08090011 CITY OF CUPERTINOs
BUILDING DIV14WON PERMITCON=TRACTOMNFORMt TIO
..� 'f1AA,V!
BUILDING ADDRESS: PERMIT NO.
7G5d PEACH BLOSSOM DR T D ROOFING 08090011
OWNER'S NAME: PERMIT ISSUEDATE
('III_',NG PHILIP AND CHIOU C 675 TULLY RD 09/03/2008
40'NE, (408) 892-8872 SANITARY NO. CONTROL NO.
ARCHREC(ENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
0 0 LICENSED CONTRACTORS DECLARATION O O O O
m,
, I hereby af0rm But 1 am licensed under Provisions;of Chapter 9(commencing Job Description
� with Smuan?")of0i,inan 3ofdm Bumem,and Proressiam Cade.and+y Becmn la RE—RF RMV SHK INSTL CONCRT/CLY TILE 7/16" OSB
m in run fame erred 3 Ol Lie.a t-( 5 304
�z LmnrCns
"q�q� �m AacxTIEc�i's o�cucAno \/ FLT 32SQ CLS A
D W U I undewnJ my pkn haul W tied u public rem' n
a
k
Licensed Profrssianal
5 OWNER-BUILDER m DECLARATION
COO hereby.(Sec WalIam 1. ucmplf an the Contractor's License Any
ncLaw for IW
COO following mama.(Section lmossm Boniness and Improve.
derona Code:Any city ms county
IRE! which ruled.a e.aim re ennmucl our6 improws,h permit
t or repair ed swmure
Z< primWslcened smm us requires Jur applicant fursucthan Cohpermitmnkatunedstsmmcnl'
that
ommenccenmlphnnnt mtk pmMsision 3 lW Contractor's LJneeLaw(Ch.pmr9 Sq.Ft. Floor Area Valuation
YI"$ thameisexawiWSCCYanInndofDiaiiiafrth almmihe exaandon.AnyviCode)m $18000
—
that im u emmpt any applicants
p li and or Dosis it We alleged cuanpnt us Any violation of
Section this n wry and dollars
•permit subjects the applicant m x unit penalty or Number Occupancy Type
not mom Wan five hundred aailvs(5300). 3 6 611117 .'�(�
❑L u hwnm of the pmpmas rs my moplcycn with wagn ss IDe'vmk Business will do the work,and e: She Com s rosktenensm anW fmsakpply uoa1,B Ter of
and property who
coda:The csnhacmrs License Law dm,and apply m an owner sr _ Required Inspections
OwnemrwW WadamimPmwsuchimpr vedwasarncucnwaetwn,elrorwouanna .
Own employ=.the Wilding
rimprosemutaart MIicar f.mpleemd for sale U.
however.We aetur improvementpond.s rot he didn am few of i m rove f t.r de ownm-
buildm HB lose the WNen of pmun,that W did cos doth m improve Ire purpose of
sok.).
1,ss owner of the property,w exclusively conussm,with licensed comucmn an
oonstnct We project(Sec.7044,Burins and!Pmfnuons Code)M Coatrcmh U. .
cane Law docs nos apply to an owner of property who Wilds or improves Wemon,and,
who contracts for such projects with a eonucso,(s)limned pursuant to tW Con oseto's
License law.
O l ren exempt under See ,B B P C for this recon
Owner Data
WORKERS COMPENSATION DECLARATION
I hereby aBlon ender penalty of Kdary man of the fallowing dmlanhaeC
i haws and will maintain a Certificate or Co.,to elf-intim for Workers Compact.
smon,u provided for by Section 37W of the Labour Code.for the peRorro mx of the
Mvr which this Permit is issued.
e aM will mountain Workers Compensation Insurance,as acquired by Section
37(I13a1the lAbm Cade,fm the pesfarmance of Ne work for which Wis .it u W,wxi '
My Workers Compemmin handsome:carrier and Policy number me
camkrt 5 I PolicyN.:
CiAPICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thlss xa ren need Irothccompleted If IW permit is forma,hundred dollars($11(1)
or less.)
1 cutily Ihat in We performame�R oak Ire Which this permit u issued,l.hall son,
employ any pemmn in mymam hect to We Workers'Compensation
Laws of California.Doc
Applicam
NOTICE T3 APPLICAN:If.afar making thisC rat 'am of E..,ubm,yah should
become Subject m ftworkers Canpcnuuon pm s of IW Resor Cmk,you most
Oforthwith comply with such provision m this permit shall W droned kca.
y CONSTRUCTION LENDING AGENCY
[ti 1 hereby ufime that them I..consumed.lending agency forth,Performance Of
!Yi i the were for which tuts permit u tssted(Sec.3(197,Civ.C.)
Lenders Name '
J z I adeesAddress
V O I wtify that I haws mad ws xPpliicm.rad cum that the aWn 1.1 mrs.m.is .
D.P contact-I agree In comply with til city and county ordinances and state laws.]ad.,to
.0 Wilding consuumion,and hareby autbodre repreaCOO211 A of this city to curer upon We
W move-mentioned property for iuNction Po,utas .
gy (we)agree to save,indemnify and keep harmless the City of Cupertino against
In Ii.biliucsJWgments.cam and upenw whkh may In any w.yamue xgunt mid Gty
IJz in cormsrquece f eyanung of Nis permit.
^ APPLICArrf ERSTANDS AND WILL COMPLY WITH L NON-POINT Issued by: Date
SOURCE n0N — 7-C
�.
Signuu of App ian✓Con Data Re-roofs
HA2'.ARD MATERIALS DISCLOSURE Type of Roof
Will tW applicant Wf' ildmj;newpantsmm mhandle hvArdons material
u darned by the Cupeniro Mu 'pal Cade.Cbapm,9.12,and Ota Health.rad S.fcty
CoJc,Section 25532(x)?
❑Yn All roofs shall be inspected prior to any roofing material being installed.
pplican,or Torero Wilding accupam tax equipment or Devices which g p
If a roof is installed without first obtaining an inspection,I agree to remove
Will We e
'�hvurdnns tar comae fined by We Bay Area Air Quality Management all new materials for inspection.
❑Yrs /X❑'NJa
Iban afe Code,he Nora mamri.Ismquimmcnuun@rChaPmsb.95af Webildi. r /c,wlk,lth�sale eon,, mw2s3Bs.23svamusx.lundvrstandumEueWaamgUX
don nm awrcn ls mnane pec i ,my m-sPecabi1hy"room tie oro tar Jere -4;w
require. wlen melprimWinuance ofa Centric.,or span
O Signator o Applicant Date
All ro coverin s to be Class'A"Ownermmthomcd agcm Dam' g or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36611117 . 00
DATE ISSUED. . . . . . . : 09/03/2008
RECEIPT # . . . . . . . . . : BS000005978
REFERENCE ID # . . . : 08090011
SITE ADDRESS . . . . . : 7654 PEACH BLOSSOM DR
SUBDIVISION . . . . . . . '
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER CHENG PHILIP AND CHIOU C
ADDRESS . . . . . . . . . . : 7654 PEACH BLOSSOM DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5249
RECEIVED FROM . . . . : LESLIE A HOANG
CONTRACTOR . . . . . . . : LESLIE HOANG LIC # 23155
COMPANY . . . . . . . . . . : T D ROOFING
ADDRESS . . . . . . . . . . : 675 TULLY RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE . . . . . . . . : (408) 892-8872
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---------- ---------- ---------- ---------- ----------
! BSEISMICR VALUATION 18, 000 . 00 1 . 80 0 . 00 1 . 80 0 . 00
1REROOFRES SQ FEET 32 . 00 416 . 00 0 . 00 416 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 417 . 80 0 . 00 417 . 80 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 417 . 80 VISA
---------------
TOTAL RECEIPT 417 . 80
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
60.1 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
CITY OF CUPERTINO
RECEIPT NUMBER: BS000005979
RECEIVED BY: PATRICIAG PAYOR: LESLIE A HOANG
• '.ODAY ' S DATE: 09/03/08 REGISTER DATE: 09/03/08
TIME: 14 : 08
1
BUSINESS LICENSE TAX RENW -T D ROOFING $110 . 00
----------------
TOTAL DUE: $110 . 00
CREDIT CARD: $110 . 00 REF NUM: VISA
TENDERED CHANGE
$110 . 00 $ . 00
•
Sam,
CITY OF CUPERTINOvS67ovi
REROOF
COF
•CUPERTINO PERMIT APPLICATION
APN # Date: 3 0 $
Building Address:
6 .S 1 f
Owner's Name: Phone #:
S 1%. ��� 42 4-,, S) c' ",
0 0 5 2
Contractor: Phone #:
i D 74, oPin qo's 8 ( 9 08 �/ O
o
9
Fax #C 8) 2-93 9 � 9
Cupertino Business License #: Contractor License #:
8y SS�i I
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑' Asphalt Shingles ❑ Asphalt Shingles
IWO Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) /\6D Other (Specify) oU a Ir CIL ',
Number of existing coverings ❑ Provide I.C.B.O. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
7-1,C 17'1 p J e S 1, a- 4 1 I7 S1 Cl I' t.")1 C Ir-e,-LL- / G I Cts/
l I I
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
18
I Have Re d, derstand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
v' REROOF
OF
CUPEkTINO 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 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•
Community Development Department
Building Division
City of Cupertino
10300 Tone 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 2007 IBC Standards
and manufacturers specifications on re-roofing. All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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$176.18. The re-inspection fee must
be Paid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of I/4 "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: S a n el e-11
Job Site Address: r. 5 0ca c,Ft pj ro 5S o yx)
Roofing Company Name: I n n o c) tt
Applicant's Signature:
• Greg Casteel
Building Official
Revised 07/30/08
w Community Development
e 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
a f.M TINO
Building De artment
JOB ADDRESS: / PERMIT #
Teo9-* .ectG1) /oss on Z�'�04�-'
OWNER'S N w a» C e vt q PHONE # o$ G 6 6 Oo
GENERAL CONTRACTOR: T> .L9 3 - 9 I
I am not using any subcontractors: IF q 13 / 08
Signature Date
Please check applicable subcontractors and com Tete the ollowin 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