmthat Iamlicensed under provisions ofChaper9(commencing -____-___ _---_-.�,._- ._.-Jab Description
Section 7010)of Division Sof the Business and Professions Code,and my license is
j eiin fell fora and- _h 17 t O
Lkeryforee a Lie.R
r•F00 Dale In-L r' Contractor\ Lxe_O(P/_ e_cA Si-
ARCHITECTS DECLARATION)
1 i t-<. I understand my plans shall he used as public records
•
C res Licensed Professional
3 OWNER-BUILDER DECIARATION
3 t f I hereby affirm that I am exempt from the Contractor's License Law far the
-o O following mason.(Section 7031.5,Business and Professions Code:Any city or county
$M which requires a permit to construct.alter.improve,demolish.or repair any structure •
-z prior to is issuance,also requires the applicant for such permit to file a signed statement
< that heislicensed pursuant tothe provisions ofthe ContractorsLicense Law(Chapter Sq.Ft. Floor Area Valuation
seCEO (commencing with Section 7000)of Division 3 of the Business and Prolusions Code)or
e 5 Iff- that he is exempt therefrom and the basis for the alleged exemption Any violation of
section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars(3500 •
). P y yP
❑I,as owner of the poperty,or my employees with wages as their sole compensation,
will do the workand the mecum is notinlended or offered for sale(Sec.7014.Business
and Professions Code:The Contractors License Law does not apply to an owner of Required Inspections
property who builds of improves thereon,and who does such work himself or through his
awn employes,provided that such improvements are not intended or offered for sale IL •
however,the building or improvement 4 sold within one year of completion,the owner.
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑I.as owner of the property w exclusively contracting with licensed contractors to
construct the project(Sec.7014.Business and Professions Code:)The Contractor's Li.
cense Law does not apply to an owner of property who builds or improves thereon.and,
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License Law.
faI ren exempt under Sec ,BA PCfor this recon
ner D
WORKER'S COMPENSATION DECLARATION
ate
.
I hereby affirm under penalty of perjury one of the following declualions:
I hare and will maintain a Cenifrnte of Consent to self-insure for Worker's Compen-
scion.as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
fThaw and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued
My Worker's Compensation�IInsurance carder and Policy number are: •
Canes: rtan Snu+vr3ALRSPolicyNo.:7lult 1217(12(1)l
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
•
(Thu section need not be completed if the permit is for one hundred dollen(S 100)
or less)
I certify that in the performance of the work for which this permit is issued.I shall not
employ any person in any manner so as to become subject to the Workers'Compensation '
Laws of California Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of Om Labor Code you mut
.J revoked.forthwith comply with such provisions or this permit shall he deemed .
Z y CONSTRUCTION LENDING AGENCY
F-1.. I hereby,firm that there is a coau0uction lending agency for the performance of
C' > de work for which this permit is issued(Sec.3097,Civ.C.)
W 0 Lender's Name
O z Lender's Address
C)Q I unify that I have read this application and state this the above information is
I3. - correct I agree to comply with all city and county ordinances and state laws relating b
O building construction,and hereby authnire representatives of this city to enter upon the
r, above-mentioned property for inspection purposes
FE (We)agree to saw,indemnify and keep harmless the City of Cupertino against i
rel liabilities,judgments,cons and expenses which may in any way accrue against said City j
t)z in consequence of the granting of this permit
APP3s10ANT ERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: -lii ' is A� //� Date �
-� ^ -'
h 4`
S U CE REGULA
- S"2
C
Sign. rs-orApplacaa on0ac r Datee Re-roofs v
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle hazardous material
dined by the Cupertino Municipal Code Chapter 9.12.and the Health and Safety
alle
,Section 25532(x)? N •
All roofs shall be inspected prior to any roofing material being installed.
Yes fu Na
• �� If a roof is installed without first obtainingan inspection,I agree to remove
Widths arplinnsoraurum befinegaxueaBuse Arca
Air(nuit devices which
P g
District?
of Lr CnaWniNmlf defined by the Bay Ana Air Quality Management all new materials for inspection.
District?
❑Yes Nu ----
I
•I have read the hazardous=lanais requirements under Chapter6.95 of the dor-
I `
thhSafetyCodnSsdas255i525533and 255341uthe 'Una �
` _
dosnot Cw1e hasert,this it is my responsibility b notify the occupant he 1 u— ) L -0
that ?S-
,
reqs a which m - tpoor to issuance ofaCanna=ofaufp -Q�_Signature-ofAPPlicant Datei
vi"ncud.authoried agent ' Dam' ' , All roof coverings to be Class's'or better
•
rotCITY OF CUPERTINO
at REROOF
IP 0 CUPERJINO PERMIT APPLICATION
080R-ohfii
APN # Date:
L35U 22 Or OD R- 114 -OR
Building Address: •
ll�q 12) en,Af4t \J c;n. tr.
Owner's Name: Phone #: ypg,;a(o ,3'-108
R atio bei es cckank
-
Contractor: Phone #: qaS. 313 ,OI OQ
±wo
eAei. e rwk Fax#: R a„-, 3( -A , S%SS
Cupertino Business License #: Contractor License #:
tcz l 6 I D C -39 "
Type of Roof Covering:
Existing: Proposed:
...r wilt-Up Roof o Built-Up roof
• ❑ Asphalt Shingles o Asphalt Shingles
o Wood Shakes o Wood Shakes
o Wood Shingles
a Wood Shingles
o Other(Specify) -e' Other (Specify) burn-las4
Number of existing coverings ❑ Provide I.C.B.O. Report#
o To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: Rcso oue` lad Wt#-k lSuro - Las# Sinve. V\3 V e.wbrotie"
Tc-rn. erl Tkxrvv.eceo_ Atu %e port • _
Residential Commercial ❑
Notes .
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 index.
Valuation:
IR Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
d` REROOF
•
CUPERJINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLROOF
Sg 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 City of Cupertino
1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards
and manufacturers specifications on re-roofing.All roofs are Class "A" per Cupertino
municipal code 16.04.080.
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, the 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 inspection is required.
6. Any roofing which is applied without first 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:
1. Flat roofs must have a minimum of 1A "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: Rn,,,f.t,o t\rtp p liccI�nA
Job Site Address: Inca?) Cry t pvt. Vtc-k-ct b-,
Roofing Company Name: , ,
• Applicant's Signat e —'. Date:fl..— -Og
Greg Casteel
Building Official
Revised 07/30/08
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INFRARED THERMOGRAPHIC REPORT
Prepared For:
Ertech
0
10960 Kester Drive
Cupertino, California
Requested By: Dick Tippett Inspection Date: 7/18/2008 - 7/18/2008
Title: Owner Number Of Days: 1
Technician: Hanna, Kevin Inspection #: 4204
• Administrative Office: 3070 Kerner Boulevard,Suite A,San Rafael,CA 94901 •(415)453-7200 Fax(415)453-2065
Los Angeles(310)791-2777•Central Valley(209)632-6167•Oregon(541)488-0431 •San Diego(619)448-7256
Toll Free: (800)640-3133(USA) email: irtesl i)pacbell.net website:www.thermolestinc.com
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July 21, 2008
Dick Tippett
Owner
Ertech Inc
100 Zils Road
Watsonville, California, 95076.
Re: Infrared Thermographic Inspection—July 18, 2008
Dear Mr. Tippett,
• On July 18, 2008 an Infrared Thermographic Inspection was performed performed on the roof of the
building located at 10960 Kester Drive, Cupertino, California. No potential problems were located
in the equipment that was inspected.
If you have any questions or concerns regarding the inspection, please do not hesitate to contact
me at 415/453-7200.
Sincerely,
James Moore
Office Manager
•
Administrative Office: 3070 Kerner Boulevard,Suite A, San Rafael,CA 94901 •(415)453-7200 Fax(415)453-2065
Los Angeles(310)791-2777•Central Valley(209)632-6167 •San Diego(619)448-7256
Full Free: (800)640-3133(USA) email: irtest(nlpacbellmet
•
• DOCUMENTATION PAGES
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Los Angeles(310)791-2777•Central Valley(209)632-6167.Oregon(541)488-0431 •San Diego(619)448-7256
Toll Free:(80(1)640-3133(USA) email: irtest(jdpachell.net website:ww'w.thermotestinccom
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Ertech Equipment Test Status Key
TBT =To Be Tested
Problem Type Key NT/NL=Not Tested/No Load
10960 Kesler Drive E =Electrical NT/TC=Not Tested/Time Constraint
NT/UR=Not Tested/Under Repair
Inspection Date: 7/18/2008 Inspection#: 4204 M =Mechanical NT/LO=Not Tested/Locked Out
V =Visual Inspection NT/NA=Not Tested/Not Available
Inventory of Inspected Items NT/NS=Not Tested/NotSpecified
NSFI =Not Selecteed for this insp.
LOCATION /EQUIPMENT: Barcode: Test Status: Problem #:
Roof TESTED
Area#1 TESTED
Roof profile TESTED
•
•
Administrative Office: 3070 Kerner Boulevard,Suite A,San Rafael,CA 94901 •(415)453-7200 Fax(415)453-2065
Los Angeles(310)791-2777•Central Valley(209)632-6167•Oregon(541)488-0431 •San Diego(619)448-7256
Toll Free:(800)640-3133(USA) email: irtest(a':pacbell.net website: www.thennoteslinc.cum
Community Development
10300 Torre Avenue
`-i Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�CUPEKIINO
Building Department
JOB ADDRESS: PERMIT #�� �G7 /
10413 C,�.v. incl \);4\-c>_ br, (� Co
OWNER'SNAM : 'Rti,,rkp 'tee? 0ircc PHONE # cos-. 317, , rion
GENERAL CONTRACTOR: bine, a � FAX # 9/C, 313 . C-9 to C
I am not using any subcon ctors: A"w
Signature Date
Please check applicable subcontractors and complete the following information:
0 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 Date
• CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # : 1
• Sec : Twp: Rog: Sub: Blk: Lot:
APN • 35628008 . 00
DATE ISSUED • 08/22/2008
RECEIPT # • BS000005864
REFERENCE ID # . . . : 08080164
SITE ADDRESS • 10913 CANYON VISTA DR
SUBDIVISION
CITY • CUPERTINO
IMPACT AREA
OWNER • RANCHO DEEP CLIFF HOA
ADDRESS • 10913 CANYON VISTA DR
CITY/STATE/ZIP CUPERTINO, CA 95014
RECEIVED FROM • DRAEGER CONSTRUCTIO
CONTRACTOR • DRAEGER, JOHN EDWARD LIC # 21895
COMPANY • DRAEGER CONSTRUCTION INC
ADDRESS • 605 COMMERCIAL ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
• TELEPHONE • (408) 536-0420
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
1.!3SEISMICR VALUATION 13 , 721 . 00 1 . 40 0 . 00 1 .40 0 . 00
1REROOFRES SQ FEET 20 . 00 260 . 00 0 . 00 260 . 00 0 . 00
TOTAL PERMIT : 261 .40 0 . 00 261 . 40 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CHECK 261. 40 137495
TOTAL RECEIPT : 261 . 40
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
601 ROOF TEAR OFF . 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
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Visit Our Web Site at www.thermotestinc.com
INFRARED THERMOGRAPHIC REPORT
Prepared For: - G
•
Ertech
• o ogoI64
0710913 Canyon Vista Drive
Cupertino, California
Requested By: Dick Tippett Inspection Date: 7/18/2008 - 7/18/2008
Title: Owner Number Of Days: 1
Technician: Hanna,Kevin Inspection #: 4205
Administrative Office: 3070 Kerner Boulevard,Suite A,San Rafael.CA 94901 •(415)453-7200 Fax(415)453-2065
• Los Angeles(310)791-2777•Central Valley(209)632-6167•Oregon(541)488-0431 •San Diego(619)448-7256
'loll Free:(800)640-3133(USA) email: irtest@pacbell.net website: www.thermotestinc.com
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July 21, 2008
Dick Tippett
Owner
Ertech Inc
100 Zits Road
Watsonville, California, 95076.
Re: Infrared Thermographic Inspection—July 18, 2008
Dear Mr. Tippett,
On July 18, 2008 an Infrared Thermographic Inspection was performed on the roof of the building
located at 10913 Canyon Vista Drive,Cupertino, California. No potential problems were located
in the equipment that was inspected.
If you have any questions or concerns regarding the inspection, please do not hesitate to contact
me at 415/453-7200.
Sincerely,
James Moore
Office Manager
Administrative Office: 3070 Kerner Boulevard,Suite A,San Rafael,CA 94901 •(415)453-7200 Fax(415)453-2065
Los Angeles(310) 791-2777•Central Valley(209)632-6167 •San Diego(619)448-7256
Toll Free: (800)640-3133(USA) email: irtest@pachell.net
•
DOCUMENTATION PAGES
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• Administrative Office: 3070 Kerner Boulevard,Suite A,San Rafael,CA 94901 •(415)453-7200 Fax(415)453-2965
Los Angeles(310)791-2777•Central Valley(209)632-6167•Oregon(541)488-9431 •San Diego(619)448-7256
1oll Free:(800)640-3133(USA) email: irtest@pacbell.net website www.thermotestine.com
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Ertech Equipment Test Status Key
TBT =To Be Tested
Problem Type Key NT/NL=Not Tested/No Load
10913 Canyon Vista Drive E =Electrical NT/TC=Not Tested/Time Constraint
NT/UR=Not Tested/Under Repair
Inspection Date: 7/18/2008 Inspection#: 4205 M =Mechanical NT/LO=Not Tested/Locked Out
V =Visual Inspection NT/NA=Not Tested/Not Available
NT/NS=Not Tested/Not Specified
Inventory of Inspected Items NSFI =Not Selected for thisinsp.
LOCATION /EQUIPMENT: Barcode: Test Status: Problem#:
Roof TESTED
Roof profile TESTED
•
• Administrative Office: 3070 Kenner Boulevard,Suite A,San Rafael,CA 94901 •(415)453-7200 Fax(415)453-2065
Los Angeles(310)791-2777•Central Valley(209)632-6167•Oregon(541)488-0431 •San Diego(619)448-7256
Toll Free: (800)640-3133(USA) email: irtest@a pacbell.net website: www.lhermotestinc.com