Loading...
07030012 CITY OF CUPERTINO BULL-ING DIVISION PERMIT i BUILDING ADDRESS: — PERMIT NO. 10120 ADELHEID CT LOS GATO,3 ROOFING 07030012 OWNER'S NAME: PERMIT ISSUE DATE CHEN WEN-CHUNG AND LU YUNG- 888 FAULSTICH CT 03/02/2007 _)NETTT SANITARY NO. CONTROL NO. (408) 298--9399 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH p LICENSED CONTRACTOR'S DECLARATION U 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description z with Section 7000)of Division 3 of the Business and Professions Code,and my I i cense is REROOF: LEMOVE EXISTING SHAKE. INSTALL TYPE 30 ? y in full force and effect. Licenscclf �' C`1 Lic.0 ��� FELT AND CLASS B MEDIUM SHAKE. p Date 2 Contractor ARCHITECTS DECLARATION wU 1 understand my plans shall be used as public records W r0 Licensed Professional y OWNER-BUILDER DECLARATION I hereby affirm that l am exempt from the Conuactues License Law for the CC following reason.(Section 7031.5.Business and Professions Code:Any city at county .t$Pi which requires a permit to construct,alter,improve,demolish,or repair any structure Z y prior h)its issuance,also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the previsions of the Contractor's License Law(Chapter 9 Sq Ft.Floor Area Valuation uF (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $8813 -. that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of E UU' p y yP Number Occupancy Type not more than fire hundred dollars($500). 35709083 ❑1,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of Q p property who builds or improves thereon,and who does such work himself or through his 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.), ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's U- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such pmjects with a contractor(s)licensed pursuant to the Contractor's License Law. C]I am exempt under Sec B&P C for this reason Owner Date _ WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: .have and will maintain a Cerdficate of Consent to self-insure tar Warkees Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code.for the performance of the work for which this permit is issued. My Worker's Cam'�asat�io I'nsurance carrier and Policy number arc: Carier.�iF Policy No.:D00?-79 -006 CERTIFICA EMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any mamncr so as to become subject to the Workcrs'Compensation Laws of Cat(fomia r)- Applicam NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. 0 z CONSTRUCTION LENDING AGENCY F+ I hereby affirm that there is a construction lending agency for the performance of ¢i> the work for which this permit is issued(Sec.3097,Civ,C.) W A Lender's Name a z L.cndees Address U J Q 1 certify that 1 have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the a above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against Co) liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. ' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCT GULA NS. Q ,, � Re-roofs Signature of Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Cade,Section 25532(a)? ❑Yes All roofs shall he inspected prior to any roofing material being installed. �No 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 nit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materia:s for inspection. ,.Iict7 ❑Yes JR Nu I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safciy Codc,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements hick must be ssttnttee of a Certificate of Occupancy. �"_� �^2_©7 Signature of Applicant Date __Z11 authorized agent Dire All roof coverings to be Class "B"or better CITY OF CUI3ERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec: Twp: Rng: Sub: Blk: I,ot: APN 35709083 . 00 DATE ISSUED. . . . . . . : 03/02/ 2007 RECEIPT #. . . . . . . . . : BS000(100590 REFERENCE ID # . . . : 07030(,12 SITE ADDRESS . . . . . : 10120 ADELHEID CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CHEN In EN-CHUNG AND LU YUNG-LIN ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERUINO CA, 95014-2722 RECEIVED FROM RECEIPT INTERFACE CONTRACTOR RANDY BROWN LIC # 23481 COMPANY LOS GATOS ROOFING ADDRESS 888 FAULSTICH CT CITY/STATE/ZIP . . . : SAN JCSE, CA 95112 TELEPHONE (408) 298-9399 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ----------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 8, 813 . 00 158 .76 0. 00 158.76 0. 00 BSEISMICRE VALUATION 8, 813 . 00 0.90 0. 00 0.90 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 159 . 66 0. 00 159 . 66 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 159 . 66 1850 --------------- TOTAL RECEIPT 159 . 66 Community Development Department Building Division City of Cupertino 10300 Torre Avenue Ow""�F Telephone: (408)777-3228 C���kT r�A O Fax: (408)777-3333 Building Department Subject Reroofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 2. New roof coverings shall not be appliec_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 appro•7al. 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 fv•st obtaining an inspection, will require the removal of all new mate ial down to the sheathing, so a proper City inspection can be perfoi med. 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 s Eated policy.on re-roofing. Homeowner's Name: A1 pi f lllq F - -�-ohSitP A dress:- �2 � - Roofing Company Name: A plicant's Signature: Date: Greg teel Building Official Revised 1/30/03 Printed on Rec ycled Paper Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Building; Department JOB ADDRESS: PERMIT# 0.7 Q3Co12.- /o/2 U - 6&zkJ � J OWNER'S NAME: /��,,� 4 0— PHONE# &5o .3/ R- - j29' 7 GENERAL CONTRACTOR , FAX # "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 I Electrical I Excavation I IFencing I I Flooring. Carpeting Linoleum/ Wood Glass/ Glazing I Heating I Insulation ILandscaping I Lathing Masonry I IOrnamental Sheet Metal I Painting/ Wallpaper Paving Plastering I I Plumbing I Roofing I I Septic Tank i I I Sheet Metal I ( Sheet Rock I i I Tile I I Owner/Contractor Signature Date CITY OF C UPERTINO 01o�vo I Z REROOF CUPEkTINO PERMIT APPLICATION FORM APN# 5-7-1)cl - Date:3 2�- T Building Address: 16,12 ) Owner's Name: Phone#: �N ri s 11•) �� k Sd 51ff-- Contracto49(�- Phone#: 0�j' License#: (r—ah-s A; d2gx-9399 kOOY07 Contact: rl&,q Phone#: Cupertino Business icen a#: "3�e, 3�o7 Type of Rcof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles Wood Shakes � Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide LC.B.O.Report# To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cup.;rtino's Tear Off Policy: Job Description: -4!?�- Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if. there are any restrictions: LJ Cost of Projects Type o Construct* Occupancy group: , Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING i BENERGY F nergy BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC ( Business License BUILDING