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99080186 PERMIT APPLICATION FOR CITY OF CUPERTINO NUMBS INSPECTION DIVISION PERMIT EXPIRATION REROOF PERMIT (408) 777-3228 PERMIT EXPIRES IF WORK IS NOT STARTED _ WITHIN 180 DAYS OF PERMIT ISSUANCE OR • 180 DAYS FROM LAST CALLED INSPECTION. BUILDING ADDRESS C 0(„ (//J.1 Vj �/I[ RESIDENTIAL�COMMERCIAL OTHER owNER's HAZARDOUS FIRE AREA YES ❑ 0 yes—I understand Utat a as, A NAME VO U N 6 — Z/ 1 160 roof assembly is regtdred. NO Initial I.C.B.O.N ADDRESS ck l(. C P L U47Y l A Ii I EXISTING ROOF COVERING PHONE or) ? 77—/ ? NUMBER OF.EXISTING COVERINGS 1 CONTRACTOR'S ,CC C.y/I-/ y/ A Q Q F/AZO, TO BE REMOVED TO BE RETAINED NAME ADDRESS "a 2 0. TYPE OF ROOF COVERING CITYS ZIP Lil CA q 0J•400. - - rp E1ISTING PHONE (10.]Q J / ,_ BUILT-UP ROOF ❑ CENSE NUMBER CAf y ASPHALT.SHINGLES ElLICENSED CO TORS DECLARATION I hereby affirm that I em licensed order,rovillons of Chapter 9(commencing Ash Section WOOD SHAKES 7000)of DIvWon 3 of the Business ark Professions Code,and my ft"mm Is In hdl force end effect. _ O ' / WOOD SHINGLES License Cleve Llc.Number Date .T r commdor d S OTHER(SPECIFY) OWNER-BUILDER DECLARATION I hereby affirm mat I em exempt fatal the Contractors Ucanee Lew for Me following reason. PROPOSED /-� (Sec.7031.5,Business end Professions Cade: Any dry or county wltich requires a permll to /n constri alter,improve,demdLeh,or repair any structure,prior to its issuance,also requires the BUILT-UP ROOF applicantD (/1`rA-J� ' for such permit to age a signed statement that he b licensed pursuant to Me provisions of the Contractors License Lew(Chapter 9(commenclng Am Section]000)of Division 3 of the ©© U exemption. xe ptio and Prdessfons Cada)or Mel he Is exempt iherefram and Me bests for the alleged ASPHALT SH NG S AUG 2- 1999 exsiness .Anyviolationof Section 7031.5 met tryany eppttl%efor ePermit a ads the applicant to • a clvll pena0y of not more than five hundred ddlere($500).): J E]1,m owner of Me property,or any employees with wages as Meir sole compensation,will dD WOOD SHAKES the wark,and Me structure is Trot m anded m offered for sale(Sec.7(1 Business and e- Profe sfomCotle:The Contractol License law does not appy to an owner of property who buldsa WOOD SHINGLE By ❑ Improver thereon,and who does such work himself or through his own empbyees,proMee that --�� such ialprowol are not Intended or offered for rale.It,fgwever,the bullGng or Improvement _ Is sold wiabla one year of completion,Me awTnr-builder All have Me burden of proving that he tld OTHER(SPECIFY) ❑ rot build or Improve for purpose of sale.). . I,as owner of the property,am exduslwly cmiracmrag AIM licensed contractors to construct the protect(Sec.7044,Business and Professlone Cade:The Contractors License Law does m; PROVIDE I.C.B.O.REPORT NO. appy to an owner of property who Wilds or Improves thereon,end Am contracts for such protects with a contractors)licensed pummat to me Contractors License Lew. PROVIDE MFGR.INSTALLATION SPECS. 1 am exempt under Sec. ,B&P.C.for mile reason Owner Data APPLICATION DATE VALUATION PERMIT FEE WORKER'S COMPENSATION DECLAAAnoN I hereby affirm under we"of perjury one of the Idlowlng declaration: I have and All maintain a Cehmcate of Consent to sell-insure for Workers Compensation, BuildIn as provided for by Seoldw 3]00 of Me Labor Code,for the periormarce of Me wark for which MIs g parmll Is Issued. TSI haw end wig maintain Workers Cdnpmartion Insurance,as rmulred Seismic by Section 3700 of ` x�Vt Labor Code,for the work far of the wfar which this permit Is issued.My Workers ` L(J Cualperuatfon Insurance carrier and Policy number are '. Total Carrier TATE (:nil loll! � cllryNo. r2y �''y� PERMIT AUTHORIZATION DATE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION)the ON INSUfor we (S1 DO) o (This section need not be completed Ii Me permit Is for one hundred dollars(5100)m lase.) 1pJr ,✓A(TA�, 1 certify that in the pedmmance d Me work for which this permit is issued.I shoe col dnp any perom M any manner as as to become subject to the Workers'Compensator Laws of= All roofs shall be i spected prior to any roofing material biding forma. .installed. If a roof is installed without first obtaining an Data Applmant inspection,I agree to remove all new materials for inspection. subject to meows m'CbmpT. l�iko,Prko,i°this vii e'Laabor Coof maem>w mustafort with�pmry Applicant understands and will comply with all non point with such pro ams or this permit shall be comact revoked. source regulations. I Cerllty met l have read able application and state that the atiow information is correcl.I agree - tocomitywith all city and county ordinancesand state amrelating tobulkungcrostrcmm.and All roof Coverings to be class".'or bette hereby aulhorae represenatroes of this Cry to enter upon the abowe ftmrifoned property for In- spectlon purposes. (We)agree to saw,Indemnity entl keep harmless the Clty of Cupertino eol Iiablikiea, judgments,costs and pewhich may In arty way accrue against said City in coruaquerce SIGNA UR O APPLICANT DATE al the renting d this permit.ralm. PRE-INSPECTION: PLYWOOD: - IN-PROGRESS: INSP. DATE INSP. DATE INSP—DATE- TEAR NSP. DATETEAR OFF INSPECTION: BATTENS: - FINAL INSP. DATE INSP. DATE INSP. DATE NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION OFFICE COPY CITY OF CUPERTINO �m 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: nancyc COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot:35618048.00 DATE ISSUED... . . ..: 08/25/1999 RECEIPT #.. . . . . . ..: 9896 REFERENCE ID q . ..: 99080186 SITE ADDRESS . . ...: 21682 COLUMBUS AV SUBDIVISION . . . . . .. CITY ........ . . ...: CUPERTINO IMPACT AREA . . . . . .. OWNER ....... . . . . .: CHOO YOUNG-IL AND SYLVIA J ADDRESS ...... . . . .: CITY/STATE/ZIP . . .: CUPERTINO CA, CA 95014-4711 RECEIVED FROM . . . .. TIM CONTRACTOR . . . . ...: LIC # COMPANY .. . . . . . ... : ADDRESS . . . . . . .... : CITY/STATE/ZIP ... . TELEPHONE . . . . . ... : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----`---- ---------- ---------- ---------- BPERMFEE VALUATION 12,000.00 177.00 0.00 177.00 0.00 BSEISMICRE VALUATION 12,000.00 1.20 0.00 1.20 0.00 ---------- ---------- ---------- ---------- PERMIT 178.20 0.00 17B.20 0.00 METHOD OF PAYMENT AMOUNT NUMBER _________________ ____________ __________________ CHECK 178.20 19735 • TOTAL RECEIPT 178.20 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ........ ............................ ........ ..............""""""'-.. 305 FRAME 307 INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS • • CITY OF CUPERTINO - BUILDING DEPARTMENT RE-ROOFING POLICY 1. Prior to permit issuance, you must agree to comply with U.B.C. standards and manufacturers specs on re-roofing. 2. New roof coverings shall not be applied without first obtaining all inspections and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofmg is completed. 3. All types of roofs shall be inspected prior to any roof being installed. 4. In order to receive a final, you must complete steps 1,2, and 3. i. Pre-inspection or tear-off approval 2. In-progress inspection approval 3. Final inspection approval a. Operable smoke detector verification 5. If plywood is installed, a plywood nail inspection is required. 6. If any roof is applied without first obtaining an inspection, you will be required to remove all new material down to the sheating and a building inspector will inspect all sheating at that time. IMPORTANT: 1. Flat roofs must have a ''/<" per foot slope, or demonstrate that there is no ponding. 2. I.C.B.O. reports are required to be on the job site at the time of inspection. If you do not have one, contact the building department. WE UNDERSTAND THE ABOVE POLICY ON RE-ROOFING AND WILL COMPLY WITH THE POLICY. HOMEOWNER'S NAME: �o U N G - T/ CN o 0 ADDRESS: 1 (o P CoCvehi?VJ AVvFZGuPr. RE-ROOFING COMPNAY NAME: C—C A r T y A o or=i�..� 1A <_ APPLICANT'S SIGNATURE: • CITY OF CUPERTINO BUILDING DEPARTMENT Re-mor/winword