05070142 CITYAF CUPERTINO 8 vn,«� ^�.,,, h:sxS cep�avh ''� t•?."�^'� "'
9Ti
BUILDING DIVISION PERMIT 1° IQl\�11�MORMA1,O .
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BUao1NGADDRPSS: WINTER ROOFING INC PERMITH0.05070142
1324 PRTMRORP WY
OWNER'S NAME: PERMIT ISSUE DATE
JU JAY L AND YANG 151
IFWNE: SANITARY NO. CONTROL NO.
4083638052
ARCHITECTIENGINEER: BUILDING PERMIT INFO
.BLDG ELECT PLUMB MECH
• t� o t� t�
LICENSED CONTRACTOR'S DECLARATION Job DesCrVOA
r� 1 hereby Ban that I ma limesed under provisions of Chapter 9(commleueimg p
with Section 7")of Division 3uf the Business and Profcaions Code,and my license Is
n nrallramnamaercecL REROOF-REMOVE WOOD SH LlceneCCk.g
3 B Dam con�nar 1/2 OS13 50 YR COMP SII
9 CHITECIS oECUR
i? I understand my plans shall he used as Public records 4
Sud Licensed Professional uV l9 2005
C
g
OWNER-BUILDER DECLARATION
4 I I hmh
ey air,.Nn m
I aexempt from the Cannanore,License law for be
00 lollnwing mason.(Seedun 71X3 13,Beat.and Pofasions Code:Any city or county
$tea which mquima•permit to eonawc4 alms,imprame.demolish.or repair any a"auro
Iva Psiono its issuam'c,also acquires the applicant for such permit to file a signed statement nipja
®780
-aF< dot he hliamdpmuanua Ne provisions of the Conmcorl Liana❑w(CMPter9 Sq.Ft.Floor Area U
',IF (commencing with Section 7000)of Division 7 of that Busina;ad Professions Cade)or
N that he h tempt therefrom and than bah for do alleged Campton.Any violation of
Section 7031.5 by arty applicant for a permit subjects the applicator in e civil penalty of APN Number Occupancy Type
not mom than live hundred dollen ISM 36618010 . 00
0 I.a owner of the pmpmy,a'my employen wlm wags a dmir elc compemdon,
will eco thcwCa Land theamannu a Is oat intended orarcered former.(Sm.7044,Business Required Inspections
and Profession,;Claim The Commences Uceose law dots not apply to an owner of q p
property who builds or improves tiemon.and whodata muchwork himself osthrough his
Own employcn,provided that such Improvement,are notinmoded oronered foaale.If.
however,the building or improvement Is cold within one year of completion,the owner.
builder will have the burden of proving that M did no build ar Improve for purpose of
ale.).
❑1,as Owner of the property am exclusively contracting with licensed contractor no
construct the project(Sec.7014.Business and Professions Cade:)The Contacoea U.
Items,law does not apply o an owns of progeny who bolds or improve.;themon.and
who contacts for such pmjects with aconmemrts)licensed Pursuant in the Contractres
License Law.
❑Imnexemptunder See .B&PCfar Wsreacon
Data
WORKER'S
WORKER'S COMPENSATION DECLARATION
1 hereby *Man under Penally of perjury oro of the fallowing aalan0ons:
❑[ham and will maintain a Cerifiao of Continuo self•Ineum for Workers Compcn.
action,as provided for by Section 37W of the Inbar Caere,for the performance of the
work for which this Permit is Issued.
have and will maintain Workees Compensation Insurance,as,required by Section
3700 of the Labor Code,for the performance of the work for which this permit la issued.
My Worker's Compemtan TInsurance Cartier and Policy number sec:
Cartier, J� af.a1 JA Policy No.: uReOI �—
CERTIFI AT OSP ION FROM WORKERS'
COMPENSATION INSURANCE
(nhb,eolan need not be completed if the permit is forono hundred do0an(5100)
or less.)
I certify that in the performance of the.,it far which this Permit is Issued.I shall no
employ any person in any maarco a in became subject no the Workerf Compensation
Laws of Catloroia.Data
Applicant
NOTICE TO APPLICANT:If,after making this CcnlOcam of Exemption.you should
become subject o the Wnhees Compensation provisions of the labor Codm you mum
QD foMwlth comply with each provisions or this Permit shall be deemed revoked.
Z a�y-hCONSTRUCTION LENDING AGENCY
[-h Ibemhy affirm that thea is a consruclan lending agency for the perfamena of
Rei the work for which this Permit is issad(Sec.7D97,Civ.C.)
A Lenders Name
z Lenders Address
U Q I anify Na 1 have reed this application and sum that the shove information is
IL4 U correct,1 agate to empty with all city and county ordinances and sum laws elating to
Q building construction.and hamby authoim repreenatim of this city at enter upon the
k37 aboal-rentanW property for inspection purpms
Ly,py (Wc)agree to ave,indemnify and kap harmim the City of Cupertino against
„yy liabilities,judgmenh.costs and expenses which may in any way a cache against and City
U Z in consequence of the{mating of this permiL
'-" APPLIC NT UNDERSTAN S AND WILL COMPLY WITH ALL NON-POINT Issued by: Date"?,-22r1'
SOURC ak-ZZ6
S
'2,?—((}" Re-roofs
sae err r namon Dam
HA ARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or Cuban building acupat time or handle hassdow material
as de0nod by os,Cupert9no Municipal Code.Chapter 9.13,ab the Health and Safety
sae,Sachem 255324)? All roofs shall be inspected prior to any roofing material being installed.
❑Ya [3 No
Will the applicant or future building Occupant use equipment Or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haysrdrus sir contaminants a acEned by the Bay Ama Air Quality Management all ne materials for inspection.
District?
❑Ya ❑Nu
I have thelurns mucrleh quimment,unser Chapter Q95Ofthte Glifory
ria Heali ly Codc.Sadons25.A)5 577 end 35334.1unacrst,na thuiftie bhildin{
doss noh ty hew a ten et my mapoaibility o notify the acupao of the
myulrt nu hichmust mivumaofaCadlleateofOccoPary. 11 1 atufe Of Appficant Dale y
owns err the rata m Dam All roof coverings to be Class••B" or better
CITY OF CUPERTINO
I� 1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36618010.00
DATE ISSUED. . . . . . . : 07/22/2005
RECEIPT #. . . . . . . . . : 30486
REFERENCE ID # . . . : 05070142
SITE ADDRESS . . . . . : 1324 PRIMROSE WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO -
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JU JAY L AND YANG W
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : FREMONT CA, CA 94539-
RECEIVED FROM . . . . : JAVIER MARTINEZ
CONTRACTOR . . . . . . . : MARTINEZ, JAVIER LIC # 21207
COMPANY . . . . . . . . . . : WINTER ROOFING INC
ADDRESS . . . . . . . . . . : 151 WYANDOTTE DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE . . . . . . . . : 4083638052
•
FEE ID UNIT, QUANTITY - AMOUNT PD-TO-DT THIS REC NEW SAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 9,000.00 158.76 0.00 158.76 0.00
BSEISMICRE VALUATION 9,000.00 0.90 0.00 0.90 0.00
-- ------ ---------- ---------- ----------
TOTAL PERMIT 159.66 0.00 159.66 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 159.66 M/C
TOTAL RECEIPT 159.66
•
Community Development
&CF
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
�UPEkTINO
Building Department
JOB ADDRESS: PERMIT #
G
OWNER'S N PHONE #
GENERAL CONTRA FAX # a — —
I am not using any subcontractors: 4 '�-4Lr
ignature Date
Please kapplicabIesu wing 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
r-
6wnW
/ ontractor Signature Date
Community Development Department
Building Division
City of Cupertino
. 10300 Torre Avenue
CITY OF Telephone: (408)777-3228
Fax: (408)777-3333
C U PEI�TI NO
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: V4 n_5 I I
Job Site Address: I.?2 Yirt�
Roofing Company Name: 4/It4
Applicant's Signature: Date: iZ?-.04—
Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
alo
REROOF
�UPERTINO PERMIT APPLICATION FORM
APN# Date: -moi
Building Address:(
/ w
Owner's Name: Phone#:
d'
ontractor: Phone#: License #:
we
'fWContact: Phone#: Cupertino Business License#:
a ^.TaC3 OS
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles A--"Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
dr'lWood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
o G
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if
there are anrestrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
__..
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING