08080018 (2) CITY OFCUPERTINO e »��. ;t1ar�r '
BUILOINr DIVISION PERMIT rpCUt�.(•.TRAC'fQR�,mORMWO
BUILDING ADDRESS: PERMIT NO.
11823 TRINITY SPRING CT LOS GATOS ROOFING 08080018
OWNER'S NAME: PERMTT ISSUE DATE
YUAN hI.N P 0 BOX 1726 08/04/2008
NE SANITARY NO. CONTROL NO.
HITECT/ENGINEER: BUILDING PERMIT INFO
RE—RF RMV SHKRF& INSTLBLDG
O ELECT O PLO MECH
O
o LICENSED CONTRACTOR'S DECLARATION �41
I hmcby aflUm Nn l em licensed under previsions of Chapter 9(commencin{ ^^--^^-^-^ ^-•^^•-•-^- "Job Description
Section 70W)of Divi,Ion 3 of NC Business aM Prefesswm Code,and my license e
nll(tree and later.
4-1U nse
DemYContractor
3
ARCHITECT'S DECLARATIO
1 uMomtanJ my Plans shall bu used as public mrnrd.
t G] Lice.ed PmMAA.ml
ray OWNER-BUILDER DECLARATION
Y�f I hereby AM.that I am exempt from IM Constitute,License Law(a,the
Liii 0 o following reason.(Section 7071.5.Business and Professor.Code:Any city.county
S$ which requires a Permit so eenmumr,alter,implore.dcmniWu or mpur my mune.
-iy prior An its issuance.tarn requites the applimnt for such permit in file as!good mtement
xx<
that be isBete,edprlmantmJmprovi,it.ofthe conuatmr,License,Law(Chapter 9 Sq.FL Floor Area Valuation
F9 (commencing with Section 70DO)of Division 3 of the Business and Pmfessiam Cade)or
Q
that he l mempt thertfmm and the bub far the alleged resorption.Any Noladon of
Semler 70313 by any Applicant for a permit mbirn+the applicant in.evil penalty of ane APN Number Occas e
cal some Own Bve hundred dollars(gem), Occupancy TYP
❑I,uownerof Wpmpcny,wmyemployeswithmg utheirmleeompeuadon,
will do thework and the suuctum Is nnrieandrd araffemd Tarsale(Sm.7014,Bu,in m
And re
d Pfessio.Cade:The Conueemes License Law does not apply m an Owner of Required Inspections
pmpeny who builds orimpmws thncem.and whodoes,mhworkhimself or through his
mm employee,,pmvlded Out such improwme ssw not intended oroRered tensile.if.
however,the building or improvement Is sold within one year of completion,the owner.
builder will haw tha burden of pmving Out be did net build of impmw for purpose of
asle.). .
❑1,a caner of the Property.am ewleawly 4on4aming with licensed contract.An
consumer the prelee.(Sec.7044,Business and Pmfesslam Code)The Contravene,U.
come Law does ret apply to..owner of property who builds lir improves dmrmn.red,
who cnemGV fnr,uch Mj m with aCon4mmf(I)licensed pmamm In Me Camuna e.
I.Mn"m Law.
❑lammmnprundor See ,B&PCfordtbrtaso.
Owner Dau
40 WORKER'S COMPENSATION DECLARATION
1 hereby affirm ander porosity of perjury one of the fallowing dWanBoor
1 ham and"I maintain a Certificate ofC...10 self-Warm Ire Workees Comport.
.He..As provided f.by Section 3707 of the labor Code,fm the perfurmanm of the
work for which this Pamir is Issued.
❑I haw and will maintain Worker's Comperm tion Imunnce,as required by Section
37W of the labor Code,to,the pOd..c..f the work far which this permit Is Intend. '
My Worker', ompenutim Imus c nnior and Policy nu r are:
Grier. L Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ibis section need notbccomphowd if the permit Inference hundred dollar($107)
or tess)
1 certify Net in tha performance of Me work for which this permit Is I.uuM,I,hall net
employ any person In any manmrse As m becamembject to the Worked CompewJw
Laws of Califamia.Data
Applicant
NOTICE TO APPLICANT:If,after making this Ceniacate of Exemption,you should
became,ubjen to the Workers Compensation pmvisiom,of the labra Code,you most
0 O
Eforthwith comply with such provisions or Nu mmended.Permit shall be deeed mked.
'Z y CONSTRUCTION LENDING AGENCY -
Ihnoh,.M.Osis then i,a camtructinn lending agency for 0.pertmon.of
? the weak for which thin Permit 1.issued(Sec.3097,civ.C.)
W 0 Lender,Name
0 z Lardees Address .
U 0 1 sonify that 1 haw reed Us,Application and sum Met IM abo.information Is
W co ntem 1 agree to comply with.11 city and county aNlnYwes and some laws relating m -
0 building construction.and hereby authadm mpmxnbdvrs of this city to Omar upon the
W above-mentiond eproperty for impaction purposes
P. (Wu)agree to taw,indemnify and keep harmless the City of Casper inn agal.t
„y h liabilides,judgmcnW emu and expmrosi which may in any way ammo alai.,said City
V Z in carueq ume Of the granting of Nis permit. (�
^-� APPL CANE UNDER ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date (}�� L, �
BREGU NS.
�uusmlllfApppliauc hnbu k DA Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will f applimmt or furore building eccapant nom or handle huardou metrial
As defined by Ote Cupertino Municipal Code,Chapter 9.12.and the Health and Safety
cmle.0Yti 25532(a)? UZNo All roofs shall be inspected prior to any roofing material being installed.
WIII W applicant or future building occupam use equipment or devises which If a roof is installed without first obtaining an inspection,I agree to remove
mit hourdnce air contaminants as dclined by W Bay Area Air Quality Management all new materials for inspection.
District? � �
0y. 114.
I ham mad the haurdmta material mquireme mitutMrchaptarti.95 ofthe Califor.
nia Hc.Im&Sefcty Cada,SmOm.25505,25577 and 75534.I underaund"it&building
does not urrenI] haw a Am lit.Net it b my remomlbility m notify Jus oncupanl of the ��llfhllldl✓ JJ T
m
y m tswhich mmlb met pdoren issu mofa Ccrfificamof Oc party. Signature of Applicant Date
�4�oP
Ot�ner 6r mthorimd agent
Dow All roof coverings to be Class'Wv or better
CITY OF CUPERTINO
• 2 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36653028 . 00
DATE ISSUED. . . . . . . : 08/04/2008
RECEIPT # . . . . . . . . . : BS000005674
REFERENCE ID # . . . : 08080018
SITE ADDRESS . . . . . : 11823 TRINITY SPRING CT
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : YUAN LIN
ADDRESS . . . . . . . . . . : 11823 TRINITY SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : P 0 BOX 1726
CITY/STATE/ZIP . . . : LOS GATOS, CA 95031
TELEPHONE . . . . . . . . : (408) 298-9399
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---- ------------- ---------- ---------- ---------- ---------- -- --
1BSEISMICR VALUATION 4, 938 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1REROOFRES SQ FEET 21 . 00 273 . 00 0 . 00 273 . 00 0 . 00
TOTAL PERMIT 273 . 50 0 . 00 273 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
---------- --------------- --------------------
CHECK 1, 244 . 30 #2663
---------------
TOTAL RECEIPT 1, 244. 30
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL- REROOF
•
CITY OF CUPERTINO
40 REROOF
0CUPERTINO PERMIT APPLICATION
APN#
Building Ad r ss: r
723
Owner's Name: Phone #:'/
Contractor: /L0 S 5 I2v o0Phone #: L-1 8
0 6' _2 9 _ 93 9
(rcL.7'o � .i cI
`J
Cupertino Business License #: Contractor License #:
23q 8 / ,7 0 70
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles �Asphalt Shingles
Wood Shakes ❑ Wood Shakes
/❑` Wood Shingles ❑ Wood Shingles
❑ Other (Specify) Other (Specify) /i�th�
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
r �ZS
S s D,S a elgss
Jo Description: �9
Residential Commercial
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: Exf3
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Sign re
CITY OF CUPERTINO
REROOF
CUPER -TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
20 5 1REROOFRES Re-roof Residential B 1SFDWLROOF
IBSEISMICRE Seismic Residential B
IREROOFMRES Re-roofMulti-FamilyB 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 paid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of r/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: 1 tut'-"I L
�U //t✓
Jab Site Address: ��Og::;t a-f-
Roofing Company Name: S TC
Applicant's Signature: pate: 3 a/6
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
r Cupertino CA 95014
Telephone(408) 777-3228
CITY OF
UPEkTINO Fax(408) 777-3333
�
Building De Artment
JOB ADDRESS: PERMIT #
U 010
OWNER'S NAME: _ PHONE #
GENERAL CONTRACTOR:
cz SFAX #
I am not using any subcontractors:
Signatm-e Da
Please check a2plicable subcontractors and complete the followin 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 �y
Owner/Contractor Signature D e r