08020102 (2) CITY OF CUPERTINO
BUILOING DIVRHON PERMIT tg�U1 "•LRAGTUR TIV '1.} TI'ON� ,
fes.
PERMrr NO.
BUILOIrI)9'T9'bEDAR SPRING CT T D ROOFING 08020102
REITs NAME:: C PERMIT ISSUE DATE
SHIN SEONG S AND JIN S 675 TULLY RD 02/15/2008
PHONE: (408) 892-8872 SANITARY NO. CONTROL NO.
ARCHITECT(ENGINEER: BUILDING PERMIT INFO
EO EO PLUMB O
300 LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm Nat 1 am licensed under pmvisiotn of Chapter 9(commencing Job Description
lug with Section 7M)of Division 3 ofthe Business and Professions Code.and my license is RE-RF,RMV COMP&INSTL 50YR COMP,NO PLYWD,CLS
.� landefresR CI um3Lcg A, 22SQ
3 F Oate Conons"ou
e AR TECTS DECLARA N ((.
y 1 undentand my pl"a x011 W used u public rt
]�U
g e,"„ Licensed Pmrcteum.1
5 j OWNER.BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the ContracmYs License Law for the
A o following memo.(Section 7831.5.Business and Pmressiou Code:Any city or County
Z21 which requires a permit to carrlruc4 alma bureaus,demolish,or repair any swcture
iy prior w its issuance.also requires Ne applaud forsuch permit to Eleasigocd Wtmmnt
gg�D that he blicensed pursuant to the proviaionaof the Contract/s U.C.Law(Chapter 9 Sq.Ft.Floor Area $8000 Valuation
9 (commencing with Section 7000)of Division 3 of the Business and Pmfesriona Coda)or
S that k in exempt tlmmfrom and the bub for the alleged exemption.Any violation of
section 7031.5 by any applicant for a permit mbjccta me applicant m a civil penalty ofNumber Occupancy Type
not mere man form hundred dollars(5500). 3 6 6 5 4 0 5 9 'lY: V
❑1,u awnor of the property,army employees with warts u meb sole compewdon.
will do the work and the suacture isnotintende'd or offered fanale(Sec.7044,Business Required Inspections
and Pmteuiau Code:The Convectors License Law doe not apply m a owner of q P
propertywho wildsorimpmvee thueon,aod who doessuch warkhimselfor through his
own employees,prodded thatsuch impmwments are notintended armilmed forsale.if.
hareewr,the building or improvement is mid within ane year of compietion,the mvwr.
Wilder will haw the burden of proving that he did not Wild or impmw for purpose of
Sale.).
❑1.as mutter of the property.am exelulnly convecting with licensed ccnvatn in
emmuct the project(Sec.7014.Business and Pmfwiam Code:)The Coouwaor's LI-
cnwe Law done noupply in an owna,of property who Wilda or imprem Wetmn,and,
who contracts for such projects with a conuactKs)licensed pursuant to the Contmetor's
License Law.
❑lanaxemptundenSee ,Bg:PCformiamuon
40-r Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury aro of the following declamations:
❑I haw and will maintain a Certificate of Carmol t self-Insure far Worker's Compen.
sauon,u pmvided for by Section 3700 of the Labor Code.far the performance of the
work for which this permit is issued
Iad will maintain Workeh Compensation lutuance,u required by Section
3 of dte Labor Code.far me performance of the work fes which this permit is issued '
My Worker's Compeosed.jpmnncc amu and Policy number am; — I —
Caller: e'SI 1 paltry Na.: ' �j
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ibis soc0an need status completed If the permit is foram hundred dollars(SIM)
or[can)
1 certify that in the performance of mm work far which this permit b issued.l shall nut
employ any parse.in any manerm u to Wceme mbjecl in the Workers'Compensation
Laws of California.Data
APPlicmt
NOTICE TO APPLICANT.If,after making this cmdriicate of Exemption•you should
become muco m me Woher's Cmaimm huon previsions of me Inbar Code,you muse
.�JQ forthwith comply with such Provisions Or this Permit shall W decreed maimed.
Z ZCONSTRUCTION LENDING AGENCY
[-w 1 hemby alrvm mat mart is a coatmctim lending agency(or the per(urmamx of
Rte > the work for which this permit Is issued(Sec.3097,Civ.C.)
WM Q lenera
z Lendder'ss AAddddress
t) I cavity that 1 ban rod this application and sate that the&hen information is
It, correct.l agree to comply with all city and county ordinances and sum laws mla8ng lo
-C)tV" building construction,and hereby autharim mpmxnWins of this city t renter Open the
IA above-men0ened properly for inspection pugtseu
Oa
(WO)agree to ave,indemnify ad keep hermlm the City of Cupertino against
ti fA
liabilities.judgments.costs and expenses which may in my way accrete against mid City
V 7 in coaegmn a of th I mntln6 a(this pmrmit.
s� APPSm a a D RSTANDS AND WILL COMPLY WI ALL N -POINT Issued by: Date
SOURCE G ONS.
� I u Re-roofs
Signature fApplian onuacto Dat
HAZARDOUS MA DISCLOSURE Type of Roof
Will the applicant or future building and atom orhandlc hatemous material
,116Lkanal by the Cupertino Municipal Cade.Chapter 9AZ and the Health and Safety
Section 255324)? All roofs shall be inspected prior to any roofing material being installed.
❑Yea Na
Will the applicant orrIf�rutarr55,�uilding occupant use equipment or device which If a roof is installed without firs[obtaining an inspection,I agree to remove
emit he'raNnw air cmuminaly(ujlkfincd by the Bay Area Air Quality Management all new materials f r inspection.
District? //--
❑Ya ON.
I ban mad the heoudoa matrialsmquitements underchaperh.95 ofthe Califon.
�/��/J I � O Y
"iOHalthb.W
u 27505,25537 and 25534.1undctstand thuifthe Wilding ( l - �., O
Jms ret cora Nat it is my responsibility t notal' Bre accts r mf me
mgairtmenI r mancertirm.tar Signature of Applicant Date
�9 t o
Owner or aulhorimd agent Dat All roof coverings to be Class"B"or better
o�oa o �a
CITY OF CUPERTINO
G � REROOF
ACUPEkTINO PERMIT APPLICATION
APN# � (] Date:
Building Address: '7
Owner's Name: Phone #:
S { �) �� s . SCo Q
Contractor: Phone #: q
I D noo �� ivcl
Fax 93
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
aGWood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) CCnjp ❑ Other (Specify) C m n
Number of existing coverings ❑ Provide I.C.B.O.. Report ##
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: C� 1,,1 ID
No Pt �/ W OCA
Residential Commercial
Fire Zone: Yes N Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: D
I Have ead, erstand and Will Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
REROOF
OCUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
'Zr l 1RER00FRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
•
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: J �0 a S � It Ll
Job Site Address: C[ f n tC C f
Roofing Company Name:
Applicant's Signature: Date: /
Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36654059 . 00
DATE ISSUED. . . . . . . : 02/15/2008
RECEIPT # . . . . . . . . . : BS000003959
REFERENCE ID # . . . : 08020102
SITE ADDRESS . . . . . : 11656 CEDAR SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SHIN SEONG S AND JIN S
ADDRESS . . . . . . . . . . : 11656 CEDAR SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5139
RECEIVED FROM . . . . : LESLIE A HOANG
CONTRACTOR . . . . . . . : LESLIE HOANG LIC # 23155
COMPANY . . . . . . . . . . : T D ROOFING
ADDRESS . . . . . . . . . . : 675 TULLY RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
® TELEPHONE . . . . . . . . : (408) 892-8872
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 8, 000. 00 0. 80 0. 00 0. 80 0. 00
1REROOFRES SQ FEET 22 . 00 286 . 00 0. 00 286 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 286 . 80 0. 00 286 . 80 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 286.80 VISA
---------------
TOTAL RECEIPT 286 . 80
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- --------------------------- -------- --------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS -60.4 ROOF IN-PROGRESS
605 FINAL REROOF
Community Development
10300 Torre Avenue
SO
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
*tUPEI�TINO
Building Department
JOB ADDRESS: PERMIT#
�; �fi 0 ?0A 0l
OWNER'S NAME: SPHONE SOS $GS 14 S
GENERAL CONTRACTOR: i D o ' t\ FAX `(n 9 2 k�
I am not using any subcontractors: 2
Signature Date
Please check applicable subcontractors and complete the fo owing mformati on:
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