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09090025 CITY OF Ci1FEKTINO BUILDING PERMIT BUILDINFaADDRESS: 10 BYRNE AVE, CONTRACTOR:LOS GATOS PERMIT NO:09090025 ROOFING XER'S NAME: AUGUSTIN CHANG P O BOX 1726 DATE ISSUED:09/04/2009 U!vPvt:R's PHONE: 4082536779 LOS GATOS,CA 95031 PHONE NO:(408)298-9399 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r PLUMB Viµ. Lcense Class Lie.9 mow MECH RESIDENTI� COMMERCIAL 1r1 Date Contractor JOB DESCRIPTION: REMOVE EXISTING SHAKE, INSTALL I hereby affirm that 1 am licensed under the provisions o Chapter 9 DOUBLE LAYER OF (commencing with Section 7000)of Division 3 of the Business&Professions TILE GUARD UNDERLAYMENT INSTALL EAGLE Code and that my license is in full force and effect. PONDEROSA I het Eby affirm under p_nalty of perjury one of the following two declarations: TILE CLASS A 31 SQUARES I tsavc and wi!l maintain r,certificate of consent to self-insure for Worker's Compensation,as pro n,Jed for by Section 3700 of the Labor Code,for the Valuation:$10646 performance of the work for which this permit is issued. Sq.Ft Floor Area: 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 thisAPN Number:35712030.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I .;ertity that I have rea6 this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to builJing constructior,,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against?:abilities.judgments, �T��I� costs and expenses which may accrue against said City in consequence of the issued Date: grant;ng of this permit. Additionally,the applicant understands and will comply with a;l non-point urea regulations per the Cupertino Municipal Code,Section Q !9. RE-ROOFS: Date All roots shall be inspected prior to any roofing materiai being.instal'ed. If a roof is .zture - -_ - installed without first obtaining nspection,I agree to remove all new materials for inspection. (✓ OWNER-BUILDER DECLARATION Signature of Applicant: __Date. 1 hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A`•OR BETTER the fullawing two reasons: I,as owner of the property,or my employees with wages as their sole compensation, \Ndi .:o the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) HAZARDOUS MATERIALS DISCLOSURE I,as:.weer Gf the property,am.exclusively contracting with licensed contractors to construct the project(Su;7044.Business&Professions Code) . I have read the hazardous materials requirements under Chapter 5.95 of the California Health&.Safety Code,Sections 25505,25533,and 25534. 1 will I herby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the dech,rations: Health&Safety Code,Section 2.3532(a)should I store or handle hazardous I bav:and wit!rr.amtai,t a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the will inn olein compliance wittaminapts as defined h the Cupertino Muthe Bay Area Air nicipal pal ualityCode,Chapter anagement District and performance of the work for whish this permit is issued. the Health&Safety Code,Sections 5,25533,and 25534. 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 Owner or authorized agent:_ Date:_tk permit is issued. I,,eriifv that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's CONSTRt,1CTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,1 bece:ne subject to the Worker's Compensation provisions o''the Labor Code,I must work'sfor fwhich this rm that hpermit is isDued(Sec.ere is a construction 309ti��Cagency C y for the performance of forthwith comply with such provisions or this permit shall b;:deemed revoked. Lender's Name APPLICANT CERTIFICA TION. Lender's Address_ I certify that I have real this application and s,ate That the ahgve information is correct.I agree to comply with all city and county ordinances and state laws relating ,.1)1!ilding construction,and hereby authorize representatives of this city to enter .:the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION icillaify and keep harmless the City of Cupertino against liabilities,judgrrents, l understand m)plans shall be used as public records. f costs,and expenses wbch may accrue against said City in consequence of the , , p g an;ing of this,permit.,Additionally,the applicant understa•ds and will comply v 1th all non-point sourry regulations per the Cupertino Muricipal Code,Section r,icensed Profess$on�l__ 1 I 9.18 1 Date- _— Signature_ --_--_ - . CITY OF CUPERTINO 3 ITEMS OF 12 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35712030 . 00 DATE ISSUED. . . . . . . : 09/04/2009 RECEIPT #. . . . . . . . . : BS000008610 REFERENCE ID # . . . : 09090025 SITE ADDRESS . . . . . : 10375 BYRNE AVE SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : AUGUSTIN CHANG ADDRESS . . . . . . . . . . : 10375 BYRNE AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2811 RECEIVED FROM . . . . : LOS GATOS ROOFING CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481 COMPANY . . . . . . . . . . : LOS GATOS ROOFING ADDRESS . . . . . . . . . . : P 0 BOX 1726 CITY/STATE/ZIP . . . : LOS GATOS, CA 95031 TELEPHONE . . . . . . . . : (408) 298-9399 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 10, 646 . 00 1. 00 0. 00 1. 00 0 . 00 1BSEISMICR VALUATION 10, 646 . 00 1.10 0 . 00 1. 10 0 . 00 1REROOFRES SQ FEET 31 . 00 403 . 00 0 . 00 403 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 405 . 10 0 . 00 405. 10 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO '4' REROOF CUPEkTINO PERMIT APPLICATION APN # 2, Date: Building Address: , �0 ( r /)i2 Owner's Name: Phone #: Contracto ; Phone #: /��' c;2 Gf'— Fax#: '7 Cupertino Business License #: Contractor License #: Type of Roof 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) e Number of existing coverings Provide I.C.B.O. Report# To be Removed 'ZpC Provide Mfgr. Installation Specs. elf- Job Des lri tion: j&q/j CV-< 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: Si re Revised 6/16/08 CITY OF CUPERTINO RERO OF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER0OF1ES ' Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B Oms C.-V 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B 73 / Revised 6/16/08 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 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: _ �y Job Site Address: .3 `?S 0 Roofing Company Name: r Applicant's Signature: Da�te: oZll Greg Casteel Building Official Revised 07/30/08 Community Development 10300 Torre Avenue =' } Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 Building Depar ent JOS ADDRESS: PERMIT le)* 3 X75 OWNER'S NAME: �,,GG n PHONE _ ` GENERAL CON T RAC10R: FAX#1 I am not using any subcontractors: � Signature Da to Please check applicable subcontractors and complete the following information: ss SUBCONT13ACTOR BUSINESS NAME I BUSINESS LICE SE Cabinets c'--Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating insulation LandscapI'nar Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving P1_astering Plumbing Roofing Septic Tank Sheet Metal (--Sheet Rock Tile :2V r ,> Owner ntra for Signature ate