06080212 (2) CITY OF CUPERTINO01
91JILDING DIVISION PERMIT -'C ,NTR°ACT'RINFORMATION`-
BUILDINGADDRESS; WE T HORE ROOFING COMPANY PERMrr"0.06080212
8025 RAINBOW DR
OWNER'S NAME; PERMITISSUEDATE
LARRY HARA 2814 AIELLO DR 08/25/2006
14 NE:
SANITARY NO. CONTROL NO.
(408) 694-0060
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
100 LICENSED CONTRACTOR'S DECLARATION
Job Description
w F 1 hereby affirm that I am I'tcenud under P loPSIOns of Caspar 9(mmmetcing
<W with Section IMM-of Division 3 of me Business and Professions Cook.and my licensees
51 in full force and efect. �$-�ZZ( INSTALL 1/2" .OSB PRESIDENTIAL COMP. CLASS A
Lnccnse Chas — L'e.p
v Da¢ C S DECLAR
uJ ARCHITECTS DECLARATION 7G()(—
i e� I unoknund my Plans ahall M useU as public records \�
'tati6ULy/
Licensed Pmfessi ..I.
'03 OWNER-BUILDER DECLARATION
E 1 hereby alTion Not 1 am exempt from the Contractor's License Law for de C
a o following meson.(Section 7031.5,Business and Profcuicas Code:Any city at county
m which requires a premie to canstrucL alcor,impm.c,okmalish,car repair any svucoure > 4255
'zY prior m its issuance.also requires Ne applicant for such permit to file a signed statement
e2G Nat he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq. Ft. Floor Area aluation
(commencing with Section 7000)of Division 3 of the Business and Predications Code)or
Net le is exempt memfrom and Ne basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicmuo a civil penalty of er Occupancy Type
not more tun five hundred dollars
I,u owner of the pmperty,or my employees with wage u Heir sole compensator,
wnl Pathe WOth.ande.ThUCmm it MtinLndedm Law
set apply
to W.Owner of Required Inspections
and erry who
Code:Th Convenor's License Law does ret appy lf an owner is 9 P
property who builds or improvesch imn,and who am bact ch wmkhimxelfor tuuugh his
own employees,however.
MeWiprovided that such imPmsaid wit tae neo intended O'Offempleti n.fOrstaleMe Ow.r.
t.
build.,.Ne building or improvement is told within one year ofcompletion.Ne owner. -
builPer will have the burden of proving Nu bo did not build,impmvc for Purpose of
sale.).
❑1.as owner of the property,am exclusively contracting with licensed mnvacmrs in
construct the ptojcc,(Sec.7(l Business and Pro[esslons Code:)The Contractor's U.
Co.Law does out appy m an owner of property,who builds or improves ft...and
who contracts for such projects with a coma s oor(a)licensed pufsmm in Ne Contractor's
License Law.
❑I an uempt under Sm ,B&P C for Nu reason
Owner Date
WORKER'S COMPENSATION DECLARATION
40 1 hereby aRrse under Penalty of Perjury one of the following declan0ons:
[how and will maintain a Cenifcam of Conscm m selGinsum far Worter'sCompdn-
sation,as provided for by Section 3700 of Ne labor Code.for the performance of the
work for which Nis permit is issued.
❑1 have and will maintain Worker's Compensation Insulation,as required by Section
37W of the labor Code.for the ponforaanm of Ne work for which this permit is issued
My Wcomes CCmispetuaCCdon Wase onaviu and Poliryn ber art: n_
Carrier;11 th P rLl.0 W Policy No.: f '2.l
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need nmbecomplcred if de permit is(Orono hundred dollar(5100)
or Cm)
1 cntify Nm in the Performance of me work for which this Permit is issued,l shall not
neoplcy ,any'parson in any manrcr so ss to become subject on the Workers Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this;Ccoiricam of Exemption,you should
become subject in Ne WorkcYa Compensation provisions of the labor Code,you muse
., O faMwith Comply with such provisions or this permit shall to dedmed temkcd.
zDi CONSTRUCTION LENDING AGENCY
Di
[-n 1 hereby hthi Net More is construction bonding agency for Nc Performance of
C' Ne work for which this permit u issted(Sec.3097,Or.C.)
QLender's Name
� z IandeYi Address
U0 1 certify that 1 have read this application and soon mu me above information is
Ly F torten.1 agree to comply with all city and county ordinances and soon laws relating to
Or) building construction,and hereby auNvrim representatives of this city in enter upon the
H Wabove-mentioned Property for inspection Pugmses.
(We)agree to save,indemnify and keep harmless me City of Curnainu against
y liabiliues,judgmcnts,costs and expcasm which may in any way accrue Mount= City
V Z to consequence of the granting of this permit.
^" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NOWPOINT Issued by:1Date
SOURCE REGUk"TIIONS.
1� -- 8-2-Y-06' Re-roofs
Signature of Applican'Convacoor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will me applicant or form building acupant store,Or handle harardous material
u ddRneP by th Cupertino Municipal Cook.Chapter 9.12,and the Health and Safety
Cook,Section 25532(1)7 All roofs shall be inspected prior to any roofing material being installed.
❑res
Will f applicant or future building occupant use equipment or dcvi¢t which If a roof is installed without firs[obtaining an inspection,I agree to remove
emit handoes air contaminants as dc0acd by tlm Bay Area Air Quality Management all new materials for inspection.
Districo7
❑Yes
Ihave aeed tAehmSectiomaterials requirements under Chsprcrddo,adNe Califon `
ria Hcahhhrenctyhave I moues 3e,itis 5A3ano7553a.1 untkntandtha acts, building V'Vt`7\\,\JwAv-�.
Jo,not currently have a mount.Nat it is my responsibility to natlfY six xcupant of Nc
require ���in In It he met prior m issuance of a cerdram of occupancy. Signature of Applicant Date
"`""' mow' V5--O
Owner wauNoriud agent DamAll roof coverings to be Class "B"or better
' '
Community Development
10300 Torre Avenue
r=✓' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
4JUPEkTINO
Building Department
JOB ADDRESS: AY , PERMIT# 1
6b �a < -L
OWNER'S NAME: t-avv acs PHONE # S 568 8th
GENERAL CONTRACTOR mole ^ FAX # 408 6C4—0g,S
I am not using any subcontractors: �S- Z�-O
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
Septic Tank
Sheet Metal
Sheet Rock
Tile
R .A. .
Owner/Contractor Signature Date
CITY OF CUPERTINO
�m 1 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36211047 . 00
DATE ISSUED. . . . . . . : 08/25/2006
RECEIPT # . . . . . . . . . : 35769
REFERENCE ID # . . . : 06080212
SITE ADDRESS . . . . . : 8025 RAINBOW DR
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : LARRY HARA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : WESTSHORE ROOFING
CONTRACTOR . . . . . . . : FOWLER, PAUL LIC # 21417
COMPANY . . . . . . . . . . : WESTSHORE ROOFING COMPANY
ADDRESS . . . . . . . . . . : 2814 AIELLO DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE . . . . . . . . : (408) 694-0060
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------ - - - - -- - - - - - - - - --- ---------- ------- --- ---------- ---------- - ---------
BPERMFEE VALUATION 15 , 000 . 00 223 . 56 0 . 00 223 . 56 0 . 00
BSEISMICRE VALUATION 15, 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00
------ --- - -- ------ -- ---------- --- -------
TOTAL PERMIT 225 . 06 0 . 00 225 . 06 0 . 00
CITY OF CUPERTINO 2
( � REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# SI_r, _I I _D Date:
((fL,
Building Address: '9 v02,5 _ Nb,y,4
dw-
Owner's Name: t/ t /1r� Phone#:��� 3�
Contractor: t-( ,5/-S/ Orae License#:
Contact: 6-b. � ( w�I4-O_ /� l Cupertino Business License #:
vType of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof _❑ Built-Up roof
❑ Asphalt Shingles .c/Asphalt Shingles
Wood Shakes ❑ Wood Shakes/
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Nu er of existing coverings 2 ❑ 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: �KS'� t� (�zu OS g/ .��e;}i_c("tZClk ��[P�(V70-f Cess
Residential Commercial r-1 �T
Fire Zone: Yes ❑ No 0/ Confirmed with Planning De t. if
there are any restrictions:
Cost of Project: Type of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•
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.
0 TL1A J� '�711`�tA��l
Homeowner's Name:
Job Site Address:
Roofing Company Name:
Applicant's Signature: Date: �� Z�lo6•
Greg Casteel •
Building Official
Revised 11/2/04