06050238 CITY OF CUPERTINO71771077�' �Nv
DUILDING,DIVISION PERMIT �XICONTRAGTQWINFORMA ) ."I
BUILDING ADDRESS: AFFORDABLE ROOFING PERMIT NO.06050238
UT 0196 COLRY AV
OWNER'5 NAME:
0 GERIN & SOOHOO 1910 DAY RD- nc;/io/2006
NE: SANITARY NO. CONTROL NO.
(408) 842-7100
ARCHITEC TISNOINEER: BUILDING PERMIT TWO
BLDG ELECT PLUMB MECH
196 LICENSED CONTRACTOR'S DECLARATION
id� theactryarfireat dmtlwl�nedu�rpmvisiomorcmw,9(m..Wins Job Description
wiNSecdon70(IU)afDiviAnn3offtgusinmwdProfmiomCoft.ndmyliccnmis
full fame and oVatTL
REMOVE SHAKES, INSTALLFt 7/16 OSB AND
LI Lk.8 ;iB FELT
can
ale " Td,LV40 YR COMP CLASS A
KlICHIIECTS DECLARATION
I understand my plans shall he used as public records
sLL
Licensed Parfined...I OWNER-BUILDER DECLARATION
I hereby affirm the Pam exempt firturn the Canumator's Unrest Law far the
cO g following reaccon.(Section 11031.5,Business and Profusions Code:Any city at county 'g
I!ff. which remines a Permit in cors tee.1ton.ireprove,demolish,or repair my suncoure
prior in its issuance.also acquires the applicant for such permit to Pie a signed stalcarecon,
Test he is licensed pursuant to We provisions of LIm Customer's Lkereas Law(chapter 9 Sq.Ft. Floor Area yaluati$[9772
commorming with Section 7000)or Division 3 of the Bushmeat and Proputdons Coac)or
'hat M I,exempt Therefrom and The basis for dess alleged resumption.Any violation of
(C
Section 7031.5 by my applicants for a permit subjects the pleficare.he.civil Family of APN Number Ob racy Type
not mom than fin hundred dolltuat(SSW. 31628035 . 00
0 1,a owmar of the property,or my amplayan,with wages as their talc couripeassathen.
will 0 does wort,and thenmacm.I.mon mounted or offered hernar(Sec.7044,Bud.
and Professions Cade:Too C.mammors,Licaress Law dam an,apply in an owner of Required Inspections
property who builds orimprow thorecon,and who don such work humseffor through his
cover=play..provided Outreach Improvements are eminuareaded oraffinted(cersale.If,
however,the building cor unprownent Is old within am yaw ofOarplOthen.the owner.
bulkier will have the burden of proving That he did not build or Improve far purpose of
sale.).
0 1,as anamor of dee property,am conclusively connecting with Unusual nuacmn be
wourew The project(Sec.7044.Business and Propessicens Cm:)The Consumes U.
come Law don not apply in an owner of properly who hall"cor Improver Thomson,Ind,
who contracts for such projecle,with a Ontracloris)licensed Forward To,the Contractors
License Law.
EI I..exonput micia,Sea. _.B A,P C par This retwor,
Owner Dam-
pWORKER'S COMPENSATION DECLARATIONhe
I hereby&film ander many of perjury mat of The following doodareadionar
i
ham and MIT maintain,Ceftifloma accustom to self-imsum for Waftes,Compen-
sation,as provided poor by Section 3700 of she labor Cm,for chm performance:of the
work for which This permit is issued.
0 1 haw And will mainum Wartime,Compernalon Insuramem,as expired by Section
3700.fft labor Cm.far the perpetrate.of the"A formIch this permit it issued.
My WorkseerC do d Paltry mberace-
-y.-ey 2 7 7
X=e" Polic No.:
---NRTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
mmsectims need act xcomplcuad time permit is form hundred clusters($tOO)
tor Ices.)
I comfy that in the Performance of The,wad for which this permit is ishead.I Null not
employ any person In my macerat®r as be became subject to the Worlurs'Compenseflon
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after melding this Carolina:of Exemption,yam should
become subject to the Workers Compensation Provisiom of W,Liber Cma you mass
z parthavith comply with such Provisional or this permit shall he doemocal makes.
z A 2 5
E C CONSTRUCTION LENDING AGENCY: 1 IHNOY affires east them is&conseacdem lending agency for the Performance of
the work far which this permit is issued(Sec.3097.Civ,C.)
dLousers Name
Z)z Landers Addrus
U0 I costly that I Mn and this application W sm no one show Informal.Is
4, P coman.I&&me to comply with all city and county oadimovan and sum laws relating W
0 U building construction.and hereby authorise reprosommains of Nis city to enter upon the
Octm-ancretioncal property for inspection purposes.
(We)agree to...Indemnify and kent,harmless the City of Cupertino against
and expenses which may In my my see=against said City
U Z in coresemnee of the traming of this permit.
APPLICANT UNDERSTANDS ILL COMPLY WITH ALL NON-POINT Issued by:qJ40aZ Date
OUR EGU
SOUR C7
Re-roofs
iSmaturse ofApplicamidermaxwor 'Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicam or too=Wilding amulantstere whandic famarmous material
U defined by The Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
Come,Sgice.25532u37
Aj No All roofs shall be inspected prior to any roofing material being installed.
01 Will ft applicant or ruturc building accepam.use equipment or darnswhich If a roof is installed without first obtaining an inspection,I agree to remove
'
..mit lumardaus air contaminants as darned by The Bay Area Air Quality Management all new materials for inspection.
DImm%7
0yes, Ap.
I haw and the hanumbstat materials requirements underChapter6.95 of the Califor.
nia Health&Safety Coadc,Samlim 75305.25533 stral 25534.1 unearned tied lithe Wilding
doe,Zonly ban.mount.0 1 fy the moment or The
ngmresponsibility W and
be ..of.ccruflum of occupancy. Signature of Applicant Date
All roof coverings to be Class "B"or better
O.mar or submizad agent 'D.w
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 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, 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=st have a minimum of " 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: e5j!/P
Job Site Address: C'v 46
Roofing Company Name:
Applicant's Signature: / Date:y29Z�
Greg Casteel
Building Official
Revised 11/2/04
alol�o
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
4VUPEkTINO
Building Department
JOB ADDRESS: PERMIT#
1691,m- �'o civ 1 06 0 So -2—
OWNER'S NAME: /21 PHONE # z
GENERAL CONTRACTOR AX #
I am not using any subcontractors: S 3G o
Signature to
Please check applicable subcontractors and complete the following information
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
om 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31628035 . 00
DATE ISSUED. . . . . . . : 05/30/2006
RECEIPT # . . . . . . . . . : 34601
REFERENCE ID # . . . : 06050236
SITE ADDRESS . . . . . : 10198 COLBY AV
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : .GERIN & SOOHOO
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : RICHARD GARCIA
CONTRACTOR . . . . . . . : RICHARD GARCIA LIC # 24428
COMPANY . . . . . . . . . . : AFFORDABLE ROOFING
ADDRESS . . . . . . . . . . : 1910 DAY RD.
CITY/STATE/ZIP . . . : GILROY, CA 95020
TELEPHONE . . . . . . . . : (408) 842-7100
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 10, 000 . 00 169 . 56 0 . 00 169 . 56 0 . 00
BSEISMICRE VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 170 . 56 0 . 00 170 . 56 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 170 . 56 AMEX
TOTAL RECEIPT 170 . 56
04/15/03 11:55 '$4087773309 CITY CUPERTINO @002/003
CITY OF CUPERTINO o(oo O2eb
REROOF
CUPEft INO PERMIT APPLICATION FORM
APN 0 si (P Date: 16�— �16T.0
Building Address:
Phone S
Owner' e:
AL1 Phone q: cense# b
17
tact: Pho lyp Cupertino Business License#;
• r�
Type of Roof Covering:
1 F�elsting: Proposed:
o Built•Up Roof •.U�� Built-up roof
gles
U Asphalt Shingles ^WoodAsphalt Shakes
Wood Shakes a Wood Shakes
U Wood Shingles O Wand Shingles
U U Other(Specify)
Odor(Specify)
Number of existing coverings U provide U provide Mfgr.I.C.B.O.
Installation
Reportstallationn
Specs•
Q To be Removed
• I Have Read Understand_and Will COM Iy With Cupertino's Tear Off Polio!
b Descrip
Residential commercial 'GABS•
Confirmed with Planning�gpt tf
Fire Zone: Yes ❑ No ❑ there arc an restnctions;Q
Cost of Project: Type of C as on: Occup cy group:
1
i
Qty.ifg�Descri don Fee Grout)
A licable Fee ID A DL�1G
BPfiRMBUU-
FM Bl Permit Fees BUILDING
Seismic
— BUYLDI�NG
BSEI5MICRE seismic Fee Res B1f1I,DING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Pee BUILDING
BUSLIC Business License