08030048CITY OF CUPERTINO
eAL IMA 6M. aAlv,
BUILblNG DIVISION PERMIT
CUNGRA.CTQRIPFF'�ORMATIQN
BUILD�Ny,SgpjtFsOFRMU
RANGE AVE
NEW CENTURY ROOF TILE, INC
NO.
PO803O048
OWNEWSUN.SAtMSEl:
PERMIT ISSUE DATE
WJOANNA WANG
23135 SAKLAN RD.
03/10/2008
ONE:
SANITARY NO. CONTROL NO.
(510)78079489
ARCHITELTMNCINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
n LICENSED CON 00i3R'S DECLARATI
m. Ing
IOU DCSCTn0O
I p
1 homey affirm that 1 am licensed under pmvi of 9 (
with Section 700M.1"Divie. 3 ofthe BW. and Prof t mei,
RE -ROOF INSTL OSB PLYWD INSTL COMP SHNGLS CLS 1
in full forte and tf
z Elocom c Uc. g
31 SQ
Dem O ARCHRERmm,em, R
NEW CENTURY ROOF TILE RENEWED BUS LIC 25304 31008
I understated my Plan WII k seed ss Publl rde
�a Licensed Professional
3 OWNER -BUILDER DECLARATION
SS 1 hereby aOhm that I em exempt from then Contractors License Law for the
O following moan. (Section 7831.5. Business and Professions Cade: Any city or county
which o lulus a permit in contract, alcor. improve, denu lah, or repair my urunure
�^ prior in its issuance, sun requires line applicant for such permit in file a signed ataement
that he is littnmd In ft of the ConucuresLccnm Law 9
Sq. F[. Floor Area
Valuation
Punmmt pmvidou (Chapter
m
9 (comencing with Section 7000) OfDivhion3ofthe Bmi.and ProfcsiCode) Or
1 8880
that he It emmpt tleaftem and the bath far the alleged eaeoption. Any violation of
Societe 7031.5 by an, applicant for a permit wbjecu do, applicant m a civil Wait, OfNumber
!R�
Occupancy Type
not mart man five hundred dollars (5500).
35714 0 5 5
L u owner of din gapmry. m mY wployeu wW mgrs u thetrale eompeusation,
Required Inspections
ME
is Out s � L4a ones �'Business
NWession c� i
Oor ut aWy
Mbe CC.mam n'te�
Property who Wilda Or improves demon. and who detestation work himalrnr through his
awn emplayees, provided that such improvemeau art oat branded uoRemA fanatic. IL
however, the Wilding orimpommem is said within ane year of completion, the owner.
Wilder will have the burden of moving But he did not Wild Or improve for purpose of
sale.).
0 I, u owner of the property, w eaGutivelY mnumdng with Iiecamd contrmwa to
construct tete project (See. 7044. Business rate Professions Cade:) The Contrmwrs U.
cede few dues a., mpl, to an Owner arlsoopany who Wilda or improves Instant. and.
who contracts for such projects with a con"mor(a) licensed paaurt m the Commoner
Lleeue Law.
0 lammumptuntec See ,Bl PCfmthisseuon
Date—
amWORKERS
_
WORKERSCOMPENSATION DECL6RATON
I hereby of r n under pointy of perjury ane orae folmwing declettions:
❑ I ham and will main am.Ceef0ua ofConsem he self -Watts for Wadmiscompem
action, u povidOd far by Samoan 3700 of the, Labra Code. for the pemfomtanm of the
wank for which thin permit is iuuml.
0 1 have AM will maintain WorkJs Compensation Insurance, u acquired by Section
3700 of NeLabor Cade. for the performance of the work mrwhlch this permit is issued,
'
My Wor Inwtaue art iv and Poliryn ,bee are'
o nuugt= policy No.�
,
CERTIFICATE OF EKEMP ION FRO ORK •RS
COMFENSATTON INSURANCE
(Orhsectimt need Out W completed if de Permit is foranc handled dollars ($10(f)
or lata)
I wtify dant in use perfmmamx of the work ser which this permit is Wood. I shall not
employ any parson in any muuerm at In became subject to the Warkn'CompensNon
Lem of Califamia' Dam
t
NOTICE
NOTICE TO APPLICANT. IL neer making this Cision, of of &ebur o you Mouse
become subject of the labra Cade, you atm
d
Worker's Coons this provision,
Or
j foMwiN cOmP1Y with such provisions m Nu permit shall be deemed rewkd.
y it hal
n CONSrRucnON LENDING AOENCY
1 hemby affirm dust Neo Us causmmmat lending agmeY far the perfurmarce of
y the work for which this -permit h hwete (Sec. 3097, Civ. C.)
Lender's Name
,
LCMets Md.
1 ceNrr I haw mad this Application ane sum that tic them, information h
"
crrteo" I agree ply with all city and cowry ord"•^•+•ne l aawe Inn relating to
Wilding co an, andk Yauthorim rtpmvmntatiw of thin Ntymanmr upon ate
above -mends 0 rty f nspenian Purpamv
L ) few coni and keep harmless the City Or Cupertino 9 Bm1L
G liabilities m co ex which may lranymyacemm agunataid City
in co a the ties malt.
AP LI NDE AN D WILL COMPLY WITH ALLN- INT
Issued by: Date (p
SOU ULA S.
V
/0 0
Re -roofs
'
Type of Roof
S' of PPliun an as
HAZARDOUS MATERIALS DISCLOSURE
WIII the applicant Or forum Wilding occupant arum or hahandleallomteri
maat
'
as, defmM dm by Cupertino Municipal Code. Chapter 9.12ne H
athe Health and Safety
cade,senlenzss3z(a)? -
All roofs shall be inspected prior to any roofing material being installed.
.
❑Yea x(90
If a rogos Installed without firs[ obtaining an inspection, I agree to remove
WIII the applicant or future building aecap.rt use equipment or denim, which
cane haysrdou air comaminanu u donned by the Bay Area Air Quality Management
all n to s spection.
❑ Y. *(Nu
I the ardrua ah omuimments undcrClupter 6.95 ofthe Cilifer•
nixHcaI sty ,Seth 5.25533 ane 75534.1 understand We if the Wilding
D
does a nil, 4 t h is my rerpansihilitY m notify de upeat ter the
mqu whi as r maccof.cmtrfeamora
AslinatureofApplicant Dat
All roof coverings to be Class '7V' or better
su—tharizedatcol Data
m am
•
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CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 35714055.00
DATE ISSUED.......: 03/10/2008
RECEIPT #.........: BS000004119
REFERENCE ID # ...: 08030048
SITE ADDRESS .....: 10381 ORANGE AVE
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ............: JOANNA WANG
ADDRESS ..........: 10381 ORANGE AVE
CITY/STATE/ZIP ...: CUPERTINO CA, 95014-2802
RECEIVED FROM ....: NEW CENTURY ROOF
CONTRACTOR .......: DARRELL DIAZ LIC # 25304
COMPANY ..........: NEW.CENTURY ROOF TILE, INC
ADDRESS ..........: 23135,SAKLAN RD.
CITY/STATE/ZIP ...: HAYWARD,•CA 94545
TELEPHONE ........: (510)780-9489
FEE ID
----------
UNIT
-------------
QUANTITY
----------
AMOUNT
----------
PD -TO -DT
----------
THIS REC
----------
NEW BAL
----------
1BSEISMICR
VALUATION
18,880.00
1.90
0.00
1.90
0.00
1BUSLIC
FLAT RATE
1.00
110.00
0.00
110.00
0.00
1REROOFRES
SQ FEET
31.00
403.00
0.00
403.00
0.00
TOTAL PERMIT
----------
514.90
----------
0.00
----------
514.90
----------
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
--------------
514.90
---------------
514.90
VOICE ID DESCRIPTION
-------- ----------------------------
601 ROOF TEAR OFF
603 ROOF BATTENS
605 FINAL REROOF
REFERENCE NUMBER
--------------------
#4748
VOICE ID DESCRIPTION
-------- ----------------------------
602 ROOF PLYWOOD NAIL
604 ROOF IN -PROGRESS
oJP03 o oYf
CITY OF CUPERTINO
REROOF
•CUPEI,TINO PERMIT APPLICATION
APN # '�/
e3�y o 5.5 .
� o
Date: p
/d U
Building Address:
Owner's Name:
Phone #:
GU
X70 c250 1p9io
tractor:
Phone #: 50 7,fo WfY
Fax #: ,5079i0542/
Cupertino sine License #:
Contractor License #:
.
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
❑ Asphalt Shingles
)Y' Asphalt Shingles
X 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:
Residential
Commercial
Fire Zone:. Yes ❑ No
Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation:
and Will Comply with Cupertino's Tear -Off Policy:
Signature
aHMO
o
•CUPERTINO
CITY OF CUPERTINO
REROOF
FEE SCHEDULE
Number of
Squares
Fee ID
Fee Description
Fee
Group
Permit Type
1REROOFCOM
Re -roof Commercial
B
1COMMLROOF
1BSEISMICO
Seismic Commercial
B
2/
C31
1REROOFRES
Re -roof Residential
B
1SFDWLROOF
1BSEISMICRE
Seismic Residential
B
1RER00FMRES
Re -roof Multi -Family
B
1MFDWLROOF
1BSEISMICRE
Seismic Residential
B
1BUSLIC
Business License
B
9
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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:
Job Site Address:
Roofing Company Name:
Applicant's Signature:
Greg Casteel
Building Official
Revised 11/2/04
iw7✓ l
CITY OF
OUPEkTINO
•
9
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS
.�/Smar-a� %tel / �_ ra�iJ�<
iliL�.f1�1/l(�lL!��
BUSINESS LICENSE #
I am not using any subcontractors:
tgnature Date
Please check applicable subcontractors and complete the following information:
60
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
e ock