08080124 CITY OF CUPERTINO �. T'� -'" per,(
BUILDING DIVISIOM1• PERMIT Vol GTOW-Iiii&.[ORw1Y TLV' L
BUILDING ADDRESS: PERMITN0.
11 '/41_ SIERRA SPRING CT LOS GATOS ROOFING 08080124
OWNER'S NAME: PERMIT LSUB DATE
1NGFl.,() XTAN P 0 BOX 1726 08/18/2008
NE: SANITARY NO. CONTROL NO.
ARCHITEC AiNGINEER: BUILDING PERMIT INTO
RE-RF RMV EXTNG RF SHK&INSTL BLDG ELECT PLUMB MECH
O O O O
3o0 LICENSED CONTRACTORS DECLARATION Job Description
ea� I bereby afft n that l am licensed under provision of Quipster 9(commoning ^^............. .....__... ...
Tj with Stttlon7000)of DiHsionlof NO Budnw and Pro(cuions Godo.and mylke n
full Toros s ef(tt 6
�y Lkenm CI Lk.g
Dee Contracmr ,
e ARCHITECTS DECLARATION
y. 1 understand my plan shall W used As public records
J O
g sed Licancd Pmfcadool
OW NER-BUILDER DECLARATION
Ji 3i I Wreby,air.that I am hemp,from One Cnaactnrs License Law for,ho
C o O fallowing mason.(Section 70313,Bedueu and Pmfeadons Code:My city o1 County
9 which na umes a Permit to conslmcL alar.improve.demolish,or repair any swaure
–Zy Prim At its Women.aim require the applicant for each permit m rite a signed stsmmcnt
Q that he is licensed punuanlmtheprovisions oftheCantractoreLin nmLaw(CMPer9 Sq.Ft. Floor Area Valuation
(Com a Is exempt
Sntiroma and
O basison l of Ne Budnw ono on.Anyo,n Csdc)of
Net he te asempl therefrom sed the bold fm the alleged exempJon.Any violation of
Section 7031.5 by any applicant for a Formiuubjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars(5100).
❑I,as awuer of W psvpaty,m my mplaym with mgn u theh uk compewden,
will do the work.Cod thesbacm.6 w1 intended m offered fatale(Sic.7014.Businv
Add Prefesdans Cade:The Caausemrs Lived,law dm nal apply m an owner of Required Inspections
propene who builds w improves Hann,and who dacesuch made himmI r ar Nmugh hu
awn employes,provided that each impmvemnts are nal intendeA molrered fm saes,if,
however.the building or impmvemnt Is sold within an year of Completion.Ne Owner.
Wilder will have On burdm of proving Nal An did Out build or improve for purpose of
uk.).
0 1,as Owner of the property,am exclusively contracting with licensed Conorcmre to
convect the project(Sec.70,14,Business and Pmfwiom Cade:)Tim Cntrsemes U. ,
tens law does not apply m an owns of property who builds or impmvce Merton,and,
who contracts far each prejeN with•Conuxemr(s)licensed pursuant m the Oomactors
License law.
O lamexemplunder Sec .Bd PCfor Nlsreuon
Owner
Data .
WORKERS COMPENSATION DECLARATION
1 hereby affn under penally of perjury ane of the following declaradome
1 ham and will names m a CatiOLwteaf Consent to self-Wun:rm Wmkeh Compe t.
.tion,As provided far by Section 3700 of On Labor Code,far the pedarmmn of the
wort for which this permit is issued.
0 I have and will maintain Workers Compnutio i Insurance,As retained by Sohn
7700 of the Labm Code.for the Performance ofthe wmk for which this permit is issued. '
My Workal C Pe sed a Cuda and Poliry bar a
Grti¢ s� �t Poliry N'o (ry/�un���.I�%fir(/0
CERTIFICATE OF EXEMPTION FROM OR1W CERS'
COMPENSATION INSURANCE
(Otis accUn need sol W completed If the Permit is fmao hundred dollars(1100) _
Cor leu.)
1 certify Nat In the performance of the wart for which this Permit W issued.I shall not
Cut any Posen in any meaner an As At became subjml to the Wormts'Compemanion
Laws of California.Data
Applicant
NOTICE TO APPLICANT.If,after making this Certificate of Exemption,you should
booms subject m the Warkers compemNn provision of the Latta Cade,you most
.,0 forthwith comply with each prom vidaser this Nall all be demew mated.
551 CONSTRUCTION LENDING AGENCY
wN
[-+ IWrebycnn that them uacomSee,3nknding agenry,fm the perfonariCo u(
lX ti Ne wort for which NW petit W ivued(Sec 3119'1,CW.C.)
GO LendersName
D z lendernAdd.
U O 1 audfy that I have read this application and sue that the above Information is
JL ^'. COMCL I agree m Comply with all city and county ordinances and note laws relining m
-o SV" Wilding Construction,and hereby sauterne representative of this city be enter upon the
[fry drove-mentioned property for inspection purposes
06 (We)agree to sure.indemnify and keep humkae the City of CUPnm0 against
h liabilities Judgments,con and expense which may in any way accrue&pins,suedCity
U z in Career, Aram grentio ANN N.IL
APPI/fQANT UNDERST DS AND WIL COMPLY WITH AQL'L NOON-POINT Issued by: Date
SQI�jQJ, E/1Y
u.Of Ah6.LI Re-roofs
Sig*u.of AppliwHAZARDO D�—
HAZARDOUSMATER dingre LS DISCLOSURE ZYPeOfRoof
Will Nea Cupertior future Wildingrem handle Halt ,material
As defined by the Cupertino Municipal Code,Chapter 9.11,and the Health uJ Sueey,
Cole.section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
OYm [),We
Will the applicant or future Wilding occupant usc equipment of rkNma which If a roof is installed without first obtaining an inspection,I agree to remove
it harArMus Air Contsmimnts As donned by the Bay Area Air Quality Management all new materials for inspection.
DieOi<lT
I have mud that huardcus makdab roqui ememu under Chapter 6.95 of the Calier.
nkHcuhhh5arctyCodu,Srcdmu25505.25533od25534.IndcrswdthalfJm building /n/�
urramly have a, n4 Net II 4 on mponsihility m Act
the occoyut or Ne LL(AA
cru which am et Prior lis ivaar,eF an catinc.m gr onp. y Sign ore of Applicant Date
fl a O
roraatharivaGagcm Dam All roof coverings to be Class'yf"or better
CITY OF CUPERTINO
• 2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: B1k: 'Lot :
APN . . . . . . . . : 36653054 . 00
DATE ISSUED. . . . . . . : 08/18/2008
RECEIPT # . . . . . . . . . : BS000005811
REFERENCE ID # . . . : 08080124
SITE ADDRESS . . . . . : 11741 SIERRA SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ANGELO XIAN
ADDRESS . . . . . . . . . . : 11741 SIERRA SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5143
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
• FEF, ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEI:SMICR VALUATION 5, 082 . 00 0 . 60 0 . 00 0 . 60 0 . 00
1.REROOFRES SQ FEET 21 . 00 273 . 00 0 . 00 273 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 273 . 60 0 . 00 273 . 60 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------ ---------------------------- -------- ------------ -------
601. ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
6 J
REROOF
•COPERTINO PERMIT APPLICATION
APN# Date:
JP
BuildingBuilding Address:
nL�
Owner's Name: Ph ne #:
Sal- 53&�S
Contractor: 4 S o o y o? C{ hone #: L la
Fax#: O, - 9?3 7/
Cupertino Business License #: Contractor License #:
2348 / ?oo ,707
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
X Asphalt Shingles >< Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) X Other (Specify)/qS-tMTupQ 36.
Number of existing coverings ❑ Provide I.C.B.O. Report
To be Removed Provide Mfgr. Installation Specs.
�0
J91b) De$cription: Ili
Residential Commercial El
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation. �2
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Si r
CITY OF CUPERTINO
1 o
REROOF
• CUPE11iTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
20-5 1RER00FRES Re-roof Residential B 1SFDWLR00F
l 1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
113SEISMICRE Seismic Residential B
IBUSLIC Business License B
•
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: S T 1
Applicant's Signature: �J! '��yZre Date: 13 6Y
. Greg Casteel
Building Official
Revised 11/2/04
Community Development
c 10300 Torre Avenue
„�„�� "� Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
�'UPEkTINO
Building De Artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: PHONE # M
GENERAL CONTRACT R: Sa FAX #
I am not using any subcontractors:
Signature e
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
ntractor ature Da