08100073 CITY OF CUPERTINO `-�'t -
BUILDING DIVISION PEFMITWORMATIOPi
BUILDINGPDORESS: PERMIT NO.
10y70 MIRAMONTE RD WORK FORCE ROOFING WFR 08100073
OWNER'S NAME: PERMIT ISSUE DATE
HUALIANG ZHANG 5569 CAMDEN AVE 10/14/2008
WN E: (408) 892-5096 SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
X00 LICENSED CONTRACTOR'S DECLARATION O O O O
ifZ C I bacby anam Nat l am licensed under pmsitimu of Chapter 9(mmmcrcing Job Description
WU5 with Section]Boll)of Division3ofdmBusinessandPmrcuiontCude,aalmylicensu RE-RF RMV 1LYR XT ASPHLTSHNGL INSTL 30YR 235LB
m in full tomo and affect PER
Dpz License Claa r-Z9 13c.t 9!(.(.'n� 3 .
p Da¢ /o-/4-nD Conmaxor,.�o+K iertcF 2•:�_c
'- ARCHrrECPSDECLARATIO� SQ CMP ASPHLT SHNGL CLS A 27SQ
sn
U 1 undersunJ my plw shell M teed a public recross
5 uso� Licensed Pmfcssi...I
3 OWNER-BUILDER DECLARATION
<E 1 herehy.flute that I am exempt from Ih<Con rsctor's Licenac Law for the
O O following mason.(Section 711313,Business and Professions Cook:Any lily.1..my
which aquas a permit to emsrucl.slur,hnpmw,demolish,or repair any structure
prior at its issuance.atm required the applicant for such permit to file a signed statement
E wt W is licensed punaam an the provisions of the commemrs licante Law(Chapter 9 Sq.Ft. Floor Area [•p' Valuation
Y�$ (commencing with Section 7000)of Divislml 3 of the Business and Professional Cad $
e)or 8100
-• Nu he u exempt themfmm and the bands,for the allegedxem
epdon.Any violation of
Section 10116 by airy applicant for a permit wbjccu the applicant to a civil penalty OfNumber - Occupancy
ten team than fiw handled dollars(M). 35601020 V U' Pane: Y Type
0 I,M owner of the pmpcmy,m my smploym with wags a thek sou cmmpenndm,
willdothework.andtheswctumumrmmndedm.Bemdforsate(Sec.10a,Bu max
and Pmfes i..Code The Conummr'r License Law dm ml apply to an ower of Required Inspections
property who builds or i mpmvex thereon.and wha does such work himself or through his
own ermploycm,provided that each impmsemau are nwtinuuleE m Offered for de If.
however.the building Or impmaanenl is sold within orc year of mmpletian.the ownef,
builder will haw:the burden of proving Nat Ir did not build m impm a for purpose of
ale.).
0 1.a owner of the property am exclusively contracting with licensed cantnemrs an
construct the pmjces(Sec.load.Business and Pmreuim s Code:)The Conteacur's U.
come Law dm not apply to an owner of property who builds or imposes Merton,and
who contracts for such ppjecu with a contactar0)licensed pursuant to the Comaanes
License law.
0 l am exempt under Sec ,B At P C far Nis moan
Owner Dam
WORKER'S COMPENSATION DECLARATION -
I hereby air="r penally of perjury am or the following decluuions:
I haw and will maintain a Cenifacam of Covent to self-insum for Workeh Cmnpum. ,
anion.u pmvidcd fm by Section 3100 M the Labor Code.rte the performance of the
waft for which Nis permit is isms. _
g]I haw and will maintain Worker's Compensation buurance,as requited by Suction
31(D of the Labor Code.far,the Performanoe.f the work far which this permit u issued
My Warke/r1 Compensation Wouran¢artier and Policy number are:
Caller. te,— li PollyNo.: 'Zk'Y-Oa'r'O}pL-Op
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Ihisaccdon used men M compleed If the permit is forane hundred dollars(SIM)
or teas)
I anify that in the performance of the work for which this permit is ussued.l shell not
employ any person in any manner.as no become subject to Ih Workers'Campevauan
laws of Cdifomia Dau
Applicant
NOTICE TO APPLICANT:If.afar making this Ccnifmau of Exemption.you should
become subject to the Workers Compensation provisions of the lahor Cade,you most
.,z forthwith comply with such porivav Or Nis peanit dull be doemnd rewknd.
Z CONSTRUCTION LENDING AGENCY
r Ihem affirm dust dem u a courtmnian funding a
(" by g Grey for thePMormausc of
a the wart for which this permit d named(Sec.7097,Civ.C.)
a0 Lender's Name
z Lender's Address
V C) I certify that 1 haw rad this application and ante Nu the above information is
gy H cared I agme to comply with all city and county ominancex and suis laws miming to
Q building construction,and hereby sanitarian repmenuo
stim of this City m uOre
r upon
W abowmendaned property for inspection purposes
G (We)agree m saw,indemnify and keep humless the City of Cupertino against
fag liabilities.judgments,coos and expeva which may In any way acme against sold City
(„)Z in conacquence of the ganung of this Permit.
'-' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 'Q— z c/�
SOURCE REGULATIONS.
M4:4 *"rc/ 9-1 -JS,2- /0-14-0? Re-roofs
Signa of Appiian Contractor Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will de appliant m future building arapalstme or handle harardov material
as defined by the Cupenum Municipal Cade.Chapter 9.12.and thus Health and Safely
Colo. zsslz(a)"
0y. �]No
All roofs shall be inspected prior to any roofing material being installed.
❑Yns
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it hax mmus air mmumivnu u dcfioed by use Be,Ams,Air Quality Mavgcmenl all new materials for inspection.
ctv
Y. 16No
I haw rend the haaNau mauriald ncquimmew under Chapter 6.95 ofthe Cslifor.
nu HahthkSduy Cadc,Sa.M5(15,25533ud25534.1unlrumdthuifthc Widdmg
dm ml curmndy how•moat this it is my responsibility to notify the oceupant of Ne N l sF f-L I rll'a5 01 NY^^-�G L
requirements which must be met priorm issuvice refs Catifrauc.facupaaq. Sign tune Of Applicant Date
Owne m mNarie d agent Dam'
All roof coverings to.be Class'%W'or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
. COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN. . . . . . . . . : 35601020 . 00
DATE ISSUED. . . . . . . : 10/14/2008
RECEIPT #. . . . . . . . . : BS000006342
REFERENCE ID # 08100073
SITE ADDRESS . . . . . : 10970 MIRAMONTE RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : HUALIANG ZHANG
ADDRESS . . . . . . . . . . : 10970 MIRAMONTE RD
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3974
RECEIVED FROM . . . . : WORK FORCE ROOFING
CONTRACTOR . . . . . . . : MIGUEL ANGEL HERNANDEZ NOYOLA LIC # 30357
COMPANY . . . . . . . . . . : WORK FORCE ROOFING WFR
ADDRESS . . . . . . . . . . : 5569 CAMDEN AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
TELEPHONE . . . . . . . . : (408) 892-5096
• FEE ID .UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ------------- ----- --------- -------- ------ ----------
1BSEISMICR VALUATION 8, 100 . 00 0 . 90 0 . 00 0 . 90 0 . 00
1REROOFRES SQ FEET 27 . 00 351 . 00 0 . 00 351 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 351 . 90 0 . 00 351 . 90 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
---------- --------------- --------------------
CASH 351. 90
---------------
TOTAL RECEIPT 351. 90
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 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 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 Raid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of i/a " 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: 4,� Lj<<?a'h r � � a
L/ i
Job Site Address: �,Z 9 /Li r0.w.� �e Q� • � Q4 . 71"Iq
Roofing Company Name: _WoY14- gy2oB l2ao�nc W F 2
IIeo n
Applicant's Signature: /L11 9 r el a 101 Date: 10-1tf-ag
• Greg Casteel
Building Official
Revised 07/30/08
CITY OF CUPERTINO
agga" REROOF
CIT�UPEkTINO PERMIT APPLICATION
APN # � Date:
��� / c� c ) • U cl : 1 Zoflb
Building Address: ��^^
Owner's Name: Phone #:
(q68 $43—
Contractor: o Phone #: (ford gg2 _�-og6
W ov-k rca cue 12ooANCS w F2
Fax #: 4.40 —t x o 4
Cupertino Business License #: Contractor License #:
yiG63 3
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
KAsphalt Shingles p( Asphalt Shingles
❑ Wood Shakes o Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other(Specify)
Number of existing coverings pti.Q- ❑ Provide I.C.B.O. Report #
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
14 Q ent o� � tilZhS QsPIa�� S� hs�p . Fns�4�/ 30 xecus
23SLn gh� tr
Residential Commercial
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:
I fnHave Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
• y• `��jLLI V ��`'I P I If/� A,"L7_
Signature
Revised 6/16/08
CITY OF CUPERTINO
Mg, REROOF
CUPEI,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2 1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
l REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•