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08060028 CITY OF CUPERTINO BUILf/INC DIVI:sON PERMIT CONTRACTOW, NFORMATION�` PERMIT NO. Bill T.T.YffE55:OLORES AVE JIM KRAUSE ROOFING 08060028 OWNER'S NAME: ll PERhfff ISSUE DATE LIU ALBERT AND PATRICIA 2310 DIANN AVE.. 06/04/2008 NE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING RE-RF T/O EXSTNG WDSHKS NEW -BLDG ELERPERMIT MECH 0 0 0 0 X00 LICENSED CONTRACTOR'S DECLARATION lob Description F I hereby affirm WI I w licensed under Provisions of Chapter 9(commencing ""'""'""--"- "" `of with Section 70M)ofDo icon 3ofJk Business and Professions Code,and my license is in full fame and IT j Licence ,a - Lic.m - ��q Dao: Conuacmr 7th ARCHf1ECfS ATI �U I ornamented Phil 0d my pkv stmt W used ss public temNa D6 k Licensed Professional 3 OWNER-BUILDERexempt form IN RATION 0I 1 herby.affirmSect that 1 1. exempt term tW Convector's Lkeve taw for tW y O O following maw n.(Section 7031.5.I.S. t.Mona and ..de oli Code:Any city or county rd$ which requires a permit re construct.msec,Wprove,demsuch olish.t or repair any uronum 9 prior,slicenedpor also requiN proappin off Conncrmiuoicensle ae Law (Chapter Y�O (that hecommuning wdpawion 7 the prodsiovmWe conhacrorruttrvcuw(empter9 Sq.Ft.Floor Area Valuation thanmendxempt Stttion,and th boarsoml of aliche cd us and Professions Couto)of that W b exempt therefrom and We baso for the illeged eacmpdon Any Holauon of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty Of APN Number T Occupancy e not mom than five hundred dollars(5500). P y •]P 0 1,as owner of IN property.Or my wployaa with wages a Weir We compensation, wits do dm wort and de,structure u out mounted Or Offered for We(Sce.7010.Buss. and Professions Cada:The Conuactors License Law dues err apply to an ow=of Required Inspections property who ben ilda or i mprom thereon,and who does such work himaelf or through his awn employs,proNded Wal such improvements are not intended attracted for We.If, havers.the Wilding or improvement Is sold within man year of completion.We owver- Wilder wits have the born of proving that IN did Mt With m improve fa purpose of sale ❑I,as owner of the property,am exclusively convening with licensed contractors to mvtvat the project(See 7014,Business aud Profcasim,Code)The Conuscwr's U. come,Law does not apply m an owtmr of property who Wilds or improm thereon.and. - wW mntrans for such projects with a mnwcmrts)licensed pursue,to IN OrwrectaYa - License Law. 0 I ore exempt under See ,B&P C for this museum Owner Data WORKER'S COMPENSATION DECLARATION 40 I hereby affirm under penalty,of perjury one of the following declarations: I ham and will mu nuin a Certifcatmof Covent W self-insure for Warkels Compen- salon,a provided for by Section 3700 of IN Iabm Code.for the performance of the wort fm which Nis permit is issueQ , her and will meinuin Worker's Compensation Watchmen,n required by Section 700 of Ne lakc Code.for the perfomsmce of the work for which this permit is bused. My Warkels Compernmon Canier., .E." /rwrana artierPo1s0aldiNry FROM nrlWumOhRrKaEmR: S COMPENSATION `�I3 INSURANCE (ITis m tteW WE Wcompleted ifthe permit is foronc hundred dollars Ig100) Or ken) 1 certify that in the performance of the work for which this permit is Wood,1 shell not employ any person in any mummer an as m become subject to tW Workers'Comp readow Laws of Califomia.Date Applkent NOME TO APPLICANT.If,after making this Certificate of Exemption,you annum become subject W the Worker's Compensation provisions of We Labor Code,you menu ,,- O forthwith comply with such p m,isinv m this permit shall h m deeed mwkcd. z" CONsTpuc ION LENDING AGENCY (-ice Ih1 which rm that Were us construction 30 len ding ageory far the perfurmana of ai We work fur which this permit in issued(Sec.]037,Civ.C.) 114 E l.cntlmS Name .7 z Landers Address U Q 1 certify War I have read this application and sum then the shove information is ULcores.l qme to comply with all city and county Ordinancesand state laws reining to C)!` building consuu,inn,and hendymtbotim represcronmof thucitym cnterupen the rLU shove-mcntianedpmpcny Pani epecden which - f•'G (We)agree to save.indemnify and kecP harmless the Cry of Cupertino spivs _- rn in uunce or ns,cam IN,taming expevmmit. may in any way attme agilvl mid City C.)z APPLICANT UNDERSTANDS ANDing of WILLWILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Stgnuure of Applicaracrm Data Re-roofs MAZA HAZARDOUS MATERIALS DISCLOSURE Type of Roof WIII the applicant or forum Wilding o ctantuom m handle Haardovd Sa rial Code.Section ed io 25 Cupertino Muniripal Cade.Chapter 9.12 and th Heilth and Safety case,o an zss3:a)T // All roofs shall be inspected prior to any roofing material being installed. Yu (tO If a roof is installed without firs[obtainingan inspection,I agree to remove Will the applicant infuture building by ft Br use equipment a densis which P g Dist hvamnus air<anumivnu v defined by the Bay Area Air Quality Management all new materials for inspection. DistrinT ❑Yes /�]No I have mal IN huLtlous makriaDrquimments underChapkr6.95ofthe Cali 0" / nu Hcilth A SafnyOaic;S wady 5505.25533 arm2553d.IuakrstsM thisifthe Wilding does ter - ally hese a tenant,Wt it b my topu echility an notify the occupant of the mqu rte c which murr"se ct p' issuarmc of a Cmr.me of Occupanry. ,� Signature of Applicant Date oeow,mauthnrirea c pate All roof coverings be Class'W'or better CITY OF CUPERTINO • 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Seo: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35714054 . 00 DATE ISSUED. . . . . . . : 06/04/2008 RECEIPT #. . . . . . . . . : BS000004994 REFERENCE ID # . . . : 08060028 SITE ADDRESS . . . . . : 21831 DOLORES AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : LIU ALBERT AND PATRICIA ADDRESS . . . . . . . . . . : 21831 DOLORES AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2801 RECEIVED FROM . . . . : EDWARD A GREGORY CONTRACTOR KRAUSE; JIM LIC # 21415 COMPANY . . . . . . . . . . : JIM KRAUSE ROOFING ADDRESS . . . . . . . . . . : 2310 DIANA AVE CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037 TELEPHONE . . . . . . . . : (408) 779-0704 ' • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 19, 000 . 00 1 . 90 0 . 00 1. 90 0 . 00 1REROOFRES SQ FEET 44 . 00 572 . 00 0 . 00 572 . 00 0 . 00 -------- ---------- ---------- ---------- TOTAL PERMIT 573 . 90 0 . 00 573 . 90 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • 9 CITY OF CUPERTINO aro" REROOF OCUPEITINO' PERMIT APPLICATION APN# Date: CV Building Address: ;?/ A3 A Owner's Name: // Phone #: '5�O fo- 2s y— 93%3 Contractor: Phone #: Zllvo'-zs��s= YzYy Fax #: �/OP— 779 YYv7 Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles >RC Asphalt Shingles 3L9 y. >< Wood Shakes ❑ Wood Shakes u Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other (Specify)rSR s79G Number of existing coverings ❑ Provide I.C.B.O. Report # To be Removed ❑ Provide Mfg. Installation Specs. Job Description: T1 ffC x/s w c/EC r i i(/ew 30 16 • C, II // , �j QS] (iPw`Yiq / � W� S'h. Aj1es Residential 9 1 Commercial Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are an restrictions: ❑ Valuation: /9C)ad I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature CITY OF CUPERTINO REROOF •CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B Y 1REROOFRES Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roofMulti-FamilyB 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B • 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 must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An LC.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. Homeowners Name: 4/ er Z/ e Job Site Address: -Z 83 _'20/0 S Al Roofing Company Name: Applicant's Signature: �C/ ZUd� Date: • Greg Casteel Building Official Revised 11/2/04 x Community Development F, 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 �UPERTINO Building De artment JOB ADDRESS: / �,3` �D/�reS PERMIT # �� 8�6a� OWNER'S NAME: PHONE # GENERAL CONTRACTOR: or 4a s� ` �q i FAX # YDd'' 77S- dXo� I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 60 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 , Kra✓�� a �� 5 Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date