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09090137CITY OF CUPERTINO BUILDING PERMIT BI 11.DING ADDRESS: 10211 COLBY AVE I CONTRACTOR: FALCON ROOFING PERMIT NO: 09090137 OWNER'S NAME: rFLIX KWOK k'NER'S PHONE: C LICENSED CONTRACTOR'S DECLARATION Livens? Class CT Lie. CcntractorF,4 i. ✓y dor>'�-jvn( Date_ 1 herebv affirm that I 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. 1 hereby affirm under penalty of perjury one of the following two declarations: I "iav,: 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 nave and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labcr Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to budding 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 hairnless 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 C �eo C OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: 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 & Professions Code) I, as owner of the property, am exclusively contracting with,licensed contractors to construct the project (Sec.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 permit is issued, I shall not employ any person in any mariner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subiect to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 1 certify that I 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 -on the above mentioned property for inspection purposes. (We) agree to save mnify and keep harmless the City of Cupertino against liabilities, judgments, ,is, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with ail non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 13088 POTTS DR I DATE ISSUED: 09/18/2009 SAN JOSE, CA 95111 I PHONE NO: (408)225-1705 r r BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH ; RESIDENTIAL COMMERCIAL .NOB DESCRIPTION: TEAR OFF I LAYER, INSTALL LIGHTWEIGHT TILE INSTALL 4 LAYERS ONB HOT MOP WITH ENERGY CAP Sq. Ft Floor Area. I Valuation: $24229 APN Number: 31528041.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspectio , I agree to remove all new materials for inspection. Signature of Applicant: %�" _ Date: e� �__e ALL ROOF COVERINGS 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 1 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 255055 ,and 25534. n, Owner or authorized agent: Date: 7 �/ 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 ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. Licensed Professional 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31628041.00 DATE ISSUED.......: 09/18/2009 RECEIPT #.........: BS000008718 REFERENCE ID # ...: 09090137 SITE ADDRESS .....: 10211 COLBY AVE SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OPERATOR: SylviaM COPY # : 1 OWNER FELIX KWOK ADDRESS 10211 COLBY AVE CITY/STATE/ZIP ...: CUPERTINO CA, 95014-4719 RECEIVED FROM ....: FALCON ROOFING CONTRACTOR .......: MARIO RENTERIA LIC # 22569 COMPANY ..........: FALCON ROOFING ADDRESS 13088 POTTS DR CITY/STATE/ZIP ...: SAN JOSE, CA 95111 TELEPHONE ........: (408)225-1705 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ---------- NEW BAL ---------- ----------------------- 1BCBSC VALUATION ---------- 24229.00 ---------- 1.00 ---------- 0.00 1.00 0.00 1BSEISMICR VALUATION 24,,229.00 2.50 0.00 2.50 0.00 1REROOFRES SQ FEET 32.00 416.00 0.00 416.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 419.50 ---------- 0.00 419.50 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 419.50 --------------- 419.50 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- 5033 VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF �4 CITY OF :UPERTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: PERMIT # ll.Ll� u aa�. �..✓+... .+ �+�.�--�---- SUBCONTRACTOR --_� _____ __ __ BUSINESS NAME OWNER'S NAME: w C� K - PHONE # / D� GENERAL CONTRACTOR:4 FAX # I am not using any subcontractors: � Si afore Date ntc„hrnn- rartnrc and complete the following information: 11GG1C7G �-L ll.Ll� u aa�. �..✓+... .+ �+�.�--�---- 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 CUPEkTiNO CITY OF CUPERTINO REROOF PERMIT APPLICATION ogcrol3-_1 APN # Date: 5/C p 2 Build'Address: t Auc_ 07 � 1 0 y Owner's Name: Fe. j , x�--` �w �;� Phone #: 11(� S - � (, -615 j HOA: Yes ❑ No If yes, provide letter from HOA Contractor: Phone #: IC I Flor 6VI Fax #: Cupertino Business License #: 2 2-5- Contractor License #: Type of Roof Covering: Existing: Proposed: 1 Built -Up Roof X\ Built -Up roof k Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Other (Specify) ❑ Wood Shingles )k Other (Specify) 4) c x,17 } } r Number of existing coverings Provide I.C.C.E.S. Report # 4 gr -14,6Z ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Tti°4 - c) i ,1 -e--1 J11>4- >4-4-11 , I i•j i3�1 e_ c -? �, [ o 12t el -7 LA F 1.4.4-- A -"P =r.5 1 v v f o, C k q I k Y c - � ©-�' � � � �►� n �7 i.� ('� � C � � j C +V 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: 2 q , 720 I Have Signature Undgrstand and Will Comply with Cupertino's Tear -Off Policy: Revised 02/05/09 -laIL-1 - CITY OF CUPEkT1NO CITY OF CUPERTINO REROOF FEE SCHEDULE Number of Squares Fee ID Fee Description Fee Group Permit Type 1REROOFCOM Re -roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICO Seismic Commercial B 1REROOFRES Re -roof Residential B 1SFDWLR00F J 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES J 1BSEISMICRE Seismic Residential B 1 REROOFMRES Re -roof Multi -Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICRE Seismic Residential B 1BUSLIC Business License 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 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 1/4 " 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:Fe- i X wID Job Site Address: [0 2 1 k � 61 Roofing Company Name: Applicant's Signature: Greg Casteel Building Official Revised 07/30/08 Date: