06090081 (2) CITY OF CUPERTINO uy " r� 4� a-�`�
BUILDING DI'71SION PERMIT P'CONTRACTOR IN ORMATION
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BUILDING ADDRESS: WESTSHORE ROOFING COMPANY PER11NO.06090081
878 ROSE BLOSSOM
OWNER'S NAME: PERMIT ISSUE DATE
CHEN HUANG 2814 AIELLO DR 09/12/2006
NE:
SANITARY NO. CONTROL NO.
(408) 6.94-0060
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
�Op LICENSED CONTRACTOR'S DECLARATION Job Description
u F 1 thereby affirm that I not licensed under provisions of Chapter 9(commencing
:¢w with Section 7")of Division 3 of the Bastions and Professions Code,and my license is
e in full for¢and a feu
4h aR Z - REMOVE WOOD SHAKE, INSTALL GERARD METAL
t,v�? License Class Lie.• [-
��o Dale Omttnctor RATZON 40:Lawes ROOF( CLASS A, 30 SQUARES 1 . SLB PER SQUARE.
'3 ARCHin—CI'SDECLA ATITt �.O'
i 1 understand my plans shall be used as public records
.0
:oH LicnucJ Professional
g OWNER-BUILDER DECLARATION
I hereby aline Nm 1 am exempt from me Con ounme.License,Law for the
00 following roman.(Section)(131.5,Business and Pretentious Code:Any city or county
S$ which roquireI a permit to eunnrucL eler.improve.dnmoRsh,or repair any suueture
prior to its issuance,also requires the ippeicam for such permit in file a signed staemcm 1b6 0 0 0
-s that he is licensed pursuant to dm provisions of the Conuaeum's License Law(Chapter 9 Sq.F[. Floor Area VaID
2�D (commencing with Station 7000)of Division 3 of the Business afld Profnniom Conic)of
s,`t mat he u exempt Ne¢fiam and do,bmu for the alleged exemption.Any violation of
Section 7031.5 by aro'applicant for a permit subjects the applicant 10 a civil pushy of APN Number Occupancy Type
not come man five hundred dollars(5500). 35904013 , 00
0 1,as owner of the properly,or my moployma with wages as meb ak compensator.
will do du,word,Man memoomoe Is notkended or offeree for sate,(Sat.7044,Buri».. Required Inspections
and Professions Code:The Contractors Liana Law door not apply to e in owner of q P
praised who builcismimpmves them m.and whodoessuchwnd hlmalf or though his
awn employees,provided Nat such improvements are oat intended maffefed fm ale.If.
however,the building or improvement is sold within one year of compichm,me owner,
builder will have be burden of proving chat be did not Wild m improve for Putpone of
ale.).
0 1,as owner of Ilse propeny,am exclusively contracting with licensed contramors b
construct the pmjea(Sec.7004,Business and Professions Code:)The Contractors Li.
carne law does not apply an,an owner of property who Wilds or improves thereon.Md.
who contracts for such projects with a comememr(s)licensed pursuant uaIbe Co eractors
Load.taw.
❑lomesmnptunder Sac .B&PCfmthiseswn
Owner Own
WORKER'S COMPENSATION DECLARATION
1 bereby affirm under penalty of perjury one of the following declaations:
1 hs ve and will maintain a Certificate of Conant to ae6insum for Workcr's Compue-
sation,m provided for by Section 3700 of on,Labor Code,for me performance of the
work for which this permit is issued.
0 1 have and will maintain Worker's Compensation Insurance,as required by Section
37W of me labor Code.for due pcff.....f on,wart per which this perm it is issued. '
My Workers Compensation Insurance carrier and Policy number am:
Cartie151_00LO Polity No.:-L6,V2—2 00 f,
CERTIFICATE OF EXEMP71ON FROM WORKERS'
COMPENSATION INSURANCE
Crhk section need not he completed if lbe permit is forme hundred dollars S I00) -
orlcsc)
1 cenify that in the performance of de work for which this permit IS issued.I shall not
employ any person in any masher so as at became subject to the Workers'Comperw0an
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,afar making this Cenificale of Exemption.you should
become subject to the Workers Compensation provisions of the Labor Code,you must
.J O forthwith comply with such provisions or this permit shall be deemed revoked.
'z uj CONSTRUCTION LENDING AGENCY
F I Wrehy eTtionm that chert is a co,utruetinn lending agency tar the perform.of
a 7 the work for which this permit is issued(Sec.3097.Civ.C.)
W�Q Condos Nation
Z)Z Landers Address
U 0 1 cenify that 1 haw road this application and some that the above information is
correct.I agree to comply with all city and county on inaneus and sum laws t eating m
0U building convection.and herehy authorie representatives of this city to enter upon the
>, L[l euve mentioned property for inspection purl uns.
f^ CL (We)agree to save.indemnify and keep harmlem the City of Cupcninu against
liabieides,judgments,eosuond expenses which may in any way accuse again¢,aid City
U in consegmnec of the granting of this permit. G
ASOURCE REGULATIONS.PPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
12b Re-roofs .Z��
Signature of ApplinamuCi mmnor Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will me ePplicanl or future building aceupants.rehandle hazardous maenae
as defined by the Cupertino Municipal Code.Chapter 9.12,and dm Health and Safety
Code,Se zs25532(e?❑y. �Na
All roofs shall be inspected prior to any roofing material being installed.
T
Will the applicant or future building occupant um equipment or deviser which If a roof is installed without first obtaining an inspection,I agree to remove
omit Im Mlous it contaminants u defined by me Bay Arta Air Quality Management all new materials for inspection.
District?
D Yes
1 have read the hansubms materials requiemenu under Chapter 6.95 ofthc Califor-
din Health&Safety Cade,Scetims25505.25533 and 25530.1 undcfsutW ms if Be Wilding
docs not currcn0y have a instant,that it is my immorehilk,.notify me occupant of the
requirements which must be met pnorwiss fm Certifeveor Occopurey Sig nature of Applicant Date
ownermanmaficaseat D,w All roof coverings to be Class "B"or better
Sep 12 08 0214p WedShom Roofing (408)2132387 p.3
Community Development
10300 Tom Avenue
Cupertino CA 95014
• Telephone(408)777.3228
CI OF Fax(408)777-3333
CUPEkTINO
Building De artment
JOB ADDRESS: PERMIT# Ly
V tM eVQ t''O OCJ
OWNER'S NAME: G PHONE#1 J - fo2 - ZI 00
GENERAL CONTRACTOR: k- V-ecPqtAtj' IM FAX # -
(�' M -00
I am not using any subcontractors: I A —(Z-O 6
Signature Date
Please check applicable subcontractors and complete the folloyAM 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
WNW
CITY OF CUPERTINO
om 1 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35904013 . 00
DATE ISSUED. . . . . . . : 09/12/2006
RECEIPT # . . . . . . . . . : 36012
REFERENCE ID # . . . : 06090081
SITE ADDRESS . . : . . : 878 ROSE BLOSSOM DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : CHEN HUANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : WESTSHORE ROOFING
CONTRACTOR . . . . . . . : FOWLER, PAUL LIC # 21417
COMPANY . . . . . . . . . . : WESTSHORE ROOFING COMPANY
ADDRESS . . . . . . . . . . : 2814 AIELLO DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE . . . . . . . . : (408) 694-0060
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--------- - - ------------ -------- - - ---------- ----- ----- - - -------- ----------
BPERMFEE VALUATION 16, 000 . 00 234 . 36 0 . 00 234 . 36 0 . 00
BSEISMICRE VALUATION 16, 000 . 00 1 . 60 0 . 00 1 . 60 0 . 00
--- ------- ---------- -------- -- -------- --
TOTAL PERMIT 235 . 96 0 . 00 235 . 96 0 . 00
•
0215p We$Shore Roofirg (408)2132397 pA
CITY OF CUPERTINO aom cc&
' REROOF
CUPERTINO PERMIT APPLICATION FORM
APN rt . it + o4—w) Date:
Building Address: Y� 1
�?5 QoSe \o own rive .
Owner's Name: Phone#: 4°
CvNty\ UQ V\ $(o —015
Contractor: Phone#: L-t.91 License#:
Mtk5 %00 (020L—,Z%00 27-1
C utact: Phone#:c(10T Cupertino Business License#:
ti� QJ (9211— IOU
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Bunt-Up roof
U Asphalt Shingles O Aspbalt Shingles
0- Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
o Other(Specify) 14
Other( -) ceQla 5� c�iiask
Number of existing coverings ❑ Provide I.C.B.O.Report ALS
£
❑ To be Removed ❑ Pmvide Mfgr,Installation Specs.
I Have Read Understand and Will Comply With o's Tear Off Polie
Job Description: `
vk" wfod Shrti�e c,e (C.. d wee oa cIrx5 01frJ'I
Residential )52� comm=a) ❑ 11 5 �b
Fixe Zone: Yes ❑ No fEr Confirmed with PIumiag Dent. if �Cf
there are an restrictions: E
Cost of Project; Type of Construction:
Oa
Qty. if
Applicable Fee ID Fee Desai tion pee Crro
BPERMFEE Bld Permit Fees BUILDING
BENERGY I Ener BUILDING
BSETSMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•
Sep 12 06 0215p WedStore Roofing 140872132387 p.5
y Community Development Department
Building Division
City of Cupertino
i" 10300 Torre Avenue
Telephone: (408)777-3228
? CITY OF Fax: (408)7773x33
UPEkTINO
Building Department
Subject: Re-roofing policy for the City of Cupertino
I. 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. NOM If you call for a plywood nail inspection and the job is not ready,
,you will be charged a re-.inspection fee of$176.16. The re-inspection fee must
be paid before another inspection can be scheduled.
rMPOIiLANT:
1. Flat roofs must have a minimum of art- per foot slope and demonstrate
that there is no ponding.
2. An T.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 reroofing.
linmeownei s Name: Cl/t 1/1 Va(A t9
)obSite Address: $} y `)'D5 OWE Y
t�
Roofing Company Name: ViecA5hotrf% F-0055 nGt
Applicant's Signature�-l. Dace: - l Z-C)
Greg Casteel
Building Official
• Revisad 11/2/04
Pdmad m Ri .WadPeper