06060020 CITY OF CUPERTINO ' ''� x3r � ::
HuaD1ING DIVISION PERMIT � ONTRACTOR�INI�ORMA TION
BUILDING ADDRESS: WESTSHORE ROOFING COMPANY PERMIT 110.06060020
11847 WOODHILL
OWNER'S NAME: PERMIT ISSUE DATE
1
TONY TSEUNG 5869 WINFIELD BLV 09/02/2006
E:
SANITARY NO. CONTROL NO.
(408) 629-2100
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
oro LICENSED CONTRACTOR'S DECLARATION lob Description
Uescrp
p I boreby affirm that 1 am lismcd under provisions of Chapter 9(commencing
;zay wits Section 7")of Division 3 of the Business and Professions Codc.amd my license is
in0r0foeeamdef m S REMOVE EXISTING WOOD SHAKE AND INSTALL DECRA ST
z Licens Class G� J 7 Lic.M
�o Dam 7 Contractor COATED STEEL SHAKE
ARCHITECTS DECLARATION
'e
< I understand my plans shall W used as public recn(N
iyU
a.t; Licensed Professional
OWNER—BUILDER DECLARATION
us I I hereby aRm that 1 am exempt from the Conuaetofs License Law far the
m C following reason.(Section 7031.5,Business and Pmfeasions Code:Any city or county
which requires a permit to construct.alms improve,demolish,or repair any svucture
lib prior to its issuance.also rcquirns the applicant for such permiuo file a signed suumcnt
:z NatWislicensedpircumttotheprovisionsoftheConwctoesLicenselaw(Chaper9 Sq.Ft. Floor Area Valu ibr1000
Jha (commencing with Section 700(B of Division 3 of tsc Business and Professions Code)or
that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects Ne applicant in a civil penalty of ' Occupancy Type
tut more Nse fico hundred deltas(5500). 3 66 0 4 UT4ee. 0 0
wi 1,a he vm of the dmperay,remyemployees witswagese Nei(ane. W,Bu i.
and dothewor a arta the he Comanatmunents,rted Law
Offeredheto
Required Inspections
and Professions Code;The Conuactofs License Law dors not apply to an owner is LI P
pmpertywho W rids Provided t avu Herron,and en odasauch while himvdfor Waugh his
however.the Wilding or
impmis ve toand ithinnot ouofmledwaReced die Owner.however,Wbuilding arimpmmmentusald within one yens of completion.Ne ownen r0
builder wiB have tie WNan o[proving Nat W did trot build or improm for PusPese a( rtI fg g� M ggp q 1�'
sakJ. Itf93I—.a tlU,1r 9pU'11�V+tg'f/�(iLst�YlfrL7d9[{�^�"
❑1,as owner of the Property am uclusivciy ccar acting wits Returned mnuacmrs m
consumer the project(Sec.7014,Business and Professions Cade:)The Contractor's Li.
cense Taw dors not apply on an owner of property who Wilds r ant tovss Norton,and. 2UU6
who contracts such projects wits sconuanor(s)lircnsed pursuantm WContractofs
Lkeve Lsw.
❑lam uemPt under See .BdPC for Nu reasons .meq
Owner Dale
q1 n,jJ ����
W ORKFRT COMPENSATION DECLARATION
I hereby aRm under penalty of perjurymm of the following dalarauons:
!.fid\
ham and will maintains Ccnifiamof Covent be self-insure far Worker's Compen-
satiern,A provided for by Section 3700 of the Labor Code.for the Wefe..of the
work for which this permit is issued.
have and will maintain Workse,Campmeadc n I.,as mourned by Section
700 of W Latter Code,for the Pciformanee of Ne work for which Nu permit is issued.
My Worker's Compensation Insurancenartier and Policy number an:
rrier.
CaS f A-IE FVN II Policy No.:660L k 90-100L
CE ' PTION FROM WORKERS'
COMPENSATION INSURANCE
(This auction need not W completed if W permit is foromhundred dollars($100)
or less)
I mnify Net in tsc pe,fomance of me work for which this Permit is Wood.1 ahali tot
employ any person in any manrer.w as m become subject to than Warkers'Compevaum
Laws of California.Dae
Applicant
NOTICE TO APPLICANT:If.afar making this Cenificae of Eacmptian.you should
become subject or Ne Waher's Compensation provisions of the Labor Code,you intro
.J O forthwith comply wits such prmvisiav or Nu d ro
Permit shall W desmeoked.
Z` CONSTRUCTION LENDING AGENCY
cz I hereby aRum Nat Nem is.ed!(See,
3 lending agency for the perfurmame of
TL ti Nc work for which Nu permit is issued(Sec.J097,Civ.C.)
G ndcfsNauru
UAdd
z lanndefAddress
s
U 0 1 comfy that 1 have read this application and sues died Ne a a ve imomtaWn is
IGF cones,l agree to comply with all city and county ordinances and state laws relating to
OU building construction.and hereby authorim representatives of this city to enter upon W
W ahovcmcnuuncdpmpeny for i expccuon purposes.
(We)agree to save,indemnify and keep humorless the City of Cupcninu against
F'Z liaemsesoorma fthecansng and upcvu which may in any wayaccruc agaivtsaid City /
U z APPLLIICCANTeUNDERSTANDS Aof rs perniii.
ND WILL COMPLY WITH ALL NON-POINT Issued by: Date O/
SOURC€ UONS.
h '2-64 Re-roofs
Sigmt rt of ApplianuConuactor Date
HAZARDOUS MATERIALSDISCLOSURE Type of Roof
Will ft vidians or future Wilding occupant store orhounc haamov mserial
as defrmd by W Cupertino Municipal Cadc.Chapter 9.12.and the Health and Safety
Code,Section.15533(x)? All roofs shall be inspected prior to any roofing material being installed.
Ya �Io
Will W applicant or future building occupant use equipment or devices which If a roof is installed without firs[obtaining an inspection,I agree to remove
emit hOemnus air contaminants a dcfinhd by W Bay Area Air Quality Management all new materials for inspection.
DisuiCO
❑Yes 7 No
I have vol W hasammu motorists requirtmcnu underCWpur G95 of Ne Califon ,a /
nu Halth&SafetyCode,Secuons25505.25533 and 255X.ImWersaM Nuira c Wilding /U. —,z r 6
does not currently have a tenant.Nat it u my responsibility m noury,W occupant Of W
regaimen hKb tW tai anxaf,Cnre,earoavpmy. ignatureofApplicant Date
Owner or aoNorimdagat Date
All roof cov m s to be Class "B"or better
" g
CITY OF CUPERTINO
!m 2 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36604064 . 00
DATE ISSUED. . . . . . . : 06/02/2006
RECEIPT # . . . . . . . . . : 34672
REFERENCE ID # . . . : 06060020
SITE ADDRESS . . . . . : 11847 WOODHILL CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TONY TSEUNG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : WESTSHORE ROOFING
CONTRACTOR . . . . . . . : FOWLER, PAUL LIC # 21417
COMPANY . . . . . . . . . . : WESTSHORE ROOFING COMPANY
ADDRESS . . . . . . . . . . : 5869 WINFIELD BLV
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE . . . . . . . . : (408) 629-2100
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 17, 000 . 00 245 . 16 0 . 00 245 . 16 0 . 00
BSEISMICRE VALUATION 17, 000 . 00 1 . 70 0 . 00 1 . 70 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 246 . 86 0 . 00 246 . 86 0 . 00
•
Community Development Department
taBuilding Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF 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.t NOTE:'If you-call fora plywood nail inspection and the job is not ready,
you will lie charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4" per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: T h H TS2�th�,
Job Site Address: 11 V 1 Wo o tll 11 i)j
Roofing Company Name: VVGS S�1d �G I�oo�l �✓1C -
Applicant's Signature: Date: f0 2. 0
Greg Casteel
Building Official
Revised 11/2/04
Pnnred ,n Recvded Paper -
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
46UPERTINO
Building De artment
JOB ADDRESS: 11$� C PERMIT#
OWNER'S NAME: e PHONE # 40k 6 -0ab'L.
GENERAL CONTRACT FAX # qo -001-9
I am not using any subcontractors:ISM �j
Signature Date
Please check applicable subcontractors and complete the following information:
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
61 zlo
Owne /Contractor Signature Date
- 1,
CITY OF CUPERTINO 0-eD(o OODU
�a REROOF
• CUPEkTINO PERMIT APPLICATION FORM
APN # In Date:
Building Address: uC
11VIhill ' C't.
Owner's Name: Phone#:
T� Set^ 'x/08
Contractor: NJPhone #: License #:
V)M-XS r7_ Roo l 1Ac-- 46C W-60000 ?tZZ
Contact: Phone#: Cupertino Business License#:
C-Mbri o1 "UA^ He 8 6°I H -00 (0-2-
Type
2Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
/0' Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) �' Other(Specify) D,CV'd 9-10 M* �l�
Number of existing coverings_�_ L3Provide I.C.B.O.Report#
N
To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Polic
Job Description:G o �
2 �Wvc.
t ' woG( SKAk- gvtG( v'1S't4�� Demet1 5rT%^t ca t&44 W OAA
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
(� b0 O
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
•