08020082 CITY OF CUPERTINO Asa .. ' js
• 13UTLDINO DIVISION PERMIT �=r�.f�'1,' 1127R � .,ATIO �,.
BUILD NG D ESS PERMIT NO.
�.1g'� ORCHARD SPRING CT LOS GATOS ROOFING 08020082
ER'S NAME: PERMIT ISSUE DATE
HEIDI CHOW P 0 BOX 1726 02/13/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHnYC(ENGINEER: BUILDING PERMIT INFO
REROOFRMV SHKS, INSTL 30#FLT O EO FLUME
O O
30 p LICENSED GGN RAGTGR$DECLARATION lob Descri tion
1 hereby affirm that 1 am licensed under provisions of Chapter 9(mmmdmis{ ^••••^ ^— P
IN Smdon 70M)ofDiviaion 7 of um Business and Prefessionc Cade,and my license is
I"
full nett end ce 11 /�
j�_ Lllsa' lss / Idea VR'20 /. ..
alt„ Dau Comrscmr .n ✓J, l
ARCH1lECT3 DECLARATION �f
1 understand my plans.lull M used u public records
7[[�
'�O
{C Licensed professional
OWNER-BUILDBR DECLARATION
I bdtcby aRmt Net 1 am exempt from Ne Contractor's License Law for the
O following..a.(Section 703 1.5,Business and Professions Code:Any city or county
422 which".I.a permit m cnnYuct,aloe Improve,demelLLh.or¢Pair any swaum
yzi priarm its issu emc.also requires theapplicam retouch pernitio Bleasigned staumem
< that he!,licensed pursuanita dm promiauofthe Comnotar'sU..law(CMpur9 .Sq.Ft,Floor Area Valuation
gmomncreingwith Section 7100)of Division J ofmc Businessand Prefessions Cole)or
—
that he LL exempt therefrom and the bust for the alleged exemption.My violation of
Section 7031.5 by my applicant for a parmu aobjec s me aPplicanl to a civil penalty of APN Number Occupancy Type
amt mom man five hundred defers($51I0).
❑1.u owtur of me pmpmy,m my mploym withwages u their mk compemdm,
wins Bothe work Codes he ContLLum's Lided or Law
had
an
Required Inspections
and Property
who
Bade:mpr Cdnuaemfs Limtu Vw dam oro apply m et owner of fl P
property who builds or ire prows themvn,and who de stilt wedt himsaif m tiuou{h his
owe employeprovided eat such Nimprovements tae not euM
however,meWelding.improvmenmidwithine )ear oWmwoQesnd,the
rehe
saiMO hanthe WNan of prong mat lex did net bld or improve1m puspYoirne Iof
d).
❑1.as ownm of Can property,am exclusively contracting with Im rued mmracsma to
cor oven me project(Sec 1014,Businm and Pnefesdou Code:)The Conoacmh U.
C.Low dans not appy man owhar of property who Isuilda or improme thermn.and.
wM conoacu far such pmjem Mm a Conoanms(a)liansd purswnt m ed Co mosew'a
Linseed Law.
❑Iamuemptunder Sen ,BBPCforthbmuon '
40-1 Dau
WORKER'S COMPENSATION DECLARATION „
1 hereby aff m under penalty of perjusy one of the following decimations:
1 haw and will maintain a Cdnifiexte of Consent m Ylf-luum for warteYs Compen-
radon,as provided for by section 7700 of me Luber Code.for the perfor omen of the
work for which this permit Is Issued.
❑1 haw and will maintain Worker's Compensation Insurance,as sequimd by Secdon
370 of the Labor Code.for the performance of she wwk for which this permit is mood. '
My Wor y a pe tiha 1. cd carrier and Policy number am:
Carrier. Policy No.; i10
C RTIFICA ^OFEKEMPTIONFROMWORKERS'
COMPENSATION INSURANCE
rDtis section hand mthecampldum if and parmh is forms,hundred dollars(SIM)
or leu)
1 etify mot In the performance of the work for which this pmol,u issued.l Coal not
employ any person in any mannerse u he become subject to Ne Workus'Compewsion
Laws of California.Data
Applicant
NOTICE TO APPLICANT:IL after matin{this CcniBcate of Exemption,you should
become subject m the Workels Compmuidon provLLions of the tabus Cada you most
.J Q forthwith Comply with such previsions or mo permit shall be deemed rzwknd.
CONSTRUCTION LENDING AGENCY
IV)
[n I hereby affirm ens them LL a com eacdon lending agency for the performanca of
pG > the work for which this permit Is Issued(Sec.3097,Civ.C.)
W� 0 Lenders Name
w`D z Lendi Address
U Q 1 certify that I have rod this application and suns that du above irdormauum Is
Correct.I agree to comply with all city and County ormnanms and sum laws missing m
0 building convection,and hereby suthodrz representatives or this city m enter upon the
W above-mendmmd property rot inspection purposes.
L}.a LL (We)agree In save,indemnify and keep harmless the City of Cupertino against
it l'A liabilities,Jud{menu,costs and expenses which may in any way accnm against said City
U',Z in coneatime a{senting of this permit
.. APPLICA ANDS AND WILL COMPLY WITH AL NON-POINT Issued by: Date
SOURCE R 0
I3 Re-
roofs
roofs, �=
Sigutum of HAZARDOUS
AZARDOU �! a�•—
HAZARDOUSMATERIALS
xuptim moorhaRE Type of Roof
Will byteCur,enim,t or fonum building Coe,Chapter 9.
handle Health andrdons aurid '
defined by she Cupertino Municipal Code.Chepmr 9.13,and she Health end Safety
,SCodo.z5533(.)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes Ne
Will the applicant or fume Wilding deception use equipment or JeHe which If a roof is installed without first obtaining an inspection,I agree to remove
emit hamd..,air mmuunt, u as definnd by the Day Acta Air Quality Marugement all new materials for inspection.
District?
❑yes No
I haw rad the buudms materials requirements under Charter 6.95 allied Califur.
Na Hrslthh ainyCadd,Seetimta 35505.25577 am13J534.l undcrmand thn Epee building
aims trot Jy haw.tenant Nat It LL my responsibllity m ratify Nd amvpant of the
regaire be metpriermivaannsanCvtircamer /3 �� Signature of Applicant Date
owner m,amm vee,sem /Dente
All roof coverings to be Class"B"or better
• CITY OF CUPERTINO
2 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36654028. 00
DATE ISSUED. . . . . . . : 02/13/2008
RECEIPT #. . . . . . . . . : BS000003929
REFERENCE ID # . . . : 08020082
SITE ADDRESS . . . . . : 11611 ORCHARD SPRING CT
SUBDIVISION . . . . . . I _
CITYCUPERTINO
. . . . . . . . . . . . . .
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HEIDI CHOW
ADDRESS . . . . . . . . . . : 11611 ORCHARD SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5122
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY . . . . . . . . . . : LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : P 0 BOX 1726
CITY/STATE/ZIP . . . : LOS GATOS, CA 95031
TELEPHONE . . . . . . . . : (408) 298-9399
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ------ ---------
1BSEISMICR VALUATION 6, 882 . 00 0.70 0. 00 0 .70 0. 00
1REROOFRES SQ FEET 29 . 00 377 .00 0. 00 377 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 377 .70 0. 00 377 .70 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- --------------------------=- -=------ ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
•
�goa oo��
CITY OF CUPERTINO
010FREROOF
•CUPERTINO PERMIT APPLICATION
APN# 3 r " — 0 2-q `C>O
Building Address:
1 S M �
Owner's Name: Phone #:
T38-"7
Contractor: Phone #:c f. )A
I ,� """" z ' o °' Fax #: Y, LOt/� -e7%-7
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles N Asphalt Shingles
NWood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) X Other(Specify) J&7
Number of existing coverings ❑ Provide I.C.B.O. Report #
X To be Removed Provide
Mfgr. Installation Specs.
JoApD�essccnption: 1, II' / /
ir)I
Residential Commercial
Fire Zone: Y esEJ. No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: ` Z
•I Have R U derst nd and Will Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
REROOF
•CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
IBUSLIC Business License B
•
Community Development Department
` Building Division
• City of Cupertino
10300 Torre Avenue
CITY Of Telephone: (408)777-3228
(U P E IST I N O 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.
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 bove st to policy on re-roofing.
Homeowner's Name: jJ
Job.Site Address:
Roofing Company Name:
ApAlicant's Signature: Date:
Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
Community Development
•�' � _ 10300 Torre Avenue
-w Cupertino CA 95014
CI
Telephone(408) 777-3228 OF
,UPEI�TINO Fax(408)777-3333
Bu111 afi De artment
JOB ADDRESS: ERMIT
Oma 2� (f Z.
OWNER'S NAME: PHONE -- 3
GENERAL CONTRACTOR: FAX# y --c
I am not using any subcontractors: w�j
v /Signature Dae O
Please check a licable 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
Tile
z d �
wner/Contractor Signature Da k