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08080121 (2) CITY OF CUPERTINOaat!�xgiezw F h=z Iss- it . a, - BUtLD7INGN,IVIstoN• PERMITACONTRAGTpR,INFOORMATIQN Zg BUIL-DINGADDRESS: PERMIT NO. 11.'152 PINE BROOK LN LOS GATOS ROOFING 08060121 PERM"L$ NER'S NAME: PERM"ISSUE J LUNG CHEN P 0 BOX 1726 08/18/2008 NE: SANITARY NO. CONTROL NO, ARCHRECT/ENGINEER: BUILDING PERMIT INFO RE—RF RMV EXT SHKRF INSTL BLDG ELECT PLUMB MECH S 96 LICENSED CONTRACTOR'S and DECLARATION 1 Imrebr ale.that 1 ate licensedaverr p provision or Clupmr 9(aommmmmg Jolt Description with Secti.7000)of Division S afw Emmons and Profcanan Coda,aM mylicc is y in full fora end effee J Z LleenM—Lie.x 1 Dem Conuacmr ARCNITECrS DECLARATION Z 1 understand my plan Sha l W u ed u p blit¢corm L U S udt; Licensed Professional OWNER-BUILDER DECLARATION I I Wmhy et7im Not I am exempt from the Contractor's License Law for w i.0 fallowing option.(Sadon 7071.5,Business and ProRssinn Cade:Any city or county which requlma a permit io mnamomet,aha.Improve,demolish,lir repair any uructum prior on its tssuma.Alan rcquira wappliam far such permit to file asigncd stsonmmt < met Wtslicensed pursontwthe provisions ofwContractor's uaneeLaw(Chaptm9 Sq. Ft. Floor Area Valuation 9 (cammendng with Section 7000)of Division 7 of the Business and Professions Code)or .. that he in exempt wmfmn and the basis fa the alleged exemption.Any violation of section 7071.5 by any applicant fm a permit subjects the appinam to a civil Penalty of APN Number Occupancy Type eat mom umn ern Wavered dollars(SK O). P Y YP ❑I,As owner of the pmpcny,or my employees with wages u wv mle compensation, will do w were.and the swctum a not Wa nde i ar offered for sale(Sec.70 a 4,Business And Pnfesnon cern:The Contra mej Liartse Law does rot appy on an owaur of Required Inspections property who builds or improves moan,and who dao ouch work lmosel f or through his awn employee,provided mat such improvements was not intended moffxed far sald.if. however,me building orimprovanmt is sold within am year of ample ion.the owner- Wilses will haw the burden of proving wt he did net build or improve for purpose of sale.). ❑I,As es ownof tax pmpeny.Am nclwinly contracting with licensed anlnemn to untrue the Project(Sec.7W.Business and Profession Cade:)Tim Curbstones U. acne Law does at apply on an owmr of property who Wilds or impnvn roman.and. who contracts for such projects with amummese(s)licensed pursuam is the Contractor's Ltserue Law. ❑Iammumeounder Sao ,B&PCfordosmasen Owrmr Data WORKER'S COMPENSATION DECLARATION 1 Wreby Af ire under perudy of Perjury arc of the following dechn0or. T haw and will far by Section of me Labor self-0nure far W Performance: of m- -' worn,r provided(pe mi Section]]00 of w uWr Code,for ma perfomAsce of w work for which this permit is issued ❑1 have um will maintain Worker's Compeawdon Incomes,As required by Smion 7700 of w Labor Coda,for w performance often work for which this permit is Issued ' My Warkees mpenWipnWuwnQ nnim and Polity numbv e: 0 - Carner. /Y[/ W-16f Po'I No.: CERTIFICATE OF EXEMPnGN FROMMWORKERS' F COMPENSATION INSURANCE (Thts each.treed mtbecemPlee d Ifo permit Is froom hummed WBan(5100) or leas.) 1 cenily that In the Performance of the wore for which this permit is issued.I Nall not employ any person in my mamrerso As on become subject to w Worker'CompenW. Iowa of California.Dam Applicant NOTICE TO APPLICANT:If,rtmr making this Certificate of Exemption,you should become subject on w Wor r s Compcawtion provisions a(the LAW Code you muss .J O forthwith comply with such Provision or this permit Nall W decreed revoked.? CONSTRUCTION LENDING AGENCY IWreby affirm that ram ata construction leading agency for w Performance of C rowan!.which this scroll IS Unocal(Sec.3097,Civ.C.) W�Q Lenmes Name z Lenders Address V O 1 only than 1 have mad this Application Am ram dent w Naw Informant.It {L Eoma I qme on comply with All city and county oNinnm and some laws relating he building construction.and hereby authoon representatives of this city to enter upon the LII AWw-mentioned Property far inspection patience. Oa (We)agm<to row,indemnify W kap hamleasw City of Cupertino against rn liabilities judgments,cats Assessment which may in any way a arm Against said City V z in consequence of the granting of this Permit, s4to� AP NT UNDERSr NDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date r SSREGUI.CTI� '54,��g Re-roofs um rf Apples muConmeour I Data HA2ARDGUS MATERIALS DISCLOSURE Type of Roof Will w appliant.future Wilding occupmemom mNrWlc hezeNon material As de0md by w Cupertino Municipal Code.Chapter 9.11,and w Health ad Safety Code. Section e Y.25532(.)? All roofs shall be inspected prior to any roofing material being installed. ❑Yea IWill tui applicant or ralare building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove t harardoae air comminants u defined by w Bay Area Air Quality Management all new materials for inspection. District? ❑Yes Do., I haw reel w ha»rtlrus mmmiatsmquirements umk:r Chmu r6.95 ofw Calirer. uHenn@ SafctyCoda Section 1550.5,15577 and 25574.1 urdemwld thatifw Wilding J tx mumw • ml dw It 6 mY mPof.Coy m mtifY capmuPant of w rc cntswhic m t met riormissu mrfeccniiicamaro p $Ig tureofApplicant Date ��7� / �D 7 w orAuthamcdagent Dam All roof coverings to be Class'JW'or better CITY OF CUPERTINO 2 ITEMS OF .10 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36655031 . 00 DATE ISSUED. . . . . . . : 08/18/2008 RECEIPT # . . . . . . . . . : BS000005811 REFERENCE ID # . . . : 08080121 SITE ADDRESS . . . . . : 11752 PINE BROOK LN SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : J FUNG CHEN ADDRESS . . . . . . . . . . : 11752 PINE BROOK LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5111 RECEIVED FROM . . . . : LOS GATOS ROOFING CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481 COMPANY . . . . . . . . . . : LOS GATOS ROOFING ADDRESS . . . . . . . . . . : P 0 BOX 1726 CITY/STATE/ZIP . . . : LOS GATOS, CA 95031 TELEPHONE . . . . . . . . : (408) 298-9399 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL --- ------------- ---------- ---------- ---------- ---------- ---------- 1.13SE.I.SMICR VALUATION 7, 524 . 00 0 . 80 0 . 00 0 . 80 0 . 00 1.REROOFRES SQ FEET 29 . 00 377 . 00 0 . 00 377 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 377 . 80 0 . 00 377 . 80 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ---------------------------- -------- --=------------------------- 601. ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • I 410F CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION APN# Building Address: J1 7:5 2 jo e �roak Owner's Name: Phone #: S �?Xeln Contractor: j—0 S �re�J—o z � U 0 1✓? C{ Phone #: y6 8' 2�j 8_ 9's e)9 � `J Fax#: 01' Cupertino Business License M Contractor License #: 2348 / '906120 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) X Other (Specify)-T Vpe 30 Number of existing coverings �_ ❑ Provide I.C.B.O. eport# ❑ To be Removed i 14Provide Mfgr.Installation Specs. 5 c S %x Roof c-/q ss Jol Description: T s 7 Res dentia] mercial ❑ Fire Zone: Yes ❑ No VI Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature CITY OF CUPERTINO 1 D REROOF CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 2gS 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roofMulti-FamilyB 1MFDWLROOF 1BSEISMICRE 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: t �, �(�•VI G /ij e h Job Site Address: II 75Z Am ,(Jk Roofing Company Name: J 0.S T i � p Applicant's Signature: //J �.fJ"y" Date: 0 (� Greg Casteel Building Official Revised 11/2/04 Community Development y. 10300 Torre Avenue i„.. •� Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 SCUPEkTINO Buildin Department JOB ADDRESS: �� 0 \ _ PERMIT# D OF r)/C�'? OWNER'S NAME: ;• PHONE # vl GENERAL CONTRACTOR: 4,4Z5S FAX # I am not using any subcontractors: 0 _ Signature —4Da � . Please check a22licable 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 Da e