08100034 CITY OF CUPERTINOa' �,-« a.sT`
BUILDING DIVISION PERMIT liXONTRACTOR`INEORMATIO N4
BUII�INN ADDRESS: PERMIT NO.
61445 MILLARD LN MENDOZA ROOFING 08100034
OWNER'S NAME: PERMIT ISSUEDATE
WM HUANG 6104 BUTANO CT. 10/07/2008
NE: (800) 440-6502 SANITARY NO. CONTROL NO.
!`
ARCHITERR:NGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
I� C-=]
0
umpp LICENSED CONTRACTOR'S DECLARATION Job Description
n I borcby aiBrm Wt 1 w lisomcd umkr provision of Che . 9(mmicc-i- P
widrScotim)0BU)ofDiviaion7ofdeBudnessandProfcs�ionCede.andmylicensis RE-RF T/0& INSTL 30LB FLT PRES SHK 50 YR 34 SQ
; s in tali fmu ansa e
tg_ LiccnmCissa�� s2�L�.. 7dy `7 CLS
Dau Contraor,
ARCHITECTS DECLARATION A
JU I understand my plans gall be used ss public accoads
W
ywLicensed Professional
03 OWNER-BUILDER DECLARATION
a� E 1 hereby a1Em that 1 am exempt from the Conuactx's License Law for the
Coo following resson.(Sade.7W I.S.Business and Profession Cade:My city or county
$E' which mr dams a permit to construct.slur.improve.demnl'uh,Or repair any endure
prior to its issuance.good requires the applicant forsuch Permit u file a signed autement
SxG
ited he is Inecoad pUMAnL to tW Provisions of the Conduatter's Licerse Law(Chapter 9 Sq.Ft. Floor Area Valuation
(commencing
xem it section 7000)and theDivisionbs )of al Bmineuana on.Any
Codc)don of $14800
.- that he u exempt therefrom and the peg for be cos de, assumption.Any vlolaaan of
not maeStX.ofvveenndrreedl dol.n(sa5ro0i.it aubjecu Ne applicantu anvil Penalty a( 32644059 .'�.Nunnbcr � Occupancy Type
❑I.u scarce of du property,army wplown wiN mgss ss Nes axle ewpenaden,
and da ones work and e, steam u rter's enaede La.do tarsale(Sec.to sm Busitess
and Ptareninn cane:Tne Cmuxmfs I.hcme law aces ml apply lf,towner is Required Inspections
Owns ywW Wilds orimpmwuNwon,ana vW dtesamnwort araffefor dmugn his
mvnwployeWiproHdeathusen imD�rnenu art not inurWedoreQered 0.a ,.
builder Ne Wildingorden of pmantishou his
arccastorcompletim,Neaweer-
b le.). will has the burden of Proving Wt he stat Out htiW or improve for PuNote of
❑1,as owrer of du properly.am Cac usively comming wids licensed emtraclers to
construct the Project(Sec.7044,Business and Profession Code:)The Cootneuts U.
cense law amnt not apply to an owner of prepeny what Wilds or impre.thereon.and.
whe cmuuu[or suW pmjecu wiN a cmtrsmor(s)11¢med porstum m thecenusmla
Lice.Law.
❑Iwaemptundu See ,B&PCfm Nisreason
Oester Data
WORKER'S COMPENSATION DECLARATION
1 hwby affim under penalty or perjury ane of the following decbmtion:
Ina.and will maintain a Certificate or Concm to uhf-inure far warlon"Co.,.-
aWm..provided for by Scedon 37W of de L+Wr Cade.for the per..or the
work far which Nis Permit is instead.
1 haw and will maintain Worker's Compensation Degrades.n required by section
37W of the labor Coat.far the perfMWM.of the work lm which this permit u issued. �y
My Wm1Mrs(=Wuw¢¢mi and Policy number oft I C I
Carrier: Pnhicy No.: d 1
C=HCATE OF FJ( P ION F ROM ORKERS'
COMPENSATION INSURANCE
(Thu mire need not W complcmd if the permit hsrorone hundred amlars(SIIXn
or Ices)
1 cannily the,in the perfomanee of the.,it fm which this Permit is issue4l shall not
..Ploy any Peuan in any manner.as u become wbjen m we Workers'Compensation
laws of Califamia.Due
Applicant
NOTICE TO APPLICANT:IL after making this Cmdri¢u of Exemption,you should
become subject m the Worker's Compensation provisions of sec labor Code,you must
.J O forthwith comply with such provide.or tau permit shall k seemed mated.
'E r CONsrBuc ION LENDING AGENCY
y. I hereby afDm dant Vert U a construction lending agent'for Ne Performance of
w�-r
the work for which this permit u issued(Soo.3097.Civ.C.)
fdd fender's Name
z Leader Add.
V C 1 coldly Nat 1 haw Wall this application and suis that the aWw infomatim is
Ug E comet I&gme to comply wids all city and county mdinan¢a and sum lanarelating m
C) Wilding crosuuction.and hereby wNorice representatives of this city to enurupon Ne
r Gs7 ataw-mentioned property for impemim purposes
LSr
(WO)agree to saw,indemnify and keep harass the City of Cupertino against
E+h liabilities,judgments.cow and experuu which may In any way amue againl&aid City
C.)Z u conequeme of site granting of thispvmiL
APPLICANT UNDERSTANDS AND WILL C PLY NW�JTH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS. car ,1
y �{ A 1a Re-roofs �✓
Signuurt of Appli¢nuCon Dau
xAZARDOLIOUS MATERIALS olsaosURE Type of Roof
will the applicant or forum Wilding e,Chaptnort or handle Heads
material
ss definea by the 32(a)?m Municipal Code.Chapter 9.11 and de HdN and Sa(cry
Card.Semien zss32(n7 All roofs shall be inspected prior to any roofing material being installed.
❑Yrs No
Will the applicant or future Wilding occupant use equipment or device wades If a roof is installed without first obtaining an inspection,I agree to remove
t haramnn air contaminated;an defined by the Bay Ams Air Quality Management all new materials for ins ection.
Di vin?
0y. 1Hfto
I have mad site bvamausr materials mquiremunu under Chapter 695 or tW Califon
.is Health&Safety Code,Sttdaes 25505.25533 and!25534.1 underwvrd that ifdu building
doss not Currently haw a un k that It u my mspmnibility m unity Ne o¢upant of the
mquicmc "nicnmug ne ipoor m eanapparacN�reatoo ra pncy. Signature of Applicant Date
Owmr or auNerierA age. c Lf I DauAll roof coverings to be Class'V'or better
'
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32644059 . 00
DATE ISSUED. . . . . . . : 10/07/2008
RECEIPT #. . . . . . . . . : BS000006288
REFERENCE ID # . . . : 08100034
SITE ADDRESS . . . . . : 21445 MILLARD LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. WM HUANG
ADDRESS . . . . . . . . . . : 21445 MILLARD LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1320
RECEIVED FROM . . . . : MENDOZA ROOFING
CONTRACTOR . . . . . . . : REFUGIO MENDOZA LIC # 25894
COMPANY . . . . . . . . . . : MENDOZA ROOFING
ADDRESS . . . . . . . . . . : 6104 BUTANO CT.
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE . . . . . . . . : (800) 440-6502
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- --- ---------- ----------
----------
1BSEISMICR VALUATION 14, 800 . 00 1 . 50 0 . 00 1 . 50 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1REROOFRES SQ FEET 34 . 00 442 . 00 0 . 00 442 . 00 0 . 00
---------- ---- ---------- ----------
TOTAL PERMIT 553 . 50 0 . 00 553 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 553 . 50 #4895
---------------
TOTAL RECEIPT 553 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
---------------------------- ---- ------------------ ---
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 - ROOF IN-PROGRESS 605 FINAL REROOF
•
+, Community Development Department
Building Division
City of Cupertino
• 10300 Tone Avenue
Telephone: (408)777-3228
Fax: (408)717-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards
and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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/ "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 withtheabove stated policy on re-roofing.
)
Homeowner's Name: W o l t e,, '
Job Site Address: I 1 I�- jf'f L^�(r._..,
Roofing Company Name: �ti�d� i �e
• Applicant's Signature: I Date: 10'7—�j
Greg Casteel
Building Official
Revised 07/30/08
Community Development
4` 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
OWNER'S NAME: ✓v` ►4,j /,, PHONE # lCJ-
GENERAL CONTRACTOR: ✓V`� FAX # — -a 3Lt
X 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
ODv3�
CITY OF CUPERTINO
REROOF
•CUPEI,TINO PERMIT APPLICATION
APN # Date: 1 aG G
0q C1 0
Building Address:
Owner's Name: Phone #: 1bc6 g�, 7— 32SVC
1wV i"I qe, $7 $4c 3
Contractor: Phone #: S51(3_gjg_cFGdy
Fax#:
Cupertino Business License #: Contractor.License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles 'lam Asphalt Shingles
41 A, Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: C�—Cs b r� zo IL
Residential Commercial El
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation C y �$G ()
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
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
1RER00FRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License . B
Revised 6/16/08