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09080033CITY OF CUPERTII BUILDING ADDRESS: 10541 BARNHART CT NER'S NAME: QING CHAAN DOU OWNER'S PHONE: 4087186353 LICENSED CONTRACTOR'S DECLARATION License Class BC5 C1 Lie. # cv9a /1 3 Contractor Date I hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I 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 building construction,, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understar:ds and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9 is. Date ❑ OWNER -BUILDER DECLARATION 10 BUILDING PERMIT 1 hereby affirm that I am exempt from the Contractor's License Law for one or the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensatior, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to constract the project (S,;c.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, 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 provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this uermit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the 'Worker's Compensation provisions of the Labor Code, I mus t forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is -sect. I agree to comply with all city and county ordinances and state laws relatin; aiiding construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. .(We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature____ Date_ CONTRACTOR: WING'S ROOFINGI PERMIT NO: 09080033 INC 3243 SYDNEY WAY DATE ISSUED: 08/07/2009 CASTRO VALLEY, CA 94546 PHONE NO: (510)889-9068 r I— r BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH RESIDENTIAL COMMERCIAL .TOB DESCRIPTION: RE -ROOF TEAR OFF AND GRAVEL, ASPHALT SHINGLE, INSTALL 7" 16 OSB TORCH DOWN CAP SHEET 29 SQ Sq. Ft Floor Area: I Valuation: $8700 APN Number: 37537026.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: RE -ROOFS: .All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my pians shall be used as public records. Licensed Professional al,(Z' CITY OF CUPERTINO RF ROOF OF CUPERTINO PERMIT APPLICATION dabR0033 APN # - 3 —7 0/ 7 fil Building Addres Owner's Name: 0; -C j 0,0,pq J)Oq Phone#: �3 C -4o) HOA: Yes ❑ No If yes, provide le-aer from HOA Contractor: i`✓� �.D 11qL ( �� -3-43 S � A4` Phone #: S 7 b �� — ?O W r� `� l� Fax #: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: NA Built -Up Roof j Built -Up roof ja Asphalt Shingles Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: TA> G,-i�C_ � t�roj UA,� C�l� ��`�� -� �t�T� l -7 %6 r/ P �s� ori ►� L' ��.ei _S * i �'2fSo 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 Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: F I Signature Revised 02/05/09 CITY OF C UPERTINO an, REROOF = CUPEkTINO FEE SCHEDULE Number of Squares Fee ID Fee Description Fee Group Permit Type 1REROOFCOM Re -roof Corunercial B 1COMMLROOF .1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICO Seismic Commercial B 1REROOFRES Re -roof ReEidential B 1SFDWLR00F 1BCBSC Cal Bldg St,mdards Commission Fee B ALL PERMIT TYPES I 1BSEISMICRE Seismic Re,,,idential B 1 REROOFMRES Re -roof Multi -Family B 1MFDWLROOF 1BCBSC Cal Bldg Stindards Commission Fee B ALL PERMIT TYPES 1BSEISMICRE Seismic Re, idential B 1BUSLIC Business Li-,ense B 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 Ciiy, 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 pei formed. 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 ori the job site at the time on inspection. I understand and will comply with the above stated policy on re -roofing. r Homeowner's Name: r aauq Y)Dz/l Job Site Address: '0, t;; rh C, Al Roong Company Name: `^ 1 �% fi Applicant's Signature: Greg Casteel Building Official 0 Date: Revised 07/30/08