05080050 (2) 'CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTI2ACTOI2kTN1�URMA' TO1
BUILDING ADDRESS: WING' S ROOFING INC PERMIT 440.05080050
`10201 PART.P.TT PI,
OWNERS NAME: PERMIT ISSUE DATE
jd 1h CHING-SU LAN 3243 9YnNPY WAY /2nos
ONE: SANITARY NO. CONTROL NO.
510) 889-9068
ARCHITECTIENGINEER: BUILDING PERMIT INFO
. BO ELECT PWM O
'lop
LICENSED CONTRACTORS DECLARATION Job Description
u I hereby Wrovscpm
by rm t 1 sm lid under vlion of Chapter 9(mmmeneing
wlNScnim7 f )of Division Oaf Nc BummusWP fession Code ndmylicevab
jninrallfncean =L I REROOF W/CONCRET TILE
z License CI Lk. s--/
Data —used apr J _
SOECLAR I / T)(� ) � � ��6r1 C ,1
lundcratand my plane shun he ucdupublie rtcorN T( U GALJ`r(/L ( ( t I✓'S
�4p
Licensed Rvfem.mal
g OWNER-BUILDER DECLARATION � ,N �q.4- � l /e
iO5 1Wmhya(Sect NalI1 exempt from No CanlnnCoe:License My
o Tarthe •• ^C W-Gf�/L l'C ` fV1�iW tl•{•/
D O following mason.(Section 713 IS,Bullus andImprove,
de Profession Code:My city or county 5$ which enquires a permit ex cnnuum,alcor,hnprow,h Permit ea e A sig any tuucmm - $9850
prior to_z� AmhaI Bernal e.pursuant
mgulrcsnthe theapplicantsforsucthe Carnevale mfdrst,LawLmmmem
€oNommentart:.1purnantwthepmviviauofNeCanoinessa arae aw(Chapw9 Sq.Ft. Floor Area Valuation
$ that he s exempt Section 7(nd of basis f rth theeged Business Profcu vi Coca)of
�.. Sec io m exempt therefrom and Be basis far be alleged exemptio.Any l penalty
of
Suction than
by.acyapplicantforapermitabjassthe&ppllunlw•dvl�pendtya( r Occupancy Type
not mart Nm Bw hundred coitus($500).
❑I,nowner of site property.my employeas with wages as their sole compewdon, n
will do the work end Neawent.is not intended otoQetoi for.1.(Sec.7044.Business ^'•r to
and Profession Code:The ConucmYs Liceoe Law does not apply m an owner of Required Inspeebot S ,
property who Wilds or impruee thmaon,am wheldocanch workhlmsalfor though his
own employees,provided thatmeh ImprownterM aro not intended Proffered formle.If, n
however,lie building or improvement issold within ane yeu of eompledm,the owner-
builder will have the bufden of proving that he did nm build ar improve far purpose of
sale,). TT
❑1.as owner of As property aro exclusively conuani^g with Became mnuanm in
contract the project(Sec.7014,Business and Profession Cade:)The Commutes U. ,{.t•/,fr jp�r7yy+jk
whom Law coca vol apply in an ownor of poprny who Wilda or improves Berton,and Not who roua
neu forsuch projects VIN. llaruemwth
e Dursuse Conuh
cnae�t))yefVp/�/J
Lteenc Law.
❑ am N o
I exempt untiesec S .Bk PClar Nes
is mon
Owner Dam
WORKERS COMPENSATION DECLARATION
I hereby^than under penalty of perjury am affix following declarations:
I haveand will maintain a CanlBam of Consent an elf-Inure for WortclsCompcn-
satian,as provided f.by Section 7700 of the Labor Cade,fm the perfofmmce or he
Iffor which this permit is Issued.
Lg ,
1 have and will maintain WorkeM1 Compensation Imm�na,u required by Section
ICM of the labor Code.for As performance of An weak forwhich this penthis issued.
y Workees Comte rata a
oIn ni and Politynumberam:
Carder.
CERTIFICATB O•EXEMPTION FROM WORKERS' -/f—
COMPENSATION INSURANCE
(This it.reed nothecomple"tribe permit b(mane hundred dollars(SIM)
.fest)
I realty that in the,performance of Ne work for which this permit is Issued,I shall not
employ any person In my mmnerm as to Wrome object in the Workers Compeusadon
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,aner making thus CeniOuw of Exemption,you Amid
become sobjea in the Worker's Compensation provision of tho Lehrer Code,you must
.J O forthwith comply with such provision or or Nia permed it shall W deemrevoked.
q rACONSTRUCTION LENDING AGENCY
'p+ (hereby Man that Nem is a onuuction lending agency fear the performance of
GL vthe work for which Nu permit is issued(Sec.7097,Civ.C.)
IQ Q Lender's Name
r7 7. Lemba's Address
U0 I certify that I have mad this application and tete that An aWve information is
D. cornet.I agree to comply with all city and county ordinance and[hate laws mladng an
0 building construction.and hereby authorize repremnutiva of this city m enter upon the
W ahwve-mentioned property for inspection Purport
%-1 agree w saw.indemnify and keep harksf the mCity of Cupertino against
Q. Ilabilidetjudgmems,com andexperuex which may In my way seem&Saint said City
C.1 In comcguencc of the grueling of this NMIL
APPLI ANT U DERSTANDS AN WILL COMPLY WITH A}}}...LLL N -POINT Issued by: Date '�`d
SOUR EG A NS.
(yl
Re-roofs
Signeturc Applicant n cwr Dam
HAZA DOUS MATERIALS DISCLOSURE Type of Roof
Will Ne applicant or future Wilding ompant Rom or hurdle hazardous material
es l ftuel by Ne Cupertino Municipal Code.Chapter 9.12,and Ne Health and Safety
Idou,
de.s.danssst2(a)7 yv,!� All roofs shall be inspected prior to any roofing material being installed.
Yes V.
Will the SPPlteant or fo4{"'i�o\o Wilding occupant sass equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
It hayvdous air contaminants M dc0ned by the Bay Area Air Quality Management all new materials for inspection.
niet7 �a�•• �.
❑Yes Syj No ' ^
Iham mad Code,Shcusma530,25quircme5534.lrClupterd.95af Ne Caliwry VV (✓j.(� / 7/- $ �lu�
HesWonceplybe..Sections 2551 *-an mporcSS3illyho ersmMNuiflMWilding VVVV / /l/�`/�•��`
rwt cameptry haw a mom thus Itis my responiMllly w ratify Ne aoupant of the
ul m BwMmm�ubc tprior toivaanceor&ccrdkawof0..pamy. Signature ofApplica t Date
own orwNo' da cal Date All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
i Cupertino CA 95014
Telephone(408)777-3228
OCIF Fax(408)777-3333
�UPEI�TINO
B I uilding De artment
JOB ADDRESS: PERMIT#
10-7,0 l a r(L e- L os'b��oso
OWNER'S NAME: IPHONE# S70
GENERAL CONTRACTOR: / AX#
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
Til
�C
Owner/Contractor Signature Date
• Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
U PEI�TINO 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: E4�_
Job Site Address �� ��V I L D
Roofing Company Name: W r 7 Ai L,
Applicant's Signature: / Datef IT_1,�Y
Greg Casteel
Building Official
Revised 11/2/04
Printed an Recycled Paper
CITY OF CUPERTINO
REROOF
CUPEfI;TINO PERMIT APPLICATION FORM
APN# 3( l Zb D �Lr Date:
Building Address: /02Z)
0ZO I ay
/ eh p l
Owner's Name: / chi — S(A La Y� Phone#:
Contractor: P one#: t-/o,98r L15 License #:
� I�7U-(. 4.o8c�o6-o�l ty
Contact: Phone #: Cupertino Business License#:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ,( y,�-� ❑ Wood Shingles p��� �, / -
I d Other(Specify) eY�T t K Other(Specify) u� W � (P
Number of existing coverings j ❑ Provide I.C.B.O.Report#
91, To be Removed ❑ Provide Mfgr.Installation Specs.
Aft I Have Read, Understand and Will goply With Cu ertino's Tear Off Policy: ❑
Job Description: b
&64; � 2 , TrkS4XJ
Con 01 lu 5:A
Residential Commercial ❑
Fire Zone: Yes ❑ No IM Confirmed with Planning DMt. if
there are any restrictions: LJ
Cost of Project: ^ D Type of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
13PERMFEE 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
2-72- ,