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09090027 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11673 VINEYARD SPRING CT CONTRACTOR:LOS GATOS PERMIT NO:09090027 ROOFING VNJER'S NAME: LJNGFU CHEN P O BOX 1726 DATE ISSUED:09/04/2009 :AVNER'S PHONE: 4084554399 LOS GATOS,CA 951031 PHONE NO:(408)298-9399 / LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELE T PLUMB w License Class l% .__ Lic.# p �� _ r MECH RESIDENTI COMMERCIAL Contractor ,�j [)ate._ I hereby affirm that I am licensed under t provisio s a Chapter 9 JOB DESCRIPTION: REMI40VE EXISTING SHAKE ROOFING (commencing with Section 7000)of Division 3 of the Business&Professions INSTALL-1/16"OSB Code and that my license is in full force and effect. SHINGLE MATE FELT AND GRAND CANYON SHINGLES BY GAF/ELK CLASS A27 SQUARES 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 Sq.Ft Floor Area: Valuation:$6470 1 have and will maintain`Yorker's Compensation Insurance,as provided for by Section 3700 of the Lat-or Code,for the performance of the work for which this APN Number:36654005.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read:his application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct I agree to comp!v with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,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 liabilities,judgments, t� costs.and expenses which may accrue against said City in consequence of the Issued b granting of this permit. Additionally,the applicant understands and will comply Y Date:•_ with all non-point Aroc regulations per the Cupertino Municipal Code,Section - 9.f 8. /� RE-ROOFS: iature _Iv -V _ Date 0 — All roofs shall be inspected prior to any roofing material being installed If a roof is installed without first obtainin inspection,I agree to remove all r,ew materials for inspection. CI OIA NER-BUILDER DECLARATION Signature of Applica:rt:_ [)ate: I hereby affirm that I am exempt from the Contractor's i icense Law for one of the following two reasans: I ALL.ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as rheir sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as-)wner of the propc:ty,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). i have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as proviued for by Section 3700 of the Labo:Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the r/ork for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation•,Insurance,as provided for by the Health&Safety Code,Section 55 ,25533,and 25534. L Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: _ __Dater_ C permit is issued. I certify that in the performance of the work for which this p-rmit is issued,I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING.AGENCY 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 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec 3097,Civ C.) Lender's Name APPLICANT CERTIFICATIO'4 Lender's Address - 1 certi`v that I have read;his application and state that the above information is corre,,t. I agree to comply with all city,and county ordinances and state laws relating r•,building construction.and hereby authorize representative,of this city to enter the above mentiol,ed property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION A.14 and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses-which may accrue against said City in c)nsequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understar•ds and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signa'ure_ Date_ CITY OF CUPERTINO 3 ITEMS OF 12 PERMIT RECEIPT OPERATOR: SylviaM COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot : APN 36654005 . 00 DATE ISSUED. . . . . . . : 09/04/2009 RECEIPT # . . . . . . . . . BS000008610 REFERENCE ID # 09090027 SITE ADDRESS . . . . . : 11673 VINEYARD SPRING CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER LUNGFU CHEN ADDRESS . 11673 VINEYARD SPRING CT CITY/STATE/ZIP CUPERTINO CA, 95014-5135 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 6,470 . 00 1 .00 0 . 00 1 . 00 0 . 0 1BSEISMICR VALUATION 6,470 . 00 0 .70 0 .00 0 . 70 0 . 00 1REROOFRES SQ FEET 27 . 00 351 . 00 0. 00 351. 00 ------0_00 TOTAL PERMIT 352 .70 0 . 00 352 .70 0 .00 METHOD OF PAYMENT AMOUNT --REFERENCE NUMBER _ --------------- ---- CHECK 1, 541 . 60 2812 --------------- TOTAL RECEIPT 1, 541 .60 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- --------DESCRIPTION _ --- -- ---------- ___ 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF r CITY OF CUPERTINO CITY OF r REROOF CUPEkTINO � �- PERMIT APPLICATION APN # Date: Building Address: 7 //,// 2 � 4/6 Owner's Name: Phone #: Contractors a s Phone #: ;2 o,7 _ Fax#: /1i `3 Cupertino Business License #: � Contractor License #: goo 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) Number of existing coverings J ❑ Provide I.C.B.O. R ort# f To be Removed ❑ Provident fgr. Installation Specs. Job Des ription: Ila 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 r Revised 6/16/08 CITY OF CUPERTINO RERO OF "'yof FEE SCHEDULE CUPEk 1 10 Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1REROOFRES ' Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08 Community Development Department Building Division City of Cupertino 10300 Tone 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: =- )n �v Job Site Address: n Roofing Company Name: m Applicant's Signature: //G, Date: Greg Casteel Building Official Revised,07/30/08 Community Development i` 10300 Torre Avenue Cupertino CA 95014 + Telephone(408) 777-3228 ClIYOF (UPE1�11��+� Fax(408)777-3333 Building Department JOB ADDRESS: /�� PERMIT; OW-NER'S NAME: � �)_�gj `✓ems � PHONE %�, � � GENERAL CONTRACT 7,-57 i - FAX ; 02 1 am not usili-any subconLractors: J Signature Dae Please check applicable subcontractors and complete the following h-dormation: cS01� '� lOBUSINESS NAME BUSINESS LICENSE #P Cabinets Cc Millwork Cement Finishing Electricaf Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tani: I Sheet Metal [-Sheet Rock- Tile ockTile Vii, O ntrac� r Signature Da e