05110088 (2) CITY OF CUPERTINO yCOieI•TR�GTORINFORMATION�
BUILDING DIVISION PERMIT rra�r„ ;-_ A!
BUILDING ADDRESS: WING' S ROOFING INC PERIHrr ND.05110088
.10390 STERLING BLVD
OWNER'S NAME: FERh9T ISSUE DATE
WILSON CHIN 3243 SYDNEY WAY 11/17/2005
NE:
SANITARY NO. CONTROL NO.
(510) 889-9068
ARCHIIECl/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
ip Zp LICENSED CONTRACTORS DECLARATION Job Description
w 1 homey of ores SW 1 am limned under Provisions of Chapter 9(commencing p
�i witr Section TIXMB ofDhWon 3ofne Buses,Apd ProfusionsCode,aM my license is
+<' inrtIrwceardc �( REROOF--T/O SHINGL_ES., INSTALL SHINGLES
j Z License CI t� =L Lw.N p 7 ffr1� t{ALE
Lu J`,
F q Daw_(.�Contranar ttt�IL^'I{11,M{l `.`Cgll(9/l'/��`A1tcB'h p
447W ARCHRELTS DECIA A ION u
f C V I understand my plats"I he used u public records
s
u Lianud Professional NOV ��
05 OWNER-BUILDER DECLARATION 2005
nC I num a1Em on 1 I.J.tempt faro do Comanm o License Law for the
O O fallowing meson.(Section Ro Is,amus and we.d ions Cade:Any city or county nn
5_ whim ram hum n ,Also ro co.the alar.improau demMlW,ore.sir any stuctum pr,� n A B S6 pmBS TI N $6500
_iy thathe itscensed moment to the dm applicant for Such Permit RlcaeLaw suumcm
x �J,
< wtheinwitpuruunt to the d Disiarmor there Bomar LWeau Law(Chapwa9 SQ.FI.FTOOr re8� Valuation
ems$ (commencingaisxewit t5mion?Dndth bans n,efneeged cu pt Professions Cb,an of {% Illi✓
that he r exempt therefrom and the bur fa the alleged eumptim.Any violation of
not
then byaundrediantforApemitsvbjtttsSteapplicantwmcivilpmdtyof Occupancy Type
trot mom Nan Tito hundred dollars(SSW]
Q I,u owner o(ne pmperty,amy wplMyaa with waguunev anleampewtian,
will dotrcwom andthe sanctumosnutintendedaraw clue,
Out a(Sat.Rkn Owner
Required Inspections
prapand entyponwho
Cade:ne COmaCw(S dud whoceme mat uch not apply f,t routh is 9 C
own cro uW Wilds o improv such iM n.And Who AM nstuhwakhimaeered for agehf.
own�ea Me Wiping or nm such improvemau art nos sue,of�or leton.for ownMr-
however.in Wilding on lee of mnntg std within one year Of c parrhe for de owmr-
W iMv win have Sr WAno of proving Wt he did nos build a improve far PUNOu of
sale.).
0 1,As owner d Ne pmpeny,Am eadusively contracting win Based contractors In
construe the project(Sec.70aa,Business and Professions Code:)Ota COMMAMM'S Li-
cense Lav does Mot apply to An Murat of propertywhoWilds or Irnpmvu Income.std
w W contracts for such projects win aconuxwr(s)Iicess ed pmsuam to den Cmtracrofa
License Law.
lamexemmumer See .B&PCrmdumussm
Owner Dau
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty ar perjury are of the,following decluauou:
Ibave and will maintain a Certificate of Consent to self-insure for Workers Compeer, ,
.our,As provided for by Secu.37W of the labor Cade,for rte performance of rte
wart for which tris permit is issued.
1 have and will maintain Wo lace,Compensation Insurance,u required by Section
Mf ureLabor Code.fm the ped' arta alrte work fa which nu permit u issued
My WMrkcrs auo rand 'e aM pudic nM.1beerr Am:
Cartier. PolicyNo.: /Z a 3 `-' / -
CERT1Fp ATFP F^ EMP ION FROM WORKERS'
COMPENSATION INSURANCE
Crus section need notocanpktel if rte permit u for one hundsd cMOua(SIM)
or las.)
1araC-net in She paformanee Of the work for which thin permit is issued.I awl rot
employ any person in any manner an u to become subject to the,Worker'COmpeuxum
Laws of California.Due
Applicant
NOTICE TO APPLICANT:If,Aber meting this Cenificau of Exemption,you should
become subject an She Worect's Compcuudon provisions of trc LAW,Cede,you most
.JO roMwid ns comply with such provisions Or pemit shall W mvo
deemed reked.
E D; CONSTRUCTION LENDING AGENCY
[—t IheebyAtli.dust nem is a cautuction sending agency for rte perfumana of
E
She.,it for which the permit is issued(Sec.3097•Civ,C.)
DJ Q Lendn's Name
z Lender's Address
I.)O 1 entry that I hale rad dos Application and sus that the Abu.e information s
U, coma coma 1 agree to comply with LI city and county mdimnces and auto laws relating w
0 SV' Wilding contraction.and hereby mthmim mpuseMMhQA of nr city a cnurupnn on
r[LI move-mentionod property for inspection puryues
(~gy+ (We)agree to save,indemnify and keep harmless the City of Cupenino against
cM liabiliuu,Judgmens.eau+md,.M.which may in any w'ayaa+aatmlutuid City
V z APPLnICAnoeuNDERSTANDS AND WILL COMPLY WITH ALL NO P Issued by: Date
SOUJI R GULATTONS.
Re-roofs
SignarWAppl7ciotlContractur Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will She applicant or forum building Occupant sore or handle hvadous mawrial
u defined by the Cupertino Municipal Cade.Chapter 9.17.and IW Heald and Wety
ode. Cyte �I No 75s3255320)? All roofs shall be inspected prior to any roofing material being installed.
❑Yrs
Will rte Applicant or form Wilding aoupant use equipmem or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mit hvtarmus air cenuminanu As de0mtl by the,Bay Area Air Quality Management all new materials for inspection.
Diatom? J
❑Yes No
I hme read rte buaN I materialsmquirowns under Chapter 6.95 ofd.Califor.
ria Hcald&Safety Cau.Sceuau 25505.75533 etu125534.IurvkasOvd dmifnc Wilding i ��_/t _/
Jas not currently bA.<A henans that it r my responsibility to notify the occupant of the Y �Lll
mquiremerts which most be met prior w issuance MIA Ocrull"In of Ocmpancy. SignSlgn aa�ll an Date
Owner or authorized agent Date All roof coverings to be Class"B”or better
Community Development
N 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building De artment
JOB ADDRESS: - PERMIT #
OWNER' NAME: PHONE #
GENERAL CONTRACTOR: / p' AX #
VI am not using any subcontractors: X I s C �C
ignature Date
Please check applicable subcontractors and c Tete the following info ation:
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/Contractor Signature Date
Community Development Department
Building Division
t� City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
U P E IST I N 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: UV o
Job Site Addressei`C> v Pi L(
Roofing Company Name: 7 / tN
Applicant's Signature: Date: �G��
Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
50— REROOFCffr
CUPERTINO PERMIT APPLICATION FORM
APN # 2—q O Date:
Building A dress:
Owner's Name: �/LzCS O Y-1 I n Phone#:q-09 7!k,�-3 Z
Contra to : C C�YI Phone#: r) ense#:
I 5 R 11V -Sl o v
Contact Phone#: Cupertino Business License#:
W, n,C Cf-(McS a6 onto
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles y Asphalt Shingles
❑ Wood Shakes ❑\ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings 1 ❑ Provide I.C.B.O. Report#
C�tt To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Com 1 With Cu ertino's Teaz Off
Policy: ❑
Job Description: �, f / L(�D j l� �� S7 /6 i
�vts
Residential ) Comm er ial ❑ P
7Fire Zone: Yes ❑ No Confirmed with Planning Det. if
there are any restrictions: i5
Cost of Project: / h 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