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05100041 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT �CCyNT1iA' ATO'Ii',INT'(?ItMr�'TIphI"•�'`; a. 5r,n5,•9i,A .N. �'s+°!f%P=,�;k^P • RXu,3F o J use, BUILDING ADDRESS: WESTSHORE ROOFING CO PE"MITNO'05100041 7465 PROSPECT RD OWNER'S NAME: PERMIT ISSUE DATE GARY ZHAO 102 OLD ORCHARD DRIVE 10/11/2005 ]NE: SANITARY NO. CONTROL NO. (408) 213-3750 ARCHITEC(ENGINEER: BUILDING PERMMNFO BLDG O PLUMB MECH O 00 Z, LICENSED CONTRACTOR'S DECLARATION e$ Il II00 Qr� 1 hereby affirm Met 1 am IIansW under provisions of Chapter 9(commencing with Section]000)of Division 3 ofd.Busrcas ant Professimu Code.W my licua¢u REROOF-ISNTALL ST ivfullforaandeaecL .ZLe a 2 Weeno� Daktfsll l�/3C Contractor -' E —T CSDECLARA O Nay �y 1 understand my pies)hall be used u public record 'OV 2005 Ds 5 C Licensed Professional OWNER-BUILDER DECLARATION ■■■ ryprs��® I hereby alarm Nat I I exempt from Nc Conions Co :Myc Law for the �/ i (h tah� OO followingvireo.. emits ]mmu Busher.and improve. doeuns Cade:MYr m or county L taj',\9 $ which requbte a permit re).res Me alar.improve,demnlW,mrepair any tvuewre F a 6+.v $15105 prim k its issuance.,Sim n...11.the p.istdiapplicant for such ractor.to file cusse Law statement y �-.( (home I,licensed pSection700)of Divions.f de eBuinesssndPree law(Chaptar9 Sq.Ft.Floor Area Valuation (commencingwithIDnd of Divutonr the Al Baintesadon,Prefectures Cndc)sir 9 that he ts exempt tMrefom and Ne Eels for tie Alleged eanmptlaL My NOIWon of Section 7031.5 by my applicant(or a permit subjects the applicant in a civil peadty of 3 rkIN RgN@Fr Occupancy Type no(more Nm five hundred dollars($500). ❑1,a owner of the property,or my employees with waste a Much auto compensation, wiH do the work and the structure is no(intended or offered for sak(Sec.7044•Bud. Required Inspections and Plainsman,code:The Conuanofs License law dors ret apply(o an owner of q P property who build,or improves,demon,and who does tush work himself or duough his _ am employes,provided thatauch improvements am not intended oroRered forsale.If, s however.the building or Improvement is old within one year of omplctio,Ne owner. builder will have Ne burden of proving Ont be did not build or Improve for purpose of tile.). ❑1.as Owner of the property am emiusively contracting with licensed conaeakll k constrct elm project(Sec.7044.Business and Professions Code:)The Conmctor's Li. came law does not apply to an owner of property who build,or imparts iceman,and. who conular.for such projects with a eontracurds)licensed pursuant an the Con(netor'a Lic em law. ❑l am exempt ucar Sec Bh PC fm this mason Owner Data WORKER'S COMPENSATION DECLARATION I hereby alum(under penalty of perjury am of tie fallowing dalmadons: 1 haw Ond will mdmdn a Ccmf(cato of Consent to salf-imam for Workers Compcn. -tion,u provided fm by Sado 3700.f the labor Code-fm ice imulma m on.f the W ok for which Nssu is permit Is issued., ❑1 haw ant will maintain Workees Compensation InsunnCe,as required by Section 3100 of the Labor Code,for the performance of the wart for which this permit is issued. My Wader'.LCompansed =ran /ynier and Polity number are: Cartier.. ys` to l't!l policy No.: CERTIFlCATE OF EXEMPTION FlIOM WORKERS COMPENSATION INSURANCE (LEU sNan wed not becompleed lithe permit Is fm am hundooldollw($IM) or lea) 1 Certify that in the performance of the wart for which this Permit u issued.I shill net employ any person in any meaner an as k become subject o the Workers'Camp u ation Laws of California.Dam Applicant NOTICE TO APPLICANT:IL after making this Cenifram of Exemption,you Nmld berate Objet in the Worker's Compewdon provisions of Ne Labor Code,you muse .JO forthwith comply with such provisions or Nu gerund 0411 be named muted. , CONSTRUCTION LENDING AGENCY F coy+ thereby calibre NatNem t,•conummvn loading agcacy far the pedmmaecoof ai 7 Ne work Asir which this Pont,is issued(Sec.31191.Ch,C.) ' WW Q Lendee,Name z Lender's Adders U Q I cardfy that I have read this application W,site that tie above Interrelate,u Lt. ^ conn I agree to comply with all city ark county andiwwxs and tun taws mladng k Q rV' building concoction.and hereby authods reptuanutiwa of this city to enter upon Nc LT) shove-men,iomd popert7 for Inspection purposes. Ly (Wc)agree to caw.indemnify and keep harmless tin City of Cupcnino against t I Iiabilities.judgments,cosn ad expenses which may in anyway aconic against said City U incomgw=ofthcgrsntingof NispamiL APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON DINT Issued by: Date SOURCE REGULA / Re-roofs f r Signa f anVC r Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building weapon,core or handle haardoa material as de0ned by the Cupeniva Municipal Code,Chapter 9.13.and the Health ad Safety IniaH.Iffia;SafctyC�,Sxd=25505.25533ad25534,lun&mmdthmi(Lhe d),Section 25533(1)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes ONO Vin the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove It haesrdna err contaminants u dented by the Bay Am.Air Quality Management all new materials for inspection. uict7 CYes ONO I hew mad the haallosmucdalsonquiremcnu underChapterd.95of Ne Califon e building cs o,cuncnt ve a knant.Nat It u my responsibility to notify the oaulamt ftheuimme muse met ' issuanceoI CcrdIII I(Be Signature of Applicant Date own r aranthariz neem d .,) All roof coverings to be Class'B"or better Community Development 10300 Tone Avenue '✓' Cupertino CA 95014 Telephone(408)777-3228 CI Fax(408)777-3333 �UPE�TINO Building De utment JOB ADDRESS: ,�� ��� 2` Rd .1 PERMIT# o o 0 �t OWNER'S NAME: r PHONE # Ltp GENERAL CONTRACT FAX # UaB-2,317 / I am not using any subcontractors: � L 0� 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 Community Development Department Building Division City of Cupertino 10300 Torre Avenue CITY�F 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-rooting 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. 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: y U ,^�Z Job Site Address: 7 H 6 1 r°S P (---t R Roofing Company Nam x A plicant's Signature. Date: �� \� ri l� \�1J�51J�10C.X1 Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO RE ROOF 6 CUPERTINO PERMIT APPLICATION FORM l APN#� !S_ p ��1} Date: Building Address: )'C/ 7 bs Proms �cr R� - Owner's Name: Phone#: CS�•r �X4U `lob- �yb Contractor: Phone#: License#: S'1SVo-E V4-f- Rot� Iv�c. u{ag 2-13,-SI-31 So 787 �.kZZ 1 Contact: Phone#: Cupertino Business License#: &Ac o le.� '4Antir . t{og Z13-37So Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles .,�W Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ . Other(Specify) ,d Other(Specify ° Number of existing coverings I ❑ Provide I.C.B.O.Report# NrR- 423 ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: 10 Job Description: ly%S-t°.\\ Cr«-a S- KA- Coo.-ted 3-tz�( ` -le r-00-fIT-U -,. ovc - -P- L wDca SKkr CIAss Q Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are anrestrictions: LJ Cost of Project: Type of Construction: Occupancy group: 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 ;L