06090122 F
OF CUPERTINO1LDInG Dlvlslory PERMIT <CONTRAOTOR'iINFORMATIONG ADDRESS: JIM KRAUSE ROOFING PP"MITNo06090122
3 WATERFORD DRS NAME: PERMp[ISSUE DATE
LANCE ZHENG 2310 DIANA AVE 09/15/2006
NE: SANITARY NO. CONTROL NO.
(408) 779-0704
ARCHITECnENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0,0 LICENSED CONTRACTOR'S DECLARATION Job Description
FC 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commnming
!iW with Schon 7000)of DivisionJof the Businev and Prpfetsiutts Cade,andmylicensb
!�„ in fullfanxandcr( �7 g135 REROOF- TEAR OFF SHAKES, RESHEET OSB, ADD 50 YE
;qi Li"°"class Co.g COMP SHINGLES 29 SQUARES
r O Da¢ 1
Contractor ,
. a3 AR `"n "DECLARATION
11 1 undersmnd my plans shall he Laid es Pulsrtc ards
°oy Limmcd Professional -.A—
OWNER-BU LDER
OWNER-BUILDER DECLARATION
0 C I hereby alum Not 1 1. exempt from the Contractor's Cm :Any C law for the -
p O following resson. emit t ]5D16,Business and w,deium Cade:Any city s county
f m which its it s a permit to quiresconstruct.er'r'or,imfor such
demolish, file
repair any structure
Z6 tela,LLl i6censed 0.nsintiWren ponvisiso for awhPermit lLiccow awJahaptarl
21-
that rrisaingwitpSeswntwtheofDiviomo[thceBusinesshalloflaw(Chapter9 Sq.Ft.Floor Area Valu$ib�000
�a,G (eoms,IS exgwith Sectionrarman 1(0)of basis for
of theBusiness
assumption.
Any
Code)or
5 that he b exempt tMmfmm and the baso for dor alleged aempum.Any violation of
Section 7031.5 by ury applicant for a penny subimad Late applicant in a civil penalty of APN Number Occupancy Type
not mom than five hundred doll.,(S500). 36617086 . 0 0
I,ssownv of the proprny,Lr my employees with waguuthc'v m4 compcnsalOn,
will do Ncwerk and theswmure is not intended or offered formid(Sec.7044,Business
And Professions Cada:The COnuacuWs License Law does not apply to an rough of Required Inspection
own enywho buipro Oriceproves himprand who doessuchwalkhimselfor through his
awn ve,.a employees.building
or ithatsuchimprowmmts arene year ofled mpeereA for sale.if.
however,the building or improvementiscoldwithin One year of ind ro of for
owner-
builder will have Law burden of proving that be did rot build w improve for puryose of a�
morin
❑h as Owner of the propeny,am exclusively contracting with licensed canwchara to a
construct the project(Sec.7044.Business and Pmfessioos Cade:)The ConuauMs U
who am macs not apply je an owner of proper(who builds or improsu themen,and. J�//
who contracts for such projects with a convuwr(s)licensed pursuant to the COnuutora
L]I.Law. /
❑ am uempt undo Sec ,0&PCfor this reawn '(O
Owner Dale
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the fallowing tweareti0m:
I ham and will mainuin a Cmtifiea a of Consent to self-insure for Worker's Compero
cation,AS provided for by Section 37M of the Labor Code,for the performance of the
work for which this permit is issued.
1 have and will maintain WOrkcri Compensation insurance,as required by Section
OOOf Ne ltabor Cads for Ne performance Of Newark for which Ibis permit is Issued. - ,
My Workef Cam on InsDurance carrier and Policy number am: 4
Carrier. 3 ^�� Polity NO.: 11'5-o0u08'13
ctKiiiiCATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
This seetian neem not be completed Bthe permit is far me hundred Callus(SIM)
or less)
I certify that in the Performance of the work for which this Permit is issued.I shall not
amploy any person many manner so as to become subject m the Workers'Compenvtim,
Laws of California.Dare
Applicant
NOTICE TO APPLICANT:If,after making Nu Ceeificare of Exemption,you should
become subject an the WLfker s Compensation provisions of the Labor Code,you most
,J.z rLMwith comply with such provisiam or this permit shall he deemed revoked.
z CONSTRUCTION LENDING AGENCY
E" I hereby Affirm that them is a conswetinn lending agency for the Performance of
E the work for which this permit b issued(Sec.309],Co,C.)
Q Larder's Name
] z Landers Address
V O I certify that 1 have read this application and saw than the above infomman is
camel.1 agree w comply with all city and county on insanes and sum Laws relating to
V building construction.and hereby authori,represenwtiveS of this city to enter upon the
r CA ahma-mentioned property for inspection purposes.
Fgy (We)agree to save,indemnify and keep harmless the City of Cupertinoagamat
" f L liabilities,judgments,costs and expames which may in any way same against Acid City
U z in consequence of the graining of this permit. /
^ APPLICANT DERS A DS WILL MPLY WITH ALL NON-POINT Issued by: Date
SOURCE R LATJ�
6/04 Re-roofs
Signawre of A,liaduCcatmnor D�
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Nc•pplinnt or(more building occupant store or handle hazardous material
AS defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Coda,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
Y. PM
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
emit haolmous air concomitants As defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes 9140� �• �S O
I ham real Ne hvaNmsmawrials reyvimments under Chapter 6.95 of the Califoo-
riaH.11h&SaktycO .Secu0m25 .25533md25534.lundem=dthmifthcomical;
does not eu ar how aIcWL ntmy ibilitym dolly the occupant of the y
rcquiremc h4A tAlfyiEm p' ofa a oroca anry.
��wb Signature of Applicant Date
Owner orwhwri.edagem D,w All roof coverings to be Class"B"or better
CITY OF CUPERTINO
,m 3 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36617086 .00
DATE ISSUED. . . . . . . : 09/15/2006
RECEIPT # • • . . . . . . . : 36059
REFERENCE ID # . . . : 06090122
SITE ADDRESS . . . . : 7623 WATERFORD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LANCE ZHENG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : BONITA JENKINS
CONTRACTOR . . . . . . . : KRAUSE, JIM LIC # 21415
COMPANY . . . . . . . . . . : JIM KRAUSE ROOFING
ADDRESS . . . . . . . . . . : 2310 DIANA AVE
CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037
TELEPHONE . . . . . . . . : (408) 779-0704
EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------- - - - - -- - - - - ------ ---------- ---------- -- -- -- ---- ------- - - - -------- --
BPERMFEE VALUATION 19, 000 . 00 266 . 76 0 . 00 266 . 76 0 . 00
BSEISMICRE VALUATION 19, 000 . 00 1 . 90 0 . 00 1 . 90 0 . 00
---------- ---------- ---------- -- --------
TOTAL PERMIT 268 . 66 0 . 00 268 . 66 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
-- -- - - --- - -- - - --- ------------ -- - - ----- --------
OTHER 617 . 15 VISA
TOTAL RECEIPT 617 . 15
•
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.
Homeowner's Name: L a,., G Z _
Job Site Address: 7C Z 33 (IJ
Roofing Company Name:
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
I
Community Development
10300 Tone Avenue
Cupertino CA 95014
Telephone(408)777-3228
CIiY OF Fax(408)777-3333
*PEkTINO
Building Department
JOB ADDRESS: PERMTr#
76 Z- .
OWNER'S NAME: PHONE # Sp - 94-
GENERAL
GENERAL CONTRALTO --/ a-�c �. FAX#
I am not using any subcontractors'ole )&C4.4� t M - /5 O 6
Signatur 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
G
Owner/C acto ignature Date'
n 1
CITY OF CUPERTINO
REROOF
• of
CUPERTINO PERMIT APPLICATION FORM
APN# 11-VBS 4 Date: ( $ /O 6
1 I � l
Building Address: 76 z -3 W p
Owner's Name:
It - O� Phone#: S O 7 - 9p (.
Contractor: License#:
3 5
Contact: / J Cupertino Business License #:
7s
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )iK Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
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 D scriptio : 27
T p " ,e W .�' (h - l K�e�` 0 5 is - &r,Qs S D 7
Residential 9a Confmercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: o, Type of Construction: Occupancy group:
a"
Qty. if
Applicable 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
•