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06070126C) C z CITY OF CUPERTINOaPi�-:x a°'�'• ^`'%^�"�"•'^'"° BUILDING DIVISION PERMIT CONTRACTnR INVORMA =IONN BUILDING ADDRESS: PRINCIPLE ROOFING & PERMfr NO.06070126 10716 S STELLING RD OWNER'S NAME: PERMIT ISSUE DATE JENNY CHU 1700 NORTH 1ST S 07/19/2006 NE: SANITARY NO, CONTROL NO. (408)436-1681 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDGELECT PLUMB MECH 0 t 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I sm licensed under provisions of Chapter 9 (commencing iN Section 70M)of0ividon 3of0e Business arq Po.11ca ov Code, and my lt..0 otfullforeeande 3CE REMOVE EXISTING WOOD SHAKE INSTALL LIGHT WEIGHT Licence, Lot.k?7�` Dame Contmemr DP/� CONCRETE TILE CLASS A OR B ARCHITECTS DECLARATION 1 understand my plans shall Po used W public recom, Licensed Professional OWNER -BUILDER DECLARATION 1 berehy afl. that 1 am exempt from the Contractors License Law far Ibo following mason. (Section NO 1.5. Business and Profcasiov Code: Any city or mussy which meet. a permit to con tme,, liner improve, demolish, or mpaif my structure prior W int issuance, aim requlm3 the applicant for Such permit to file a signed statement that he is licensed personal o 0m provisions of the Contractor's Lnmrve law (Chapter 9 Sq. Ft. Floor Area ValuSL 5 0 0 (commencing with Section 7000) of Division 3 of 0e Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the amUclat W a civil penalty of not more call five hundred dollars (SM. N Number G�" y- Occas ane Type d P Y YP 35922064.00 /r• La sowmvof aM propene,m wpleyen withwage ssIBe'v sok compensstiess .' I. at Badness intended a,offereddoes will do We work. ands: ri--�y ' mealict he, Conunot cosi Pmfvdov Code: The to Luse law ala rot apply to rt owns of Required Inspections,. ,, mttaac tracer. who smeh Mmselfor his Property who Wilds rams th � own pdovided improve am notimande edWrough however. or proveau himpmvementsart notinlendcdoroBued forsads. If. however. Ne building or Improvement u sold within arm yes of completion, due awn.- live Wilding the marner- •-.� � 100, U builder will haw the buNen of proving that Ise did rot dtik or improve far puryoa of sans). ❑ I, u owner of the propene• am exclusively contracting with licensed contractors; W em project (Sec. 7044. and Codebr The term La cove taw c«a not jean owner of property we builds or improves thereon. and weer of Property who Wilds r,s damWn. nd who acts for such projects with a convavor(s) licensed pursuant W the Canuxlors License taw. ❑Ism uempt sends See .B&PCfor this Owner Dale . WORKER'S COMPENSATION DECLARATION 1 hereby alfum under pcvlty of perjury one of dm fallowing decleruiov: I have and will maintain a Certificate of Consent to self -insure for WormesCampen- nation, as provided for by Section 3700 of the labor Code, for the perfarreamm of the work for which this permit is issued. ❑ 1 have and will maintain Workers Compensation Insurance, as, no mmd by Section 37W of the Labor Code. far the pecturne . oflhe weak for which this permit is issued ' My Workerfs•Compevatiou bawrarrue carrier and Policy number am: Sh Carrier. t+<L Policy No.: 191221:C CERTIPI ATE�PI'ION FROM WORKERS' COMPENSATION INSURANCE (This acetum need not Is, completed itlhe permit is foram, hundred dollars (SIM) Or Iess.) I certify that in the performance of the work for which this Permit a issued, I shall not employ any person in my manner5e as W become subject W ITC Worker] Compensation Laws of California. Due Ap,licmt NOTICE TO APPLICANT: IL after making this CemiEcam of Exemption. you should become subject to the Workers Compensation provisions of the Labor Code, you most forthwith comply with such provision or this FermiuMll b, deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm em them is a,o cturna nm lending agent, or the perfmon. of Ne w.h for which Nu Permit is issued (Sec. 3097, Cir, C.) Landers Nuns L<nders Address 1 certify that 1 have tend this application and sum that the above informed.. is comet. 1 agree to comply with all city and county uNinances and stole laws relating to + building construction, and hereby autharim mprescnwives of this city W enter upon the above -mems. ed property for inspection no,ol s, (We) agree to saw, indemnify and keep harmless the City of Cupertino against liabilities. judgments, tomo and expenses which may in any way accrue aF mL said City APPLICANT AePLIC N"r of Negrating of thispermit.WILL UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SOURCE RE U¢�LATIONS. Issued by: Date —/ C/z PLATIO VL1 — ot�/�9/cam Re -roofs -Z—� Signature of ApplicmUConRDOU am HAZARDOUSMATERIAUnsameoDISCLOSURE Type of Roof Willy applicant w forum Wilding eceupmt rare or handle hamNav material as defined t Ile Cupertino Munidpal Cade, Chapter 9.I2, cosi the Health cosi Wery Section Casio. El Y.uslx(a)T Yp Ne All roofs shall be inspected prior to any roofing material being installed. 10 Will the applicant or futon building occupant use equipment or denims which If a roof is installed without first obtainingan inspection, I agree to remove P g emit heartless air contaminants as defined by the Bay Arta Air Quality Management all new materials for inspection. Diaricl? O Yes No I have mase the lurard.v..data mquirtmcnts under Chapter 6.95 of the Cxiifm- / c&Sntl yhamaSmiudouit4 5533 tM Wilding dies act myrand25SiC.l odwifdc ells rot currently hast annual,t dot it i my responsibility amity ie re dm vcupml of Nc T ✓ s ccitui ofy reyulmmants winch coos be met pdarW issumcc afa Ccrti6cam of Ocapmry. Signature of Applicant Date �� All roof coverings to be Class "B" or better Owner or au rind agent Dmc D Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building De artment JOB ADDRESS: --w* SUBCONTRACTOR PERMIT # 060-7o �2 6-- OWNER'S NAME: Jc,, Cabinets & Millwork PHONE # `-/OF GENERAL CONTRACTOR' Cement Finishing FAX # ` V I am not using any subcontractors: _ 0,7-/ oF Signature Date Please check applicable subcontractors and complete the following information: Owner/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 Owner/Contractor Signature Date !m 1 of 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35922064.00 DATE ISSUED.......: 07/19/2006 RECEIPT #.........: 35316 REFERENCE ID # ...: 06070126 SITE ADDRESS .....: 10716 S STELLING RD SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............: JENNY CHU ADDRESS ..........: CITY/STATE/ZIP ...: , RECEIVED FROM ....: PRINCIPLE ROOFING OPERATOR: amyw COPY # : 2 METHOD OF PAYMENT AMOUNT ----------------- ------------ OTHER 214.16 TOTAL RECEIPT 214.16 • NUMBER ------------------ MASTERCARD CONTRACTOR .......: DERECK LOI LIC # 27564 COMPANY ..........: PRINCIPLE ROOFING & ADDRESS ..........: 1700 NORTH 1ST STREET, #154 CITY/STATE/ZIP ...: SAN JOSE, CA 95112 TELEPHONE ........: (408)436-1681 �EE ID ---------- UNIT QUANTITY ----------------------- AMOUNT PD -TO -DT THIS REC NEW BAL BPERMFEE BSEISMICRE VALUATION 14,000.00 VALUATION 14,000.00 ------------------------------ 212.76 0.00 212.76 1.40 0.00 1.40 ---------- 0.00 0.00 TOTAL PERMIT : ---------- ---------- ---------- 214.16 0.00 214.16 ---------- 0.00 METHOD OF PAYMENT AMOUNT ----------------- ------------ OTHER 214.16 TOTAL RECEIPT 214.16 • NUMBER ------------------ MASTERCARD 0 a t nv or CUPEkTINO • 0 CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM wotl1 Q APN # Date: C9 J /9*11C Building Address: Energy ./07/G, S Sf� ddb Owner's Name: BUILDING vfionc #: Seismic Commercial BUILDING 1' — �,_L-% Contractor: BUILDING License #: 8/ 6 3 it 2rrn ti d cc �W Sf C tact: Cupertino Business License #: t26 0-6 Loi, Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ /ksphalt Shingles ❑ Asphalt Shingles * Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Other (Specify) ❑/Wood Shingles �3 Other (Specify) lil w2i �1�py/G.�Y% 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: /'-,�yn�(p✓2 Ex, !7'rvy Wsr� SN,�+Cr Shr,Le -er v✓�i2' CvrGiiri° �/''a!C Residential Commercial ❑ C�r- Fire Zone: Yes ❑ No B� Confirmed with Planning Det. if there are any restrictions: Cost of Project: `� Type of Constructioy� Occupanc groua, .113, s -e �J= —}-------------------- Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING I BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING 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 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. �LlvyLt� t/ywt Homeowner's Name: � Job Site Address: )-16 SC if C�— Roofing Company Name: - � - Cin ll-�—"air Applicant's Signature: Date: • Greg Casteel Building Official Revised 11/2/04