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06010160 CITY OF CUPERTINO zee«€ lt�wk' °Yr � if- BUILDING DIVISIONPERMIT VCEONTR°ACTUR�INF'ORMATIQN, ; BUILDING ADDRESS: WESTERN ROOFING COMPANY PERMITNO.06010160 • 7575 NORMANDY WY OWNER'S NAME: PERMITLSSUEDATE Al I 1h GEORGE WANG 2174 DIANA PL 01/27/2006 IF NE: SANITARY NO. CONTROL NO. (406) 258-7749 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH MIA uQ LICENSED CONTRACTOR'S DECLARATION INV lies 'prion i� I hereby affirm that I w Ihx�d under proviilons of chapter 9(commcncing m�1 wish Section 70110)ofDlvlslon 3 ofdm amorous and Professions Code.and my luenseu in full to=and of , REROOF--T/O KES, . ALL SHINGLES jg4 License ChatFFFF Date I _� i Cmmacw}�� O, 0 1 � 1006 E F ARCHITECTS DECLARATION 1 Professional my plea shell nc used u public records �� IW J;c. Licensed Pmfrasional OWNER-BUILDER DECLARATION 0 I hereby aEirtn that 1 I. exempt from rte Comactor's e:My C law for rte 00 following ressoa.Permit t 7 onstruS. t.Business and Professions,dem Cade:My city or ucccounty �}$ which requires a permit re ennsim0.alter impmw,h Permit t m repair any tamnuro $9500 u Sr, prior to its issuance,alsorequires shovisio antsof forsucthe Contractor's Lice se Law tuumcm g < Ibex ucdpuntion7 the pmviviouu(thcComsiness niansolaw(Chapter 9 Sq.Ft. Floor Area Valuation y (commencingeisxwWSecfmot and ofDivulofr the the Bmhessmdon.my viCoale)ion of $ dot he u axempt therefrom and the Wsis far ter Waged exemption.My violation of Secdon 7031.5 by my appliums far a permit ab*U the applicant in a ovil penalty Of 3 N;gg�rT v Occupancy Type not more duo fw huadmd dollars(55001 ❑I,a Ownerof Nepmpeny.mmfemployeuwithwagoudepmlecampeus0oe, .111 do the work and the someone i.mtinunded orarteted Imsau(Sec.7OµBusiness Required Inspections and Professions Code:The Cmntracnces Liceem law does amt apply m an owner of q P property who builds err improves tumor,end who doea uch work himself 9r through his own employees,pmvlded that men Improwmmu art nut Intended oraffered forssle,If, however,The building or Improwmmt i,sold within one year of completion.the Owner- Wilder will haw the burden of proving that he did not build Or impmw for purpose Of sate.). D 1.as 9wsmr of the property am exclust contracting wish licensed convacmn to construct rte project(Sec.7044.Businen and Pmfesdons Cade:)The Compliances Li. cense law does not apply an an owner Or property.who build.nr improve,shemon.and, who contracts for such pmjecu with a commctorts)licensed pursuant in the Communes Lueom law. D l am exempt under Set .B@P C for this mason Owner Dam Adk WORKERS COMPENSATION DECLARATION I hereby aRrm under Penalty of perjury one of she following dechummu: - I hawond will malnuin a Cerdfacale oconsenuo self-insum for Wormea Ccmpen- , action,as provided for by Section 3700 of the labor Cede,for the performance of the work for which this permit I.issued. D 1 haw and will maintain Worker's Compnwtlon Insurer,as required by Section 3700 of the labor Code,for the pMormance of the work for which this permit is ise ed. My Workers Compensation Inse.earr�iiaAyananrd PoNmCQ�Q y/—Caro4ry � COMO�EMPnON b - FROM WORKERS' COMPENSATION INSURANCE (Thu section need not hecomplesed If the permit is krone hundmAdollms(SI00) or las.) 1 certify that in the Performance Of Ne work for which this permit is issued,I,hall not employ any person in any counter so as to become subject to the Waken'Compensation Laws of Calik h.Dam Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption.you should become subject to the Worker's Compensation provisions of the labor Code,you most - �Z forthwith comply with such provisions or this permit mail be deemed revoked 'Zti'y CONSTRUCTION LENDING AGENCY E+ I hembyidibm this term is a cummcfinn lending agency errthe performer of > the and for which this permit is usual(See 3099.Civ.C.) QIsnMYs Name z Lenders Address V 1 certify Nm I Mw read Ws application and state that the bow InformNun is IT.;-'! correct.I agree in comply with all city and county ordinances and sum laws misting to O tSJ' building construction.and hereby authorhe represemmiscs ofhis city to enter upon to W show-memiomd property for impeNon purposes pyo (We)agree to caw.Indemnify sed keep harmless tae City of Cupertino against w,a to liabilities.judgments,cuts and eapenso,which may u any way acme against said City () in consequence of um granting a 3 Permit. APPLICANT UNDERST AND WILL COMPLY WITH ALL NON-POINT Issued by: Date — Z� SOURCENT ULA / Re-roofs Signature of Appli ontmctor Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding occupatlmoro mrbandlc harudou material as de0ned by the CupeNno Municipal Code.Chapter 9,12,and site Health and Safety rode,Section 15532(a)7 All roofs shall be inspected prior to any roofing material being installed. Oyu NNo Will the applicant or future building occupant use equipment or devicns which If a roof is installed without first obtaining an inspection,I agree to remove mil heroins sir conuminmu as darned by tM Bay Amo Air Quality Management all new materials for inspection. District? Dy. kNo Ihaw mad do,hanrd.Weedalmquimmems mderCMpm+6.95ofdic Calif.,- / O� nia Hca W&SafetyCode. 25505.25533am1253M.1 understood ter ifthe building dors not currently hew that it u my responsibility to notify the occupant of the mqulmments which.It IpdorWW.a c.fa C.mfteamof Oc,.p 04 Sig re pplicant Date / i 7 Owner ormthe a rot Dem All roof coverings to be Class"B"or better aClOF Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 UPEI�TINO Building De artment JOB ADDRESS: PERMIT# P- AA6610� �b OWNER'S NAME: — v PHONE #( GENERAL CONTRACTOR: W G � AX# I am not using any subcontractors: 9 7 b6 Signature Date Please check applicable subcontractors and complete the following information: 60 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 �VCr,)PVA Ro 6 S 3 Septic Tank Sheet Metal Sheet Rock Tile /z 1 ?, :7 06 Owner/ ontractor Signature Date Community Development Department Building Division City of Cupertino 10300 Torre Avenue SCITY OF Telephone: (408)777-3228 UPEkTINO 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. Homeowner's Name: . "Tn P_ _ WA Q lob Site Address: 7676 A)O(LMAA1 .7 y t))A-1. Roofing Company Name: ,e e-Y AO Ce Applicant's Signature: Date:J� 6 Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper TV - CITY OF CUPERTINO REROOF U CUPEI,TINO PERMIT APPLICATION FORM APN # Date: 6 It 15 6 IE Building Address: 5 a ^^ w G Owner's Name: Phone#: FDR L 6 10PI9 S 5 Contractor: Phone#: License ih 0le4e-r6 to, &OPV60-1741 ef-GS Contact: Phone#: Cupertino Business License#: 0 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles X Wood Shakes ❑ Wood Shakes ❑ Wood Shingles )I, 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 Cu ertino's Tear Off Policy: Li fiWob Description: IM PF A E 26of X797 CMOU kneALI 30 Aedy-nE"0'Jf woo {4kt Residential $j Commercial ❑ e(arf e— Por Fire Zone: Yes ❑ No QL Confirmed with Planning D_pt. if there are anrestrictions: LJ Cost of Project: Type of Construction: Occupancy group: D 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