06050233 (2) CITY OF CUPERTINO a ,t„. r eW.Aa,�„c-,rte
sulLurvc D3vlsloryFV
PERMIT ro��,NTI2eliC`111OR I,NI''ORMATIQN
BUILDING ADDRESS: T D ROOFING PERMITNo.06050233
11537 SILVER SPRING QT
OWNER'S NAME: PERMIT ISSUE DATE
Ilk MONICA CHEN 3540 MARGATE AVE 05/26/2006
NE: SANITARY N0, CONTROL NO.
(408) 892-8872
ARCHrTECr/ENGINEER: BUILDING PERMIT INFO
BLDGPL
ELECT UMB MECH
0 0 0 0
Too LICENSED CONTRACTOR'S DECLARATION
w 1 homey affirm That 1 am licensed under provisions or Chapter 9(Commencing JOb O
iZ with Section 7000 of Division 3 of the Businev and Professions Code,and my license is �j��
±�„ mrnnrore anderreel 3 $�{ —5 y REMOVE. WOOD SHAKE AN EDAR LITE
y vyz License s Cog
comramr 'CLASS A MONIER ROOF LIGHT T
ARCHr1ELTs DEri h 7 JUN
1 ne< 1 understand my plans shall bo used az public ncemds 200sa
)yU o
G Lionsed Pmfcssional 81461
.�
S OW NE o C.,.DEB DECLARATION epV■LT'�
z 1 bomhy,?erre Out I em exempt from Ne Contractors License taw far 1W
p o following mason.(Section 703 L5,Business and Professioas Calc:Any city or county
3_ which roquires a permit to Consistent.slot,improve,demur W,or.,no any structure
_Zj, prior in its issuance,also requires fle applicant for such permit to Ole a signed statement �s
< that he is licensed purmanttotWprovisions oftheContractor's License Law(Chapter 9 Sq.Ft. Floor Area witi $dn3000
YD (commencing with Sation 7000)of Division 3 of the Business and Professional Codc)or
i r3 that he is exempt therefrom and die basis for the alleged exemption.Any violation of
Section 7031.5 by arty applicant fora permit subjects Nc applicant to a civil penalty or • P Number Occupancy Type
not mom Nan fico hundred dollars($500). 3 0(551028 . 00
❑I.asawner of Ne property.wmy uoployar with wagaazdev sole compenvtion,
will do the work and Nestrumure is nothrumd d orolfered forsale(Sec.70x4,Business
and Pm(essioral Codc:ren ComeraeNrs License law dose net apply to an owner of Required Inspections
property who buildsorimp rms themon,and whodoessuchwork himself or through his
owe employees.provided that such improvements are net intended or cifere l far sale If.
however.the Wilding or improvement is told within one yexr of completion.the owner-
builder will have Ne burden of proving that M did not Wild or improve for purpose of
tale.).
❑1,as owner of the property,am exclusively contracting wit licensed contractors to
constmct the projeci(Sec.7014.Business;and Professions Code:)The Comuacbrs U.
cove law dors not apply to an owner of property who WHO;or improves Nemo..and
who contracts for such Projects wish a contractor(s)Bossed pursuant us the Contractors
License taw.
❑1 am accept under Sec .B A,P C for this recon
Owner Dat
WORKERS COMPENSA710N DECLARATION
I hereby of ton under pevity,of perjury one of IN following dolaruims
I have and will meinwin a Certificate of Consent to seIf.lasure for Worker's Compen.
moon,as provided fw by Section 3100 of the tabor Cade,for the Nrfwm.of the
w rk for which this permit is issued.
1 have and will maintain Workers Compensation Iraluranm,as required by Section
37 of Ne labor Cade,fw Ne performance of Um wwk fw which Nis permilisissued.
My Workers Componeadon bund.cart:t�and Policy number are:
carrier. :, el l3� '{-1\7sonlicy No.: I t S C
CERTIflCATE F�PI'ION FROM WORKERS'
COMPENSATION INSURANCE
(ibis accGms heed not W completed if Ne permit Is fortune humboudoBars($1007
or las)
I cordry that in she pu(omtuta of IN wort far which Nis peneit is issued,1 shall not
employ any porton In my mannorm a aa become subject to BM Worker]Compensation
Laws of Cabicarma.Dam
Applicant
NOTICE TO APPLICANT.If,after making this Certificate of Excmpeon,you should
become subject to the Workers Compinulion provisions of IN Labor Cade,you must
.J aZ forthwith comply with such povisiom or this Permit shall be domed revoked.
z'O CONSTRUCTION LENDING AGENCY
[-+� Iherebyafirm that them is a consruction lending agency for tiro performance of
err> the work for which this permit is issued(Sec.3097,Co.C.)
6W. Undes Name
7 z Lenders Address
U O 1 certify Nat I have mad this application tab supe that pec show,information is
IL F correct.I agree to comply with all city and county aNinsrmes and mute laws misting m
DU building construction.and hereby mOOTIm mprcacntatives of NiS City to enter upon One
U aWvc.mendoned Property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
rF.r/1 Iiabilitia.judgmems.cats and cape secs which may N anyway amue,gaiut said City
U2 in consequcna
off
of Nis permit.
^' APPLICANT UN R A DS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dale �-�e
SOURCE REGUL 0
Re-roofs
Signature of Applicant/Co ntracmr Dat -
HAZARDOUSMATERIALSDIs LOSURE TypeofRoof
Will Neappliantorfuwm Wildingwcupanl meorhmdleharudoamaterial
az deflned by the Cupertino unmrpal Code,Chapter 9.13,and IW Health and Safety
Cade,Section 25532(a)? All roofs shall be inspected prior to an roofing material being installed.
40 ❑Ya N P P Y g g '
If a roof is installed without first obtainingan inspection,I agree to remove
Will w applicant or futons building by ft Bty A equipment or Mara which P g
omitict? a err contaminants u dc0ned by pec Bay Area Air Quality Management all new materials for inspection.
District?
❑Ya
1 have read the Word' mamlodsreq.iremcnu under chapter 6.95 ofOc Califon
nis FlealNhSafcty ade,S-6.25505.25533 and 25534.1 malsonub On ifshc Wilding
Joel not curren0y h vei((to an4 Nat it ismy responsibility N lmi ly scup of Nc
requirements whkhm m prmi nonce tui,cmdrra¢ r apartcy. Signature of Applicant Date
t a-6 06
Owner or authorind agent D,m All roof coverings to be Class"B”or better
CITY OF CUPERTINO
om 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36651028 . 00
DATE ISSUED. . . . . . . : 05/26/2006
RECEIPT # • • . . . . . . . : 34589
REFERENCE ID # . . . : 06050233
SITE ADDRESS . . . . . : 11537 SILVER SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MONICA CHEN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : LESLIE HOANG
CONTRACTOR . . . . . . . : LESLIE HOANG LIC # 23155
COMPANY . . . . . . . . . . : T D ROOFING
ADDRESS 3540 MARGATE AVE.
CITY/STATE/ZIP . . . : SAN JOSE, CA 95117
TELEPHONE . . . . . . . . : (408) 892-8872
kE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 13 , 000 . 00 201 . 96 0 . 00 201 . 96 0 . 00
BSEISMICRE VALUATION 13, 000 . 00 1 . 30 0 . 00 1 . 30 0 . 00
---------- ---------- ---------- ------ ----
TOTAL PERMIT 203 . 26 0 . 00 203 . 26 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 203 . 26 VISA
TOTAL RECEIPT 203 . 26
•
SAW
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building Department
JOB ADDRESS: PERMIT #
II S3 I S.� � / , ,- 5� % % �1 C Sb-z-3
OWNER'S NAME: l o—1k U-N e\- PHONE # yob cl y 1 S I y
GENERAL CONTRACTOR: IjZ o o i 1�q I FAX #
I am not using any subcontractors: / .2-G 10 6
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
Owner/Contract ature Date
CITY OF CUPERTINO
,�Q' REROOF
CITY or
CUPEkTINO PERMIT APPLICATION FORM
APN# ?) n 1 11^ _5 ^�� Date: S
Building Address-
it
i1 5 3 S'. I V e S vt �� c 0't
Owner'sN ne: Phone#:
11WV" (1/1eCgDs ) 3C) .1 � s �
Contractor: ,i- D o � » License#: S 4 S S c I
Contact: 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 ❑ Wood Shingles n } /
❑ Other(Specify) X Other(Specify) Co t� C.lS e-li �' c
Number of existing coverings ❑ Provide I.C.B.O.. Report�rD
ATo be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
J?-,c:w o\ t? Wood Sit c��a.� hu- L�Cv V\J CQ-d ),t,
Residential inCommercial ❑ ri-1 O -n ;T-
�,ss roo J
Fire Zone: Yes ❑ No [S Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
t7? hC - n o o
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
•
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 LC.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: /( e tL�Ctt o C.l-1 (a
Job Site Address: 15 3 S J e SP��� C' Ct
Roofing Company Name: A I D P_
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04