08040039 (2) CITY OF CUPERTINO � R - 4"tq •"�-d,
BUILDING'DIVISION PERNIIT °aCON Rr1CTQRIIVPNO
�(}RMA I N
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HELLY DR TNT ROOFING CO PERMIT08040039
OWNER'S NAME: PERMIT SUE DATE
HUNG CHEN 1610 BLOSSOM HILL RD STE 6C 04/07/2008
PHONE: SANITARY NO. CONTROL NO.
Ick
HITECT/ENGINBER: BUILDING PERMIT INFO
BLDGRE—RF RMV SHK RF INSTL CLS 9G EIPCr PLUMB MECH
3oa
LICENSED CONTRACTOR'S DECLARATION Job Description
Wu1 knotty Nu
y gI,m li¢ued under pmvitim m
aof Chapter 9(comencing '-----"----"'
with Se,M3 LIcturs.ction 7T/d.ff)oC yfyDywiv'i air Budnrsv,nd Profcuiuru Code.andmyliceve I.
s❑ in furs forte ends forte ef! --
Dau Conuacwr
ARCHITECT'S DECLA1 1&N
I understans my plana call W used as public reoNs .• .
J`s
50�a Licensed Professional
y 3 OWNER-BUIIAER DECLARATION
IMO 1 achy.Inco on 1 son attempt from the Conu.stCac e:Any
Lew for the
IMO following muga.Permit
t 7113 construct,
t,anus. and Pross,de use Coda:Any dry or county
$ which its ima a permit rhe cnnsWct.slur,hnprow,demolish.ore a sig ed ewctum
_2> use us Wiubssedpesamgo therea the applicants far such permit.U..signedw(cuumem
< NssablkenwtSmon to the provlai"u of Ne Conmcmraucencl,w(Chmur9 Sq.Ft.Floor Area Valuation
$ (csm e W succ mpt Scct1on 70W)of basis n 3 of Na egeinav and Pr.A.,na Code)of
Nn a u ewnPt therefrom and Ne bub for Ne alleged caemptian.AnY vlalation of
Secden 7031)by my applicant far a permit subjects the spplkant w a civil Penslty of APN Number Occupancy Type
trot come Nur Rw hundred dollars($30)).
❑I,umnaof0 pmpmy.mmymploymwlNwa uNelrmkeompemdon,
will dotim won.mddu heCambmtitunense Law
apply 70aa,ow.or - Required Inspections
and P y we u Code The Can n,Uaue law don net him u m owe Of - q p
own enyvra Wilds i edtaseu theseon,andwa ments mann,ch sort himselfar Wrrom deb
awn emplayen.doWori Wtsuehimpro id witusemyearn fcompled @md them e,
however,the building or improwmenr b cold within ane year or Impmom for Ne owner•
builder will have she burden of proving Nu k did not build or impmw for purpose of
ural.
❑1,n Mnor of also property am exclusively automating with licensed cmmuacun u
mower the project(Sec.71161.Buono and Pm(estlans Cade:)The Comme m's U.
cone law does not apply w an owner of property who builds or Improves Incomes,and.
who comm,far ouch projects wide a songs oo(s)licensed Panama w the Conrrsheme.
License law.
❑Iameaempcusem Sec. ,B&PCfm Nismuon
Owner Data
WORKERS COMPENSATION DECI.URATION
1 Aeby dllm under penity of perjury ane of the fallowing deckndou: -
aw wM will maintain.CaniRau of Consent to self-iuum fm Worker'sCompen-
n,u provided fm by Scamn 3700 of de tabor Code,for Ne Performance of the
for which Nb peen is issued.
❑I new and will maintain Worker's Compensation Iuumtm.a required by Section
37W of Ne Labor Code,far the performance of the wart for which this Permit is issued. ._
My Worker's m do�u mm amu and Polity umber (� -
Camer� /uGM
CERTIFlCATE OF EXEMPTION FROM WORK S'
COMPENSATION INSURANCE
(This section heed an,W connucu d if rhe remit is fuune hundtW dollars(SIM)
or he )
1 camly Wt in Ne perfomanco of he work for which Nb Permit b issued,I shall am
employ,nyper,M In my mmnerm sa w arome subject m to Workers'Compensation
Laws of Califomia.Date
Applicant
NOTICE TO APPLICANT.If,after meting this Cenincaw of Exemption,you should
became subject be the Workers Compensation provisions of the labor Coda you must
Q forthwith comply with such provisions m Nben peshall W deemed nonsked.„z,t
CONSTRUCTION LENDING AGENCY
E.. I Mmby alum Nu Hers b,conswctinn knding,pnry mer Ne Perfomanem u(
Ci> the work fm which this Permit is issued(SIT.3W7.Co.Q
Qlaches Name
.7 M Lender's Address
V Q 1 cutify that I have mad his application and show NW the along information Is
k.^! comet.I agree w comply with all city and county ordinances and sure laws resting to
.0 trJ' building consuvnion,and hereby authorim reprocenudva of this city in cmerepnn the,
ti] show-mentionM progeny for inspection purposes.
d (We)ague to save,indemnify and keep hamlets the City of Cupcmno,plot
del limilides,judgments,cnu and arPcnses which may in my may accox against said City
t.) in canxpuence of the granting of this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITHAL NON-POINT Issued by: Date 7 r�
SO E TIONS. /
Re-roofs
Sig ort ofAppliwDue
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will y the C bot m future Wilding e.Chaps rbrt wanthandle hawdons e,urial
u dented by the Cupertino Municipal Cade.Chapter 9.13.and dw HaIN and safety
Code,Scene.25532(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes ❑
Wall thc applicant or cum building occupant use equlpmcot or dewcas which If a roof is installed without first obtaining an inspection,I agree to remove
It hundnm air..tuminanu u defumd by the Bay Am,Air Quality Mangpmenr all new materials for inspection.
cr7
❑Yes CIM”' .
I hew mad the lwsNumJmauria.requirements and nu underCapurd.95 ofdw Califs-
nig Haub&SalatyCode.Schouue it 4 yona2553a.I to understood d Nuicup Wof
does not cumntly hew g Tenant.Nu it 4 DIY mepouihility w notify the occupant of
royuiromc whkh nbcmet or as 'fcauo Signature of Applicant Date
naathadrea.pnt Data. All roof coverings to be Class's"or better
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . 1 : 35911021. 00
DATE ISSUED. . . . . . . : 04/07/2008
RECEIPT # . . . . . . . . . : BS000004378
REFERENCE ID # . . . : 08040039
SITE ADDRESS . . . . . : 20619 SHELLY DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HUNG CHEN
ADDRESS . . . . . . . . . . : 20619 SHELLY DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2923
RECEIVED FROM . . . . : MICHAEL D WILLIAMS
CONTRACTOR . . . . . . . : WILLIAM TYLER LIC # 22988
COMPANY . . . . . . . . . . : TNT ROOFING CO
ADDRESS . . . . . . . . . . : 1610 BLOSSOM HILL RD STE 6C
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
TELEPHONE . . . . . . . . : (408) 277-0800
• FEE ID UNIT--- QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--------- -------- -------- ---------- ---------- ---------- --- ---
1BSEISMICR VALUATION 12, 000. 00 1 .20 0. 00 1 .20 0. 00
1REROOFRES SQ FEET 28. 00 364 .00 0. 00 364 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 365 .20 0 . 00 365 .20 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 705.10 VISA,
---------------
TOTAL RECEIPT 705 .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
0 � o V �3 �1
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION
•
APN# o�/ Do Date:
Ll
Building Address: L d l G Sk ea(
Owner's Name: Phone #: �C S ?-7( __ Z
Contractor: Phone #: Z 7 7— O-Cd Cl0
TN LO /tV Fax#: _ GOI - 2-s-_03
Cupertino Business License #: Contractor License #:
So
7-
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles k Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
41 ❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: kQ<_�kav-p y6_ 0_,O-up Z N S i-� O8
w %jWDOD
Residential Commercial El
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation:
I Have Read, Understand a Will Comply with Cupertino's Tear-Off Policy:
• 1gna e
CITY OF CUPERTINO
REROOF
oF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
Z 1REROOFRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 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 Raid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of Y4" 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: �Jtr 1 p rnt
job Site Address:
Roofing Company Name: R�� p Y®r,M
Apphcant`s Signature�� Date: %I
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
h,�'�.q,, Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
CUPERTINO
Building De artment
JOB ADDRESS: PERMIT #
�iiell 32_ 0J�_o �(oD34r
OWNER'S NAME: e" PHONE # Yl:I - Z7/ - lz'
GENERAL CONTRACTOR: d FAX # ,l
I am not using any subcontractors: �c� 7/71-/d
Signature Date
Please check applicable subcontractors and complete the following information:
66 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
veer Contractor Signature Date