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08050117 CITY OF CUPERTINO irikr BUILDING DIVISION PERMIT CONTRACTOR'�INFORMATIpN Bu1LD>I ?r II 'TVINE BROOK CT LOS GATOS ROOFING PEt1 08050117 ER"NAME: PERMIT ISSUE DATE CI?EN MENG—CHID AND BETTY L ET P 0 BOX 1726 05/13/2008 PHONE: SANITARY NO. CONTROL NO. AacHlTscrreNCIhLEER: RE—RF RMV EXSTNG SHK RF& BLDG BUILDING PERMIT PLUM B MECH R RPP X00 LICENSED CONTRACTOR'S DECLARATION w I herby affirm uses l am licensed under provisions of Chapmr 9(commencing —_ ..Jo73 Description Z with Section 7010)of Division 3 ofde Business ud Pcefetimu Cole.ad my licutxu ^=o in full force end cleat �LI Llanx . Dam ConsuWr ARCHITI DECLARAT ION ! 1 undersand my plies dull W uvd u public A.MA !7 JyU g Licensed Professional - OWNER-BUILDER DECLARATION i�f I hereby affirm that 1 am eacrept from the Contractors License law for the t O O following mason.(Section IID I.S.Business and Pmfessiou Code:Any city or county S_ which reqmit W requires a percunswq alms Wpmve.dcmolW,Or repair any suumum prior to its issuance,also petioles the applicant for such Permit o fele a signed SUWment pp < that he is ucenecd puru.m W the provision,of the conammm's License Law(Chapter 9 Sq.Ft.Floor Area Valuation t(�$ (colors ingwith S=Uw70E0)of Division3ofthe Buslne mdPmf=iau C^de)or that W u exempt dmmfmm and the basis for the diegod exemption.Any violation of Section 7031.5 by any applicant ler a Permit subjects the applicant W a evil prsWty of APN Number Occupancy T not more than ftw hundred Mlus(SSW). P Y YPe I,u owner of tW poPertY•a mY eroployeu wW wagex u dew sore compenssdon, wdlldo thewomk.and thesuuctum u notN¢ncied oraRcmA for rale(See.7014.Business and Professions code:The Conoamnes License law arcs rot apply W an owner of Required Inspections pro W tr who builds a im poser du:rmn.and who does such wary himself ser Wmugh his own cmploytex,proHded that pmb improsemcnu m not inendm aroQered for sale IL however,the building or impmvsment is sold within one year of completion.the owner- Wieder will haw the burden of I m emir dist W did Out Iwld or Wprow for purpose of ask.). . 0 1.as owner of dr property,m exclusively mmoucting with Reenud com uton W central the project(Sec.7044,Business and Professoriat Code:)The CoutrutWs Li- cease law does cot apply W an owner of pcopeny who Wilds or improves deemuo.And, who contracts for such projects with a coauactm(s)licensed penunt W the Contrumrs Lice.Law. ❑I am exempt under Sec ,B&P C for this mason IM, Date WORKER'S COMPENSATION DECLARATION 1 herby aftion under prulty,of perjury ore of the following d x1anumnc 0lh mamw lmainwnacmd wof Conium Wself-iuumefwwa SCMPM- udoes.as provided for by Section 3700 of the Labor Code,for the Performance of the wok for which this permit is issued. 0 1 haw and MM maintain Workers Compenution Issoranlo,As required by Section 37Wof the Labm Code.fa the Performance of the wok for which this permit u issued. My warkeh C°�R/ps_auoro Insurer¢curler and Polity nu/m6cr m: Cartier. Sr1 Nle paltry me.: /03c;—/9 O�� CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE f rldsuodon used rotbecompleted time permit is foouhuadrm doll.($100) or kat) 1 lonely amt in the performaae of the work for which this permit u ivued,l shill nm emFine,any person in any mam,crse As W become subject W the worsen Compevadon Laws of California.Date Appdnnr NOTICE TO APPLICANT:If.after making this Campeau,of Eum inion.you should become subject W the Worker's Compensation provisions of Ne Labor Code you muss ., O forthwith comply with such povivov As this permit Nall W deemed mnkcd. 'Z '" CONSTRUCTION LENDING AGENCY (rte 1hens,self this there[.ooastrectiot leadingagency,per the perfwmncoof ai> the wmi,for which this permit k issued(Sec.3097,Civ.C.) fA Q Lader.Name = z LmAII Address U O 1 certify that 1 haw mud this applicamm and cam this the&Ww bdpon une u ly ^ mrta't I aya W cmmp(y with all city And county ordiwm at and sue laws milling W O rV" building constrction,and bemby authoem mpmsenamMs of Nis city to carom upon up, yhovcmlocam o popery for irupttvon ppsmil. s . (Wa)ogres ro my or reds icy Lid Map harmless de Cfty of Cupertino agaiut n,m Vl Iisbiliuex,Jmgmcnts.<asu end eapenres which mryin NY wyattmC aguutsaid City U'Z m PLICAPIT oftheRSTANoSlA pR1111L �7 APPLICANT UNDERSTANDS AND ]LL COMPLY WITH ALL ON-POINT Issued by: Date SOURCE RE ONS. a r S� f 51orRe-roofs S,gnSignaturef oacmDSignaturer Dae HAZARDOUS MATERIALS DISCLOSURE Type of Roof WIII de applicant a per.Wilding oceupan,core or handle hawerdous memdal defmed by the Cupertino Municipal Code,Chains'9.12 and de Heald,and Safety .section M532(.)?F ❑YCy. o` ' All roofs shall be inspected prior to any roofing material being installed. Will the. Ikam or rulum Wilding Occupant use If a roof is installed without first obtaining an inspection,I agree to remove M g e equipment or Mann which g P g eDmultrcmardnu oil contaminants u defined by the Bay Area Air Quality Management all new morose for inspection. ❑Yes 7q'T Nu Ihmc,W du:huaNws\Smamcial wWe cmcrosundcrChapw6.95ofdm Califon / C � � nu Health&SmlctyCme,SecomAZ 05,25533and25534.1undentsnd thmifthe Wilding J data rot=rallY a umant l k my responsibility W mtiry the occupant or the rtquimmcnu h Wme rW iasuaae ora Cutificae of Pie $1 re Of Applicant Date a ��i- 1� owner or authorized agent DaoAll roof coverings to be Class'}'"or better CITY OF CUPERTINO • 2 ITEMS OF 6 PERMIT RECEIPT OPERATOR: pdtg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36655038 . 00 DATE ISSUED. . . . . . . : 05/13/2008_ . RECEIPT #. . . . . . . . . : BS000004766 REFERENCE ID # . . . : 08050117 SITE ADDRESS. . . . . : 11826 PINE BROOK CT SUBDIVISION . . . . . . . CITYCUPERTINO . . . . . . . . . . . . . . IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : CHEN MENG-CHID AND BETTY L ET ADDRESS . . . . . . . . . . : 11826 PINE BROOK CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5114 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, 960 . 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 604 ROOF IN-PROGRESS 605 FINAL REROOF • v�DS v l/7 CITY OF CUPERTINO SIR, -- REROOF CM OF •CUPEkTINO PERMIT APPLICATION APN# v 0 Date: Building Address- n Owner's Name: (' Phone #: Am q, &1 11d/ yob 2S3 rd o � Contractor: ! Phone #: 7 U 8 2�� _ ")s -j 9 L o S CY'C'L./-U S C1 Fax #: --'&F J f - �73 Cupertino Business License #: / Contractor License #: c 70 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) Y Other (Specify) Number of existing coverings 1 ❑. Provide I.C.B.O. Report# To be Removed I)d Provide Mfq Installation Specs. S Cvo �' e/qss Job Description: Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if Valuation: there are any restrictions: ❑ � GQ Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: �� AA Signature / 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. Homeowners Name: job Site Address: Roofing Company Name: S TC y 2 Applicant's Signature: Z7//�� i Date: • Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO REROOF �CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B IREROOFRES Re-roof Residential B 1SFDWLROOF / 1BSEISMICRE Seismic Residential B IREROOFMRES Re-roofMulti-FamilyB 1MFDWLROOF 1BSEISMICRE Seismic Residential B IBUSLIC Business License B • • - Community Development ��t\i 10300 Torte Avenue ,`.,mss•"-='�- - Cupertino CA 95014 Telephone(408) 777-3228 OCR OF Fax(408) 777-3333 CUP JINO Building Department JOB ADDRESS PERMIT # _ OWNER'S NAME: - PHONE — GENERAL CONTRALTO 0 U S FAX # � I am not using any subcontractors:, Signature Please check a2plicable subcontractors and complete the followin 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 ate