05100209 CITY OF CUPERTINO - - - s Izx�uRa f4° ' ' •`' `� `• -
r BUILDING DIVISION PERMIT ' CCSN<T.I2A.CTC'TIt INk` ?• A'I'L - N«�,
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BUILDINGADDRFSS: WING' S ROOFING INC PERMIT NO.05100209
10231 WESTERN nR
NEWS NAME: PERMIT ISSUE DATE
ZHOU XINLAN 3243 SYDNEY
NE SANITARY NO. CONTROL NO.
(510) 889-9068
ARCHrrECr/FNGINEER: ., `.1-• 1 ' BUILDING
IIECr PERMIT INF
BLDG NECH
l rt l� l�
jOp i LICENSED CONTRACTDWS DECLARATION Job Description
I so i I hemby affirm that 1 sm 1(¢wN under proviuooa of Clumcr 9(cemmmems
with Section 7000)ol'Dlvidon 7 ofthe Business Profs uu andmylkemeiu
'onH infallrweaand a. `.. - ([ T/O WOOD SHAK, INSTALL 7/18” O. S.B. AND ASPHALT
iJ= Lioenm Cln Lld.g _
�, Di¢ Canua.7ai SHINGLES
q ARC I7EC'S DECLAR ON•
12 ' I undenund mY Plw shall be used a puMfe rtedrde, _ /
s ig Licensed Professional
b OWNER-BUILDER DECLARATION
Commends
i 55 1 hereby iRirm.Not I am emmpt fmm�the Canuectors Lkcnm Law for the
a O following moon.(Salon 7.51.5;Busher. and PmfdWml Cada:Any city m maty 0
3$
which mqulma a e,postal,A].m tun l the alar.Improve•demolLat or rtdoii any ameture
seen,
pat ac is ocrun gum m inims pinvis icanr ranuch p darts Ne a Law(aatemem
latheuliccwcd pdrweol w Ne of Disimuar the,Contid ractor'sLhxwemons Code)or Sq.Ft. Floor Area 'qWWi70 (��QOQ
5 $ (dot he is
p,thmaith ran Rand of basis nlaf Alleged
and Profeuiavi Code).
(� Natio u 31.3 b Ncmfmm;and far
per for the Ylct a eaempaoto Any violation of
act on 70T.5 by any bed dont(a a perch sabjedu the applicant to•civil palmy of 5 91 Number Occupancy Type
act roam lunfiw nudrd aollan(55ao1. .. 35911008 . 00
0 LU owmrr of ler PmPerty.army employca with"gnu amirmu cempewdon.
will dodie work.and Nemuawe is amuundd motioned forsale(Sao.70th.Business
and Pmfasalom code:The contractors L)aanm a ro
Law aot apply N an owner or Required Inspections!
praprny who builds m improv Orrean.and who son awn work Himself or Inroegh his
own cmploym,provided that such Impmnman s art eon inendd uraRaed fmsala B.
however.the building or Impeavereant is mid wWdn oro Year of m tpldlan•err manam-
builaer will have that burden of proving that ho,did rot Irild or 4nprove for purpose of
ate.).
0 1.as,away of Na property.am modualnly Watacting with Bawd mmnams in
connroct the project(So.7044.Business W Profession,Code:)The Cantacturt U.
iewa law dors am apply in an owner of property+•ho builds m Improves thereon•and,
whomnmcufmswhpmjcmwithamnuwLor(OIieon dpurwnnmthe Contractors
License raw.
❑l un exempt under Sec .B St PC fm Nu recon
Oar
WORKERS COMPENSATION DECLARATION
I hereby 481m under penalty a(perjury na of the following Eeclardoan:
❑I have and will meinuin a CeNliceu ofComenn N self-Wort forWoulmeaCompen-
sedan,u provided for by Section 3700 of the Labor Code.for W performance of W
work for which Ws permit is barred,
0 1 ben and will maintain Workers Compensation Insurance.u required by Section
3700 a(Ne labor Cade.forth performaappee of Ne wart fmwhich N4 permit is laswd '
My Workeh rep mlwl ummce ayrier and Polley Quyl2arce
Grrkr. E,tML Policy Na.:4/
CERfIFI •OF EX PITON FROM WORKERS'
COMPENSATION INSURANCE
milssealo t meed mthecamplemd trust permit is foram hundred dollars($I00)
or Wt)
I andy Net u Nc performance of the work(a which Nis perms V issued 1 shall own
employ anypermn in my manucrso u in become subject to err Worked Canpenwim
Laws of California.Data
NOTICE
NOTICE TO APPLICANT:If,eller making his visi of of E Labor
Code
should
become mbjca m Ise Wmkero Compensation pmvWmai of the Labor Code you moa
.JO ranhWlNamply with scab provisloumNu permitshall be dared.voted.
z'tiCONSTRUCTION LENDINGAGENCY
F.m Thereby Nirrms NU Nem is a construction lendingagem for the performance of
C ti the work fur which Npermit is peit la lewd(Ser.3071,Civ.C.)
aG Lemlet' Nmc
D Z Lender:Adams
U O 1 certify that 1 have rad this application W sum aw de above iarmcmdon Is
',•'•� mmact.I agree to amply with all tiny and county oNiwncca and stem laws mluing in
O rV' building construction.and hereby authorize mprnenmhes of this dory a enter upon Ne
W alrve-menlaned property for Inspection purymes.
(We)agree u save.Indemnify and kap hamkas Ne City of Cupertino against
y Iiabilllea judgments,Was and upansa which may In any my maw against aidCity
UZ inconsequence of ler arming or this permit. ^�
"•' APPLIC Nr UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date C•—p C—
SOUR E U ATIONS.
Re-roofs (2-Z
Signa ppllcho on0dpr Dau
HXpARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or lot=building occupant Imre or handle hazardous material
u defined by the Cupertino Municipal Code.Chapter 9.11.and the Halt Vol Safety
.Section 25531()? All roofs shall be inspected prior to any roofing material being installed.
Oyu o
Will Na applicant m to building occupant wb equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hua m.air conuminanu as darned by the Bay Ams Air Owlity,Management all new m8 erials for inspection.
District?
OYn Ip{,N. /
I have mW ere hamdutrumiab mqulrtmcwunduC7upurd95 offt Calif.-
Ns Health&Safmy Cade Samw253M.15533 and 25534.I understood thwifae balding
doesacro manN
y have a enl u u m
it is my responsibility dfY the mcupont of Na
m,Fo n h' hmua met priormissuance err.cmlrram Signature of Applicant Date
a All roof coverings to be Class"B"or better
Ow ra umriW 1pir Date'
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
�UPCITY OF EI�TINO Fax(408),777-3333
Building Department
JOB ADDRESS:a3/ PERMIT#�/�aG,
}
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: C `S (/1/ FAX # a — c6 8
I am not using any subcontractors: z
ignature Date
Please check applicable subcontractors and cqinplete 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
Owner/Contractor Signature Date
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: euem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35911008.00
DATE ISSUED. . . . . . . : 10/26/2005
RECEIPT #. . . . . . . . . : 31748
REFERENCE ID # . . . : 05100209
SITE ADDRESS . . . . . : 10231 WESTERN DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ZHOU, XINLAN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2944
RECEIVED FROM . . . . : XHINLAN ZHOU
CONTRACTOR . . . . . . . : CHEA, WING LIC # 21240
COMPANY . . . . . . . . . . : WING'S ROOFING INC
ADDRESS . . . . . . . . . . : 3243 SYDNEY WAY
CITY/STATE/ZIP . . . : CASTRO VALLEY, CA 94546
• TELEPHONE . . . . . . . . : (510) 889-9068
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 81000.00 147.96 0.00 147.96 0.00
BSEISMICRE VALUATION 8,000.00 0.80 0.00 0.80 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 148.76 - 0.00 148.76 0.00
METHOD OF PAYMENT AMOUNT NUMBER -
----------------- ------------ ------------------
CHECK 148.76 308
------------
TOTAL RECEIPT 148.76
•
OSI oOZoq
CITY OF CUPERTINO
REROOF
�UPERTINO PERMIT APPLICATION FORM
APN# i ) pOg. OO Date. D —Z- S,
Building Address: /D I_ `Cs+_eVA
Owner's Name: X
` Zh vu Phone#:
Contractor:' �s C „�� Phone# D/ License#:
Contact: Phone#: /� �- Cupertino Business License#:
u\1 1 Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles X 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#
To be Removed ❑ Provide Mfgr.Installation Specs.
Ali Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑
Blob Description: �,/. // 7� C/o s`- O
iu^ti-
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Projer 8 Type of Construction: Occupancy group:
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
� '7
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• Telephone: (408)777-3228
000F Fax: (408)777-3333
CUPEkTINO
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 Ucyon re-roofing.
Homeowner's Name: 2� �,r
job Site Address b � / ,` S t"'► A t
Roofing Company Name: 'v Suri/V
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper