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08030139 -CTTY OF CUPERTINO ?t�.at• 'Y; BulLolnG olvlstoNPERMIT •ICONTRACTQIt INFURMATIQ . BmLQRic�tpgttEs PPERMIT NO. ARK CL TBD- - TO BE DETERMINED 08030139 1R'US NGALME/: PERMIT MS DATE CHU STANLEY C AND NANCY I 03/25/2008 PHORIaOTTV SANITARY NO. CONTROL NO. ARCHITECTIENGINEF3t: BUILDING PERMIT INFD BLDG ELECT PLUMB MECH 0 0 0 0 X00 LICENSED CONTRACTOR'S DECLARATION OFIOb Description 1 hereby afOrm Wt 1 am lisneed under provisions of Chapter 9(commencing - P with Section 7OrXB ofDivWon 3 of the Bwmmas orb Prafsdom Cede,and my licew u RE-RF, T/0 SHK&REPLC W/30LB FLT CLS A, 30 SQ ^ N in cull form and an L 1 -7 fe o ? Lleenseclau `L` � 9 Lu, 9 DateContractor ARCHr1ECrS DECLARATION 1 unaermnd my plans shall be used as public anari yillaCC LimwaPmreauomal y OWNER-exampt trDECLARATON 1 mason. .affirm that 11. exempt from the Contractors Co e:A nae Law for the i D following moon. eccuon 703 1.5,Business and Profee moll Code:Any city of county which its to.•permit re core she alley,improve,h Permit t ri e a ut,sig n d umctum —Z C prior dour he its sensed p amu paramount in requires pro'su applicant for sucC.Oun un w ftie ae Law suument 4< Na haulimwdpumuntwW pmviposofthConumtofsllmnte aw(Chapu 9 Sq.Ft. Floor Area Valuation 3 roar he is roomot uw�ar a"mmnd ft basis s fa<maeamgad e�xa pt�.Any viola ah)ei $11000 Section 1031.5 by any applicant for a permit enbjema We applicant w a tial penalty Of yy�t Number Occupancy Type nut roam than fim hundred dallars(5.100). 32632012 :17 P1• , 0 1,u ownu of Oe propwy,m my employes with toga n IWb miecompewdon, will dothewank andec The num srotsoundedm Law dofm sale(See.1011.Budnw and Property ar�case The c000clora and sho law acro ant appy W rt owner is Required Inspections man ertywW Wipar idmprma dh turpoandwho ane rani twukhimvJfm Ouwgh 4h man employees.the iprodded poomen imp.mid wain orm inundedmoaemd for W&If. hawemL the buildingorlmprowmmnVmide did oroyear ofc promefrthaOwner. bailout MR haw W burden of Paring Nat W did not build m W prow far purpose of 0 1,as owner of ted Property,am exclusively contracting with focused mnttslms in canton the yrojct(Sec.7011,Business and Pmfc"..Cade:)The ommmwfs Li. mw Law dos not apply in an awtmr of property who Wilds or improves thereon.and. who comrscu for such projects with a con tmonar O licensed punwnt blit Commences Lkcm Law. ❑lameaemmundesSee .BBPCforthiareamn Dau WORKERS COMPENSATION DECORATION 1 hereby Nirm under penury of Perjury ono of the following cslentios: ❑I ham and will maintain•CenlOcate ofCownt to self-alum fu Worma's Compere salon,as provided for by Section 1700 M the labor Code.fm W Performance of de work for which this permit is issmd. 0 1 have and will maintain Worker's Compensation foramen,u required by Secuan 3700of Ne labs Code,far Ne pact.. a ofde woh formich this permit is Issued. ' My WorkeYr Co eas4 rent is and Policy number am: Carrier.-�uPa icy Na.: l g i o 3 l a CE CATS OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE msLmnion need not W campicud Bre permit Is Intone hundred dollars($100) lir Inas.) 1 mN(y Wt In We perfarmsnm of We woh for which this permit U Issued I shall not employ any person in any meaner an u to become subject in We Workers'Compewl m Laws of California.Dae Applicant NOTICE TO APPLICANT:If. for making this Co tifhcate of Emmptian,you should become subject to the Watker's Compensation previsions of the labor Cede,you mut .J O forthwith comply with such provisloru m Wu permit shall W accrued remkd c ' y CONSTRUCTION LENDING AGENCY, f" 1 hereby afnrm that team L a conamanin t lending agency for the performance at lYithe woh far which this permit as Wood(Sce.3091,Civ.C.) h . pt7 A Lanaets Nunc ]z Leaders Add. U O 1 certify that 1 haw tan this application and atw that the above information L conn 1 agree in comply with all city and county ordinances and swe laws misting in Wilding contraction,ma hemby mhmim mpmmnutwa of this city to sour upon We W alpve-meManed property for Impeetan purposes (We)agree m nam.indemnify and kmp harmhw the City of Cupertino against C11 liabilius,judgments,costs and upenms which may in my way mean,against aid City U Z In conaequenm of the granting of this Peron. ^r APPLICANT ULXrUNDERSTANDS AND IL COMPLY WITH AppNON-jOINi Issued by: Dale S RCE REGULATIONS J �.S 2 Re-roofs Si re of ApplisntConummor HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building oceuPant stem or handle l uxdom material dcOned by the Cupertino Municipal Code.Chapter 9.13,and tie Health and Safety .seal.35533(41 All roofs shall be inspected prior to any roofing material being installed. 0Ys tpo Will ft applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit huardaus air constructions u dcfmed by the Bay Area Air QueRIY Management all new materials for inspection. District? DYs Frau Ihammad Wehuudouamamrlabmquimmcnuunder Chapmr6.96ofW Clifor- c\ / 1 ZQ be ria HcoLhh Satly CaM,Scetiau2150.5,25533aW]SS34.luedcrarmd thuifde WildingNYW _ kV I )��� rimanot &Safcyhawa scant Nat Itu553 mm53.Iwmatydegifu ntlitthe �ljA neamm in which mutWmetrtoiss oraCcrtifiuuof aPamy. Signatt of Applicant Data 2 200 ownuor hmnuoi.gers D All roof coverings to be Class'W'or better • CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32632012 .00 DATE ISSUED. . . . . . . : 03/25/2008 RECEIPT #. . . . . . . . . : BS000004257 REFERENCE ID # . . . : 08030139 SITE ADDRESS . . . . . : 10227 PARK CL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : CHU STANLEY C AND NANCY I TRUS ADDRESS . . . . . . . . . . . : 10227 PARK CIRCLE W CITY/STATE/ZIP . . . : CUPERTINO CA, 95014- RECEIVED FROM . . . . : JAMES HIRSCHBEK CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . • TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY . AMOUNT PD-TO-DT THIS REC NEW BAL ---------- -------=----- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 11, 000. 00 1.10 0 . 00 1 .10 0. 00 1BUSLIC FLAT RATE 1 . 00 110. 00 0. 00 110. 00 0. 00 1REROOFRES SQ FEET 30. 00 . 390. 00 0. 00 390 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 501 . 10 0. 00 501 .10 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CASH 501 .10 --------------- TOTAL RECEIPT 501.10 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------=------------ -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF 0903 of -�9 (p. CITY OF CUPERTINO REROOF • OF CUPERTINO PERMIT APPLICATION APN# �tP Jz �, , 0 D Date: BuildingAddr ( 002 7_ 7 AP, Owner's Name: Phone #: N � � � � �➢ � � or9' � s� eg7S Contract r: � Phone #: Fax #: Cupertino Business License #: Contractor License #: 7 (oT9 0 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles m( Asphalt Shingles )i 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:r ej I e r Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: J p 0 J •I Have Read, Understand land Will Comply with Cupertino's Tear-Off Policy: VYY\-t Signature CITY OF CUPERTINO REROOF •CUPEI�TINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group IREROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B IREROOFRES Re-roof Residential B 1SFDWLROOF 20 1BSEISMICRE Seismic Residential B IREROOFMRES Re-roof Multi-Family B IMFDWLROOF IBSEISMICRE Seismic Residential B IBUSLIC 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-ruufing. Homeowner's Name: f� C4'44 Job Site Address: / �-�- 7 ° A P, � C RC-`l ,, S� Roofing Company Name: C /— O f� Applicant's Signature: Date: Greg Casteel Building Official . Revised 11/2/04 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 U n C kT I N O Fax(408)777-3333 rC t Building Department JOB A RESS: r PERMIT # C) cl eS . D 3o �3P OWNER'S NAME: St-6 N I C u PHONE # S o GENERAL CONTRACTOR: C — P P` o FAX # I am not using any subcontractors: v" 2�; Signature Date Please check applicable subcontractors and complete the following information: RI 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 I�n ^ Owner/Contractor Signature Date