08030139 (2) -CTTY OF CUPERTINO ?t�.at• 'Y;
BulLolnG olvlstoNPERMIT •ICONTRACTQIt INFURMATIQ .
BmLQRic�tpgttEs
PPERMIT NO.
ARK CL TBD- - TO BE DETERMINED 08030139
1R'US NGALME/: PERMIT MS DATE
CHU STANLEY C AND NANCY I 03/25/2008
PHORIaOTTV SANITARY NO. CONTROL NO.
ARCHITECTIENGINEF3t: BUILDING PERMIT INFD
BLDG ELECT PLUMB MECH
0 0 0 0
X00 LICENSED CONTRACTOR'S DECLARATION OFIOb Description
1 hereby afOrm Wt 1 am lisneed under provisions of Chapter 9(commencing - P
with Section 7OrXB ofDivWon 3 of the Bwmmas orb Prafsdom Cede,and my licew u RE-RF, T/0 SHK&REPLC W/30LB FLT CLS A, 30 SQ
^ N in cull form and an L 1 -7 fe o
? Lleenseclau `L` � 9 Lu,
9 DateContractor
ARCHr1ECrS DECLARATION
1 unaermnd my plans shall be used as public anari
yillaCC LimwaPmreauomal
y OWNER-exampt trDECLARATON
1 mason.
.affirm that 11. exempt from the Contractors Co e:A nae Law for the
i D following moon. eccuon 703 1.5,Business and Profee moll Code:Any city of county
which its to.•permit re core she alley,improve,h Permit t ri e a ut,sig n d umctum
—Z C prior dour he its sensed p amu paramount
in requires pro'su applicant for sucC.Oun un w ftie ae Law
suument
4< Na haulimwdpumuntwW pmviposofthConumtofsllmnte aw(Chapu 9 Sq.Ft. Floor Area Valuation
3 roar he is roomot uw�ar a"mmnd ft basis s fa<maeamgad e�xa pt�.Any viola ah)ei $11000
Section 1031.5 by any applicant for a permit enbjema We applicant w a tial penalty Of yy�t Number Occupancy Type
nut roam than fim hundred dallars(5.100). 32632012 :17 P1• ,
0 1,u ownu of Oe propwy,m my employes with toga n IWb miecompewdon,
will dothewank andec The num srotsoundedm Law
dofm sale(See.1011.Budnw
and Property
aro case The c000clora and
sho law acro ant appy W rt owner is Required Inspections
man ertywW Wipar idmprma dh turpoandwho ane rani twukhimvJfm Ouwgh 4h
man employees.the iprodded poomen imp.mid wain orm inundedmoaemd for W&If.
hawemL the buildingorlmprowmmnVmide did oroyear ofc promefrthaOwner.
bailout MR haw W burden of Paring Nat W did not build m W prow far purpose of
0 1,as owner of ted Property,am exclusively contracting with focused mnttslms in
canton the yrojct(Sec.7011,Business and Pmfc"..Cade:)The ommmwfs Li.
mw Law dos not apply in an awtmr of property who Wilds or improves thereon.and.
who comrscu for such projects with a con tmonar O licensed punwnt blit Commences
Lkcm Law.
❑lameaemmundesSee .BBPCforthiareamn
Dau
WORKERS COMPENSATION DECORATION
1 hereby Nirm under penury of Perjury ono of the following cslentios:
❑I ham and will maintain•CenlOcate ofCownt to self-alum fu Worma's Compere
salon,as provided for by Section 1700 M the labor Code.fm W Performance of de
work for which this permit is issmd.
0 1 have and will maintain Worker's Compensation foramen,u required by Secuan
3700of Ne labs Code,far Ne pact.. a ofde woh formich this permit is Issued. '
My WorkeYr Co eas4 rent is and Policy number am:
Carrier.-�uPa icy Na.: l g i o 3 l a
CE CATS OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
msLmnion need not W campicud Bre permit Is Intone hundred dollars($100)
lir Inas.)
1 mN(y Wt In We perfarmsnm of We woh for which this permit U Issued I shall not
employ any person in any meaner an u to become subject in We Workers'Compewl m
Laws of California.Dae
Applicant
NOTICE TO APPLICANT:If. for making this Co tifhcate of Emmptian,you should
become subject to the Watker's Compensation previsions of the labor Cede,you mut
.J O forthwith comply with such provisloru m Wu permit shall W accrued remkd
c '
y CONSTRUCTION LENDING AGENCY,
f" 1 hereby afnrm that team L a conamanin t lending agency for the performance at
lYithe woh far which this permit as Wood(Sce.3091,Civ.C.) h .
pt7 A Lanaets Nunc
]z Leaders Add.
U O 1 certify that 1 haw tan this application and atw that the above information L
conn 1 agree in comply with all city and county ordinances and swe laws misting in
Wilding contraction,ma hemby mhmim mpmmnutwa of this city to sour upon We
W alpve-meManed property for Impeetan purposes
(We)agree m nam.indemnify and kmp harmhw the City of Cupertino against
C11 liabilius,judgments,costs and upenms which may in my way mean,against aid City
U Z In conaequenm of the granting of this Peron.
^r APPLICANT ULXrUNDERSTANDS AND IL COMPLY WITH AppNON-jOINi Issued by: Dale
S RCE REGULATIONS J �.S 2
Re-roofs
Si re of ApplisntConummor
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building oceuPant stem or handle l uxdom material
dcOned by the Cupertino Municipal Code.Chapter 9.13,and tie Health and Safety
.seal.35533(41 All roofs shall be inspected prior to any roofing material being installed.
0Ys tpo
Will ft applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit huardaus air constructions u dcfmed by the Bay Area Air QueRIY Management all new materials for inspection.
District?
DYs Frau
Ihammad Wehuudouamamrlabmquimmcnuunder Chapmr6.96ofW Clifor- c\ / 1 ZQ be
ria HcoLhh Satly CaM,Scetiau2150.5,25533aW]SS34.luedcrarmd thuifde WildingNYW
_ kV I )���
rimanot &Safcyhawa scant Nat Itu553 mm53.Iwmatydegifu ntlitthe �ljA
neamm in which mutWmetrtoiss oraCcrtifiuuof aPamy. Signatt of Applicant Data
2 200
ownuor hmnuoi.gers D All roof coverings to be Class'W'or better
• CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32632012 .00
DATE ISSUED. . . . . . . : 03/25/2008
RECEIPT #. . . . . . . . . : BS000004257
REFERENCE ID # . . . : 08030139
SITE ADDRESS . . . . . : 10227 PARK CL
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CHU STANLEY C AND NANCY I TRUS
ADDRESS . . . . . . . . . . . : 10227 PARK CIRCLE W
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-
RECEIVED FROM . . . . : JAMES HIRSCHBEK
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . .
• TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY . AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------=----- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 11, 000. 00 1.10 0 . 00 1 .10 0. 00
1BUSLIC FLAT RATE 1 . 00 110. 00 0. 00 110. 00 0. 00
1REROOFRES SQ FEET 30. 00 . 390. 00 0. 00 390 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 501 . 10 0. 00 501 .10 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CASH 501 .10
---------------
TOTAL RECEIPT 501.10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------=------------ -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
0903 of -�9
(p. CITY OF CUPERTINO
REROOF
• OF
CUPERTINO PERMIT APPLICATION
APN# �tP Jz �, , 0 D Date:
BuildingAddr
( 002 7_
7 AP,
Owner's Name: Phone #:
N � � � � �➢ � � or9' � s� eg7S
Contract r: � Phone #:
Fax #:
Cupertino Business License #: Contractor License #:
7 (oT9 0
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles m( Asphalt Shingles
)i 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.
Job Description:r ej I e r
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: J p 0
J
•I Have Read, Understand land Will Comply with Cupertino's Tear-Off Policy:
VYY\-t
Signature
CITY OF CUPERTINO
REROOF
•CUPEI�TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
IREROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
IREROOFRES Re-roof Residential B 1SFDWLROOF
20
1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B IMFDWLROOF
IBSEISMICRE Seismic Residential B
IBUSLIC 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-ruufing.
Homeowner's Name: f� C4'44
Job Site Address: / �-�- 7 ° A P, � C RC-`l ,, S�
Roofing Company Name: C /— O f�
Applicant's Signature: Date:
Greg Casteel
Building Official .
Revised 11/2/04
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
U n C kT I N O Fax(408)777-3333
rC t Building Department
JOB A RESS: r PERMIT #
C) cl eS . D 3o �3P
OWNER'S NAME: St-6 N I C u PHONE # S o
GENERAL CONTRACTOR: C — P P` o FAX #
I am not using any subcontractors: v" 2�;
Signature Date
Please check applicable subcontractors and complete the following information:
RI 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 I�n ^
Owner/Contractor Signature Date