06060144 CITY OF CUPERTINO ^
`BUILDING DIVISION PERMIT .,CONT UQTQ�„Rj I �AMATIIO ;,$_
BUILDING ADDRESS: MONKS ROOFING """"o-06060144
7575 NEWCASTLE D
OWNER'S NAME: PERMIT ISSUE DATE
KARLESKIND JOHN 794 BERRYESSA ST 06/16/2006
NE: SANITARY NO. CONTROL N0.
(408) 262-4797
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH _
_Op LICENSED CONTRACTOR'S DECLARATION Job DOSCOPU00
rd� I hereby AM.Nn 1 am licensed under promme
visious of Chapter 9(concing .
�_ with SuaiM7000)ofDivWon 3ofmc Business and ftfiosi o0.An mylkenseb TEAR
mmmm�ende &. C CLASSOAFF SHAKES IN ] J MP SHINGLES
z neem a< Lk.N P
a Do¢ Contr 1CL
As"I he usS DECLAR TION
lunderwnd mypWsalWlheusedu Public records
' JUN T 2006
t G Licensed Professional
OWNER-BUILDER DECLARATION
i 1 Mrchyntso .ffirm(Sec the 1 1. exempt from the Comoss Co e:Any c law far the
p o following tumaa(Sedan 713 L5,Business and vel de all Cade:Any city or county
$ which its issu a permit re cores t.alcor.improv,tie permit
t fi repair ed suuctum
_ifyn prior"he iuisswae,Aw requires theappin oftwCch Permittoicese Lawduammenl
i o rotaheerdngn tpursuantatheo(DialiooftheCanutim Ilttnselaw(Chepmr9 Sq.F[. Floor Area alts Ibd000
s�$ (commemmgwhh5rnen7land of Diasis fraeallegdaxemdon.An vl Codc)or
.- Net hem¢xempt mmefrom and use buts for the alleged",•mption.Any violadun of
Section 7031.5 by arty Applicant for a permit subjects me applicant to a civil penalty of 4e�pypyN A7v,,7tl her Occupancy Type
not mom NM Rve hundred dollars($500). 3 0 0 1 /C)�6 . 00
❑I,u awns of the property.err my employers wWr n{n u tieh axle compenssdon,
will do ma went,and theAwaure u aatmmndd araQered foraak(See.7014,Business
And Profession Cade:M CaapKbYs I IGLe law does Ml apply b an owner of Required Inspections
property who Wilds Or Impravet menton,anti alto does sue h wort himsrlf ar darou{h his
awn employee,provided thatauch improvements am not intend oraffemA fasala lf.
however,the building or improvement is sold within am year ofcompkdon.the awncr.
builder win have the burden of proving that he did Mt build or improve for purport of
sold.).
C I.As owner of dre property,am exclusively ennuadng Mm licensed contnemn to
mmwct me pmjea(See 7044.Business an Prp(exsiaus Code:)M Contncmrs LI-
some Law dun not apply e an owner of property who builds or improve thereon,and,
who contracts for such project/with aconuamor(s)licensed pummnt to the Contractah
Lice.Law.
❑I am exempt under See .B At P C fm this..on
Owner Dam
WORKER'S COMPENSATION DECLARATION
40 1 hereby a Wo miner penalty o(pe7my arc o(the following declawimu:
I have per will for by ecdon Sam of Consent ,CodAnfom for Wmkela ce of -
w were
r provided far by Sedan 3700 0(Ne labor CdA,for No performance of sire
work far which Nis perish is issued. ,
I have and will maintain Workees Compensation Imunmc,as required by Section
37 of Ne labor Code.for dae Perfar era(dae work for which thin permit is issued.
My Workeh Campeau Imuran 'er an Paltry number
Carrier. Policy No.: a
CERTIFICATE OF EXEMPTION MG WORKERIk
COMPENSATION INSURANCE
('Ihtsudnn need nothecomp recd If the permit Is!areae hundred dollars(3101)
or esa)
I unify that in tie performance of the wart far which this Permit Is issued.l Ault not
cmpley any penin in sexy rammer An As e haeme subject to the WorkentOompemadon
Laws of California.Data
ADPIkAm
NOTICE TO APPLICANT:If.after making this O:nificate of Exemption,you should
become subject m the Workers Compensation provisions of the IaW Cade,you muse
.JO forthwith comply with such provisions m this Permit shall he domed revoked.
Z� CONSTRUCTION LENDING AGENCY
I hemby .ABlrm data UCm I.,cormnachM mnding a{CKy for dC pedomlaaC of
5 > tint wort for which this person is issued(See.3097.Civ.C.)
OWi E lane(!Name
,7. zLcnde(s Address
U Q I certify that I have read this appticaden an sum dart me shove lefarmatiun ie
t(.P eaneeL I agree to comply with all city and county on inanca and sum Int mining m
0 V Wilding construction,and hereby allthOdM mpMJMMAtives of this city to enter upon the
W arose-mendoad property for inspection pmpeares.
(We) RC to nR.indemnity and keep 11Ynnns me City of Cupertino against
ti y liabilities, 9 meaY,emm Md npCKea which may Many way Accrue agent said city
V 7 in co m fm me granting of miss perrnit.
F7 APPLRM
D WILL COMPLY WI�jALL NON
e-POINT Issued by: Date
Sou �L7� e Re-roofs
Signatut Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant nom Or handle hazardous an,"
as defined by the Cupertinomipst Calc.Chapter 9.11n m
•ae Health and Safety
Code,Seaton 15531(s)7
❑tars � a All roofs shall be inspected prior to any roofing material being installed.
Will tint applicant err furore building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
lett huardnus air conumu u fired by me Bay Arta Air Quality Mtaugement all new materials for inspection.
Disuict7
❑Ya u
Ihav the forsaken;materials requirements undcrChapmr 6.95ofdie CAllfar-
nhHralm S lyCde.Sedmts13505,15533an15534.IwWma dauifdacbulding
docs Mt ny have A meant.that it u my ref risibility a Mdfy the Occupant of the
require wnkhmulk `m (AcmtiaaeofOccupancy. Signature of Applicant Date
Owner or amrorbcda Ant Data All roof coverings to be Class"B"or better
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rnq: Sub: Blk: Lot :
APN . . . . . . . . : 36617076 . 00
DATE ISSUED. . . . . . . : 06/16/2006
RECEIPT # . . . . . . . . . : 34894
REFERENCE ID # . . . : 06060144
SITE ADDRESS . . . . . : 7575 NEWCASTLE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KARLESKIND JOHN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : MONKS ROOFING
CONTRACTOR . . . . . . . : MONKS, DAVID LIC # 22117
COMPANY . . . . . . . . . . : MONKS ROOFING
ADDRESS . . . . . . . . . . : 794 BERRYESSA ST
CITY/STATE/ZIP . . . : MILPITAS, CA 95035
TELEPHONE . . . . . . . . : (408) 262-4797
*EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 11, 000 . 00 180 . 36 0 . 00 180 . 36 0 . 00
BSEISMICRE VALUATION 11, 000 . 00 1 . 10 0 . 00 1 . 10 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 181. 46 0 . 00 181 . 46 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 181 .46 1599
TOTAL RECEIPT 181 .46
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPERTINO
Building De artment
JQ� ) 7SES�w f� PERMIT#
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: MJ I n FAX #
I am not using any subcontractors: G 6
Signature Date
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 r✓ �,
Septic Tank
Sheet Metal
Sheet Rock
Tile
•
Owner/Contractor Signature Date
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 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: �tJ�l� 1�) k-e-1 r.)e S k 1 ri �a
Job Site Address: /S /yew IfAs P,7
Roofing Company Name: ►��Cl W T t ;\"g
Applicant's Signature: A4� Date��/0v
. Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# I� �DI D /
Building Address:
�j75—Own s Name: Phone#i
>, 9cle- I-c-s K'm s - 3a
Contractor:W Wks t License#• 1 9 r
ContpeK Cupertino Business License #:
f o S
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles 01SE Asphalt Shingles
c*K— Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
To be Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
�2�12 U6b uCLe as till as t-s- L1 C-s 1L-&
Residentia Commercial ❑
Fire Zone: Yesm No ❑ Confirmed with Planning DeMt. if
there are any restrictions: LJ
Cost of Pr ecct: l7 Type of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Pemrit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•