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05060193 (2) CITY OF CUPERTINO 3a /�7��r�.« :n ��yv5,g/ga` BUILDING DIVISION PERMIT �X�!LV?tit CTOR ItYR'ORMATION aUILDINC ADDRPss: CINDY ROOFING CO INC PERMIT N%5060193 stntj RT ANnRF.Wq A17 OWNER'S NAME: PERMTf ISSUE DAM YUE-WEN CHEN 5554 HA 05 ONE: SANITARY NO. CONTROL NO. 408) 286-9990 ARCHTfEC IENGiNEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH �OO LICENSED CONTRACTOR'S DECLARATION O O O 1 hereby afilmm that l am licensed under provisions of Chapter 9(commencing Job Description with Section 7M)of Division 3 of the Business and Profcaio m Cod sand my license is In full fares and eea�-3 2IS�l REROOF W/COMP. ]�? LimmDate Clan L .J Co. r.�, [ Dau Conlrseor I)/((p'-' R HITECI'S DECL is ren N '� 1 vedcrslanJ my Pbu shell he sited u public records ipI n (Iqy ted�a Licensed Professional n 5 3 OWNER-BUILDER DECLARATION S I hereby,hast Net l am accept from Ne Contra:lora License LAW for the ! /l7 m D O following moan.(Section 7001.3,Business old profession Code:My city or county O f]� $ which m uimv a Permit w construct,alter,inferno,demolish,m repair my structure O O O _ZY's prior b its issuena.ilsu requimA the applicant fmsech permit to rile a signed wlemcnl I'that he I. nUm licensed pum.,1.Ne provisioof Contractor's Llcensc U.(chapter 9 Sq.Ft. Floor Area `V' /fp/{)' (jjj❑jjjt)))��r \\fy l Valuation S (commendngwidiSectlon7BOO)ofD"ion3of Ne Businenand Profmians Cmu)w fel V��{f,�lj sex .. that he Is exempt therefrom and the basis for Ne alleged cutup ion.Any violation of Secam mOundred Mile.(SSW).applicator for a permit subjects Ne applicapplicantto wivll ppenalty OI er 0 omWn livelive hOccupancy Type ❑1,uO.werof Napmpeny,mmyanployeawithwageauftbwkcmnpcwpan. will do the.,Lead the structure is not Intended oraRered for sale(Sec.7061,Business and Pmfonian Code:The Committees Limme,Law does not apply to an Owner of Required Inspections property who but lds or im prows thereon,and who dote such work himulf or through his awn employme.provided that such improwmema are not intended oroRered forale,if. however.Ne building or improvement is old within an year of completion,Ne owner- bollder .will have the burden of pmving that Ice did.l build or improve for purpose of tele.). ❑I.u owner of the property,en exclusively convecting with licensed cone oom to construct the project(Sec.70".Business and Pmfasion Cade:)The Contractor's U- ceme Law done not apply 0 an owner of property who builds or Improves Ihemon,and who contracts for such projects with a contncuu(s)licensed pursuant to the Contractor's License Law. ❑IanaemPlundasee. ,11kPCfarth4reasen Owner Dam Adh WORKERS COMPENSATION DECLARATION I hereby a1Rrm under Penalty of perjury one of the following declwtlons: I haw and will mainuin a CertlBeam of Comet w self-insum far Warker's ComNn- allan,u provided for by Section 3700 of Ne Labor Code,for the Performance of the work for which this permit is issued, ❑I haw and will maintain Workers Gmpenadon Irtsmma,as required by Section 3700 of Ne Labor Code,for the performance of Ne work for which this permit is Wood, My Workers Compensation Insurance carrier and Policy : num re carrier ZPalmy Na.: �cS, d CE EXEMP0N FROM WORKERS' SAION INSURANCE 0111,aced.need not has completed if Ne Permit term..hundred dollen(g100) or las.) 1 certify that in Ne performance of the work for which this permit is Issued,I shall net employ any person In toy manner so as to became subject to the Warhn'Compensation Laws of California.Data Applicant NOTICE TO APPLICANT:If,after making this Cerd fiaue of Eumption,you should become subject In thc Worker's Compensation provisions of Ne labor Code,you must wJ O forthwith comply With such provisions or this permit shell be damad mvnked. .'�.m CONMUCfION LENDING AGENCY ]—mmom. I bereby a n.Nal them is a construction lending agency for the Performance of 14? Ne work for which this permit b issued(Sec 3097,Civ.C.) WQ Lenders Nu. Q91�z Lenders Add^•.. _ f,Q I certify Na I haw read Nis application and sum Nal the&bow inform W un is U. !� correct.)agree to comply with all city and county o linanaa and some laws relating to Q SV" building construction,emu hereby auNodre mpmsnu0ws of No city to enter upon the W above-mentioned Property for Wpectmn Purpnses (We)agree M saw,indemnify and hep harmkss the City of Cupertino agarol IA Ilabililu,judgments. an .eu d tepwa which may in any way mature against said City O 7 In conmquene of the grenGng of Nis penia / Fl APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POIM SOURCE REGULATIONS. Issued by: Date 61-2 Re-roofs riga HAZARDOUS plicaDa HAZARDOUS MATERIALS DISCLOSURE Type of Roof , Will ft apPlianl or(Muni building actmputmum aeand th h ealloameterid as deRned by tiro Cupeni.Municipal Code,chapter 9.11.rob the Health mU Safely ado.Sm 1.11 1333x,)7 All roofs shall be inspected prior to any roofing material being installed. Yea No Will the applicant futon building Occupant use equipment ar devices which If a roof is installed without first obtaining an inspection,I agree to remove It hasudnn air anteninmu an dclined by the Bay Area Air Quality Management all new materials for inspection. imicG P ❑Yes ❑ u I Irk&wreWNeha&AMt ns 25305.25533 5305.25531 ed2553.1u Chrstand mirth.C&lding �� rAry ash Haa Ih&Safayhe bacanctian13eialse533andnts undmdcmondth&l lfthe building v Lam• docs.t curcrod,haw a unmi,Na It is my respomimi ty Or notify,the..p.(.r the myulmmcnts which he mm prior on Issuance,ore CAniAam of AOc-cu ry11 O Signa of App]icant Date vl' owns, a adycda em Dam Al]roof coverings to be Class"B" or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 OCOF Fax(408)777-3333 �UPERTINO Building De artment JOB ADDRESS: PERMIT # DLI-tog �`T ratil5 SD 010/If 3 OWNER'S NAME: PHONE # tto R-Q 53SSa GENERAL CONTRACTOR L%A rl u CO. FAX# � I am not using any subcontractors: 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 4 CITY OF Telephone: (408)777-3228 U wJ��I�O 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: 71 A2nnt J�r1 Cl lob Site Address: a a`1b 5 S"r. (1J_nJreAA S fie- Roofing Company Name: /1 O S Applicant's Signature: _V\l Date: 1 Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper CITY OF CUPERTINO RE ROOF 2CUPER,T ANO PERMIT APPLICATION FORM APN# 3 6( D 4o/(e Date: 5 Building Address: n Owner's Name: Phone #: u. Jp- , CJ)e-r, `lC:6- a53-55 a- 3 Contractor: L1r1Cl Oc) r� e(,)o ne .L� License #: C�, 58 /! Contact: 1` t P ne#: Cupertino Business License #: d v 128 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles 5<'Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Polic Job Description: l�tr�c]��2. e�ci S I.r,� S r cx� I h resl cQ�,�, Se 19 Residential,` Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are anrestrictions: IJ Cost of Project: Type of Con ction: Occupancy group: 5 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 # 3 oS2 os�,