06070160 CITY OF CUPERTINO d -a°f�`
BUILDING DIVISION PERMIT COCT"R tFo. ,TIO. i
BUILDING ADDRESS: s R E ROOFING & CONSTRUCTION FTIfVO06070160
7594 WATERFORD DR
OWNER'S NAME: PERMITISSUEDA7E
THOMAS LIN 15230 CLYDELLE AVE -----Q3/24/2006
NE:
SANITARY NO. CONTROL N0.
(408) 626-9320
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
0 0 m 0
Op LICENSED CONTRACTOR'S DECLARATION
FF 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing Job Description
;iWwith Section 7t11M))of Diviaiun 3 of the Business surd Premum Code.and my It"=is
It in run room and e �� e�q REMOVE EXISTING 1 LAYER OF WOOD INSTALL NEW 1/2
;qi ucemse class Lic.N
Date 2;41// .ar Conuanor, CDA 30# ASTM, CLASS A ASPHALT COMP.
ARCHITECTS DECLARA ON
i < I understand my plans still be used as public¢coat
lyU
°try Licensed Professional
OWNER-BUILDER DECLARATION
y 1 hereby affirm that I am exempt from the Contractors License Law for the
:O O following mason.(Section 703 1.5.Business and Professions Code:Any city or county
n fLs which requires a permit to consumes.alter,Mpmw.demolLxh,or.Pair any structure
9 i prior in its issuance,also mquims the applicant far such permit in rile a signed sentiment
s C that he is licensed pursuant to the pm,onti s of use Contracsori Ued.Law(Chapter 9 Sq.Ft. Floor Area Valu Ibi 0 0 0
2� (commencing with Section 7000)ofDivision 3 or Ne BusinessaM Pmfessiam Codc)or
$ that he is exempt Ncmfmm and the basis for the alleged cumpdon.Any violation of
Section 7031.5 by airy i pplieanl fora permit subjects this to a CiAl pesslty of �p 616 0 tiOccupancy
YPmber Type
not mom than RK hundred dollars(SM 3e a6 03 . 00
Q I,va owrw of Niepropeny,amy employee with wageuthev sole compenssdon,
winmNnwon,and.:Muc Contractors awdraesrutapplyheanown�t Required Inspections
proand Rty who
obu Cade:The ats doecto ,License Law doer Out apply m r through owner of q
Own enYwyees,pdsorimproseuchimpr aMwho daessuchwark tooffe adforWe his
Ownemployees, pr suchimpsowm wthartnot intendedooRemd for sale.r-
f.
however,the building or impmwmat u sold within one yeara completion.Ne owrrte-
builder will base the bunds of proving that he Jia cot build m improve for purpose of
Cl I,as owner of dm property am exelunroly contracting with licensed contraction in
crostmthe, 0x4
et pmjca(Sec.7 ,Business and Professiots Cade:)The Conumcmri Li-
come e to
what law etrnot apply es owner of Dmpeny who ed 0r improve thereon.and
License race for such gojett5 withacanvactor(s)Ilcenxe pursuant btime Convectors k/
014 exempt undo Sec .BBPCfor out;reason /
Owner Date
WORKER'S COMPENSATION DECLARATION
1 hereby alrvm under penalty of pejury one of the following declarations:
1 have and will maintain a Cerurmam o(Cememro xlf--insert for Workers Campen-
satian,as pmvidcd for by Section 37011 of Ne later Code,for dere purumadce of the
work for which this pe.I,is issued.
❑1 haw and will maintain Workers Com a mauo t Immo nee,an myuimd by Section
3700 of the labor Codc,for Ne Performance of dm work for which this permit is issued '
My Wotkdrrs Compensation bslunna carrier and Policy number art:
Cartier.S'fU.YP wVl PolicyNa.:_S-7 1—/V SLi
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(7hissccden reed Out he completed if the p.I,is loran,hundred Wt.(SIMI
or less)
I to irk Nat in the perform ince of led work for which this Permit is issued,1 shall not
employ,any permed in any marmeran 0 b become Subject in Ne Workers'Compensadon
Laws of Califomia.Dam
Applicant
NOTICE TO APPLICANT.If.after making this CeniOcam of Exemption,you should
bcc0me Subject b the Workers Comptuat ion Provisiamn of the labor Cada you mus
.J,Z, forthwith comply with such provisions or this permit shall be deemed revoked.
Z O CONSTRUCTION LENDING AGENCY
f•-' 1 hcrtby afrum Nat Ncrt iso emeswcunn lendi,tigony for the pe fa.....f
6i `7 the work for which this permit on issued(Sec.3037.Civ.C.)
oLender's Name
7 Z Leaders Admen.
U O 1 certify that I haw mnd this application and sum Nat the thew information is
U, HcomecL 1 agree on comply with all city and county oNinamxs sum laws sulaws relating to
C) U building construction,and hereby autheri7c repmsenmtiws of Nis city to enter apnethe
�0. abbvc-mentiancdpa.con for d0.1 ,which m.
(We)agree to saw,indemnify and kap harmless the City or Cupertino against
nFiZ I-crotie,Judgmc this
Of thiscswhich mayin any way accra agaimtsaid City
U z A PLICAcnco of the granting of this permit. �7 /
^' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
/J -� -17-4* Re-roofs
Smgna�A�p6lran✓carome or Date
HA]ARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building oceupantsmrc of handle havardous material
de4as
de.fined by Bre Cupertino Municipal Code.Chapter 9.12.and tk Health and Safely
Code.Section 2ss3z(a)± All roofs shall be inspected prior to any roofing material being installed.
❑Ye �e
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
crit havafdous all conumim us as defined by the Bay Are All Quality Managcmcnt all new materials for inspection.
Div c"
❑Yes No
I have mal the henNos mvcrous mquimmens under Chapter 6.95 of the Califor-
nia Health h SafctyCod,.Sections 25505.25533 arta 25534.Iundcrsmnd Na ifNc building
Jess Out currently haw I moNat it all.my rtsporsdifi ty 10 beefy the oaudm
pant of
myuirt moan.dust
eertirmamarQ,mpanry. Signature of Applicant - Date
Owncrmituthonzcd.Sent /ZDam All roof coverings to be Class "B"or better
Community Development
✓'
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
46UPERTINO
Building De artment
JOB ADDRESS: q PERMIT #
I Awz�x ,'R, 1 0607010' 0
OWNER'S NAME: Np /r`j L,10 PHONE #
GENERAL CONTRACTOR tTIJ1F I h! FAX # $_ 2 _
I am not using any subc ntractors:
S ature Date
Please check applicable subcontractors com lete the following information:
21 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
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax:.(408)777-3333
UPEkTINO
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.
nstallation4. 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.
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 INYVV5
the above stated policy on re-roofing.
Homeowner's Name: LJ
tJ V p y
Job Site Address:
Bay I lVNRoofng Com y e: 4 1
A plicant Signature: —Date:
• Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36616003 . 00
DATE ISSUED. . . . . . . : 07/24/2006
RECEIPT # . . . . . . . . . : 35354
REFERENCE ID # . . . : 06070160
SITE ADDRESS . . . . . : 7594 WATERFORD DR
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : THOMAS LIN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : RE ROOFING
CONTRACTOR . . . . . . . : PROCTOR, PAUL LIC # 20615
COMPANY . . . . . . . . . . : R E ROOFING & CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 15230 CLYDELLE AVENUE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
TELEPHONE . . . . . . . . : (408) 626-9320
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---- - -- ------ ---------- ---------- ---------- ---- ------ ----------
BPERMFEE VALUATION 14 , 000 . 00 212 . 76 0 . 00 212 . 76 0 . 00
BSEISMICRE VALUATION 14 , 000 . 00 1 . 40 0 . 00 1 . 40 0 . 00
------- - -- ---------- ---------- ------- ---
TOTAL PERMIT 214 . 16 0 . 00 214 . 16 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
------------- ---- ------------ ------- -----------
CHECK 214 . 16 10149
TOTAL RECEIPT 214 . 16
•
CITY OF CUPERTINO �d�(Q(�
RFROOF
• CUPEkTINO PERMIT APPLICATION FORM
APN# -3q I Date:
(0-00Z ob
Building Address: 9614
WAIIA foR
Owner's Name: Phone #:
) LIQ b�- ` iz - �2 h
Contractor: I N C0 Phone 4: C pq j - License #:1�0,012-7591
1 ray p
Contact: l/ Phone# Cupertino: CiBusinessLicense #:
(7b1� �}T���t- sok- 4z1__I 13 20� 15
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
X_Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings -- ❑ Provide I.C.B.O.Report#
XTo be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Polic
Job Description:�6&0y� om`SIIliq I LAti� (f W06V SItAKd IIVST I 2 ` 9X1
3c, A5TM s (,1-Ass `k' AIMA-uf ejM r
Residential Commercia ❑
Fire Zone: Yes ❑ No Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Projerr l (1(J/` JU Type of Construction: Occupancy group:
l T U
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
•