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CITY OF CUPERTINOt#F�^o-
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BUILDING DIVISION PERMIT
;CONTRACTOR TiVF'ORMATION--:
x. %r:R,'•¢r. _, h$ 5•h.. r'S`a,T x, R-.'
BUILDING ADDRESS:
LOS GATOS ROOFING
P"""N0-06070135
10247 VISTA KNOLL BLVD
OWNER'S NAME:
PERMIT ISSUE DATE
EVA WANG
888 FAULSTICH CT
07/20/2006
NE:
SANITARY NO. CONTROL NO.
(408)298-9.399
ARCHITECTTENGINEER:
BUILDING PERMIT INFO
BLDGELECT PLUMB METH
0
LICENSED CONTRACTOR'S DECLARATION
lb Description
o
1 hereby affirm thatam l 1 licensed under prons visioof Chapter 9 (rommcncing
P
with Section7W )of Divtdan3of Ne Bu neasand Profmium Code andmyliccmmis
is fun rare=Ona errea 3q koo-0
REMOVE EXISTING CEMWOOD SHAKE. INSTALL 7/1611 OS
Li c`nL1Cg
Date me'az� Z�Can.., Ons
ROOFERS. SELECT FELT AND LANDMARK TL COMP.
ARCHITECTS DECLARATION
I understand my Plans shall he umJ as public records;
Licensed Professional
OWNER -BUILDER DECLARATION
li
I hereby affirm Nal 1 am exempt from Ne Cortrano's License Law for the
following reason. (Scetion 70313, Business and Professions Calc: Any city or county
which metals a permit to construct. eller, improve. demolish, nr ¢pose, any stmmum
prior. its issuance. also raquira the applicadl forsoeh permit m file a Signed summc.
Nal he is licensed putsuanuo the provisions of Ne Constrictor. Li'mate Law (CMpmr9
Sq. Ft. Floor Area
Valu ibi1467
(commencing with Suction 7000) of Division 3 of the Business and Professiam Code) or
Nat he u mempt Nerefmm and the basis for the alleged eaemptiom Any violation of
p N�tr�lber00
Occupancy Typenow,not
Semon 7031.5 by any applicant for a permit subjeou the applicant to a civil penally of
mNun Ove hundred dollars (53(10).
3ppN22 613 9
❑ I,uawrcr of the property,. mY emPloym with waguas Neu role cpmpenastion,
Required Inspections
will da the work and One structure is not intended m Offered for sale (Sec. 7044, Bud'was
and Profeasin. Cade The Cantrxcme, License Law don and apply in an owner of
progeny who builds or impom Nncon, and who does such work himself ser Uuough his
own implores, provided Nal such improvements see notimended proffered foraale. If,
however, the building or improvement u said within arc Year of eumpietion, the ownery
Wilder will have use Women of proving Nat he did not build or impmwc for purpose of
P�
]
❑ 1, as Owner of the property, am exclusively contracting with licensed convectors m
ry
�
the Project (pee W Cade:) The Coao-a:mrs Lid
es;Wilds
Bam
worse, a o an of propertywho
cense law dose at apply je ts owner of pmPeny who builds or impmvea flamenti,Commuc and.
f(�/Jl
®
whocontractsLa fm such Projects with aantrxtor(s) licensed pursuant m Ne Contracmh
License
�
❑Ions aempt under See .B&PCfm Nis mason
0
��Oou
Owner Data
WORKER'S COMPENSAtDIRATION
mi
1 hembY affirm under penalty of perjury ane Off the the following dedanuom:
I have and will maintain a Certificate of Co.., to self insure for Workers Co.,. -
moon, as provided for by Section 3700 Of the Labor Code. for On pe,formarce of the,
wort for which this permit is issued.
❑ 1 have aM will maintain Workers Compemalion Imunnce, u rugNmd by Section
3700of the labor Code, for the performance of the wort for which this permits is issued.
My Workers Commutation Insurance artier and Policy number am:
Carrier. S*9Xrflg:�y.0 PolicyNo.: zzi9-Ze06
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu account wed Oat M eomplcmd if Nn permit is far one hundred doll= (SIM)
Ove)
I cenify Net in tho pcif.. of Ne wah for which this permit is i¢ved, 1 shall not
employ any person In any insouciant m to become subject to the Workera' Comp ri moort
Laws of California. Dae
Applicant
NOTICE TO APPLICANT: If. after mating Nu Ccrtinate of Exemption, you should
become subject m On Wahers Compensation provisions or the Labor Codc, you must
'
foMwits comply with each limvitiom or Nu Permit shall m dcemcd revoked.
CONSTj
1 hembY Oat is. moNLENDMGAGENCY
thi Nat Nem iss leading agency (or the pcRarmance of
ch
work fur which Nu permit u issued (Sec. 309T. Civ, C.)
issued
Landers Name
Le
Lsenders Address
1 1 certify Nat I have mad this application and Bute WI tic above information is
' cornet. I agree to comply with all city and county ominances and state laws relating to
Wilding construction, and hereby Atowdre rcpresenutives of this city m enter upon the
shout -mentioned property for inspection pugwecs.
(We) agree m save. indemnify arta keep harmless the City of Cupertino against
liabilities judgments, costs and expenses which may in any way we= against slid City
In consequence of the grunting of Nu permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
�7 2�
Issued by:
SOURCE REGUtATi}]N9y
,
Date-),
/
Re -roofs
7/Z,e//
Signature ofAppliausu Date
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will ticappliantm fulare material
ad
Coe.
u defined Mmuipul
the Cupertino Municipal Code. Chapter 9.13. sed Ne HuIN and Safety
Chaney 9.12. t1 Health
Code. genion 26332(a)?
Section
[3y.
All roofs shall be inspected prior to any roofing material being installed.
Will Nn, Rea. or future building eRu rot ma of whim
pP e w ea
If a roof is installed without first obtaining an inspection, I agree to remove
g P
.mit hmamous air conuminanu az defined by the Bay Area Air Quality Management
Air Qui Mara
all new materials for inspection.
District,
❑Ym �Au
I have mal the harardws commiSmquimments under Chapter 6.93 ofthc Giiror-
SafelyCow, teetiomnit it 8533amR6534.1 Nm ifU WI Of ing
nice NOut
/
COO
Jae not curently have l tenunL Nat it u my impassability b Irotify Ike attupunt of Ne
Wossify
/ L�
myaimmaawhm�mu�x�Lgrinr ,saan r,cnrteateoroeapy
Signature of Applicant Dale
// 7/ z%6
All roof coverings to be Class "B" or better
g
owner ser amhorisd ascot Data '
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408) 777-3??8
CITY OF Fax: (408) 777-3333
CUPEkTINO
Building Department
Subject Re -roofing policy for the City of Cupertino
L 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.
•
D. 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.
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 Name:
— ---------- -- ---- -
Roofing Company Name: - S ' �%— �
A plicanYQSignalture:
Greg teel
• Building Official
Revised 1/30/03
Printed on Recycled Paper
Date: I Ci i
y "e`
`r
CITY OF
CUPEkTINO
0 Buildinz Ike
F'
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
JOB ADDRESS: PERMIT #
/e2y� �1,s7X 4LL, O -?d �3f
OWNER'S NAME: (NAIL Zr PHONE # -7 3 d'— D °IS --O
GENERAL CONTRACTOR: �TC p FAX #
v
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors anri rmmpla+o +ho FnTht. C
Owner/ Contractor Signature
A- -eI)ae?
Date
SUBCONTRACTOR
BUSINESS NAME4 Y BUSINESS LICENSE
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
I
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing_--------------•---__.. ---- — .- - -- — -----...__ __ •_------ - - -- - _._ _ _ - -_. _
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/ Contractor Signature
A- -eI)ae?
Date
2 of 2
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 32613129.00
DATE ISSUED.......: 07/20/2006
RECEIPT #.........: 35324
REFERENCE ID # ...: 06070135
SITE ADDRESS .....
SUBDIVISION ......
CITY .............:
IMPACT AREA ......
OWNER ............:
ADDRESS ..........:
CITY/STATE/ZIP ...
10247 VISTA KNOLL BLVD
CUPERTINO
EVA WANG
9
OPERATOR: amyw
COPY # : 2
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT
is
AMOUNT
------------
439.22
------439 22
NUMBER
------------------
1758
RECEIVED FROM ....:
LOS GATOS ROOFING
CONTRACTOR .......:
RANDY BROWN LIC
# 23481
COMPANY ..........:
LOS GATOS ROOFING
ADDRESS ..........:
888 FAULSTICH CT
CITY/STATE/ZIP ...:
SAN JOSE, CA 95112
TELEPHONE ........:
(408)298-9399
EE 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
TOTAL PERMIT
--------------------
257.76
----------
0.00 257.76
----------
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT
is
AMOUNT
------------
439.22
------439 22
NUMBER
------------------
1758
0
0
0
CITY OF
CUPERTINO
CITY OF CUPERTINO
REROOF aboMrS
PERMIT APPLICATION FORINT
APN # 2�-1
33-(Z5
«.,..
Blda Permit Fees
Date:
-71`I GG
Building Address:/6
Z / /
(�/S
Owner's Name:
uG W
...--- _ BSEISMICRE
ISMICOM-- --
Phone #:
,9,
Contractor:
Q.
Phone #: C�
—9Z399
License #:
g00 %o
Contact:L_.J
Phone #:
Cupertino Business �License #:
BUILDING
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
❑ Asphalt ShinglesAsphalt
Shingles
❑ Wood Shakes
❑ Wood Shingles
Other (Specify) e
❑ Wood Shakes
❑ Wood Shim,les --7n 4
❑ Other (Specify) /
Number of existing coverings
❑ Provide LC.B.O. Repo
To be Removed
❑ Provide Mfgr. Installation Specs
I Have Read, Understand and Will Com I With Cu eAmo's Tear Po c
Job De scrip tion:
7L
Residential
Commercial ❑
Fire Zone: Yes ❑ No
Confirmed with Planning D_e_,pt. if.
there are any restrictions: LJ
Cost of Project:
_�_C_7.y 6.7
Typeo Constructi Occupancy group: ( /
p P,/
Qty. if
Applicable
Fee ID
BPERMFEE
«.,..
Blda Permit Fees
ree vrou
BUILDING
BENERGY
Ener Q
BUILDING
...--- _ BSEISMICRE
ISMICOM-- --
._ �___..�Sersmic Eee _._....--
._.. _.....- ----Seismic Commercial ---..._
-
- ... - --BITILDING _..- --
- ---BUM-DINGBPLANCHK
Plan Check Fee
BUILDING
BUSLIC
Business License
BUILDING