08080208 CITY OF CUPERTINO ct -�
BUILDING DIVISION PERMIT CONTRACTOR IINFORMA.TION�" :
BUILDING ADDRESS: PERMR NO.
>0686 CRAIG CT T D ROOFING 08080208
JhVEWS NAME: PERMIT L61M DATE
JOSI:111H CHEN 675 TULLY RD 08/26/2008
PHONE SANTI'ARY NO. CONTROL NO.
ARCHrrECTMNGINEER: BUILDING PERMIT INFO
REMOVE WOOD INSTALL COMP 30 BLDG ELECT PLUMB MECH
0 0 0 0
u o o LICENSED CONTRACTOR'S DECLARATION
1 herobyaffirm that 1 an limnscd under provisions of Chapter 9(commencing Job Description
`ZZW wilASCe40n 1Ma)of Division 3 of the Business Nd PrOTeaSIOm Code.aM my licerecis
^=s in full farce apd of L u L,l ^ —C. I -
�ysf�
License Cl Lk.Y
=q Dau: Contrxwr
££7W7W AR ITERS DECLARA
k U I uMerstud my plana shall W used.public re
to
`OI Ucensed PmfessimnN
Oan I Am ournin fr DECLARATION
'C 0 E I hereby affirm that I I.S.cumpe from IW Contractors Licco.law for qc
3❑O following reason. erfuuu ID31. ,4 Alan. and sae.din ons Calc:Any cite or county
$ whim mquirns a permit m rnnslro[L alter.improve.Mmnlbh,Or mpwn any structure
_i< On,in its romance.sista mquims Ne Applicant for such permit to fie asigned statement
�ct that the is licensed pursuant o the provisions of the ConuacWh Limn.law(Chapter 9 Sq.Ft. Floor Area Valuation
(commencing with Section 7000)of Division Sof Mao Business and Prefessiou Cnde)or
$ than W is exempt therefrom and the bss6 for Me alleged exemption Any violation of
Section 7031.5 by any applicant for a permit. u th
subjects applicant m a civil penalty of APN Number Occupancy Type
Irot mom thou raw wMmd dNlan(SS(10). P Y YP
❑I.As owner of the property.a my employees with wages as their sole compen adon,
will do the wort and the structure is not intended or offered for As,(See.10th,Business
send Professions Cnde:rte COnmKlmrs License law does at apply As u owner of Required Inspections
property who builds m im prow the mem,and woo does such work himsel f m through his
Own employees,provided that inch impmwmmta Are not intended oroRered forsale.IL
howewr,the Wilding or Improvement 1..Id within arc year of eempledoo,the mmer-
Wilder will have the WNm of quving that M did not Wild Or improve for purpose of
tale.).
❑1.as owner of be property.w c tshoiwly contraning with licensed contruron in
construct the project(Sec.7W,Business and Professions Code:)rise Contractors Li.
cense Law does not apply On An owner of proper who Wilds or improves d erten.and.
who comae t for such pojeeta with aeontractne(s)Reacted pursuant.the Contractors
License Law.
❑latnesemptunderSee .BAPCr.Mb.n
ee Date
WORKER'S COMPENSATION DECLARATION
1 Wish,affrm unier penalty of peeper,one of the following declantionc _
❑Ihawand will mainuin•Certi(.ofConscntroself-InsumraWadrelsCompn-
ution,As provided for by Sacdon 3700 Of the labor Code,for Ne perform.of the
work for which this permit is issued.
w and will maintain Warier.Compensation InsWan¢,as required by section
100 of NC labor Code.for Me of the wart for which Nis permit is issued. '
My Wmrkefs CAAom,mrumdon Insurance caner and Policy number Am;
Carncr, t -1 f C Policy Na:�,L2, 1,
CERfIFl ATE OF EXEMMON FROM WORKERS'
COMPENSATION INSURANCE
(3Lu seNtm need trot W completed if the permit i,fe rone hundtW dollen(SIM)
or leu)
1 certify,Nes in the performatce Of the wart for which this Permit is issued,l shall am
employ any person in any manner.as to bmar a mbject to Ne Wmkcrs'Compcnuuon
Laws of California.Dam
A,11.t
NOTICE TO APPLICANT:If.atter making this Certificate of Esemption,you should
become subject to the Winter.Contestation provisions of Ne{abet Coda you most
.J rz foMwith comply wit such provisions or this permit shill w Maned revoked.
z O CONSTRUCTION LENDING AGENCY
w; Ihcmb affirm thallhele u•mnsouction lendin
F' Y g gcnry for Me perrwmanm Of
1:4 Me the wurk fur which this permit u issued(Sec.3W7.Ci,.C.)
OW. A lenders Name
.7 z Is:ndeh Address
U O 1 certify that 1 have read this application and sum dor the allow information is
U, Cis eeL 1 agree on comply with all city and county pNinanR.Md scale I]M muting in
.� Wilding construction.ad hemby aulborin repm.ntatiwA ofthu city in enter upon the
Lr] [,hove-mentioned property for inspection Purposes.
gy (We)agree to save,indemnify tad keep harmless the City of Cupertino againtt
res liabilitie;Jomd�jTmenu, of udexpenses which may in try way accrue ageinstseid City
U z APPL CANS Ur gSTANDS Ali SWILL COMPLY WITH U NON-POINT Issued by: Date
SOURCER U
Re-roofs
sigwum Appli AZARRDOUS MATERI DISCLOSURE Date Type of Roof
Will the applicant or comm wilding« Isom orhadle haprdon.maCnal
Mined by dee eupenil. mnpai C poer 9.12,and the Health send Saran
M.0y.o.25532(a)1 All roofs shall be inspected prior to any roofing material being installed.
To. a
If a roof is installed without first obtaining inspection,I
Will the applicant or forum building Occupant u.equipment Of Mvim which g anns agree to remove P
rmn ha ardnma air contaminann filed by Me Bay A.Air Quality Managem.at all new materials for inspection.
Disuiet7
OYes
Imaffih =W
dramuenalsourommenunnMrchapma95ofMcCalimr-
nix H.I" ttwns0M.25533md25534.1uM =sin uif the Wilding
does vol canan4 situ R i,my responsibility m nobly the mcupwm m me
mquirtmcnt minuvcsofacenfc of Onavpancy.
b Signature of Applicant - - yI Date
-LOwnvaauthamrd agcm Date Al I roof verings to be Class r%Ta'or better
CITY OF CUPERTINO
REROOF
CITY OF
•CUPEkTINO PERMIT APPLICATION
APN # Date:
ZA � 0 8
Building Address: L
,20 � s c rC11 CI
Owner's Name: Phone #:
Contractor: Phone #:
L4 0 8 (4 o
ax #:
Cupertino Business License #: Contractor License #:
4 SSS I
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles >10Asphalt Shingles
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 Mfg. Installation Specs.
Job Description: L
tre rnov e , W 0o C( CNM-) Q 1
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:
to l 3
•I Have Read, Under t d and Will Comply with Cupertino's Tear-Off Policy:
1
Signature
Revised 6/16/08
-� CITY OF CUPERTINO
REROOF
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee' Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLROOF
I 1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
IBSEISMICRE Seismic Residential B
IBUSLIC Business License B
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.
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 V4 " 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: , (D1�1_o n (a I,1 R
Job Site Address: .7-o 6 Y Cu-
Roofing Company Name: I D 2,3 y1 C
• Applicant's Signature:
Greg Casteel
Building Official
Revised 07/30/08
T,
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
SCUPEkTINO
Building Department
JOB ADDRESS: PERMIT#
08 o g 0 J2Q
OWNER'S NAME: o s 1 (,. '1 E Y) PHONE ro 23
GENERAL CONTRACTOR: n Q o 11 q FAX #
I am not using any subcontractors: x2l� 6 0 g
Signature Date
Please check applicable subcontractors and complete the followin ormation:
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
Owner/Contractor Signature Date
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35915020 . 00
DATE ISSUED. . . . . . . : 08/26/2008
RECEIPT # . . . . . . . . . : BS000005907
REFERENCE ID # . . . : 08030208
SITE ADDRESS . . . . . : 20686 CRAIG CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JOSEPH CHEN
ADDRESS . . . . . . . . . . : 20686 CRAIG CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2912
RECEIVED FROM . . . . : T D ROOFING
CONTRACTOR . . . . . . . : LESLIE HOANG LIC # 23155
COMPANY . . . . . . . . . . : T D ROOFING
ADDRESS . . . . . . . . . . : 675 TULLY RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
• TELEPHONE . . . . . . . . : (408) 892-8872
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ------- ------- ----------
1BSEISMICR VALUATION 10, 360 . 00 1 . 10 0 . 00 1 . 10 0 . 00
1REROOFRES SQ FEET 24 . 00 312.. 00 0 . 00 312 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 313 . 10 0 . 00 313 . 10 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
-- --------------- - -----------
CREDIT CARD 313 . 10 VISA
---------------
TOTAL RECEIPT 313 . 10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
- --------- ------ ---
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•