06050055 (2) CITY OF CUPERTINO
BUII.DINC DIVISION PERMIT �C,,ONTRA�1'.fli�T.Nk'ORMAIO,N
BUILDING ADDRESS: r CUPERTINO ROOF, INC PERMITNo.06050055
10826 E ESTATES D
OWNER'S NAME: PERMIT ISSUE DATE
CHANG YAOPEI ET AL 1052 KELLY DR. 05/08/2006
ONE: SANITARY NO. CONTROL NO.
(408) 973-9427
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
EL
' BLDG ELECT PLUME MECH
LICENSED CONTRACTOR'S DECLARATION - Job Description
u I hereby am.t 1 licensed under provisions of cmpmr 9(munmancm, p
1 o am
m
TEAR OFF SHAKES INSTALL 40 YEAR ELK CLASS A
gData ` Canuxmr p
D
;p CHffECTS DECLAR E
I understand my plans shall be used u public ucards
FI e B\T�t(ALG`
C In Licensed Professional
'y3 OWNER,BUILDER DECLARATION
i Z I bmcby M.that I am exempt from the Conuacme.License Law far the ,I�a/ 'n .SOO�
O O following reason.(Section 703 L5,Busireu and Professions Cade:Any city or county MAY ` L
t.2 m 2 which natim.a permit m eansuoer,alum.hapneve,demnllah.or n:peir any museum 9000
°zY
Her ler its issuance,also requires the applicant(m such permit in rile a signed s mrcm
that he is licensed pursuant an tie provisions Of the Canuacmr's Ucmm Law(Ch Ptm 9 Sq.Ft.FI -Not
^/^ Valuation
5 $ (commencing with Section 700G)of Division 3 of she Business and Professions Code)or
thal he is exempt tbmefrom and the basis fm the alleged esenplim MY violation Of
Section 7031.7 by any applicants vt fm a permit subjthe aPPImant m a awl penalty of r Occupancy Type
amt roam than ave hundred dollars($3004
0 I,m awnm afde pmpcny,m my employca with wges u Neje role compcmdon,
will do thework,md the structure is commanded ar offered formic(Sec.7044,Business Required Inspections
and Professions Cade:The ConuacmYs License Law does Out apply m m Awa m at q p
property who builds or importer de reon,and who does such work himself or through his
Own cmploym,provided that such improvements are not InmMed or offered for via If.
hawevm,the building or improvement 1.sold within om year of mmpktian.the"Mr-
builder will have the burden of proving that Im did not Wim or improve(m purpose of
ask.).
0 1,u owner of the property.am exclusively conoacting with acensnd ennuamav to
mmarma the pmjcm(Sec.7044.Buatinea and Poefenens Code:)The Coam,3o'.U.
cmc law does rot appy m m owner of property who builds m improv therm,sod.
who rnnuacu for such Projects wim a canuacmr(s)licensed pursuant as Ne Contranoh
Lkenm Law.
0 l am cram,'under See .B&PC far mice reason
Owner Data WORKER'S COMPENSATION DECLARATION
1 hereby al under penally of perjury ane of the fallowing declmtions:
Ihaw andeid mainu)nen 3a of ConsentmCO&_far to aresurnen Of cast melon, r pmvidhi fpe mi Sectiond. of the Labor Code,fm the peAarmmce of aM
wah for which this permit is issued.
0 1 have and will maintain Worker.Compensation lntsuranm,as required by Section .
1700.!the Iabm Cede.ren the parfao .ofto work fm which this perch u lasered.
My Warkee.Compenudoe lamer carrier and Policy number m`:/
carrier:Tr1�'Q'1•L �i,✓1 Policy No.: p Z 7 0-0<
EITnFICATEOF EX PILON FROM WORKERS'
COMPENSATION INSURANCE r
(This setian mad not be completed If the permit is farm hunueddallata($IUO)
lir leas)
1 cenifv that In the performance or ere work for which this permit is issued.I.hall not
employ any person in my motorman a In become subject in tewaotere Compensation
Law.of California Dam
Applicant
NOTICE 7'O APPLICANT:If.al making this Ccniaam of Escreption•you mould
become subject to the Workrls Cosepcmdon provisions of the Labor Code.you am
,J O forthwith comply with such provisions m uced this permit"I W derevakcE.
z 0 CONSTRUCTION LENDING AGENCY
a14 I Wmby alikm me,inert is a construction lending agency for me lerforman¢of
7 me work(err which that permit k named(Sec.3097.Co,.C.)
W�0 Lender'.Name
.7. z Lmake,Address
(„)Q I sonify that I have road this application and sum tat to show information is
U, f~ conecL I agree to comply with all city and county ordinances and suer laws miming 10
0 building construction,and hereby authorise Mprasenuti.a of tis city to enmrupm the
{21 above-mentioned property for inspection purposes.
g4 (We)Agra m taw•indemnify and icer,hamlet to City of Cupertino against
sti V) liabiliteawa
..judgments,eu and expenses which may In my y acme against said City
U Zt. inence of the lintating of this rnii.
2E ICICA`NTT UNDERSTAN 5 AND WILL COMPLY WITH ALL NON-POINT Issued by: Date -:: =O's—0
SOU UlA NS.
UL Re-roofs
agi of ApplicmbCanuecm, Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will No applicant or future building occupantsmro of handle Mee daus msmrial
as deaned by the Cupertino Municipal Cade.Chapter 9.13•and the Health and Safely
Codc,Satuon 25532(07 All roofs shall be inspected prior to any roofing material being installed.
DYa --Q7t9
Will the applicant or future building Occupant ma:equipment or dcvi=which If a roof is installed without first obtaining an inspection,I agree to remove
Omit haurdous air contaminants as deem l by me Bay Am,Air Quality Management all new materials for inspection.
District?
Oyes
u
I haw read" ahuardm ma is requlremcnes umerOmpter 695 afde Califon-
am
alifonau Health&Safety Code.Satimss 25705.35533 and 25734.1 wWcmwd Lass if de building - Lll iyC)f
d qu oat corm hi haw a c met tat it imy rtspafa ccty c tory cc Occupant of the
myu sunk: mautWmet priormissuame cera Certiricam or occupmcy' Signature of Applicant Date
o m afueae em D0� All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
aClOF
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
SEUPERTINO
Building De artment
JOB ADDRESS: z GPERMIT#
�t �"oS�ao s�
OWNER'S NAME: o !jPHONE # Z -12- - 9-1 9
GENERAL CONTRACTOR: C-0 Pt L o FAX #
I am not using any subcontractors: - -
Signature Date
Please check a hcable 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
Owner/Contractor Signature Date
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: YY)l e s C__1--N c%, ( 11
Job Site Address: d 2 C_ S��frt
Roofing Company N U 1
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
am 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36922008 . 00
DATE ISSUED. . . . . . . : 05/08/2006
RECEIPT # . . . . . . . . . : 34285
REFERENCE ID # . . . : 06050055
SITE ADDRESS . . . . . : 10826 E ESTATES DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CHANG YAOPEI ET AL
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4534
RECEIVED FROM . . . . : CUPERTINO ROOFING
CONTRACTOR . . . . . . . : DAVE SMITH LIC # 25701
COMPANY . . . . . . . . . . : CUPERTINO ROOF, INC
ADDRESS . . . . . . . . . . : 1052 KELLY DR.
CITY/STATE/ZIP . . . : SAN JOSE, CA 95129
TELEPHONE . . . . . . . . : (408) 973-9427
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 9, 000 . 00 158 . 76 0 . 00 158 . 76 0 . 00
BSEISMICRE VALUATION 9, 000 . 00 0 . 90 0 . 00 0 . 90 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 159 . 66 0 . 00 159 . 66 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 159 . 66 1737
TOTAL RECEIPT 159 . 66
•
+ CITY OF CUPERTINO
' � REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# 3to q _ 0qn -� Date: _ — 0 (0
Building Address: I D,arb ff�S+
Owner's Name: Phone
Contractor: License
<' U R 4? l-H v o0
Contact. Cupertino Business License #:
w�
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
—'—q 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-,---o
Job Description: , J /
tcge,A� ' �l� 2 h S l� o c
Residential ffj- Commercial ❑
Fire Zone: Yes ❑ No--0 Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Pro'ect: T of Construction: Occupancy roup:
6A n
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
•