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08010050 CITY OF CUPF,RTINO /� ��!�.�.�♦ .a &asa '+r BUILDING DIVISION PERMIT YVom fJ.�l1�TQRjNEQ i/ • BURL41NG ADDRESS: PERMIT NO. 10565 SAN LEANDRO AVE WESTSHORE ROOFING INC 08010050 OWNER'S NAME: PERMIT ISSUE DATE ANTHONY MONTEFUSCO 2814 AIELLO DR C 01/10/2008 NE SANITARY NO. CONTROL NO. (408) 694-0060 ARCHITECT/EbIGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 �o p LICENSED CONTRACTOR'S DECLARATION IU Description r�bw 1 bomb,air,.Jut 1 am n mmOBSCTIP licensed under provisioof Chapter 9(co encing x with&clan]IXIO)ofDiHalon3ofJUBuslneuand Pmfuimu eCado,andmylicenseis RE-RF,RMV 2 LYRS COMP, INSTL PRES SHARE, 30SQ n n< is full tamp and fW1. C Ys� License Cl — Lic.a DauI Contractorw ARCHITECTS DECLARATION I and remand my plaru shill W used as public rearms y c Licensed Professional OWNER-BUILDER DECLARATION 1 Wanly affirm that I am exempt frac the Convectors License law for the O O following moon.(Sadon 703 IS,Business and Professions Cade:Any city or county $fir. which aqui.•Permit to construct,alter.impmva,demolW,or mpuir my stractum i Prior kr its issuance,aim requires the applicant forsuch permit to file reigned statement G 0 that he Is licensed pursumuomeprovisions ofdue Contracmr'sUccnmlaw(chapter 9 Sq.Ft. Floor Area Valuation g (commencing wins Section]000)of Divulon 3af NC Business and Profruinr Cnde)ur 1200 that ho U exempt therefrom and the beds for the Nlegcd assumption.Any violation of Section 70315 by acy applicant for a permit subjects Ne applicanuo a civil penalty ofNumber Occupancy not more Nan five hundred dolln(SSW), 35705058Typhe ❑Lo the wa oftho pmpmty,amy wplayw withwagnuse4mle eompenution, will prthework.and the heCantbnoULicens Law Russia(Sec.]Old.Business and terlywh ons Codes The msthereon.Ucero law does tot apply 1f an miner of Required Inspections property who bui Itis or ice pmwu thereon,and who dao such wok himael f or f orale h4 awn employesui provided thausuch improvement Improvements am m youn fc moBered fora mer. bull,. the building m improvement h cold within aro you ofcompletion.m roves r the use of Wildv will haw the burden of prying Nn M did not Wild m Improve for Puryae a( ale.). ❑1,as enamor of de property.sun exclusively contracting with llcerued mnwctnrs to construct the project(Sec 7014.Business and Profession,Code:)M Coma Curs W- eare law does not apply a an owner of property who Wilds or improves thereon,rod, wW ewntrama far soc I projects with a mnvavoru)liccnud pmwant m the Convactae, LICamn Law. ❑Iamexamptundv Seu .BBPCfuthbmnan Owner Data WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury ata of the following dechanalons: hamand will malnuin a Cerofirm ufConant to self4rurt for Workers Comon- k _ - on,as provided for by Schoen 3700 of the labor Cade,far the performs.of the work for which this Permit ie issued. ❑1 have and will mainuin Workers Compeaadon Insurance,as required by Saran 3W)($of the lahorCode.for the performance of Ne nark fur which Nu permit is loved. ' My Workefa CampeLnsafian buuran ce esnicr roomer Policy namr K: Cartier. S l�; —Policy Na.:Um i 64 Z� CE FICA OFEKEMPION FROM WORKERS' COMPENSATION INSURANCE cridba cdoo need tot W completed iftlu Permit is formic hundred dollars;(SIM) or less.) 1 certify that in the performance of the work f«which this permit Is Waw,1 shall nor employ airy person in my mmmrm as to baceme subject to the Workut Compevadon Laws of Califamis.Dau Applicant NOTICE TO APPLICANT:IC anor making this Certificates of Exemption,you should became subject u the Workers Compensation provisions of the Lahr Cade,you must 07 O forthwith comply with such provisions or this Permit shall Im decreed Invoked. a r~N., CONSTRUCTION LENDING AGENCY [r I homby alRnn Wt Nem iso contraction lending slower far the lerfmmanceuf a > the woe for which this permit is Wised(Sec.3097,Civ,C.) Lenders Name .7. z fendeh Addm.• U O 1 e airy this I haw mad this appliwiun W stsu dw the show lamansum a IT+ ^ rnrrttL I a{rce 10 complY with all City and county mdbumeas and Nu laws misting m Wilding rnnmmamm,and hereby mthorl representatives;of this city,new upon lM show-mentioned property far inspectim purposes (WC)agree to saw,indemnify and keep harmless the City of Cupertino againat ti f/1 lumilWa,Judgments,cents and expenses which may in my way accrue against said City U�F7j in coaequence of me grating of this Permit, APPLICANT UNDERSTANDS AND WIL MPL WITH ALL NON-POINT Issued by: Date f o SOURCE ONS. / 114 2 /11 Re-roofs �Iof ApplianUCan r D.16 - 1lAZV1tDOUS MATERIALS DISCLOSURE Type of Roof. Will the appliant or tat.Wilding aaop arnom or luwlc harallor ma¢rW as deOncd by the Cupertino Municipal Code,chapter 9.11 and IW Health and Safety Code,section 25532(a)T ❑Yes Ne All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,.I agree to remove haurdar aif conuminnu a defied by the Bay Ama Air Quality Management all new materials for inspection. nT ❑Yr ❑Nu I have mad the,haardous materials mquirtnunu undcrChsmm6.95 ofthc Califot. I /o O nice Health h SaPotyCwa.Seed.15.505,25533 uW255N.l uridvrunE Nnlfthe Wilding dor not curtendy Nw a unsnk this It u myy����'PPoonsiin.. a mtifY ted occupant f de mquimmenu Wmetpdorto'sfrrfuuofa liesuuf0avp ignatureofApplicant Da er ser eathodvea ascot C D All roof coverings to be Class"B"or better CITY OF CUPERTINO ©" REROOF CITY OF ®CUPERTINO PERMIT APPLICATION APN# Date: Building Address: 10 S65 S., Leo rAJro PrV4 . Owner's Name: M o v% E 'e f vs L O Phone #: Contractor: Wes-r-5Kore F,00��r_� Phone #: (,cio$) 69 o06O Fax #:Q/61 6 9 41 — do S ej Cupertino Business License #: ` Contractor License #: 7t2 0 z 1 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof fa' Asphalt Shingles Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes' ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other(Specify) Number of existing coverings 2 ❑ Provide I.C.B.O. Report# To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: (Z{MokAt_ Z lwy r vs GO,n^ F i dey,. r&l 5 hwt�e 1 3 0 Residential �' Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation:_j (�.� D 0 0 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature CITY OF CUPERTINO Aw REROOF CUPERTINO FEE SCHEDULE e Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B ICOMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLROOF � d / 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B e 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: A yd h Owy rn o vl to f v 5 c o Job Site Address: I S 6 S s OWN l e a Yk a P A Ve Roofing Company Name: W Applicant's Signature: /=/ �i 4� � Date: ) l0 013 ® Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO ® 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35705058 . 00 DATE ISSUED. . . . . . . : 01/10/2008 RECEIPT #. . . . . . . . . : BS000003655 REFERENCE ID # . . . : 08010050 SITE ADDRESS . . . . . E 10565'. SAN LEANDRO AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ANTHONY MONTEFUSCO ADDRESS . . . . . . . . . . : 10565 SAN LEANDRO AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2701 RECEIVED FROM . . . . : PAUL R FOWLER CONTRACTOR . . . . . . . : PAUL FOWLER LIC # 21417 COMPANY . . . . . . . . . . : WESTSHORE ROOFING INC ADDRESS . . . . . . . . . . : 2814 AIELLO DR C CITY/STATE/ZIP . . . : SAN JOSE, CA 95111 TELEPHONE . . . . . . . . : (408) 694-0060 ® FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 12, 000. 00 1.20 0. 00 1 .20 0. 00 1REROOFRES SQ FEET 30. 00 390 . 00 0. 00 390 . 00 0 . 00 ---------- ---------- -------- -- TOTAL PERMIT 391.20 0. 00 391 .20 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ---.---------------- CREDIT CARD 391.20 MC --------------- TOTAL RECEIPT 391.20 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ---- ------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF . Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPERTINO • Building Department JOB ADDRESS: LO y(0 5 5aK Lemnd fo 4V, PERMIT# O ` O O OWNER'S NAME: ov% M oVl fe t15cp PHONE # g) 6 a tj — 00 60 GENERAL CONTRACTOR: FAX# I am not using any subcontractors: 0 0 Signature D 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 ��g - ) 6 Ug Owner/Contractor Signature Date