06090225 CITY OF CUPERTINO
BUILDING DIVISION PERMIT xC01VTRACTORTNI+OItNIATIQN
BUILDING ADDRESS: TN OFING CO ` PERMIT N0.06090225
20638 SHELLY DR
OWNER'S NAME: PERMIT ISSUE DATE
JING ET AL 21Q SAN JOSE AVE . t19 09/25/2006
NE:
SANITARY NO. CONTROL NO.
(408) 277-0800
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG EIECf PLUMB MECH
0 0 0 0
X00 LICENSED CONTRACTOR'S DECLARATION
Job Description
1 w C I Inco by,ffi�that i are,lisnsed under previsions of Cranium9(commencing P
;iat with 5cnipn 7lNAB of Division Ja(thc Busnm and Prof lore Cade,andmyliccnxis
in full force and ofZ� REROOF- REMOVE SHAKE ROOF, INSTALL CERTAINTEED
�c DatcyyJ�j [ �-�--c'�aewr fl`� S PRES T/L, SHINGLES, CLASS A, 28 SQUARES .
( ARCHITECTS DECLARATION
i¢ 1 understand my plans shall be used as public records
IyU
'u y Licensed Pmfcssional
'Og OWNER-BUILDER DECLARATION
Z 1 hereby athrm Na,I am ascmp,from the Contractors UCenx Law for thee
Ac following more..(section 703 1.5,Businessand Pradmd.m Calc:Any city or County
which requires a permit to Curti arm,,,improve,demolish,or repair any muctum
.sZ6prior to its issuance.aSo OCCUR=We applicant rot such permit to rile a signed sammere
that he is licensed purauad,to the provisions of the Contractors Ucertx Law(Chap,er9 Sq.Ft. Floor Area 6Va tion
�~$ (commencing with Section 70(a0)of Division 3 ar We Business and Prormsons Code)or $12500
I
— Nat he is exempt Usrefaom and the bnsis for the alleged caemption.Any violation of
Section 7031.5 by my application,for a Permit subjects the applicant m a Civil penal,Y of APN Number Occupancy Type
not more Nan I ve,hundred dollars(MM),
p y YP
❑1,uowneroftkpmpemy,ormywploymwithwa utk Colecom don,
will do the work.and theswnure is not intended or offered forsak(Sce.7045.Business Required Inspections
and Professions Code:The Conmetors Limm,Law dm e ns not apply M an owner of q p
property who Wilds or i m prove thereon,and who does such work himmel f m through his
own employees.pmvided aha a ch improvemerots arc not imerldW oroRered forssle.R.
however.We Wilding or impmvemmt is mid within one year of completion.the owner.
builder will have We burden of proving that he did net Wild or improve for purpose of
ale.).
❑1.as owner of We Property,ms eac,lio ival,conhacting vale licensed Contractors to
concoct We project(Sec.7014.Business and Professions Code:)The Contrxmr's Li.
ccnu taw does not apply to an owner of property who Wilds or improses themon,and
who contracts fat such projects with a eon,ramr(s)limned pursuant to the Contractors
Ube=Law.
❑1 ase aempn,under Sec .B k P C for Nis muco
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under pesWry of perjury oro of We following declarations:
Iand will maintain n CetaiOeau of Cementinfor Workers Campem
ation,or provided for by Section 3700 of the tabor Code,for Cite performance of the
were for which this permit u issued.
❑1 have and will maintain Workers Compensation Iromemen,as morseled by Section
3700of Me Labor Cade,for the performance of the work,for which the Permit is issued.My '
Camcrrkc Cosi surmli Polity Nm.catund Y numl)e vq it�
CERTIFICATE OF EXEMPTION FROM WORKERS 1f
COMPENSATION INSURANCE
(Thio xctimn nmd nal k completed ifft Permit u foram hundred dollars(SIM)
or less.)
I totally Na,in the performance of the work for which this pormi,is issued.I shall not
employ any person in my matter m as to become subject to OC Workeas'Compewdon
laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after m,king this CeNEnm of Emmin on.you should
became subjM to We Workers Compensation provision of We Labor Code,yen most
,J O forthwith comply with such provisions or this Permit shall be m
deemed mked.
Zy CONSTRUCTION LENDING AGENCY
F+ Ihereby affirm that Nem is n Compose inn lending agency for On perfuremnm of
fY
We work for which this permit u issued(Sec.3097,Civ.C.)
1 Q Lenders Name
a z Lenders Add.
U 0 1 certify that 1 have tend this appliexdon and stare that the aW vc information is
f-' correct 1 agree to comply with all city and county am in rams and sum laws mining to
OUWilding concoction.and hereby authors¢presenmives of this city to enter upon the
r C abovementionedproperty for inspection pugtous.
(Win)agree,m ave.indemnify and kcep b,rmieo We City or Cuper,ina against
► Z incoreaquece Of W,ctandind Of Win Permit. maythany way acrnm against said City
U z inconsCANJeafthegra TANDfNis per mit
'^ SOURC!A NDERSTANDS AND WILL COMPLY WITH ALL NO POINT Issued by: Dale
SOUR EG TIONS.
S
Signazum mfApplicmUContrxmRe-roofs r Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ne a Cupertino
or fMuni Wilding e.Chapter
r9.1 or handle h Health
anmaxrial
az defined by the Cupertino Municipal Code.Chapter 9.11,and the HGIth and S,(cty
Cabe.Section 25532(41
❑Yu P<-� All roofs shall be inspected prior to any roofing material being installed.
41 Will the applicant or future Wading oteupam use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hvalloua air cmnmminmts as defmcd by,hc Bay Area Air Quality Management all
District? new materials for'nsp
�
❑Tins 0)tW�
I have mad On haardars ma¢tials requiremcnrs under Chapter 6.95 oldie Califon
nix Health k SadetyCah:,Sections 25505,25533 and 15534.1undersund,hdifthe Wilding
Ones no,Carmody haw a,mmL Was it u my tcsponsihility m notify We oaupmt of but
require nu whkh mus,be mer prior to issm
ucc oda Certikac ofomupanq. Signature Of AppIIC t Date
weer arta, Corned agent D,ta. All roof coverings to be Class "B"or better
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 LC.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:
Job Site Address:
Roofing Company Name:
Applicant's Signature: -AL") Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
om 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35915007 . 00
DATE ISSUED. . . . . . . : 09/25/2006
RECEIPT # . . . . . . . . . : 36182
REFERENCE ID # . . . : 06090225
SITE ADDRESS . . . . . : 20638 SHELLY DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JING ET AL
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : TNT ROOFING
CONTRACTOR . . . . . . . : WILLIAM TYLER LIC # 22988
COMPANY . . . . . . . . . . : TNT ROOFING CO
ADDRESS . . . . . . . . . . : 210 SAN JOSE AVE. #19
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 277-0800
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---- - -------- -------- -- ---------- - ------ - - - --- - ------ ----------
BPERMFEE VALUATION 13 , 000 . 00 201 . 96 0 . 00 201 . 96 0 . 00
BSEISMICRE VALUATION 13 , 000 . 00 1 . 30 0 . 00 1 . 30 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
- - - ------- ---------- ---------- - -------- -
TOTAL PERMIT 308 . 26 0 . 00 308 . 26 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
- - - - - - - - - -------- ------ - ----- ------------------
OTHER 308 . 26 MASTERCARD
TOTAL RECEIPT 308 . 26
•
Community Development
I1 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
#UPERTINO
Building Department
JOB ADDRESS: j PERMIT #
OWNER'S NAME: I N PHONE #
GENERAL CONTRACTOR FAX # `t o 6' L-Z S v
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
60 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 rLu ri N '
Septic Tank
Sheet Metal
Sheet Rock
Tile
er/Contractor Signature Date
owogn2 5
CITY OF CUPERTINO
• ( REROOF
CUPEkTINO PERMIT APPLICATION FORM
APN#
Building Address: �� f
Owner's Name: Phone#:
Contractor: \ t)V (�, License#: J / C Z
j z `� � l
Contact: Cupertino Business License #:
kp,
Type of Roof Covering:
Existing: Proposed:
O Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles .4il' 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.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
Residential]_ Commercial O 2cas`� G a
Fire Zone: Yes ❑ No O Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Project: Type of Constructi n: Occupancy groug:
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
•