08090083 CITY OF CUPERTINO
BUILDING DIVISION PERMIT t�-.CONTRA-CToR IN'FURMATIO.N -
1x'a3:.wsv .B'x •r,A. -,>x :'CAi;�' -t:F!Y to
BUILDING ApDRESS: PERMR NO.
101.52 BERKSHIRE CT MBROWN CONSTRUCTION, INC 08090083
OWNER'S NAME: PERMIT ISSUE DATE
SIMON CHOW 702 S DANIEL WAY 09/15/2008
NE: (408) 260-1260 SANfTARY NO. CONTROL NO.
ARCHITEC"VENGiNEER: BUILDING PERMITl9FO
BLDG ELECT PLUMB MECH
3;o LICENSED CONTRACTORS DECLARATION O O O
r�� 1 barely aflrm Nal I am licemcd under provisions of Chapter 9(commencing Job Description
6
with Section 701fU)ofDivivan aruxBavms.and Pmrw;my�w ,ng�yliamni, RE—RF RMV EXT SHK&INSTL APPRX 28SQ COMP RF &
- rn m ten face ane effect2i L (.�
7, Licene Lk.Y SHEATHNG
JJ Dau: Co.—
ARCH=S IEVRAOON
•w� luntkwnJ my plw Nallbeumtlsspublic monrds
yU
l03Licensed Fmfessann.l
N Oat I am exempt
From
DECLARATION
aC O E 1 hereby affix that 1 1. .umpt ram Ote Contractor.License law for the
i p o following aamn. emtia 710 I.S.Business and Improve,
de rev Cade:My city or aunty
$�i which mquiru•pewit m cnrruvc4 alter,improve,dcmoluh,or reptile my:uterus
_Zy Mar to its issuance.alis mquira the applicml forsuch permit to lle a signed stelemenl
than W is licensed punumtto the,provisions or the Contractor's license Law(Chapter 9 Sq.Ft.Floor Area Valuation
(commncing with Section 7000)of Division 3 of IW Business and Prefeasiov Cnde)an $6090
$ Nat he is eumpt thorniness and the basis for Ne alleged exemption.Any violation of
Section 7031.3 by airy applicant for a permit subjects the applicant to a civil penalty ofNumber Occas
act team than five hundred dollar(35W). 34212109 Occupancy Type
0 1,u awrer of tic property,army employees with vnga u tle'vmk ampewtioe,
will do the works and the structure as e tiinteaded or offered for We(Sec.7044,Busiess
.it Professions Cade:The Coruscate.License Law does not apply toan owner of Required Inspections
prepalywM Wildserimpmvea Neaan,and wW dare.such work nimselrar through has
onmemplayea.prNded that such impmvemems ane not intended reoffered rosah,B. .
Wwesar,the building or improvement herald within one year of completion,Ne saner,
Wilder
will have the burden of proving that he did not mild or improve for putpose of
ask.).
❑1,u owner of the property w aclusively conuadins with licensed Coniranas an
anstmct thea prjcm(Sec.7044.Basis.and PafWiona Cade:)The Commerce,U.
came law does not apply m an ower of property who Wilds or imprem thereon,and
who camcu for such projects with a contranrrts)licemed purmanl to the Contractors
License Law.
❑I am eeetept under See Bh PC for Ni.marten
Owner Date
WORKER'S COMPENSATION DECIARA77ON
1 hereby LM m under penalty or perjury ae of the following dalentions:
1 ham and will mainuin a Cenifiam of Covent bexlf-imam ror Workera
sComp -
suia,as pmrlded fns by Section 3700 of the labor Cade.fan tk performance of the
wokfor s permit is assned.
have ere will maintain Worker.Compensation work,
for hi h require t i Section
MYW the,talar Cade,for the pcHormau of the wort fawhich Nu peamilas'....^
My Workers Cam jmsulm Ivan a c 'v and iky numbs aa:
Grtier: No.:
AMO E%TIONINN FROMWO
COMPENSATION INSURANCE
(Gras ascdon recd tet be completed if the permit is face hundred dollars($100)
an less)
I CMhfY Nal k tW performance of the work for which this permit is issued.l Hill not
employ.try perms in any macer an as in became subject to the Worker.'Compevanlun
Laws of Califoria.Date
Applicat
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you NwW
became mnice,as Ne Workrls Compensation prv(siov of the talon Code,your muse
.J 0 forthwith comply with such prvisimer or thio permit Nail be deemed ravelled.
Z ""' CONSTRUCTION LENDING AGENCY
the woWwhich
artirm than Nem sea anmucis lending agency fo tW perfarmarmce of
C> rt rte which Nis pewit as issued(Sar..3(171,Civ,C.)
Wh Q Landers Name
z lander.Addams
U C 1 certify Nat 1 have mad this applcatia and sate dant lW above information is
corms 1 agree rc comply with alt city and county oNim o ser and sole laws relating rc
O building construction,and hereby authodre apresenaivcs alibis city to color upon the
above-men ioond property for Inspection purposes
4 (L judgments,
g me to ase,indemmiry,and kap hay in M the,City aro Cupertino against
to incoi0a,judgmenu.cosu softhinsarwhi. may in MY way save agaivtmid City
U z in caruegeen of Nc granting of Nis pcaiL Q C
" APPLICA U ERSTANDS AND W 1.COMPLY WITH A L NON�PO NT Issued by: Date
SOURCE RE U
r Re-roofs
Sidrumm of AppiicantlContrano Data
HAZARDO MATERIALS DISCLOSURE Type of Roof
Will ft applianl no -accupmlamm onanek haaartlou mauxial
as delned by the Caperton Municipal Cade.Chapter 9.13,and the Health and Wet,
Code.Seniea zsmzpr
❑Ya No All roofs shall be inspected prior to any roofing material being installed.
Will the,applicants mare Wilding ami If a roof is installed without first obtaining an inspection,I agree to remove
pp G bent use rq Air Qu v dcvica which g P
-anctTaNnns air conuminanu//u defied by the Bay Asa Air Quality Management all new materials for inspection.
❑Ya Ian /
I have mW the huatdme maneriaas at(3 andI 534.1 u dNPand the orthe Califon
nalrh85afcty Cod.Sador 35 ,my=possibility
rout Y4NuifNc Wilding
jd=not erre Y vc•v"•"s II as my asporilility b notify arup l de
agnimmeruw icer bene 'orrc issuarta aro,Cmream arra $i$natUreO APPI rat Date
ower o sumo. dagcnt Date' All roof coverings to be Class'jg"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN 34212109 . 00
DATE ISSUED. . . . . . . : 09/15/2008
RECEIPT # . . . . . . . . . : BS000006085
REFERENCE ID # . . . : 08090083
SITE ADDRESS . . . . . : 10132 BERKSHIRE CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : SIMON CHOW
ADDRESS . . . . . . . . . . : 10132 BERKSHIRE CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5600
RECEIVED FROM . . . . : KRISTINA M HAGAN
CONTRACTOR . . . . . . . : CHRIS BROWN LIC # 25108
COMPANY . . . . . . . . . . : MBROWN CONSTRUCTION, INC
ADDRESS . . . . . . . . . . : 702 S DANIEL WAY
CITY/STATE/ZIP . . . : SAN JOSE, CA 95128
TELEPHONE . . . . . . . . : (408) 260-1260
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 6, 090 . 00 0 . 70 0 . 00 0 .70 0 . 00
1REROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 .00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 364 .70 0 . 00 364 . 70 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 364 . 70 AMEX
---------------
TOTAL RECEIPT 364 . 70
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO oFuq v 013
Z REROOF
CUPEkTINO PERMIT APPLICATION
•
APN # / / Date:
Building Address:
0 13z v sir C-t .
Owner's Name: Phone #:
S;rnon CG�ooJ
l�bpj r165 D30/
Contractor: Phone #: yam. . ( 0 G D
IUhJI�LWJ �arrS�hl cl�2,-�� �yiG_ Fax #: (t aCoO /.zCa0
Cupertino Business License #: Contractor License #:
R,9 z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ,K Asphalt Shingles
pC Wood Shakes ❑ Wood Shakes
o Wood Shingles o Wood Shingles
o Other (Specify) o Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: axKh' shit e Cts i ��k ,2
pi oo( she--4A
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions:
applicable, include in plan set & the sheet index.
Valuation:
I Have Read, Under tand and Will Comply with Cupertino's Tear-Off Policy:
Signature --
Revised 6/16/08
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 2007 IBC Standards
and manufacturers specifications on re-roofing. All roofs are Class "A" per Cupertino
municipal code 16.04.080.
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.
O5. 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/a " 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.wow
Homeowner's Name: SIWlO�I Ow
Job Site Address:
Roofing Company Name: M {'CAA4 rytS SIC, /
Applicant's Signature: Date:
• Greg Casteel 1,
Building Official
Revised 07/30/08