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08040039CITY OF CUPERTINO r� ��kR` BUILDING VISION PERAUT �p��p Qin S�P� TQ h BQILIItrt`ppD>_'E HELLY DR LI.� TNT ROOFING CO PERMIT08040039 OWNER'S NAME: PERMIT SUE DATE HUNG CHEN 1610 BLOSSOM HILL RD STE 6C 04/07/2008 PHONE: SANITARY NO. CONTROL NO. CHITECT/ENGINBER: RE—RF RMV SHK RF INSTL CLS BUILDING PERMIT INFO BLOC ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION '-"-'"-'--"' Job Description 1 hereby a(Ilrm Nu I am Increaseunder pmvitiom of Chap 9 (commcruing with Section ]Dfll)oC fp{vi n oInhaling nrsv nd Profcuium Code.and myliceve la in (u11 fame end eff License Lk. g - Dau Conuacuor '- ARCHITECTS DECLARAWN I undermaml my plana call den used as public records . • . Licensed Professional OWNER-BUIWER DECLARATION 1 arch, olnrm that 1 am attempt from the Contractor'] License Lew for the following moon. (Section 7113 1.5. Business and Professions Code: Any city or county which requirca a permit to comtruct, alar, hnprow, demolish. or minor my structure prior us its Issuance. alW requires; the applicant far such permit in Me a signed resonant dm Conrsemrs license Law 9 Sq. Ft. Floor Area Valuation Nu a is licensed pursuant to the provisions of (Chapter (Commencing wine Sectio 7f)(0) of Division 3 of ant Business and Profession Code) Or Nat he u wmpt the arrom and she bub for dm alleged exemption. A., vloladan of APN Number Occupancy Type Secdan 70314 by arty appllant far a permit subjects the applicant m a civil Penalty or not man Nan Rw hundred dollars ($500). ❑ I,umna Ofneepmprty.mmympluymwithwwgesu Neerspkeompemdon, - Required Inspections - for toan Businor whi m Newdo. he Iapply. Llceun law dos rot apply u rt owes and au Code The do Code-Com este, License q p ms ther'urr is Property Improwa thereon, andwM measuch sort himselfsir through deb erty who Wildo wh own i ssehimpro awn ear man, thea,ding or i pral the Owner• ofdaro@rcd the most, however, the buildingorimpwwmentbast withinateyes a(c id within am parow, for builder will have she burden of proving Nu he did not brim or improv for purpose of ala). ❑ 1, es awns Of dm property am aelaively conuacting with licensed aentracuts u conatmn to project (Sec. las. Bairns, and Pro(nssh m Cam:) The Cwuae e's U. cense law does not apply Is an owner of property who builds or Improves the con, and. who contracts for such projects wide a conuanar(o) licensed Panama m the Cantrurce. License law. ❑ Imatcumpcunder See ,B&PCfa Nirmuan Owner Data - WORKERS COMPENSATION DEC URATION 1 hereby Man under pmulty of perjury one Of the fallowing deckndo s: aw will mar Cem3am r Code,fort a erformaCompo- byn. fur by Section 3700 0( see labor Code, for the performance a( to n, providedof ft Labor (sir which Nb permit is issued. for , ❑ I hew and will maintain Worker's Compensation Inemma. u required by SCcdon 37W Of Ne lata Code, far the performance of to wart for which this permit is intend. My Worker'o m du�u same oma and Polity umber tib �� CanierT /uGM Polity No.: N CERTIFlCATE OF EXEMPTION FROM WORK S' COMPENSATION INSURANCE (This section bond ani be canplemd if the Permit is (mane hundrW dollars (SIM) or legal 1 certify tat in Ne performance of to work for which Nb Permit b issued, I shall am employ anyperaM In my rainstorm a m b ucarc subject m to Warteta' COmperemon Lam of CaliromiL Dam Applicant NOTICE TO APPLICANT. If, after making this Certificate of Exemption, you should became subject be the Workers Compensation provisions of the labor Coda you must forthwith comply with such provisions or Nb permit shall a memed newked. CONSTRUCTION LENDING AGENCY 1 Money ailing tat Vert is•conlending agenry for the Performance of Ne ' work which (a which oda permit b (Se,. 3issued (Sec. a'1, Civ. CJ ' IanmYC Name Lender's Atldrcu 1 certify that I ban road tills Application and Sam that the above Information Is ' correct. I agree u comply with all city and county ordinances and sum laws reeding in Wilding consusunion, and hereby amhmim repromuhms of this city in enterupon ant ahnve-mentioned property for inspection purposes. (We) agars to save, indemnify and keep hotmlesa the City of CupMino against j Il.biliues,JWgmenst. cast and expects which may in my wayaccroeagsinst said City in canregance of the graming of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALI, NON-POINT Issued by: Date _ 7 rrl, SO E TIONS. Re-roofs Type of Roof / Sit ort of AppliwnVConu.cur Dam HAZARDOUS MATERIALS DISCLOSURE Will to ippllant or future Wilding accupmt sum or hurdle awdou masedsi as earned by the Cupertino Municipal Cade. Chapter 9.13. and the Health and Safety Cam, sender 25532(.)7 All roofs shall be inspected prior to any roofing material being installed. ❑ Yes ❑ If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or sum building occupant use sculptress or devises which It ha s ma air conuminanst u defmcd by Ns Boy Arta Air Quality Mwgement all new materials for inspection. ct7 ❑Yes f-12i� . essentials unearCapkrd.95 of I hem mW theCOde. Caldin SNum Scan 535.requirements 33 mu he no Wof dies nonh&snd, haw, does not currtntly hew a renanL Ns it 4 mss rospouihility m notify dm occupant of see it 4m ortfi34.1 hemmmde Occup rcllnlrcroe whichsbcmnt 'musiumn irle.ma Signature of Applicant Date All roof coverings to be Class's" or better Dam . r annear;Sed.gtnt • 2 ITEMS OF 4 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN .......1: 35911021.00 DATE ISSUED.......: 04/07/2008 RECEIPT #.........: BS000004378 REFERENCE ID # ...: 08040039 SITE ADDRESS .....: 20619 SHELLY DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: HUNG CHEN ADDRESS ..........: 20619 SHELLY DR CITY/STATE/ZIP ...: CUPERTINO CA, RECEIVED FROM ....: MICHAEL D WILLIAMS OPERATOR: patg COPY # : 1 95014-2923 CONTRACTOR .......: WILLIAM TYLER LIC # 22988 COMPANY ..........: TNT ROOFING CO ADDRESS ..........: 1610 BLOSSOM HILL RD STE 6C CITY/STATE/ZIP ...: SAN JOSE, CA 95124 TELEPHONE ........: (408)277-0800 •FEE ID UNIT--- QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----- ----- ----------------- 1BSEISMICR VALUATION 12,000.00 ---------- ---------- 1.20 ---------- 0.00 1.20 ------ 0.00 1REROOFRES SQ FEET 28.00 364.00 0.00 364.00 0.00 TOTAL PERMIT ---------- ---------- 365.20 ---------- 0.00 365.20 ---------- 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 705.10 --------------- 705.10 VOICE ID DESCRIPTION ----------------------------- - 601 ROOF TEAR OFF 603 ROOF BATTENS 605 FINAL REROOF REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION --- --------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 0�o V �3�1 CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION • APN#�`—(� Do Date: LlI����� Building Address: L l G Sk e�( 1 0 1Z, Owner's Name: Phone #: �t sII ?-7( __ Z 1 Contractor: Phone #: Z % 7 — O -�d Cl0 TN LO /tV Fax#: �—�( -Zs-_03 Cupertino Business License #: Contractor License #: So 7 - Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles k Asphalt Shingles 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: kQ�kavp y6_ 0_,O -up Z N S +�O S 6 w %IWDOD Residential Commercial El Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: Z I V I Have Read, Understand ai;d Will Comply with Cupertino's Tear -Off Policy: 0 ' of CUPERTINO 0 CITY OF CUPERTINO REROOF FEE SCHEDULE Number of Squares Fee ID Fee Description Fee Group Permit Type 1REROOFCOM Re -roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B Z 1RER00FRES Re -roof Residential B 1SFDWLROOF 1BSEISMICRE Seismic Residential B 1REROOFMRES Re -roof Multi -Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B 0 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 Raid before another inspection can be scheduled IMPORTANT: 1. Flat roofs must have a minimum of Y4 " 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: �Jtr 1 p rnt job Site Address: Roofing Company Name: Applicant's Signature�� )�� Dater / • Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue h,�'�.q,, Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 CUPERTINO Building Department • JOB ADDRESS: ZOc/-? �i4el1 3-1- PERMIT # OWNER'S NAME: e" PHONE # Yl:I - Z7/ - lz' GENERAL CONTRACTOR: d FAX # I am not using any subcontractors: �c� Signature Date Please check applicable subcontractors and complete the following information: 45 veer Contractor Signature Date 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 45 veer Contractor Signature Date