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07090038 CITY OF CUPERTINO BUILDING MVISION . PERMIT BUILDING ADDRESS: PERMIT NO. 11465 CHARSAN LA WESTSHORE ROOFING INC 07090038 OWNER'S NAME: PERMIT ISSUE DATE CHU CHEUK W AND SALLY H 2814 AI17,LLO DR C 09/10/2007 NE: SANITARY NO. CONTROL NO. (408) 694-0060 ARCHr1EC17ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 Ind 0OLICENSED CONTRACTOR'S DECLARATION m F I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is REMOVE EXISTING WOOD SHAKE H in full force and a feet IX ? Licensccla� — Lie.n z-Z INSTALL 05B FELT, PRESIDENTIAL TL COMPOSITION p O Datc Contractor Y.w ARCHITECTS DECLARATION oa, ROOF a< 1 understand my plans shall be used as public records �a. U.H Licensed Professional OWNER-BUILDER DECLARATION >. j< I hereby affirm that 1 am exempt from the Contractor's License Law for the ❑O following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure Z y prior to its issuance,also requires the applicant for such permit to rile a signed statement _< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation F $ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $14538 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of A�V Number Occupancy Type not more than five hundred dollars(5500). 3 6 2 1 0 0 5 . . V ❑I,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 Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of q P property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Coouaaoes Li- cense Law does not apply to an owner of properly who builds or improves thenxm.and who contracts for such pmjects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑I am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-insurc for WorkeesCompen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued My Worker's Compensation IqRrance carrier and Policy number are: Carrier 'Stet rid Policy Na.:0001610'-Z00"� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify 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 Workcrs'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after malting this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code•you must Z forthwith comply with such provisions or this permit shall be deemed revoked. z OCONSTRUCTION LENDING AGENCY E-+(A I hereby affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) Wil,Q Lender's Namc z Lendees Address U Q 1 certify that I have read this application and sate that the above information is V." correct.1 agree to comply with all city and county ordinances and state laws relating to ID U building construction,and hereby authorize representatives of this city to enter upon the a ahove-mentioned property for inspection purposes. j (We)agree to save,indemnify and keep harmless the City of Cupertino against -� liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. �-" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURC ONS. T� HAZARDOUS Re-roofs rc SignatuofApplicaer HAZARDOUS MATERIALS DISCLOSURE Type of Rc of Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municip Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs s Tall be inspected prior to any roofing material being installed. ❑Yes No Will the applicant or forum building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit haiardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? O Yes Ihave read the tararddousmaterials requirements under Chapter 6.95ofamCalifor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if ibe building j docs not curtently hav�tcna�nt. hat it is responsibility to notify the occupant of rhereyuirem is which m ' trance of a ficate of Oce ey Signature c f A pl ieant D e owne ora arise gent a All roof coverings to be Class"B"or better CITY OF CUPERTINO t` /Y �M�Y }` REROOF CUPEkTINO PERMIT APPLICATION FORM APN# Date: 9 Building Address: jHbS cVnUv5uv) Lrnr%e Owner's Name: Phone#: CL.Oc cVw Ccense �ntr Sc 5�_ � 1�C., Lid g- Z,2 Contact: Cupertino Business 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) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cur)ertino's Tear Off Policy: Job Description: V--C vvLO- e -4Q-K)'� '-I 5 v"��d s kl>A K-e , 4 rx!>f C 1 I I 0 � f E ( / Residential `P` Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: ET Cost of Project: T e of Construction: Occupancy grou l 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 bu:lding 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 apprcval. 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 f 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 :)f$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: C LA CA, C Vl 1 Job Site Address: � ` L"165 kA U 6(A Roofing Company Name: 5� 5�U✓`Q Uy f� h J'A C, Applicant's Signature: Date Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO 2 ITEMS OF 2 PERMI'C RECEIPT OPERATOR: nancyc COPY # 1 Sec: Twp: Rng: Sub: Bl]:: Lot: APN . . . . . . . . . 36210051.00 DATE ISSUED. . . . . . . : 09,'10/2007 RECEIPT #. . . . . . . . . : BS000002590 REFERENCE ID # . . . : 07090038 SITE ADDRESS . . . . . : 11.665 CHARSAN LA SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CH1J CHEUK W AND SALLY H ADDRESS . . . . . . . . . . : 11.665 CHARSAN LN CITY/STATE/ZIP . . . : CU'.?ERTINO CA, 95014-4981 RECEIVED FROM . . . . : BEN FOWLER CONTRACTOR . . . . . . . : PAUL FOWLER LIC # 21417 COMPANY . . . . . . . . . . : WESTSHORE ROOFING INC ADDRESS . . . . . . . . . . : 28:_4 AIELLO DR C CITY/STATE/ZIP . . . : SAN JOSE, CA 95111 TELEPHONE . . . . . . . . : (408) 694-0060 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 14,538 .00 223 .56 0.00 223 .56 0 . 00 BSEISMICRE VALUATION 14,538 .00 1.50 0.00 1.50 0 . 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 225. 06 0 .00 225.06 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 225. 06 MASTERCARD --------------- TOTAL RECEIPT 225. 06 Community Development - 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 tin OF Fax(408)777-3333 7UPEkTINO Building Department JOADDRESS: PERMIT # I( 5 C 1—o ► t �e c` ) 0'r 3 OWNER'S NAME: Vvr- /G PHONE # Z Z 6 GENERAL CONTRACTOR, y, o FAX # I am not using any subcontractors: Gl�c�—� t o U . Si€nature ate Please check applicable subcontractors and co m fete 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 .--l-Tile Owner/Contractor Signature Date