06080052 CITY OF CUPERTINO y'tkkaX ". �t
BUILDIN4''DIVISION PERMIT Ct1NTRA.CTOR I[ '0..l �''10
..�iFs d's4-;a�
BUILDING ADDRESS: s YORKSHIRE ROOFING PERMIT No.06060052
11582 MQRNING SPRING CT
OWNER'S NAME: PERMIT ISSUE DATE
SHUM 7275 NATIO AT, DRIVE OR /OR/2009
ONE: SANITARY NO. CONTROL NO.
(925) 484-1900
ARCHITECGENGINEEM: BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
O0 LICENSED CONTRACTOR'S DECLARATION Job Description(� I hereby affirm that 1 am licensed under proviakm;of Chapter 9(commencing
with Section 70(10)of Division 3 of the Business and Protestations Cade,and my lkense is
„ Infmllfa.eanderc TEAR OFF WOOD SHAKE , ROOF AND REROOF WITH COMP
,qz uan,9�ia—Lk.a CLASS A
1,o Dam�-al-n-7 Conlranor}
ARCIII C1•5 DECLARATION
i I understand my plans shall he used as public Martin
i�U
C In Licensed Professional
s h 3 OWNER-BUILDER am ompt lir DECLARATION
aI boob M.that I sur eumpt s an U Profession CanuanCc : ny c ty o for the
a 0 following rcuaa(Semon 7031.5 Bualneas and w.dcoCade:Any oily or county
S$ which requires a e,adw m cn ea the seer.Impmve,demolish,or.paig any Mentis.
2'�^ pnabslicensed pursuant to
Oro app0cant f.Conrpermit s n fill a LiceneLA.(Wcmem t�NOOO
itheheucingwtpursuant'7theofDialarsofNe BusinssLicenselaw(Codc)9 Sq.Ft. Floor Area 'Valuai
s $
(commencing with Section7000)ol Division 7a(the Buenas and Prafruiaa Cade)or
— that be is e oupt Ourcfrom and the basis far On alleged aemptlon.Any sloistion Of
Semon 7031.5 by any applicant for a permit subjeeu the amPlkmt no a civil Penalty Of APN Number Occupancy Type
net co.Nan live handled dollars(SM 36652036 . 00
❑I,as owner of the property,or my employees with wages as their sole compensation,
will do the vast and Ne swnu.is not NWtded or offend forsake(Sec.70th,Bud.
and Professions Code:The Comraetor's Licence Law d0es act apply m an owner of Required Inspections
property who Wlldsmrimprowtberean,and whodoe.lo chwork himself err through his
Own cmployca,provided dun such imProvemcau art not iOMM proffered forsase.If.
however,the building
ru Improvement is Mid within ane Wild
ofi.Mw fr throwers aF'
Wilder w10 have the huedm of proving Out be did set build err improve(a puryase of
sale.).
❑1,as owner Of the pmPenY,am allusively contracting with farsm mnu.nma in
construct the project(Sec.7044.Bmsnas and Professors Code)The CommemYs U• fl'�
leve law does not apply an m owner of property who Wilds or improves dumon,and,
who contracts for such projects with a cannnacter(O featured pennant On the Comranars
License Law.
❑14m aempt under See ,e As P C for this..on
owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby afMo under penalty of perjury one of the following decisn0esc
1 have and will maintain a Cm dicam of C...tas self-buure for Workers Campers.
nation,as provided for by Sawn 3700 of the labor Cade,for the performance of esu
work for which Nis permit is issued.
❑1 haw and will maintain Workers Compensation lesama,as.qui.d by Section
PILO ofthe Labor Code,for the performance of the work for which this permit is issued.
My Workers Compensation Immosom artier and Policy number s.:
Cartier.S. �a019stat Policy No.: %'��
FATI ICA'fEOFEXEMMONFROM ORKERS
COMPENSATION INSURANCE
(Thu section need not bo completed if the permit Is form hundred dollars(SI001
or iter)
I certify Out in the performance of the work for which this pencil is iasum,I shall not
employ any Person in my manr.r an as an become subject.the Worlci Campommon
Laws or California.Date
Applicam
NOTICE TO APPLICANT.If,after making this Cenifate of Exemption,you should
become subject to the Worker's Compensation provisions of the labor Cade,you mat
Q O forthwith comply with nch provisions or Nu Permit shall W doemed revoked.
LZ,t .~N. CONSTRUCTION LENDING AGENCY
F+ IW.by.Rum than ft.is.construction sending agency far f Performance of
Ix 7 the work for which Nis Permit is Wood(Sec.3097,Civ.C.1
W 0Undoes Name
CL.W z lenders Acidness
V Q I certify that I have read this application and sum thin the above informadun is
It,E~ coram.I agree in comply with all city and county aNinsui and auc laws misting an
Q V building Construction,and hereby authori..P.ecmariws of this tiny to cnmr upon the
W above-mentioned property for inspection purposes
G (We)agree In save.indemnify and keep harmkass the City of Cupertino against
sat y liabilities,judgments,costs and expenses which may in any way accrue against mid City
U Z In mouequerce of the greeting of this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUBVM REGULATE NS.
� QIIQf ( 1�Q1� (L Re-roofs
s .or pplicam mntranar Da
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Oc applicant or future Wilding mccupanlnoro afhandlc hazardous material
as de ned by On Cupertino Municipal Code.Chapter 9.12.and the Heald and Safety
Cade.Secti0n 25732(x17 All roofs shall be inspected prior to any roofing material being installed.
41 [3y. pNn
Will tho applicam or future Wilding comment use equipment of devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants n de0ned by Om Bay Area Air Quality Management all new materials for inspection.
Di trict?
❑Yes I[7Nu
I have mal the hmasdau mneri.u.quhcrnew under Chapmr G95 of the Califm-
meHealth k Safety Code,Summer 25505,25533 and 75534.1 understand the if ft Wilding
does not currently have a tmml Out It is my responsibility m notify Ou nempent of the
M �h1muCl mapdWnanceaocemrcxmoaaPmy. Signature of Applicant Date
C eroormthodbmT zed`agent —q De. All roof coverings to be Class "S" or better
CITY OF CUPERTINO
!m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # : 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36652036 . 00
DATE ISSUED. . . . . . . : 08/08/2006
RECEIPT # . . . . . . . . . : 35553
REFERENCE ID # . . . : 06080052
SITE ADDRESS . . . . . : 11582 MORNING SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SHUM
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : YORKSHIRE ROOFING
CONTRACTOR . . . . . . . : CLARK, PETER LIC # 21890
COMPANY . . . . : . . . . . : YORKSHIRE ROOFING
ADDRESS . . . . . . . . . . : 7275 NATIONAL DRIVE
CITY/STATE/ZIP . . . : LIVERMORE, CA 94550-8868
TELEPHONE . . . . . . . . : (925) 484-1900
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 7, 000 . 00 137 . 16 , 0 . 00 137 . 16 0 . 00
BSEISMICRE VALUATION 7, 000 . 00 0 .•70 0 . 00 0 . 70 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 137 . 86 0 . 00 137 . 86 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ -------------- ----
CHECK 137 . 86 17685
TOTAL RECEIPT 137 . 86
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 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 Name:
pSNn U n(
Job Site Address: I1 G✓(72 -
Roofing Company Name: �V_sh\('.e
Applicant's Signature: Of MW Date:
1
Greg Casteel
Building Official
Revised 11/2/04
Community Development
%MCIOF
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
UPEI�TINO
Building De artment
JOB ADDRESS: `� G+ PERMIT#0��00��
16a'1�M
OWNER'S NAME: PHONE # - 0
GENERAL CONTRACTOR pFAX #
am not using any subcontractors:( Y 1 ��Qf1C(�
Signature XV Date
Please check a licable 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
Owner/Contractor Signature Date
CITY OF CUPERTINO _
oo , REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# -�94 LQ — 5,:2:—Cp,�V Date: 010
Building Address:' 1�gz /�/�0 2✓l l^ Sp v_ ( _ lJl l�
Owner's Name: l S Phone#:hu
g
Contractor*j6 �D2,Pg# G)A License#:
0 lr
Contact: ( Pon #:Cupertino Business License#:� C q� &OCA
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles 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.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: 11
Job Description: j 1,6
Residential Commercial F1 / C
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are anv restrictions: LJ
Cost of Project: '1 Type of Construction: Occupancy group:
T(
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