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07080133 ------------ CITY OF CUPERTINO PERMIT ��►�T��r��IU� 'TIf�N BUILDING'DIVISION PERMIT NO. I BUILDING DDRESS: LOS GATOS ROOFING 07080133 1543 MORNING SPRING CT PERMIT 155UEDATE OWNER'S NAME: P O BOX17 SAMTARYN . CONTROL NO. CHEN JO—LAN (408) 298 -9399 BUILDING PERMIT INFO BLDG ELECT PLUMB M ECH ARCHITECT/ENGINEER: LICENSED CONTRACTOR'S DECLARATION Job Description affirm that I am license I hereby d under provisions of Chapter 9(commencing REMOVE SHAKE ROOF. INSTALL TYPE 30 FELT AND GAF U with Section 7000)of Division 3 of the Business and Professions Co�and my license is CANYON SHINGLES in full force and cffec GRAND License CI Lic.fi Date Contractor 1 ARCHITECTS DECLARATION r 1 understand my plans shall be used as public records U ti Licensed Professional a OWNER-BUILDER DECLARATION t hereby affirm that I am exempt from the Contractor's License Law for the cfollowing reason.(Section 7031.5,Business and Professions Code:Any city or county Valuation which requires a permit w construct,alcor,improve,demolish,or repair any structustatement 5,1.Ft.Floor Area - N prior to its issuance,also requires the applicant for such permit to tilt a signed statement $4800 < that he is licensed pursuant to lite provisions of the Contractor's License lase(Chapter 9 c (commencing with Section 7000)of Division 3;is for of lite Business and Professions Codc)or Number Occupancy Type ii that he is exemptn.Any violation of any applicant for a perm subjccthe ltsthe hasetlte appl cged antto a coil penalty° 3665203- not 6 6 5 2 0 3-.Av� Section 70315 by y not more than five hundred dollars(5500)• Q I,as owner of the property,or my employees with wages as they sole compensation, Required Inspections will do the work.and the structure isnot intended or offered for salt(Sec.to an Owner of and Professions Code:The Contractor's License Law does not apply work himself or through his property who builds or improves thereon,and who does such own employees.provided that such improvements are not intended or offered for sale If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). Q 1,as owner of the property,am exclusively toms icling with licensed contractors to construct the project(Sac.7044,Business and professions builds ds or improves thereon.and. cense Law docs not apply to an owner of property W the Contractors who contracts for such projects with a contractors)licensed p License Law. ,B&P C for this reason Q I am exempt under Sec Date�— Owner WORKER'S COMPENSATION DECLARAT] I hereby affirm under penalty of perjury one of the following declarations: Q 1 have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued• required b Section O 1 have and will maintain Workers Compensation Insurance,as tell Y 3700 of the Labor Code,for lite performance of the work for which this permit is issued. My Workers Compensation tanccicartier and Policy—num ��—o rL Carrier d Policy No..v CERTIFI C MPENSP T ON 14WORKERS* SURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) 1 certify that inthe ncaa marirmance e work for which this permit is issued.I shall not ne Laws to become subject to the Workers Compensation employ any pc Y ) Laws of California.Date Applicant p you should NOTICE TO APPLICANT:If,after making this vision O of Exemption, become subject to the Worker's Compensation provisions of.the Labor Code,you must Z forthwith comply with such provisions or this permit shall be deemed revoked. C) CONSTRUCTION LENDING AGENCY .�.. I hereby affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) a Q Lender's Name . Lenders Address �z �� I certify that i have read this application and state that the above information is f~ cored.1 agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon lite U above-mentioned property for inspection purposes. 1. Q+ (We)agree to save,indemnify-and keep harmless the City of Cupertino against Uj liabilities,judgments,costs and expenses which may in anyway accrue against said City Date v `� zin consequence of the granting of this permit. � APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued y: So REGULATIONJftd D2' Re-roof 3 Date Type of Roof Sign re of Applicant/Contractor HAZARDOUS MATERIACLOSURE Will the applicant or future building occuore or handle hazardous material as defined by the Cupertino Municipal Code,C9.12•and the Health and Safety Code,Section 25532(a)? All roo's shall be inspected prior to any roofing material being installed. QYesIf a rocf is installed without first obtaining an inspection,I agree to remove Will the applicant or future building ocuse equipment or devices which emit hazardous air contaminants as defined byy Area Air Quality Management all new materials for inspec*.Ion. Distrct? � �jQ Yes o4I have read the hvardous materials requis under Chapter 6.95 0!the Califon- �/�niaHcalth&SolctyCodc,Sections25505,2553334.IunderstandthatifthcaLo btndin-g /J�(\�CDate does not urently have a tenant,that it is my rehilily to notify the occur Signatlrre of Applicant requ'r this which must 4c met prior w iss`anCertificate o�(4coP t� All roof coverings to be Class"B" or better n iAG 1 Date Owner or authorized agent CITY OF CUPERTINO 2 ITEMS OF 6 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Bll : Lot: APN . . . . . . . . . 36( 52031. 00 DATE ISSUED. . . . . . . : 0814/2007 RECEIPT #. . . . . . . . . . BS000002375 REFERENCE ID # . . . : 07080133 SITE ADDRESS 111343 MORNING SPRING CT SUBDIVISION . . . . . . . CITY CU:?ERTINO IMPACT AREA . . . . . . OWNER CH:�',N JO-LAN ADDRESS 11543 MORNING SPRING CT CITY/STATE/ZIP CUPERTINO, CA 95014-5121 RECEIVED FROM LAS GATOS ROOFING CONTRACTOR RA>IDY 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 ____ _ __ ---------- --- ____ --------- ------ BPERMFEE VALUATION 4,800. 00 115 .56 0. 00 115 .56 0. 00 BSEISMICRE VALUATION 4, 800. 00 0.50 0. 00 ----- - ------0_00 ---------- ---------- - TOTAL PERMIT 116 . 06 0. 00 116 .06 0. 00 CITY OF CUPERTINO &: REROOF CUPE�TINO PERMIT APPLICATION FORM CtC, 1-2, APN# � Date: ,366,--5_Z _0 3 / F /`1 19 Building Address: //S y3 AVh/n c S e-7f Owner's Name: 4 ' / � Phone J-o #: �Q G 29 �-1-.� rJ O � y Contractor: Phon #: 0 License#: a 21S- 9392 �00 207 Contact: _�— Phonf;#: Cupertino Business License#: same.. 3V 3 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt ShinglesAsphalt Shingles k. Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles 3d ❑ Other(Specify) � Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# To be Removed �I S E3n Provi e fgr .Installation Specs. /?00 I Have Read, Understand and Will Cgmpjy With Cu ertino's Teg Off Policy: Job Description: i�rl2 Residential Commercial [] Fire Zone: Yes ❑ No Confirmed with Planning Dept. if. there are any restrictions: LI Cost of Project: Type o Con;tructi Occupancy group: Qna k Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING —-.- ( -_- BSEISMLCRE----- -_ Seismic_Fee-Res __ _ _- _BUILDING-- - BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING Community Development Department Building Division g. .; City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 Fax: (408)777-3333 C U P E T!N® Building Department Subject: Re-roofing policy for tLe City of Cupertino 1. Prior to permit issuance,you must 3.gree to comply with 1997 UBC Standards and manufacturers specifications o:1 re-roofing. 2. New roof coverings shall not be ap-Aied without first obtaining all inspection and written approval from the buil.linginspector. 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. 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: _.—Job-Site-Address:- �� L. T. Roofing Company Name: Q Aplicant's Signature: Date: D Greg teel Building Official Revised 1/30/03 Print sd on Recycled Paper Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CIT1f OF Fax(408)777-3333 CUPEkTINO Buildin De artment JOB ADDRESS: PERMIT# OWNER'S NAME: L PHONE # - G` GENERAL CONTRACTOR: '' 6-� o 5 FAX # 93 -7 10 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 D e