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08010088 (2) CITY OF CUPERTINOt BUILDING DIVISION PERMIT WRY ' T(J» .Sts.A. """MI T & P0801 RESIESTA IN PRINCIPLE ROOFING 0088 OWNER'S NAME:r PERMIT ISSUEDATE ZONGFU YUAN 1700 N 1ST ST 01/15/2008 INNE: SANITARY NO, CONTROL NO. (408) 436-1681 ARCHITEC(ENGINEER: BUILDING PERMIT INFO BO EO PLUMB - MOECH o p LICENSED CONTRACOR'S DECLARATION e FF 1 hereby affirm Wt 1 am licensed under provisions of Chapmr 9(commencing - Job Description T2`� with Section 7")ol'Divislon 3 of to Business Md Propfes/sions Code.and my license is RE-ROOF,RMV EISTNG WD SHARE, INSTL OSE ^ o, in full fares and effort. O C L 3�^ Di license Clos La.g SHEATHNG, INS'PL 30YR COMP SHNGL,CLASS A 26SQ 3— Duro ry, / G Canuacur .'.({ ir�z`G'sr ee ARCHITECTS DECLARATION L U I undersand my plans shell W used As public recmis g G Licensed Professional y OWNER-BUILDER DECLARATION .� 1 hereby AR.that I oraexempt From to Contractor's License Law for the I:a O following mason.(Section 70313,Business and Profession Code:Any city or county which mquim a pernat in construct altos improve,demolish,or repair any mature u�f„^ prior to its issuance,also requires the applicant for such permit to file a signed,uement that he is licensed pursuanrto the provisions of the Convector's Lomas Law(Chapter 9 Sq.Ft. Floor Area C Valuation $ (ammencingwith Section 7000)of Division 3afsh,BusineasandProfession,Code)or $9000 — that he is exempt themfram and the bale for the alleged mum ption.Any vlalad'on or Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of e,��aT Number Occupancy Type AM mom Ehm fin hundred dollam(gSIIO). 36213022:V e/' P y yp ❑Luownsof die Property,re tets wW togaatheirmk compensssion, will an da the work, d the ahucrum is is nmkunhumaded or Offeredde(nota(Sec.7014,Business and olywhka Cade TW Conoacton,Chino Law does not apply to an mvna of Required Inspections . propemploy .promimnaveslhimprove who AM asucltwork himffem4 for ugh nk awneer.the iproWdad prsuchimpmwments are oat ear ofdmoRerW for ale.B. Wilder thewildingft orhmprovemanriotoldwithin aveyea or mmpve for the ase of Wilder will low W buNm of proving Wr bo did Inst Wild Or improve for purpose art Asia). ❑1,As..or of the property,am exclusively contracting with Rmnsnd mntrncton An construct the project(Sec.7044,Business and Profession,Code:)The Contractors Li- tome Law was not apply In an owner of property who Wilds or improves thereon,and, who contracts for such projects with a convumr(s)licensed pursuant m the Cor mmob License Law. ❑I AM"amp[undo See ,B k P C far this reason Owner Date WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury ane of the fallowing decarWona: have and will maintain a Certificate of Consent to selfAnsum for Warkers Compen- on,As provided for by Section 3700 of the Labor Code,for the peefarmmm of de _ wade for which this permit is Issued. ❑I have and will maintain Workers Compensation Insurance,As required by Section - 3700ofthe LaborCode,fm On performance of Ne work fm which this permit is lamed. ' My Worker,Compensation Insurance carrier and Policy number ore: Carrier. J'/!q Hen✓ Policy No.: rNWe29 G-240 CsEn'G(TEO !&—'P ION FROM WORKERS' COMPENSATION INSURANCE (This union wed not bo compleed Rise Permit Is two=hundred dollen($100) or loss) 1 cerafy the,in the performance of the work for which this permit Is issued.I shall an, employ any person in any muner an an to became subject to de Workers Compenu0on Lawn of California.Dare Applicant NOTICE TO APPLICANT:If,spur making this CcrrIDCae of Exemption,you should Income subject to the Worker's Compemdtlan pmvisiam of the labor Cade.you noel .J z forthwith comply with such provision or this permit All be dammed mated. EZ ! CONSTRUCTION LENDING AGENCY nom. Ihemh aRrm that thou its construct an lending a F r g unci for the Performance of E thewaarmwnmhsuspermutslswd(see309 ,Cis.e.) 0.G Lenders Name M Z)z Lenders Aedm.. V Q 1 certify that 1 have read this application and sum Net the above information is D,E Carmel.I agree in comply wit all city and county Militants and sou laws minting to C) building construction.Md hereby mdu n epmunudves of this city to enter upon the {rI ahme-mentioned property for inspection purposes G (We)agree to ave.indemnify Md keep hamlass the City of Cupar im against ry h Imbllities,Judgmcnu,casts and espeaes which may in any way warue again,aid City UZ in corwqueme or the granting of this warms, t"t APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:9102� Date SOURCE R�S. Re-roofs Signature ofApplicaDare HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will theApplicantCup rm(orae Wildinge.Chapter iundlc Health nmaterial As deRnd by rte Cupertino Municiryl Code.Chaptor 9.@,aM the Hmtlth and safety Cork,Section 25572(a)? NO All roofs shall be inspected prior to any roofing material being installed. Will tho applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,.I agree to remove t h4VAMMua air com minanu u defined by the Bay Area Air Quality Management all new materials for inspection. act? Dyes ❑Nu I have real the haardmu materials requiretwms umlcr Cheptorg.95 of the Cslifor. Ma Heal"Safety Cadc.Scrum 25505,25533 M,125534.I undersand thatisan Wilding does not currently haw a marl.an it is my responsibility to notify the oceupent at the mquircmemsichmostWMetprior toIssuance,ofaCerGfcaeOfOpmq' SignatureofApplicant Date O,r, o Owner or suthom.dlgins Dark All roof coverings to be Class"B"or better CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36213022 .00 DATE ISSUED. . . . . . . : 01/15/2008 RECEIPT # . . . . . . . . . : BS000003695 REFERENCE ID # . . . : 08010088 SITE ADDRESS . . . . . : 7895 FIESTA IN SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : ZONGFU YUAN ADDRESS 7895 FIESTA IN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4118 RECEIVED FROM . . . . : DERECK LOI CONTRACTOR . . . . . . . : DERECK LOI LIC # 27564 COMPANY . . . . . . . . . . : PRINCIPLE ROOFING & ADDRESS . . . . . . . . . . : 1700 N 1ST ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 436-1681 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 9, 000. 00 0.90 0. 00 0.90 0. 00 1BUSLIC FLAT RATE 1. 00 110. 00 0. 00 110. 00 0. 00 1REROOFRES SQ FEET 26 . 00 338. 00 0 . 00 338 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 448.90 0 . 00 448.90 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 448.90 MC --------------- TOTAL RECEIPT 448. 90 - VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF • 00 fig . CITY OF CUPERTINO REROOF • OF CUPEkTINO PERMIT APPLICATION APN # Date: 8 (DAI Building Address: X895 Fi�ST,a L�� Owner's Name: Phone #: 7 a'3 2 Contractor:�p� Phone #: C4C4) 3'99 -7-2-gP Fax #: Cupertino Business License #: _ Contractor License #: 02�� (O d'/635j Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles R�Asphalt Shingles Lf' 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 Mfg. Installation Specs. Job Description: �Z�M�✓�- gt'iSf/;vlr 'Nf/:/D SHak£, In/S/ALL O.S.6' S�/C�TN�u¢ lvs1-4/� 3 v Ca��Z1, -i sly r Gts fl 26 / Residential Commercial Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are an restrictions: ❑ Valuation: 9 aOG I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature CITY OF CUPERTINO REROOF •CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 113SEISMICO Seismic Commercial B Zc1REROOFRES Re-roof Residential B 1SFDWLR00F / 113SEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 113SEISMICRE 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: Job Site Address: 7"e-9 S cSTf Lt+r✓� Roofing Company Name: pei'G'/� �d/ j Gr/✓sr5�u _ Applicant's Signature: V Date: • Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue oclor Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CUPERTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: Ns i✓ PHONE # GENERAL CONTRACTOR. �ti;c; FAX # .¢ Gliiva f7l�.�fi7-s..� I am not using any subcontractors: Signature Date Please check applicable 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