04090048 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTORANFORMATI'ON
BUILDING ADDRESS: WING' S ROOFING INC PERMIT"G04090048
PTI
ER'S NAME: PERMIT ISSUE DATE
HU LEON L
ONE:
SANITARY NO. CONTROL NO,
(510) 889-9068
ARCHITECLrENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0
LOp LICENSED CONTRACTOR'S DECLARATION Job Descri II00
W I Wrote,amnio that 1 am licensed under,mvisi.ns.f Chapter 9(commencing P
i� FINALED
wiNSeetion]Ofp)ofDivision3c, Busixssand Profesamu ,andmylicuueis
c. i.men force ande_rtaL ' T/O WOOD SHAKE/INSTALL ASPHALT
ELPIc. L f[I re Lic.N
o D.te .anaxon4i. ai
5',` ARCHRSEP 2004
ECTS DEC LAR n
1 undersand nnplans shall W used as Public mcordr
�yU p
3�n Licensed Professional
��I�®�
OWNER-BUILDER DECLARATION
X 1 herchy affirm'has I am exempt from the Conlrecmr's License Law for the
NG
F.p O following Mason.(Seed 7031.5.Business and Professions Cade:Any city or county
m which requires a permit to construct,alter,impur e.demolish,in repair any structure
Fly pilot to its issuance.alw"iires thcapplicam for such permit to Ill.a signed statement
< that he is licensedPursuanuotheprovisionsoftheContractorsLicenselaw(Chapter9 Sq.Ft. Floor Area Valuation
'FC (commencing with Section 7")of Diviuon3 of Oae Business and Profession Code)or
y Out he is exempt aluminum and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 442142 "cr0 0 Occupancy Type
not mom than Eve hundred culture(8500).
I,uowna of Ne propoty,omy emplayces with wagesasthev sole eampewtion,
willdo doe work and theawcture is not intended oruffemE retail.(Sec.7044,Business
and Professions Code:The Comracmr's License Law ext amt apply m an owner of Required Inspections
property who buiIda or impact.thereon,and why does such wart himself x through his
own employees,provided that such improvements are not intended oroRered forsak.IL
however,the building or improvement is sold within one year of completion.the owner,
Wilder will hate the burdw of proving Out W did net Wild or improve for purpose of
sale.).
O 1.as owner of the property,am exclusively contracting with licensed contractors d
convect the projttt(Sec.7014.Business and Pmfeations Code:)The Coveractori U.
come law docs not apply to an owner of property who Wilds or improves thereon,and.
who contracts for such projects with a conuacmr(s)licensed pursuant in the Consxrors
Lkenx law.
0 Iameaemptunder Sec. ,e4:PCfarthisreason
net Date
WORKER'S COMPENSATION DECLARATION
1 hereby Num under penalty of perjury one of the following discus tions:
0 1 have and will maintain aCertifiate of Consent in self-imam for WorkcruCompen-
ration,az provided for by Sec ..J]00 of the IaWr Code,for Ne perform.of Uma
work for which this Permit is issued.
0 1 new and will maintain Worker's Compensation Insurance,u required by Section
3700ofthelabor Code,rx the pelf armee of Omewerkfo which this permit is honed.
My Workers mpemati .sono carrierand Polmynumberate: _
Cmricr. Polity No.: tq
CEM A 0 E EMPTIONFROMWORKERS'
COMPENSATION INSURANCE
(ihusection reed notbe completed Ruin permit is foratcehundmd d.ars(8100)
o kis)
1 certify that in the perfnmunce of the work for which this permit is issued,I shell not
employ any persan in any manner an as to immune subject o the Workers'Compensation -
Laws of Califoria.Date
Applicant
NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should
become subject to the Worker's Compemauan previsions of the laMr Com.you muse
.J z forthwith comply with such provision in this permit shall W dxmed revoked.
z O CONSIRUCnON LENDING AGENCY
[—s l homey affirm that them us exh unn modingaperay for the perfoommeuf
Gx the work for which this permit is issued(Sec.3097.Civ.C.)
127 Q Lenders Name
=z 1<ndcr's Address
V 1 certify Out I have read this application and state Net the a Ww information u '
Femmect.I agree m comply with all city and county ordinances and sum laws relating to
Op Wilding commotion,and hereby authodm reprexnutives of this city a center upon Into
above-memiuned ntapropertycosts
for expenses puryoes
C (We)agree m save,indemnify and keep harmless the City of Cupertino against
z in conescal judgmenhecots and expenses which may in any way eamc against said City
0 z P,cPLIC ce of the granting of this permit.
PPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date '
UR ER GULATIONS. _91taza
Re-roofs
Sig o pplr connector Date
H ZARDOUSMATERIALSDISCLOSURE Type of Roof
Will the applianl or future Wilding xcupmt since or handle havrdom material
as dclined by the,Cupertino Municipal Code.Chapter 9.11.and the Health and Safety
ode.section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
0Yes 0 N
Will the applicant buildin If a roof is installed without first obtainingan inspection,I agree to remove
pP or future g oxupam esu equipment or Jcvixs which P
cont havatdous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
Dutrin7
Oyes ON.
Iha on the hmadnus mamrials rtyuimmcnts under Chapter6.95ofthcOlifar-
maHeahb& deety Code.sectios25505.25533 and 25534.1 understand!Naz ifda Wilding
dors not c mly have a scann that it is on,rtaponsibility to notify the=up=,or the
mqui nus hichmuubemtlpriormissusuccofeCenifu ofa Pa" Signature of Applicant Date
Own. nthf-1 nl D te All roof coverings to be Class"B"or better
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 34212066.00
DATE ISSUED. . . . . . . : 09/10/2004
RECEIPT 4. . . . . . . . . : 26993
REFERENCE ID # . . . : 04090048
SITE ADDRESS . . . . . : 10230 ANTHONY PL
SUBDIVISION . . . . . . .
CITY . . :. . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HU LEON L AND DEBBIE J
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : FOSTER CITY CA, 94404
RECEIVED FROM . . . . : WING CHEA
CONTRACTOR . . . . . . . : CHEA, WING LIC # 21240
COMPANY . . . . . . . . . . : WING'S ROOFING INCA
ADDRESS . . . . . . . . . . : 3243 SYDNEY WAY
CITY/STATE/ZIP . . . : CASTRO VALLEY, CA 94546
TELEPHONE . . . . . . . . : (510) 889-9068 r
IfEE ID UNIT QUANTITY AMOUNT PD-TO-DTTHIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION VALUATION 8, 000.00 147.96 0.00 147.96 0.00
BSEISMICRE VALUATION 8, 000.00 0.80 0.00 0.80 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 148 .76 0.00 148.76 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 148.76 VISA
TOTAL RECEIPT 148.76
Community Development
_MU' 10300 Torre Avenue
�' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
�UPEkTINO
Building Department
JOXAHDRESS: L PERMIT #
23� 16 N
OWNER'S PHO
GENERAL CONTRACTOR FAX #
I am not using any subcontractors:
A1C
Sigfiature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
AM Linoleum / Wood
WF Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing - - -
Septic Tank
Sheet Metal
Sheet Rock
Tile
-Oo /Contra for Signature \ /pate
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
. Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
REROOF TEAR OFF POLICY
1. You must schedule an inspection for the tear off the day before
you wish the inspection to be made. The procedure is to call the
Building Division (408) 777-3228 between the hours of 7:30 a.m. and
4:00 p.m. to request a next-day inspection.
. 2. When the roof is torn off, the nails have been removed or driven in;
and all of the dry-rotted wood has been replace, you must call the
City Building Division. An inspector will be there within one hour.
There are special hours for this service: from 7.30 a.m. to 10:30 a.m.
and 1:00p.m. to 3:30 p.m., Monday through Thursday and from .
7:30 a.m. to 10:30 a.m. and 1:00 p.m. to 2:30 p.m. on Friday. (Note:
Building inspectors are on lunch break from 11:30 a.m. to 12:30 p.m.
and will not be called during that time. City Hall is closed between
12:00 and 1:00 p.m. daily.)
3. If you call for a tear-off 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
. Greg Casteel
Building Official
Revised 8/13/04
Community Development Department
Building Division
• .l City of Cupertino
10300 Tone Avenue
Telephone: (408)777-3228
CITY OF Fax: (408) 777-3333
UPEkTiNO
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 whichis 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.
IMPORTANT:
1. Flat roofs must have a minimum of Y4" 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 NapW.
Job Site Addre L7Z. c) /n i
Roofing Company Named
Greg tei \
A plicant's Signature: Da\t�e�
l `
• el
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF
OUPEkTINO PERMIT APPLICATION FORM 6 �40 �/Db�41�
APN# —2;7Lf 2 b666 Date:
Building Address: ON p L.
Owner's Name: Phone#:
Contract ;^ f. f Phone#:S o License#:
Ir Iv L -q 6
Contact: Phone#: Cupertino Business License#:
k)C C�� \ "J Db /U
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles X' Asphalt Shingles
X 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.
IdI Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑
Job Description: fi
c/ � �� 0 $ 13
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with PI t. if
there are any r tions:
Cost of Project: Type o Co st ctio Occupancy oI r /
v "
Qty. if
A c ble Fee ID Fee Description Fee Group
ERMFEE Bldg Permit Fees BUILDING
BE RGY
Energy BUILDING
EISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING