06050183 CITY OF CUPERTINOt.. ,4y„�f
BUILDING DIVISION PERMIT CO�V] RACT�BQR INFORMATION
Bu1LDING ADDRESS: PRINCIPLE ROOFING & PERMIT NO.06050183
1133 STAFFORD DR
OWNER'S NAME: PERMIT ISSUE DATE
Alk ERIC WANG 1700 NORTH 1ST STREET 54 05/22/2006
NE: SANITARY NO. CONTROL NO.
' (408) 436-1681
ARCHITECT/ENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
0
too LICENSED CONTRACTOR'S DECLARATION Job Description
m I hereby affirm that I am heaved umlcr provisions of ChaPmr 9(commencing P
?i with Section]U(10)of Divimet 3 efum Businessand Profwamor Cade.and my license is
in full forte and effectp REMOVE EXISTING WOOD SHAKE, INSTALL 30LB FELT W
Li"" ass' LIC., BATTEN SYSTEM, INSTALL METAL TILE, INSTALL ONE
Commenr
ARCNITECI'S DECLARA ION SUN TUNNEL
I m< 1 understandnary plaru snail be uac0 u public records ����
50U
°LLo
Licensed Profcuional
3 OWNER-BUILDER DECLARATION �1 f)'
iq 1 heresy sf0rm Nat 10.1. exempt from she Contractor's :Any C taw for the waawSwwrlPRo
p o following reason.(Stttiu]03 LS Business and Pmfessiom Cum:Any city or county
i m which requires issuance.permit re eonslrveL aher,improve,demolish,nr e a sig any Alumina,ummer, Fs
pdormsliesedpum mquirm the applicant for mchpannitmcense LawJwttmcm s
Neshe mencing wit pSewa.uothe of Diviov of sheeuxmhlJanztuw(Chapter odc)or Sq.Ft. Floor Area �US Valuation
Chat he s exuarwithtSecsion d and the
basis
3 of al egeBusiness and Pro Any vi Codc)of $16500
y Nat io u emmps shemfrom and the baso it the subjects
the nemam In Any violation of
Sermon 7031.5 five
any red doll fora permit subjects she applicant m a civil penalty of ApN Number Occupancy Type
not mase than fivs hundred dollars(SSW). u•�
1,as awmr of the ProPrnY•m mY employece wish wage u Heir sale eomPrnsauon, ,
will do the work.and the Academic is notinmtdcd or offered forsam(Sec.]014,Business -
and Profeuiam m
Cud.The Cacscmes Loans:Law does not apply m an owner of Required Inspections
Meant,who builds mimproses thcreon,and whodoessuchwmk himself or though his _
own wplay.,Provided that men improvements an not intended oroffered farsa4.If.
however.the Wildiagor Impmaemut u mid white arm year of camPletion.dee awtarf-
builder will have me Writes of proving Nat be did not Wild or improve for purpose of
sale.).
❑1.as owner of the preplan,am exclusively...tract.,with lusted contractors to
uvtaxt the project(Sec.71114.Business and Professiom Code:)The Contractors Li
cave taw dna not apply m an owner of Properly"a Wilds or improve thereon.and
who contracts for such projeca wish a con racmr(s)licensed pursuant in me Contractors
License Law.
❑I am exempt under See ,B@P C for this reason
Owner Die
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury arc of the following declarmiov:
I ham and will maintain a CeNfmate of Consent to self-ivum fm Wafker's Comped-
union.u Provided fm by Section 3700 of um Labor Code,for she Md..of the
woh for which this permit is issued.
❑1 have and will maintain Workers Compensation I..As required by Section
37W of Ne labor Cade.fa me performance ofshe work for which this permit is Issued. '
My Workers Cmapla.m.n Insurance artier and Policy number art:
Cartier. Ci'/a""-- Policy No.: —
CERTI CATEFl OF EXEMPTION FROM 0 RS '
COMPENSATION INSURANCE
mftisamdon=ad not W completed if the Pr unit is forgot Wsmred dollars(SIM)
or less)
I ccnify that in the performance of the work far which this Permit is based.i shall not
employ any perms in try mxnnerm as As become subject in the Wafkmt'Compevation
Laws of Califomia.Dam
Applicant
NOTICE TO APPLICANT:If,afar,making shu Cmuficam of Exemption you should
become subject m the Workar a CamPenution provisions of on,labor Cade%you most
.J z forthwith comply with such prn alibou m mu Permit shall he deemed revoked.
.Z.t 7 CONSTRUCTION LENDING AGENCY
[-•� Iherebyaffirmdutthereisaconsrucdon luim'. ea,forsha
eporformsnof
P:.�. the work for which this permit is issued(Sec.309],Civ.G
GQ Lender's Name
7 z Lenders Address
U Q I certify that I have tend this application and sum that me allow information Is
U,F comtt 1 agree to comply with all city And county umivness and sum laws reaming to
pU building eonstmetion,and hereby subeamrepresentatives of this city in enter upon the
r W above-mentioned property for impaction purposes.
(We).,me to save,indemnify And kap harmless the City of Cuperom,agent
N li4biliues,judgmems,eosu and expenses which may in anyway seem against mid City
U z APPLICANT UNDERSTANDS AtND WILL COMPLY WITH ALL NON-POINT Issued by:S4��Ca Date
SOURCE Q€GULATIONS. — ��_✓/)))
Signature of pplianUConuacmr at Daub Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicanl or future Wilding uccuputstore or handle hazardous material
As defined by the Cu,mM Munich I Code.Chapter 9.13,and she Health And Safety
Cook,Section 25532(a)?
❑Y All roofs shall be inspected prior to any roofing material being installed.
No
If a roof is installed without first obtaining an inspection,I
Will she applinns or future Wilding acupant me equipment or Devices which g agree to remove P
emit ha>amom air contaminants as dcrincd by the Bay Arta Air Quality Muagcmcnt all new materials for inspection.
District?
❑Yce No
Ihavereadthe me
Wardrmatefialsrequimmmmum rChapmrb.95oftheCalifor-
niaHcalmaSafcty Codc,ucciov ZM5.25533and]5534.Iundcuundshaifmc Wilding
does not currently have a amass that it 4 my respomibody as ami the aeupmt of ft
myubcmcn wt�hicemus.Wme,Pd.,to is.an..is CnuOcamof�`apan.y. Signature of Applicant Date
0h1ied _ �S/2 L/O-C
Owner m,athornna spent�-- Dam All roof coverings to be Class "B"or better
,b. Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
1 1 3;_3 STA P P4Z 06o- 3
OWNER'S NAME: F7-9- C wA-NG1— PHONE # c-e4ug> 36 6 - 6 5-zs-
GENERAL CONTRACTOR: ru,,,N tP FAX # ( 4utl 4136 - 6P/
I am not using any subcontractors: c21�� - ut ZL/a
Signature Date
Please check applicable subcontractors and complete the following information:
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
•
C� va
Owner/Contractor Signature Date
CITY OF CUPERTINO
!m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # : 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36206014 . 00
DATE ISSUED. . . . . . . : 05/22/2006
RECEIPT # . . . . . . . . . : 34498
REFERENCE ID # . . . : 06050183
SITE ADDRESS . . . . . : 1133 STAFFORD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ERIC WANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : DERECK LOI
CONTRACTOR . . . . . . . : DERECK LOI LIC # 27564
COMPANY . . . . . . . . . . : PRINCIPLE ROOFING &
ADDRESS . . . . . . . . . . : 1700 NORTH 1ST STREET, #154
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 436-1681
WEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- - ---------
BPERMFEE VALUATION 17, 000 . 00 245 . 16 0 . 00 245 . 16 0 . 00
BSEISMICRE VALUATION 17, 000 . 00 1 . 70 0 . 00 1 . 70 0 . 00
---------- --------- - ---------- ----------
TOTAL PERMIT 246 . 86 0 . 00 246 . 86 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 246 . 86 MASTERCARD
TOTAL RECEIPT 246 . 86
•
CITY OF CUPERTINO 050 I
d- REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# Date:
� 2. -w -o1 0S127-106
Building Address:
JJ33 S 7A 'FO2I-) OA--
Owner's Name: Phone#:
u•A�G� C4a�7> 366- 6sa�
Contractor: , License#:
P�wiU' Gc�� vrt ClivSt/Gc(,176rL &163 9J—
Contact: V Cupertino Business License#:
D CMEGIc Lai .27-
Type
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) Stena-G "Gl�
Nua`ber of existing coverings Q Provide I.C.B.O. Report# /✓E,e 42 3
iX To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: ,g&rv70vC, cXiSti✓t> ~L) sHaico, i vrtatt 30 "/ Ft GT w/ a to Z
S .0,e-- , Ifn.CG iK ,LL -kl-& , iNS o Sutii
Residential [ff Commercial ❑
Fire Zone: Yes ❑ No [ Confirmed with Planning Dept. if
there are any restrictions: Ll
Cost of Project: Type of Construction: Occupancy group:
i16 SOU ' class A-
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•
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 1997 UBC Standards
and manufacturers specifications on re-roofing.
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.
Homeowners Name: E'erC WA A/
Job Site Address: 7/33 5 Tajr yzi� p/Z� L�Z,_H �O
r
Roofing Company Name: 41 Co.v.f7x-�fra55'o,v
Applicant's Signature: �L Oh—` Date: 2'r 2
• Greg Casteel
Building Official
Revised 11/2/04