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08120087�C Z� CITY OF CUPERTINO BUILDING DIVISION PERNIITCONTRAC�TOR'�INFORMATION BUILDING ADDRESS: PERMIT NO. 11897 WOODHILL CT ALL SEASONS ROOFING' OWNER'S NAME: SERVICES PERMIT ISSUE DATE NE: A CONTROL N0. (408)971-4455 ARCHITECT/ENGINEER: BUILDING PERMIT INFO • BLDG ELECT PLUMB MECH LICENSED C'ONTRACTOR'S DECLARATION Job Description 1 hereby affirm Ilei I am licensed under provisions of Chepter 9 (commencing with Section 7") of Division 3 of the Business and Professions Code, and my license is in fallforaaandcrmcl. RE—RF RMV 1 LYR EXTNG SHK RF, INSTL 24..5SQ CLS A License Class Lk.P Dam conlmcmr + • ' 9 50 YR CMP ROOF RCHfTECrS DECLARt T ON 1 understand my plans shall he used as public retards Licensed Professional OWNER -BUILDER DECLARATION 1 hereby alarm that 1 am exempt form the Commerce$ License Law for the following mason. (section 703 1.5, Business and Professions; Calc: Any city aro county which tequims a permit an conatroc6 amr, improve, demoliah, or repair any su acture prior to its L6ulMY, also requires the ippllcanl forwch peont to rile a signed statement that he is licensed pursuant to the provisions of the eo nactu's Lkcnm Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section ]000) of Division 3 of the Business seat Pro"comu Crede) or $11000 Nal he u exempt themfmm and the basis for the alleged exempd.. Any violation O( APN Number Occupancy Type Section ]031.5 by any applicant far a permit subjects the applicant to a civil penalty of not mom Nan five hundred dollars (5500), 36604069 .00 ❑ L, as owner of On property. or my employees with wages as their sale compensation, Required Inspections will d0 the work, and the souuam is an( intended or offered for sale (Sec. 70X4, Business and Preload. Cade: The COnuacmrs License Law does art apply to an owner or _ property who builds or improves thereon, and who does such work himself or through his Own employers, Provided Nat won improvements are not intended or offered far We. IL 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 Wild or improve for purpose of sale.). ❑ 1, as owns, or rhe property am exclusively contracting with liarued armraelaes Or construes the project (Sec. 7061. Business aM Professions Code:) The COmnctora Li. cense Law does not apply On an owner of property who Wilds or improves thuean. and, who commeta for such projects with a commact ar(s) licensed pursuant re the Contractor's License Law. 71 I oro exempt under See ,B&PC for this mann Owns Data WORKERS COMPENSATION DECLARATION I hereby+term under pcnslty of perjury ane of the (allowing declarations: b1 have and will maintain a Cersifteate of Coaxal to selr-iname for Warkehcompcn- an, as provided for by Section 37M of the labor Code, for the Performance of the work for which this permit is issued. ❑ 1 have and will maintain Warkera Compensation Insurance, as mquind by Session 3700 of Ne LOW, Code, for the perfamor. of the work for which this Permit is issued. ' My Workers Compensation Inw ace cartiu and Policy number ere: Cameo Q a POliry No.: LL" Q CERTIFICATE OF EXMPION FROM 0 ERS' COMPENSATION INSURANCE (f hu section reed no t M com Pleud it Ne Permit is foram hundred dollars (S 109) _ or It.) I certify that in the performance of the work Ion which this permit is issued. I "I at employ any person in any mannerso as to become wbjcu to the Worama'Compensation Laws of California. Data Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject no the Workers Compensation provisions of On, Labor Cede, you mall ' forthwith comply with such pmvidnas or this enr it shall he doomed navked. CONSTRUCTION LENDING AGENCY te rlurmaof I hereby thi that then is o etinn lending agency rte thepenec ' the wart fur whichich this permit is issueded (See. 3097, Civ. C.) Lender's Name Lenders Add. j I coolly Nat I have natal this application aM suss Nor the Above information Is ' count. I yren m comply with all city and county Modulators and state laws elating to Wilding construction, and hcmby auhonse upresenuusrs Of Nu city ro enter upon the aWve-mentioned pmpeny for inspection purposes. (We) agree la save, indemnify and keep harmirw the City of Cupertino against j liabilities,7udgments, costs and expense which may in any way earns against said City Inc ...... co of do granting of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -P INT Issued by: Date ,er SOU REGULAnPNS. r Re -roofs Type of Roof \` (ly(1 i/,1 L 2le 1, �`��l/ (%1 Sig Sig soneApplic truchor HAZA DOUS MATERIALS DISCLOSURE Data Will the applicam rr future building mcup=tswm or handle hmuscous maurial as defined by the Cupertino Municipal Cade. Chapter 9.13, and the Health and Safety Coda, Section 255320)T All roofs shall be inspected nor to an roofing material beim Installed. P P Y g g ❑ Yes ON. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future Wilding oc vpam saw equipment or devices which i"mus air conuminan s u defined by the Bay Arta Air Quality Management all new materials for inspection. mcR < (]Yes n< I'J nu ' 1havenal the hvak mamriaHn uimmenuunder Clupmrd.95a(the Califon nu Health&Safety Code.Sccdons2550.5,25533 andM34.1 undcrsund thmifthc Wilding does rot ca end, have a mane. thX it k my responsibility to neofy the m eapam of the nquinmcnts which` W roti prior to Issuance ofa Cudfcale of cep Signat eof Applicant Date ' All roof coverings to be Class'/}!' or better Owner cr automirnd agent Data 2 ITEMS OF 2 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36604069.00 DATE ISSUED.......: 12/11/2008 RECEIPT #.........: BS000006807 REFERENCE ID # ...: 08120087 SITE ADDRESS .....: 11897 WOODHILL CT SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: VINCENT FUNG ADDRESS ..........: 11897 WOODHILL CT CITY/STATE/ZIP ...: CUPERTINO CA, 95014 OPERATOR: patg COPY # : 1 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 326.10 --------------- 326.10 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF 604 ROOF IN -PROGRESS L REFERENCE NUMBER ------------ #25164 VOICE ID DESCRIPTION 602 ROOF PLYWOOD NAIL 605 FINAL REROOF RECEIVED FROM ....: ALL SEASONS ROOFING CONTRACTOR .......: GORSHTEIN, VLADISLAV LIC # 21035 COMPANY ..........: ALL SEASONS ROOFING SERVICES ADDRESS ..........: 1720 SMITH AVE CITY/STATE/ZIP ...: SAN JOSE, CA 95112 TELEPHONE ........: (408)971-4455 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- 1BSEISMICR ----------------------- VALUATION 11,000.00 -------------------- 1.10 0.00 -------------------- 1.10 0.00 1REROOFRES SQ FEET 25.00 325.00 0.00 325.00 0.00 TOTAL PERMIT 326.10 0.00 326.10 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 326.10 --------------- 326.10 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF 604 ROOF IN -PROGRESS L REFERENCE NUMBER ------------ #25164 VOICE ID DESCRIPTION 602 ROOF PLYWOOD NAIL 605 FINAL REROOF U n Community Development Department i 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 with 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 buildu1g inspector when the re -roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. sl. To receive a final sign off from the City, flee 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. (5. 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 $176.18. The re -inspection fee must be paid before another inspection can be scheduled IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re -roofing. Homeowner's Name: � \ac cennk Job Site Address: _��$a1 \� OO d H�\\ C 01 )eeA_Ait\O C\SQW\ Roofing Company Name: A\\ 5e&s j,n_aV�0-1� I C, Applicant's Signature: � �Qdl� Date: .-\.) VAQ Greg Casteel Building Official Revised 11/2/04 • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department RESS: JOB B ADD ' e PERMIT # n Cab �, t7 W OWNER'S NAME: PHONE # ' GENERAL CONTRACTOR:,4// _' FAX # �' S�'VrQeS I am not using any subcontractors: '41,- r,AA Ln 2r)r/ia La Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature /;z Date 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 /;z Date r- a CITY OF CUPERTINO 1(31�_ REROOF C17Y OF CUPEkTINO PERMIT APPLICATION 0SW 0,0- APN # 2 Q (v U� ov 1, Date: Building Address: \\�O1 W00A 10�-A\ CA C.U�Wl�r`u C\S01L_� Owner's Name: Phone #: V\rce�k �vr� lao��ti�� -o3\s Contractor: Phone Lt Lk Fax #: yp ff) 2S:ta— Cupertino Business License #: r�G� � O Contractor License #: `? C-\ Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles X Asphalt Shingles X 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: (Z�r�o�l OAC \ a,fe i' C?C�S�i SWnk� C Oo c , nS ic.t \ ;7Li , j12 �� Cow•Q �vo�. 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: 20, \ \ `ono 1 Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: • Signature Revised 6/16/08