05110088CITY OF CUPERTINO y
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COieI•TRACTOR�INFORMATION'
BUILDING DIVISION PERMIT
_.s.
BUILDING ADDRESS:
WING'S ROOFING INC
PERMIT NO. 05110088
-10390 STERLING BLVD
OWNER'S NAME:
PERMIT ISSUE DATE
WILSON CHIN
3243 SYDNEY WAY
11/17/2005
NE:
SANITARY NO. CONTROL NO.
(510)889-9068
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
0 0 � I�
LICENSED CONTRACTORS DECLARATION
lob Description
p .
1 hemby affirm then 1 am limned under provision of Chapter 9 (commencing
with Section 70M) of Division 3 of the Burins, apd Prolesslom Code, anal my litems is
m ten mmea We �(
REROOF--T/O SHINGLES-y INSTALL SHINGLES
Licenu Cl t� =L Lic.N
p7�N{�\`
Dam GOnflYmf
II[tliiCP 1kF11✓/p/1
ARCHITECTS DECIA ION
I{11,J{l f1Y11 j[[�I(�
he use r
I undewnJ my plan dull he used u public retards
NOV a$ 2p05
Licensed professional
OW NER-BUILDER DECLARATION
I heroby affirm Nal 1 Law for the
exempt faro the Gssionso Any
: C
i fallowing mason. Amur O 7031.5, Basions and Profusion Coot: Any city or county
1.
which rcquiru a permit m construct alms. Wpmw, demoted, or repair any atnhnum
n
y� n 11112 SS RM$ n $6500'
prior an it, issuance, also requites the Applicant for such Permit o file a signed statement
e wlheis licensed munitothe provislanoflWContrumr•aluenseLaw (chaptu9
5q°F
•�xt.FI'bortsrea'�
Valuation
pumti
' (commenting withSmion7")ofDivision3oftheBusitussWProfessionsCode)W
"�I&
Su
3 Any
that he is esempl tWrefrnm and the bniv for the alleged exemption. violation of
Section 703" by soy applicant fora permit subject, the applicant w a civil penally of
er
Occupancy Type
not mom Nan nw hundred dollau (SSW]
Q I,ssowm a(Ne pmpemy,ormy wployma with wagesuthev mlemmpensston,
Required Inspections
swctumurmfbhmnens an
will dothcwona
Cdthe
discs, OutOwner of
and Cade: The Canlsermrs LicensendwW law dons hot apply lf m owner of
9 p
whon
propertywho Wild m imprewa lh m who ghhu
omffered
me nateh nded!ork
for
mchimpmwmmuart.yeareded for age.
improvements
owit em rove
ping
hunmm.loyva, cdccmd
owner-
however. NebuildingmimPmwmenl usolewithinm yearofimpromfortheowmr-
or I pr
huiMv will haw to burden of proving that W die not build a impmw far PUNou of
vie.).
❑ 1, u owner d Ne propeny am eatlusiwly contracting with Banned mnvacmrs m
construct the project (Sec. 70x4. Business and Professions Cede:) The Consracmrs Li-
cone law does ooh apply to an owner of propertywhobuilds or impro. thenen.. and
w W contracts for much project, with.comm lr(s) Monad pormam to the Co stmemfs
License Law.
lamesemmunderSee .B&PCr.tosroamn
Owner Date
WORKERS COMPENSATION DECLARATION
1 hcroby affirm under penalty ar perjury One of the following dedications:
I bsw and will malnuin a Catifimu of Consent to self-intim For Wmke(sdampen-
.due, as provided for by Section 37W of the labor Cade, for the performance of the
wart for which this permit is id.
1 hew and will timmuin Worker's Ceopsomdon lnsuruta• u required by Section
Of drc laborCode. fm ted perfo anon of Uhe wok fm which Nu permit u issued
'
My Werkcrs mo rand 'er madPedicy immlbeerr am:
Cartier. Policy No.: I`s'N's�"
CERTIFI AIE OF ^ EMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This secton aced mthecanpmual 11 the permit u for one hundred dooms (SIM)
or less.)
1 certify tut in the perform..[ of the work for which this permit is issued. I "I nm
employ any person in my mMNr an Ia to become subject to the Walken GompenaWn
Laws of California. Due
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
become subject b the Worker's Compcnaatan provision of the Labor Code you menu
a rothwith comply with such provinom or this permit shall be deemed mwked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm Nat them is a c agency for IW Perfurmanm of
the work fur which Thu permit u issued (Sri. J097, Civ. G)
d (Sec.i 0 7. Ch,
Lender's Name
I<ndcra edemas
5 1 mnffy that I haw mad N. application mal sum then the W. information u
Comm 1 agree to comply with all city and county Ordinances and state laws Misting an
Wilding construction. and hereby mtbmiM mprescnuti ea of Nu city m cnmrupun the
mon-mentiaMe PmPenY for inspection parpaaCL
(We) agree to saw, Indemnify and keep harmless the City Of Gupertma.phal
14j Ilabllltea.jndgmCnm.cana d,ape. which may In my wayactmCagalntaLd City
in consequence of Ne granting of this permit.
' APPLICA NDERSTANDS AND WILL COMPLY WITH ALL NO P
Issued by: Date
SOUJI R GULAnONS.
Re-roofs
Type of Roof
Sig (APPbaMCommcmr Dam
HAZARDOUS MATERIALS DISCLOSURE
Will ton applicant or (alum building Occupant store or handle baradous material
as defined by the Cupertino Municipal Cade, mope, 9.17. and the Health and Wety
adc. section 2.55320)?
❑Yes T.
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future Wilding Occupant use squipurcnl or demma which
-it
mit hvardnus air contaminants as JcOmtl by IW Bay Area Air Qualify Management
all new materials for inspection.
n?
❑Yes No
I
J
a
Ihaw mad NehvN mamrialsmquimment, unJcr Clupmr 6.95 of ton Caldor-
nia Health&Safety Cal.Sectat,25505.25533U 25534.1undcssuM ifthc building
�i ['lid I I
Jona rot curmmlY Ww • Imhma tut it u my rt4pomihililY b maty the acupmt of the
I I V `��_
i
requim=nmwhichmuubcmetpriormissummafl CmF"mofocmpawy.
Sign use r�e of Appli fanV Date
All roof coverings to be Class "B" or better
Owner ormthorirreagent Date
CITY 0,
UPEI,TINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building De artment
JOB ADDRESS: -
b b
PERMIT #
aeT
U 8 UD
o C)
OWNER' NAME:
PHONE #
GENERAL CONTRACTOR
/ lte4 1
AX #
I am not using any subcontractors: / t X 's
ignature Date
Please check applicable subcontractors and c plete the following info ation:
a
Owner/ Contractor Signature
Date
66
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
a
Owner/ Contractor Signature
Date
CITY OF
UPERTINO
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Building Department
Telephone: (408) 777-3228
Fax: (408) 777-3333
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.
Homeowner's Nar
Job Site Addresse"i
Roofing Company
Applicant's Signat
Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
an of
CUPERTINO
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION FORM
n
o- ( 0-0 kk
APN #
2—q O Date: / / CE
Building A dress:
Owner's Name: . O Y -A n 1 Phone #: q-09 7! k,�-3 Z
Contra to : C COY l Phone #: r) ense #:
I 5 R V Flo U
Contact W, nrC Phone #:�Cupertino Business License #:
C. cS—a6 onto
Type of Roof Covering:
Existing: Proposed:
❑ Built -Up Roof ❑ Built -Up roof
Asphalt Shingles y Asphalt Shingles
❑ Wood Shakes ❑\ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings 1 ❑ 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: / ! (/D j l� �sfkd FS /6
/ T.KS 7
-e -
Residential) Comer ial E)m
Fire Zone: Yes ❑ No Confirmed with Planning Det. if
there are any restrictions: i5
Cost of Project: / h Type of Construction: Occupancy group:
Qty. if
Applicable
Fee ID
Fee Dew.rintinn
FPP i:rnnn
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
Qty. if
Applicable
Fee ID
Fee Dew.rintinn
FPP i:rnnn
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
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