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05100222 CITY OF CUPERTINO � � � a ��_ rex�s "°" `�` �'�'"A BUILDING DIVISION PERMIT m' ,eo ,,I2t1C-�Ta-RORM, TN BUILDING ADDRESS: MARCO ROOFING PERMIT NO. 05100222 7525 NEWCASTLE DR ER'S NAME: FERMJT ISSUE DATE LIN LILIN 43230 PHONE: SANITARY NO. CONTROL NO. (510) 656-6400 ARCHITECTYENGINEER: BUILDING PERMIT INFO BLDG ELECTPLUMB MECH 0 0 0 0 ±o o LICENSED CONTRACTOR'S DECLARATION 1 d C ith SI hereby"an that l am liccvell under provisions of Chap ar 9(ammencing Job Description tl with Section of Division 3 of NC Business and Nofcssiom Code antlmyliccnuis ±esy in fun force arhdcfett3 C3 yQZQT/O SHAKES . RESHEET ADD 40 YR COMP SHINGLES $Z Dittos CI Lit.a Fp Das on ag ZZ 7W ARC CTS DEQ I R Off • ®� C Licensed underwndpr' g h fic�pNs--�-r. N Stu 5 I Licecd ProfessionalProfessionalal al OWNER-BUILDER DECLARATION COC I Mshy.(Tian on i 1. .Berens from the Conon Co License Law far the n�wA L D o following mown.Permit co I.S.Business and Ps.de o l Cade:Any airy or acture /." ounty $�i which requites a permit re cores the alar,improve.demolish,ri spur any statement pnormis issuance.alw requires the applicwt for such Permit tofilc asigncd stateroom c thisliccvcd the p pursuant to rvisions of te hContractor's license law(Cbxptm9 Sq.Ft. Floor Area o0J Valuation x~ man he(commencing with Section?O)O)of Division 3 of the Business and Professions Cade)at Y that M Is exempt sfsmfmm and the basis fon the alleged exemption.Any violation of Section 7031.5 by any ippiksom for a permit subjects the applicant to a civil penalty of D 9f= Occupancy Type .I mart Nun five hundmd dollars(SSWI l9_�gy P Y YP 01.as owner of the property.a my employees with wages as their sic compensation, will do the workand P theswcwntrmuoatintendedoraffe lora (Sec.?014,B.i. rv� and afeasiov Code:The Coactor's Limto oer a Law does act apply an wnof _ Required Inspections property who builds or improves thesson,and who does sada work himself or through his own employees,provided that such improvements me not intended or offered for sale.ID however,the building or impmsement is and within ane your of completion,the comer- Wilder will bare she burden of proving door he did not build on improve for purpose of sale.). 0 1,as owner of the property,am esclunwly contracting with Banned contractors In tovwct the project Ike.7W.Business and Professors Code:)The contractors U. ave Law does not apply to an owner of prapenywho builds or bnprows thereon,and, who contracts for such projects with a eantractor(s)licensed pursvnt to the Contractor's License law. ❑I am ucmpt under 5 ,B&P C far this mown . Date WORKER'S COMPENSATION DECLARATION I herby affirm under putty of perjury one night following declmviortc 0 I haveand will rmu uina CeruBeateof Camenuo self-Insure fa Worker's Compcn. asuun,as provided far by Sauan 7700 of the labor Code.far Ne pm(mucnceof the wart for which this permit is issued. have and will maintain Worker's Compensation Insurance,as mgoired by Section of the Labor Code,far the performance of the work for which this permit u ivuc6 My Workeh Com pe on hhw exam.mW Policy nuelmr art: Gmm'.._ �e Policy No.: J /t —J4—IJ Z. CERTIFICATE OF EXEMPDON FROM WORKERS' COMPENSATION INSURANCE (This section ted wtbec.nploted if the permit is foranc hundred dollen($100) ^ or less) I certify that in the performum.of the work for which this permit is issued,I"I not crept%any perwn in any manor.as in become aubj.t to the Warkeri Co npcvaden Laws of Califomia.Dam Applicwt NODCE TO APPLICANT:If.after making this CeniOnte of Exemption.you should become subject to the Worker's Compensation provisions of the Lame Code,you most wJ z forthwith comply with such provisions on this permit shall be seemed revoked. Z'7 CONSTRUCTION LENDING AGENCY [—t 1 herby affirm,that them I,.construction lending agency for the perfuanan.of Uj Ne wart for which this permit u issued(Sec.709T,Civ.C.) Q Wti lender's Name .7 z I<ad,e.Address - U O I c.tlfy that I haw aced this application and some thm the shot[information is D. Whe 1.I agree to comply with all city rob county adi.an 1 state laws rtlating to 0 Wilding construction,and hereby authorize reprvrmurws of this city to cater upon the thaw-mcnu.md properly for inspection purposes. H y (We)agree to saw,indemnify and kap harmless the City of Cupertino against fq Iiabiliuu,jhMgmenu.costs at f hich may ,in anywyaettue againstsaid City cquers U z in cavegrunun f Trost. APPLICA NDER !D A w y,J�Ty ALL NON-POINT Issued by: Date SOURLj TIONEV /D�}t f 5 Re-roofs / ,.fes Signature ofApplicunUContrstor Oeste HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will tic appliont ar imus Wilding occupant axon,mbmhdlc havrdov masnal dc0ned by Ne Captnino Municipal Code.Chapter 9.12,and the Health and Seery e.Section 255320)? 0y. � All roofs shall be inspected prior to any roofing material being installed. Will the applicant or(taws Wilding occupant use equipment Of devices which If a roof is installed without first obtaining an inspection,I agree to remove emit In ardous air concomitants as dc0ned by Ne Bay Asa Air Quality Management all new materials for inspection. David? 0yv Nu 1 have mad the lova dsss materialsvquiremcma undcrcWpmr6.95ofrixcalifor- m Health k SafttYCade.Sections 25505.25533 m 425534.1 umkrawd thmifdm baiting does amt c Y how steryynn.an.7 p my rNhdny on notify the oavpst auto ¢yuimmc whiw �bfinetpn�Y�u - faCcvteofOcu Signature Of Applicant Date " owner ar aatharimd asenr , 6'Dow All roof coverings to be Class "B"or better • CITY OF CUPERTINO Item 1 of 2 PERMIT RECEIPT OPERATOR: quem COPY # 3 Sec: Twp: Rng: Sub: Elk: Lot: APN . . . . . . . . : 36617068.00 DATE ISSUED. . . . . . . : 10/27/2005 RECEIPT #. . . . . . . . . : 31768 REFERENCE ID # . . . : 05100222 SITE ADDRESS . . . . . : 7525 NEWCASTLE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : LIN LILIN ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5220 RECEIVED FROM . . . . : BONITA JENKINS CONTRACTOR . . . . . . . : CREEDEN, MIKE LIC # 21317 COMPANY . . . . . . . . . . : MARCO ROOFING ADDRESS . . . . . . . . . . : 43230 OSGOOD ROAD CITY/STATE/ZIP . . . : FREMONT, CA 94538 • TELEPHONE . . . . . . . . : (510)656-6400 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 13, 000.00 201.96 0.00 201.96 0.00 BSEISMICRE VALUATION 13,000.00 1.30 0.00 1.30 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 203 .26 0.00 203.26 0.00 • x G � Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 % CITY OF Fax(408)777-3333 PEI�TINO ( t,, h _ sio S-3V-LOB g ) Building De artment JOB ADDRESS: PERMIT # 7s2 5' Y\Q.wca.�_ C/%, a S / o v -2- OWNER'S OWNER'S NAME: ),,;,N, PHONE # 6 ,Z1 - Oy/ J GENERAL CONTRACTOR:')On FAX # I am not using any subcontractors,�l�.co_ 5. - — Y- ignature Date Please check applicable subcontractors and complete the following information: 6d I 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 p M co /'BIZ OOwner/Contractor Signature Date CITY OF CUPERTINO REROOF *UPEkTINO PERMIT APPLICATION FORM APN # 2r Ow� Date: /O/ZZ /a_S Building Address: -75-s-_5' J� J Owner's Name: ) Phone#: Contractor: Phone #: License #: O 2 L �S 6 656 _�L- )6 `� I Contact: e U z t Phone#: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles rd Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) � Number of existing coverings El Provide I.C.B.O.Report# 7' To be Removed ❑ Provide Mfgr. Installation Specs. Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description:T/D -a�&,X� - . �zApd qU y � n Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if there are any restrictions: Cost of Project: Type of Construction: Occupancy group: /lt Ft 3 p Qty. if A licable Fee ID Fee Descri tion Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING Community Development Department Building Division Q/ City of Cupertino • 10300 Torre Avenue Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 CUPEkTINO 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: Job Site Address: 25 -7-5 l- .. Roofing Company Name: _ Applicant's Signature: - Date: >�c S Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper