06070134 (2) CITY OF CUPERTINO �� e .,,'cre
21UILDINCIDIVISION PERMIT CON41'RA.CTOR INF RMATIO ,
BUILDING ADDRESS: v LOS GATOS ROOFING p`R "°06070134
7516 DONEGAL
OWNER'S NAME: FERMrr ISSUE DATE
KUANTAI CHEN 888 FAULSTICH CT 006
NE: SANITARY NO. CONTROL N0.
(408) 298-9399
ARCHITECTIENGINEER: BURRING PERMIT INFO
BLDG ELECT
17-1C= PLOUM
0
Ip LICENSED CONTRACTOR'S DECLARATION Job Description
u I hereby affil m tie l Am Ik..nsed under provWam of Chapin 9(mmmmwln{ P
MN Section 7001))of Division 3 ofthe Business and Profnsdom Code.me my license if
ina11room sad affect..C3L) jj007d7 REMOVE 2 LAYERS EXISTING ROOFING. INSTALL 30LB
i License Class Lie'If
Dam 712I=Conlrxlar hrS6n FELT AND CLASS B HEAVY SHAKE
ItARCHITECTS DECLARATION
i 1 understand my plans shall he used as public records
a
W Licensed Pmfcssional
j0 OWNER-BUILDER DECLARATION
I 53 1 hereby m Em that I am exempt from the Conummor',License Law for the
:0 O fallowing mason.(Sccdun 70313,Business and Prefeuluns Code:My city or county
$ which requires a Permit an consumer,Allo,hopmw,demm ixh,or repair my etsuetum
prior to its issuance.Alan requirca the applicant forsuch permitho fit a signed ale mem
`e
that heialicensed putmmtmthe provisions ofuse canonewe,UmomLaw(Chapter 9 Sq. Ft. Floor Area Valu tb8747
ITF (comeencin{with Section 7000)of Division 3 of the Business anal Pmfeuions Code)Or
$ that he is exempt rhesefrom and the hub for dm alleged exemption.My violation of
Sad.7031.5 by arty applicant fn a permit subjects the applicant Ire a cwll penalty of399th Nltmber 0 0 Occupancy Type
nal mart No
an w hundred dollars(SM 6616 U L 7
❑Lasowneraf the prolumclus myemptayca wird wa{eaasen(role eompenation,
will do Ire nous and do ah Con meet Intended ter Law
domras apply toad,Businw
and Proraalam code:The eandaemh Laeertse law aoa mat apply to an owner of _ Required Inspections
property who builds orimprova lhemon,and who does,uch warkbim,elfar through his
own employms,provided the such improvements see not intended Watered for de.It,
however,the building As improvement i,sold within aro year of completion,the ower.
builder will have to burden of proving the he did not build or improve for purpose of
ale.)• o
0 1,As Maar Of do property am exclusively contracting wird license d endaMn in
camtmm the project(See.7044.Batman and Pmfadana Cocla)The Cmmmar',U.
erns LAw dao ore wpb m m o a papeny wbo builds or impmva Iheran.and O
whocomacts fnauch gajea,wird a convactar(Olkenmd pursmnt m Ne Contrr7oM1 /
License Law.
lam (\7
aempt under See ,BhPCfor Nb wan
OwnerDECLARDam
WORKER'S COMPENSATION ATION
I hereby affirm under penalty of perjury am of do fallowing declensions:
1 have and will maintain a CmiRmm AMAAnn At to elf-im are for Worker%Compen.
sation,As provided fm by Section 3700 of the Mbar Cade,for the performance of the
work for which this permit is issued.
0 I have and will maintain Worker's Compensation Immanm,As required by Section
3700 a the lxbn Code.fm the perfamunm of de work forwbich this permit is Issued
My Worker',Compensation Insurance carie and Polity number am:
Cartier. —V/WA'''��VJ Polity Na.: 2279•ZOd6
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thin need.need arhecompleted If the permit is fnmc hundred dollars(SIOt)
ter ices.)
1 certify dmf in the performance of the work for which this permit is Wood.l shall not
employ any person in any manner an As a becomo mbject to the Workers'Competnaths,
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you shouhl
Income subject m the Worker's Compensation provisions of the LAW Cade,you mum
.JO forthwith comply with such provisions ter thin permit she] em
W]be deed revoked. '
z� CONSTRUCTION LENDING AGENCY
[.r Ibereby affirm sive dam is.comuuction lending agency rattan bcrtmvannu f
a
the woh far which thin permit Is issued(Sm.3097.Clv.C.)
aQ Undoes Namc
z lender's Add.
zw)U0 L certify that 1 have read this application and some Nm the show informAtiu t Is
W F comm.lag=is comply with ml city and county ordinances and sate laws relating to
0 V building can5wction,and hereby auNanse representatives of this city,o mc,upon rbc
U move-mentioned property for inspection purposes.
O. (We)agree to save,indemnify and keep harmless the City or Cupertino again
rig Iiabilidesjudgmemts,costs andexperse,which may in my way acerae sg inesaid City >
V Z in camummmu a of the{anung of thin permit.
'••' APPLICANT UNDg&SIANDS ANP WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGU O
7�Za�d Re-roofs
Signature of ApplicaHAZARDOU
HAZARDOUS MATERIALS
Occupant
DISCLOSURE Type of Roof
Will the applicant orforumbuilding e..Chantmarc orand hazardous material
As defined by tie Cupenim Municipal Code.Chapter 9.11.and rhe Health and Safely
Code,Secdon 15531(1)1 All roofs shall be inspected prior to any roofing material being installed.
41 0 yin �N.
Will the applicant or future building Occupant use equipment or dcvicos which If a roof is installed without first obtaining an inspection,I agree to remove
emit hvavdnm air contaminants As Jelbud by the Bay Area Air Quality Management all new materials for inspection.
Curter?
0Yn
III aveWLhehwwdodalsmquire=wunJerChapanrd.95ar Ne Cal �/Z�/O(y.I.Halthk od,255ling
does no,currently have a rename dW It b my lespomihilhy At mtiry de o c amat or de
rcyvimmcnu which ` mu of a Cetrrcae of J Signature of Applicant Date
7o
iZoo All roof coverings to be Class"B"or better
Owner ser authmimd,gera Dam
CITY OF CUPERTINO
len 1 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36616027 . 00
DATE ISSUED. . .. . . . : 07/20/2006
RECEIPT # . . . . . . . . . : 35324
REFERENCE ID # . . . : 06070134
SITE ADDRESS . . . . . : 7516 DONEGAL DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER KUANTAI CHEN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY . . . . . . . . . . : LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : 888 FAULSTICH CT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 298-9399
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 11, 000 . 00 180 . 36 0 . 00 180 . 36 0 . 00
BSEISMICRE VALUATION 11, 000 . 00 1 . 10 0 . 00 1 . 10 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 181 .46 0 . 00 181 . 46 0 . 00
•
ZCITYOF
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408)777-3333
CUPERTINO
• Building Department
JOB ADDRESS: PERMIT#
-115"6 Ob i-c p L -7e ( -] "l
OWNER'S NAME: CH-&-A PHONE # 6
GENERAL CONTRACTOR Lj aao� �AX #
I am not using any subcontractors:
Signature Date
Please check a licable subcontractors and complete the follow.-formation:
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
_ ---
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CI OF Telephone: (408)777-322$
C U.P E IST I N® 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 buildingeinspector. 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 allnew 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 with the aboo�ve/stated policy on re-roofing.
Homeowner's Name:
Job.Site_Address:-_r. — /S/(e _�Qn e�C l!�
_._._.__._. - - - - -_. - ..-- ------- - -
Roofirig Company Name: -
O
A plicant's Signature: Date:
Greg eel
• Building Official
Revised 1/30/03
Printed on Recycled Paper'
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APPLICATION FORM
• APN# Date:
�o- l(0 -027 9 IS" os
Building Address: / 5H / bd n F a I O r
Owner's Name: �(� Phone#:
lean a OA &yob a5 -,2916
Contractor: Phone#: O License#:
a, koo' 0
Contact: Phone#: Cupertino Business Iicen5e#:
Sa�m� 358
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ 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 0 "
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
• JJob De�,sc 'P 'on: 2 h 3
Residential 'Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if.
there are an restrictions: LJ
Co t o�project: C Type o Constructi Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Gro'
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
- _. .-_.._ __ BITII DIhTG-----
--_.. .. _...._._.._.__BSEISMlCOM-..---_-_.. ----_. ---Seismic Commercial---_..,.._.. __. .... . _-BUILDING_..._-._.-
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•