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08020069 CIT OF CUPERTINO 7 t -ta & £' ' BI)ILDINC DlVisior4 PERMIT iCONTR'AGT.OR INFURMATIO m.�a: a.`, BUTTO1N gqOBgESS: PERMIT NO. JOLLYMAN LN WING' S ROOFING INC 08020069 ER'S NAME: PERMIT LSSUE DATE LIN ROBERT K C AND CAFNIE C 3243 SYDNEY WAY 02/12/2008 PHONE: SANITARY NO. CONTROL NO. (510) 889-9068 ARCHLTECI'r3NGINEER: BUILDING PERMITINFO BLDG ELECT PLUMB MECH Sop LICENSED CONTRACTOR'S DECLARATION Ib Description m 1 hereby arnrm Nal l Am lixnwunder der proviau isof Chapter 9(mmOIP mencinw withSmtian TOM)ofDlIdmm 3afthe Busimas dPm, sio de,and my licenm is RE—ROOF,T/O SHK & INSTL 7/16" OSB k ASPHALT n''N In full to=and mL 5' w...clua — LM.g !. SHNGL,CLASS A 27SQ Date CO DELL e plus anatur RCHIN use DECLAc race i I understand my plus ebtll he used a public rtcnNt 56 sad Licensed Pottcuional Sy OWNER-BUILDERm DECLARATION _ COO hereby a?nn o n I.m Burin From the Canaan Co License Law for non COO followingmoon.(Section RDI.S.Boste. and Pmrusiuu Code:Any City mrounry 3$ which mquiru•pah m core,the alter,impmse.de cirroh ore a sir uY structureant I�^ prior b its issmm0.also mquiru the applicant far tach permit m file aaiwnrd wmmenl < Nal mencimucdpuccuMloNcpmviuion3af Conuacmr'rU¢ cuiomNpmr9 Sq.Ft. Floor Area Valuation chat exempth Smtianr andtr basisf th Alleged wi CAM)or S7800 — Nn he b exempt aeefmm and don bum fm the alegca ermPtiom Any it pen lty of Smtim than fly any reddomfm 5ML. ttubjccu Ne applicant lolrivil penalty of Number Occupancy Type not mart than haw nandmd dalWatxSBm. � 35922055 'CJ tf ❑ dothe work. had proptruclu mycmploym with wguu Neaham mmpeeaaon. will da thewons ante The Cumisnot Intendedconfirmedroealapplyt An.Business Nd property bis Cade:The Cantr%mYr 04 who IJW do L']an,apply lf rt aWMr Or Required Inspections pmpeny who bisIlda a ed that Hereon.and who aressuch work dooffe ar Iluuuwe his awn employee,protea,i Nal ouch improvements are not intended moeeMd for osa.r- builder the building orimProwmant(smid within am year of mprove fn.Heowner- As ilder will haw Use buNm of proving that he ala not ddb lir improve for puryoM of anMJ. ❑I,As owner of the property am eacluavely contracting with licensed!mmumra to .1.1 the project(Sem.1014.Business and Profusions Code:)The Canlnemra Ll- come law does not apply As an owner of property who Wilds m improwt therms,and. who cmuacu far Avon pmjecu with a conuacmr(s)licensed purawnt m use ConuattoYa License lAw. lam exempt under See .Bl PCforthbmhmn mer Data WORKER'S COMPENSATION DECLARATION 1 hereby after under penalty of perjury am of the following declanaou: I haw and will mainWn a CeA6MM ofCoueni M self-iuum fm Wort es Compen- sation,As provided for by Section 3100 of the Latour Code.for We performance of Ne wort for which this permit is issued. ❑I haw and will maintain Wortels Compensation Iumaem.As required by Section 3M Ne labs Code,for the Petrone mor Ne wort car welch this Ranh is issued. ' My WortrftC pc do num '" and Poliry 0 =a�rt�. Carrier: Policy No.: () CE IEC TE OFFJ(EMPITON FROM WO EAS' COMPENSATION INSURANCE (raissectlnn need rot bccomocted lithe Permit is foram hundred doll=(SIM) ' or less.) I really Nal in the performance of Use work far which this permlt U Tuned,I shall not r employ any person In any mannerha As to become habjet m the WURmb'CamPensatim Laws of CaifoMa Data Applicant NOTICE TO APPLICANT:ir.armr mating Nb,cot ricare of Raemption.you should become subjett m Ne Workers Compensation previsions or the labor Coda you muss .J O frMwNr Comply with such pmu visioor this pe..it,hal he deemedw mked. ? CONSTRUCTION LENDING AGENCY F.t Thereby affirm than Vert ba construction lending agency for the performanCo of a > the wart for which this permit Is ismed(Sec.3091,Civ.C.) G Lanier',Name , Lenders Addmv ' I renlfy that 1 haw mW this appllatlon and sum Last the show information II U4 conecb I agree to comply with all city and county om ame ate SUM laws totaling in building construction.and hereby autharin Mpmsenbams of Nis city to enter upon the W 'hove-mmmuce!property for inspection purposes gy (We)agree to haw.Indemnify and keep halon the City of Cupertino ILaut y liabilitie,judgments.costs and expenses which may In any way acme Against said City UZ in coesegnence lirds rutins of Ni,pail. ti APPLICA D STANDS AND WILL COMPLY WITH A NON D1111[[[[llTTTT Issued by: Date r Zjyi SOURCE G L ONS. / b Re-roofs Signuum Ofwoi6LAdCan r Dam IIOUS MATERIALS DISCLOSURE Type of Roof Will she applicant lir Oruro building occupant nam or handle assertions materia darned by the Cupertino Municipal Code.Chapter 9.11,and the Heath and Safety oda•Section 25532(.)? All roofs shall be inspected prior to any roofing material being installed. ❑ye t. Will Ne Applicant or future building occupant use eyvipment lir&,I.,which If a roof is installed without first obtaining an inspection,I agree to remove ..It ha'rArdnua'iI...W bran u dcnncd by the Bay Area Air Quality Management all new materials for inspection. District ❑Ye No Thaw Madthehbvdo dabmquim=uunaerChap h.95orthe Caifor- _ nuHuINBSarcly Cade,Seetiuu25305.25533and25534.1 thatifdse building drca ml Connally haw a unu4 that it b my mpouiinlity b 'ry ocm uor of the rryulm nMwmmhman,xxme pirrmiva niticatiEa r ignatureofApplicant Date i Cnt All roof coverings to be Class"B"or better Owner w auNari>ca gent Dow� ' D� oa von q CITY OF CUPERTINO z REROOF •CUPEkTINO PERMIT APPLICATION APN# �/�� D `J Date: Building Address:ZO S J��� h�1 ') x-0%11 e- Owner's Name: Phone #: C) Ll 402 Contractor: Phone #: 44 Fax #: Cupertino Business License #: ^/ 2 Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles 9� Asphalt 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 Mfgr. Installation Specs. Job Description: ke�j ���/ '_n ,` �' Residential Commercial Fire Zone: YesEl No Confirmed with Planning Dept. if there are an restrictions: ElValuation: �-7 �yU v •I Have Read, nderstand and Will Comply with Cupertino's Tear-Off Policy: Signature CITY OF CUPERTINO ` REROOF *CUPE"kTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares ' Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEI MI S CO Seismic Commercial B c� 1REROOFRES Re-roof Residential B 1SFDWLR00F I 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B • 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: V, 8'l� job Site Address: 6 �— [ p Roofing Company Name: Applicant's Signature: Date: • 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 . . . . . . . . : 35922055 .00 DATE ISSUED. . . . . . . : 02/12/2008 RECEIPT #. . . . . . . . . : BS000003918 REFERENCE ID # . . . : 08020069 SITE ADDRESS . . . . . : 20895 JOLLYMAN LN SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : LIN ROBERT K C AND CAFNIE C ADDRESS . . . . . . . . . . : 20895 JOLLYMAN LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4315 RECEIVED FROM . . . . : WINGS ROOFING INC CONTRACTOR . . . . . . . : CHEA, WING LIC # 21239 COMPANY . . . . . . . . . . : WING'S ROOFING INC ADDRESS . . . . . . . . . . : 3243 SYDNEY WAY CITY/STATE/ZIP . . . : CASTRO VALLEY, CA 94546 • TELEPHONE . . . . . . . . : (510) 889-9068 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 7, 800. 00 0. 80 0. 00 0. 80 0. 00 1REROOFRES SQ FEET 27. 00 351 . 00 0. 00 351 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 351 . 80 0. 00 351 .80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 351.80 VISA --------------- TOTAL RECEIPT 351 . 80 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 aClOF Cupertino C9014 Telephone(408)777-3228 Fax(408)777-3333 � UPEt�TINO Building Department JOB ADDRESS27 g^ �© / ona V7 PERMIT # ZOOG OWNER'S NAME: ( o ( Y'! PHONE # GENERAL CONTRACTOR: AX # I am not using any subcontractors: 2 d Si afore Date Please check applicable subcontractors and com Tete 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 Til Owner/ o ignature bate