06060019 CITY OF CUPERTINO
BUILDIAG DIVISION PERMIT `
�;ON-TRAeV INFORMATION
i?
BUILDING ADDRESS: WESTSHORE ROOFING COMPANY '"'NO,06060019
20873 SOLA ST
OWNER'S NAME: - { PERMIT ISSUE DATE
milk WAN RUNG GUO 5869 WINFIELD BLV 2006
IF ryE_ SANITARY NO. CONTROL NO.
(408) 629-2100
ARCHITECDENGINEER: BURRING PERMIT INFO
BLDG ELECT PLUMB MECH
iota LICENSED CONTRACTOR'S DECLARATION
1 wF 1 hereby affirm Nm li
al 1 amned under preisi
von,of Chapame
r 9(commencing Job Description
:ir`;S with Second?")of Division 3Ofthe Business and Profession,Code.sed my license is
�y inm11171nde eeL � 2Z REMOVE EXISTING 1 LAYER SHAKE AND INSTALL GRAVE
,v�? License Cter Lk.M
e Dale — — ranuctol 15 a X 9 STONE COATED STEEL
L m d� DECLARATION WESTSHORE RENEWED LICENSE BL 6/2/06
1 understand my plans shall bo used as public records
L u
u t, Licensed Pmfessionel
o OWNER-BUILDER DECLARATION
E 1 kmhy strum that I am exempt from the Cuntrumr's License Law for the
:00 following mason.(Smtisn?031.5,Business and Profcesiam Code:Any city or county
IS ff which¢quirts a permit to construct,aline improve,demolish,or repair any structure
2< prier to las issuance.ad.ns-,lret the applicant fel such pcmd,t0 R4 a Signed f¢tomo t -
:xp that he u licensedpustmm to the provdams of thLi
e Commewes cense Law(Chapter 9 Sq.Ft.Floor Area Valuation
il- (eommemangwithSectionIOW)ofDivisionJoftheBusinessandProfessiauCeMe)or $18000
$ that h d exempt therefrom and the basis for ho alleged assumption.Any violation of
Section 1031.5 by,my appliam for a Permit subjects the applicant m a civil Penalty of APN Number Occupancy Type
not mom than fico hundred dollars($500). p y yp
1,uowner Of the Nvpmy.ormy wployw with waguutheu sale mmpeitsadon,
will do Nework Cadthe he Comisnots License
ice star Law
do forsC4(Ss-.l01d, wner o. -
Lad Proksdobu code:The Cnncocmrs and
Isco doss Out apply b an owner of Required Inspections
property who s.Ids u(mpmvrs thm Improvements Sed who area suchwart orofffar Wresale hf.
own employees,provided this such oldwitin net intended oro@sed for Owner.
however,theormtngortmpmprevinvement uhathe didac act
of cprove for
thrpose of spp��� GGG111
builder cola have the burden of proving that h did ret build or improve(or purpose of q ��®
sa4.). tp8154--a tttyyy/7/7/7
1,as Owner of the property,am excluively concocting with licesued contractors to
cotmmct the Project(Sec.1004,Business and Predications Code:)Tie Comrmades U.
cense Law does not apply to an owner of Property who Milds or improves thereon,and
who contracts such proiecls with a consumr(s)licensed poEuanl o he cmdraider's /Ij� /�9oOC
License Law, f f L 6
I am umrlm under See. ,B&P C for his mason
Owns Dam tk\ip
WORKER'S COMPENSATION DECLARATION
I htebY¢?tan under porosity O(pedury one of th following deciantiou:
1 hsre and will anumaia a Certificate of Commas to self iu s.for Worker,C.pcn-
cation,as provided for by Section 3100 Of the Labor Code,for dm pcAormarrm of the
work for which this permit is issued.
1 have and will maintain Worker's Compensation Ismoranm,u requited by Secdon
T00 Of the labor Cade,for the performance of the work for which this permit Is issued '
My Worker,Compensation lasureanm Cartier Last tacky number
r,.r' CZ
Cartiei'd} AA Policy NO.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
Cihu section need tet becompleod if ase permit is forane hundred dollars($100)
or less-)
1«nifv that in the performance of the work for which this Permit is issued.I shell not
employ any person in any mLanerso as m become subject to Ir,Worters'Cernpevation
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should
baane Subject to the worker,Compensation pmvisions of the Labor Code,you a=
.J ,2, foMwith comply with such provisions or this Permit shall M doomed rooked.
Z O CONSTRUCTION LENDING AGENCY
[•vI hereby affirm that done is a construction Lending agency for to forfurmance of
n:
Its
work for
which this permit Is Issued(Sec.W.Civ,C.)
GQ Landers Name
0z Landers Address
U C) I Coolly that 1 have read this application she state Nu th above information u
I,. r stance I since w comply with all city and county ordinances and sere laws¢Irving m
0 U building concoction,and hereby moloorim mpresenmtivm of Nis city to enter upon the /F! �.I_,/tA(/, / L
above-mcntivaed.repent for inspeo er purpose:.
H W (We)agree to save,indemnify and kap hermless the City of Cupcnino against r
N liabilitiesjnce of the costs of this
may in anyway accuse against said City
s
U z A PLIC once Ofthegranting of Nis Permit.
^ APPLIC UNDE0.STAN A D WILL COMPLY WITH ALL NON-POINT Issued by: Date
SO I. db].A S. p
�+
Sig a al AppliCan nRDO Re-roofs
em
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ih a Cupertino
or future bottling e.Chaptnore or her doh eaNeu ma¢ri,l
az definN by he Cupertino Municipal Code.Chapter 9.13,and the Health and Safety
Code,Section 25532(a)?
pr All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future MiWing occupant use equipment m devices which If a roof is installed without first obtaining an inspection,I agree to remove
Cmit hanNnes air conumiunts as dcfnncd by the BOY Area Air Quality Management all new materials for inspection.
District?
Oyern
Ihave madthe ad,Ser macrialsrt33 and ntsumkrCestand.95ofthe Wilding
Lou Health&Safny ,Section255U5,255JJ and 25534.1undervand thuifthe Wilding
Coca
at curtentiy w a¢nano Nat it u my/u'Wordility o ratify Ir,occupant of the
require Woods be p(et pljef(d issdLam reaeerocrt�pan Signature of Applicant Date
owne�er mnw'Ss`�e/it /� Dad All roof coverings to be Class"B"or better
Community Development Department
Building Division
City of Cupertino
• a�S" 10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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.
.-I •r' •7. NOTE: If yod call f6r 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.R
Homeowner's Name: Wap) .H.p�h (Sl^O
lob Site Address: 2-0) t 13SoS
Roofing Company Name: p --VOn
Applicant's Signature:
h�
Date:1W016
•
Greg Casteel
Building Official
Revised 11/2/04
wlnrad nn Recvcled Paper
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
SUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: Vjo vs (Zvi CTv o PHONE # 6 •0010 O
GENERAL CONTRACTOR: Z }T�ko of
f FAX # 6 ll 005'1
4-
I am not using any subcontractors: r bO ' G/��D�
ign tore Date
Please check applicable subcontractors and complete the following 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
e ontractor Signature Date
CITY OF CUPERTINO
eem 1 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35913055 . 00
DATE ISSUED. . . . . . . : 06/02/2006
RECEIPT # . . . . . . . . . : 34672
REFERENCE ID # . . . : 06060019
SITE ADDRESS . . . . . : 20873 SOLA ST
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : WAN RUNG GUO
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : WESTSHORE ROOFING
CONTRACTOR . . . . . . . : FOWLER, PAUL LIC # 21417
COMPANY . . . . . . . . . . : WESTSHORE ROOFING COMPANY
ADDRESS . . . . . . . . . . : 5869 WINFIELD BLV
CITY/STATE/ZIP . . . : SAN, JOSE, CA 95123
TELEPHONE . . . . . . . . : (408) 629-2100
*FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 18 , 000 . 00 255 . 96 0 . 00 255 . 96 0 . 00
BSEISMICRE VALUATION 18, 000 . 00 1 . 80 0 . 00 1 . 80 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 362 . 76 0 . 00 362 . 76 0 . 00
•
CITY OF CUPERTINO U6NCOOP
REROOF
CUPEkTINO PERMIT APPLICATION FORM
APN # Date: lL, ^ 12 I O
Building Address:
Owner's Name: Phone #:
I,JGtr1 RJA%n (r(A40 y0,%- ZSS-
Contractor: Phone #: License#:
wts�ts�V%ert obi �,/k • ` i99 -6961-0015D ?9 3 ZZ)
Contact: Phone#: Cupertino Business License #:
(!%Ck\M4_1A 1�"V^AAV% jc)g-6q --oo6z.
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles cJ
❑ Other(Specify) ,B- Other(Specify)o?_ (o K co q'k4
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:
�R�Mnt1 S4-4,Itt a IAS'sxi CTt `SbV%t (.o�45k je..
Residential - Commercial _❑.
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: LI
Cost of Project: Type of Construction: Occupancy group:
0o 0 - O-F S ,
Qty. if
A licable 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
•