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08120138 CITY OF CUPERTINO a ,p„-« '� •� '+� n '' BUILDING DIVISION PERMIT CCIIVTRAC�'TnR IQRMATION° BUILiI!—ADDRESS: PERMIT NO. 1152 KENTWOOD AVE MBROWN CONSTRUCTIQU OWNER'S NAME: PERMIT Mn DATE 0 SA CONTROL NO. ARCHTITZUENGINEER: BURRING PERMIT INFO BLDG ELECTPLUMB MECH RE—ROOF 22 SQUARES O O O O atop LICENSED CONTRACTOR'S DECLARATION Job Description U I l meby affirm that I me licensed under provisions of ouipur 9(commencing P with Section I )I Diviaion 3 ofthe Business and Profcsrimu_Code,mutiny license is .nLin full force and arce Lion¢elan Lie.• . t„ Dau Contractor UkAjy g ARCHITECTS DEC RAMI I understand my plans ahall Wines u public records JyU g o H Licensed Professional 3 OWNER-BUILDER DECLARATION iI I Wrtby affirm that I am exempt from Ne Contractor's License law for Ru zoo following mason.(Sccdon IIA 1.5,Business and Profeuiou Code:Any city or county $ which requires a permit in com om,alter,improve,demolish,.r repair any su.ctum prior to its issmnce.also requires the applicant for such permit to file a signed statement EE `e that k is licensed pursuant to he provisions of ch,corsonscier's Liecance Law(chapter 9 Sq. Ft. Floor Area Valuation Y� (commencing with Scetion 7000)of Division 3 of the Business and Professions CMc)or y`<� Nn k is uempt Nemfrom and the bulk for the alleged exemption.Any violation of Sccdon 7031.5 by any applicant for a permit subjects the Applicant n a civil penalty of APN Number Occupancy Type not mom dm five hundred dollars(5.583). ❑I,uownm of die propeny,ormy employcu with wagauduir sole cmnpewtion, will do the work and the auuaum Is.utimended or.ffemd tarsale(Sec.7014,Business and Profestiom Cade:The Con.acmrm s License Law dasal apply In an mvmr.f Required Inspections property who builds or imp,.ther.un,and who docames work himself.,through his own employees,provided that such improvements art not immmded or offered for sale If. however,the building or improvement is sold within one year of completion,Ne owner- builder AAR have the burden of proving that he did rot build Or improve for purpose of sale.). ❑1,u cease of the property.am es.1mm,ely conuanirig wits licensed mnoacrors to construct the Project(Sec.7064.Business and Professions Cade:)The Conuvam's Li. cense law does not apply u an owns of property who Wilds or improm thereon,tad, who contracts for such projects with a cemracter(s)licensed puruau in the CondacmYs License law. ❑1 am exempt under Sec. .B 8 P C for Nis won Own" Data WORKER'S COMPENSATION DECLARATION I heri aRrm under penalty a(perjury one of the following declarations: ❑I here and will maintain a Cenifimte of C.uent ro alt-iuurt(or WorkcrsCampcn- suian,As provided for by Section 37W of the labor Code.far the performanx of dte work for which this permit is issued. have and will maintain Workct's Com moltdon Insurance,As required by Section 3 of the Labor Code.for Ne perfmmancc of the woh for which this permit is issued. y%rkefs mems an ran tamer and Poll,cy be Cartier. U't "it, 'D/ TI^CATE OF EXEMPTION FROM WORIF S' COMPENSATION INSURANCE (Ihisaction need nottic completed if the permit is forum hundred dollars($I00) or ick:) 1 cenf( thus in the performance of dm work for which this permit is issued,l shall not employ any crson In my mMncrao at to Weome Nbjcci to the WorkarS Compensation Law.of Califomia.Dau Applies., NOTICE TO APPLICANT:If,ofur making this Cer iOmu of Exemption,you should become subject u the Wortmes Compenution provisions of Ne labor Calc,you mut .JO faMwiN comply with such provisions or this permit shall W decreed¢naked. CONSTRUCTION LENDING AGENCY [--� .�. Ihereby.Rum dist Wert iso construction lendingagcmy for the perfurmam of f� the work for which this permit is issued(Sec.3097,Civ.C.) GA Lender's Namc z Lender's Address U Q 1 certify that 1 have read Nis application and suss Nat the.Ww information is ,i ^' connect-1 agree u comp" with un all city and county mdimnm and mu Iowa mu imm, .SSV' building mnstranion,and hereby.who ire reproact ss ofthis city to enter upon 0u Del alv e-mcnmmcd property for inspection purposes G (We)agree m save,indemnify and keep harmless IW City of Cupcnino against Fy lishilimOijudgm.nts.eosis andexpcmu which may in any way aecmcagalrm aid City U,Z in consequence of the gmnang of Nis pcnnit. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL ON-P Issued by: Date SOURCE REjU TIONS. y l Re-roofs Signature of AianUCa tar Date HAZARbOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building Occupant atom m handle Woutic is material As defined by Ne Cupertino Municipal Code.Chapter 9.11.and the Heald and Safety Calc.Section 25532(.)? All roofs shall be inspected prior to any roofing material being installed. [I Y. a Will the applicant or f sere building Occupam use equipment ser dcvicu which If a roof is installed without first obtaining an inspection,I agree to remove .mit ha�nuk air con.min ts u defined by the Bay Ama Air Quality Management all new materials for inspection. District? ❑Yes ❑ / VU Itimmad Ne Wise aurialsmquimmenuundcrCWpur6.95ofthc Califor- /Q, ((( nus.11 Safety Code Seed titi2myram125534.1 anderstsnd Wolf N.holding f' dors mtcunt ly Wsca tNatit imynce ofa Cottbmufy de pant nfpre reyuimm.n u m met priorroissuance ora Certifimh of Oces u. /t�(fI Signet a pelican[ Date Owner on armed.sem Dau All roof coverings to be Class'n"or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 U n C kT I NO Fax(408)777-3333 fC Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: G v? vc.�r PHONE # 50—/Z-60 GENERAL CONTRACTOR: FAX # I am not using any subcontractors: 1 2 Signature bate 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 CITY OF CUPERTINO e2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35931027 . 00 DATE ISSUED. . . . . . . : 12/23/2008 RECEIPT #. . . . . . . . . : BS000006885 REFERENCE ID # . . . : 08120138 SITE ADDRESS . . . . . : 1152 KENTWOOD AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JACKSON HVANG ADDRESS . . . . . . . . . . : 1152 KENTWOOD AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5839 RECEIVED FROM . . . . : BROWN CONSTRUCTIO CONTRACTOR . . . . . . . : CHRIS BROWN LIC # 25108 COMPANY . . . . . . . . . . : MBROWN CONSTRUCTION, INC ADDRESS . . . . . . . . . . : 702 S DANIEL WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95128 • TELEPHONE . . . . . . . . : (408) 260-1260 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ------------ ---------- ---------- ------ ------- - -- 1BSEISMICR VALUATION 3 , 520 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1REROOFRES SQ FEET 22 . 00 286 . 00 0 . 00 286 . 00 0 . 00 ----- - ---------- ---- TOTAL PERMIT 286 . 50 0 . 00 286 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER --------- -------- - -------- CREDIT CARD 286 . 50 amercian express --------------- TOTAL RECEIPT 286 . 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 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 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 with the above stated policy on re-roofing. Homeowner's Name: �1C <sz e_N� AU0 n Ce Job Site Address: I (S Z V6f 1 fWb 0 Roofing Company Name: ) lL Applicant's Signature: Date: Greg Casteel Building Official Revised 07/30/08 1 CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION APN # Date: Building Address: Owner's Name: �_—= Phone #: aG9�on jAva clog- �zt , 3� Contractor: Phone #: I Fax #: 1��• �I� .�� Cupertino Business License #: Contractor License #: a51 o� SZZ Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof _ wilt-Up roof /Asphalt Shingles Asphalt Shingles ❑ 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: 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: lave Read, Understand an Will Comply with Cupertino's Tear-Off Policy: �I Signature Revised 6/16/08