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08040006 CITY OF CUPERTINO K a- . ��k a = 1' � k BUILDING DIvSSION .. PERMIT CONTRACTOR TNFaURMATIOI�a au"1 bff8DR g5hINDELL WAY ALL PHASE ROOFING PEROt5040006 OWNER'S NAME: PERMIT ISSUE DAIS JU KEN JEN—GOW AND WANG DAPHNE 315 CLARKE LN 04/03/2008 NE SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: O . RE—RF,T/O 1 CMP RF,RPLC W 'BLDG BPERMIT ELECI' PLUMB MECH 0 0 0 0 �o O LICENSED CONTRACTOR'S DECLARATION Job Description rd u 1 hereby affirm that I sm thorned under previsions of Clopmr 9(commencing with Section 7000)of Division 3 oflhe Business and Professions Code,and my license in in full force end it o ? Lkene Clus Lk.Y GG F- Dam V Quiranar - RRECI'SDECLARA 10 !!$$ fid my p all M unedp public rtcnrd ;W 5 In Lonallial fcssional 5 OW NE - IAER DECLARATION 1 hereby a1Rrm that I am exempt from to Committee License Law for the C e following moan.(Section 7131.5,Business and Professors Code:Any city at county which requires a permit m conswm,alter.improw,dcmoluh,or mpoir any someone r�Z�a prior m its issuance,also requires IMapplicant for such permit to file a signed statement that he is licensed pursuant lot the provisions ofthe Contractor's Liminse Law(Chapter 9 Sq.Ft.Floor Area Valuation (commencing with Section 7000)of Division 3 of the Business and Professions Code)or �.. that he is esempt tbemfroo and the basis fm the alleged eempthm.Any A.I.M of Section 7031.5 by any app0mnt for a permit objects the applkaml to a civil penalty of APN Number Occupancy Type nut moi man five hundred doll.($SM. P y YP D 1,as ownes of the Property.or my employees wire wages as their ole mrapeumdon. win do the work.and abaaweure 1,Out intended orofkmd mrsalc(San.7(t44,Busirsaa Required Inspections and Profravians Code:The Committee License law dons not apply m ns an awr of q p property who builds or im prows demon,and who does such work lumsel f m though his owncmployeet,provided thatsuch improwme m;me not im ended croRered fmule.if, however,the building or improvement is sold within one year of mmplcdon,dee owner- builder will have the burden of proving that he did of build or improve for purpose of ala). C]1.as an=of the property,am exclusively convecting with licensed contramom in cons Tact the pmjea(Sec.70x4.Business and Profusions Coda:)The Covemaes U. came law dos not apply to an owner of property who Milds or improves themon,and who contracts for such projects with acoavemRs)licensed pursuant to me convectors Lkerse law. ❑lamaemptundesm ,B&PCfothismuon Owner Dam WORKERS COMPENSATION DECLARATION - I hereby affirm under penalty of perjury one or the following declarations: Lhaw and will maintain a Cenificee OlCOnsem 10 elf-Mame fm workers common. ,as provided for by Secdan 3700 of dm labor Code,for the Performance of can work for which this permit is issued. ❑1 haw and will maintain Worker's Compensation Insurance,an acquired by Section 37]1X1 of me labor Cada,for de perfmmance (the rah for which this permit is issued, ' My Workers Compoexti nInsurance carts and Poncy number>R: Cankn ��'1'PC Ful Policy No.: CERTIPICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu orlon need o1 he completed if the permit ufmonchumland dolor(SIM) or less.) 1 cerdh-that in the performance of the work far which this permit is issued,)mail not employ any pmem in any mmncrm as in Moron subject to the Worker'Compensedon Laws of California.Dam Applicant NOTICE TO APPISCANT.If,after making Nie camfncate of Faemption,you should become object 0 the Wo&ars Compensation previsions of me labor Coda you most z forthwith comply with each provisions or this Permit shall be demand newked. CONSTRUCTION LENDING AGENCY [r I Mraby affirm that then is a construction leading agency fm the Performance of {Y, the murk for which this permit is issued(Sec.3097,Civ.C.) W�Q Lender's Name , z Lenders Address V Q I certify the I Mw mad this application and sum the the show information is iL H orient.1 agree to comply with all city and county ordinances and sok laws relating in DU building conswmion,and hereby authode representatives of this chy,to enter upon de R7 show-mentioned property for inspection purmea. g21 (We)agme to un,indemnify and keep harmless the City of Cupertino against y liabilities,Judgments,costs and eapomes which may In any way acerae against said City V'L in consequence of me granting of this Permit. y ^ APPLIC DERSTAND WILL COMPLY WITH ALL NON-POINT Issued by: Date / — SOU ATION Re-roofs v SignatimmolApplicare/Contraqwl 0 Data HAZARDITUS MATERIALS Type of Roof Will Ute applicant or forum building e.Chantuom m handle R.IM and u de.Setl io the Cupenina Municipal Code.Chapter 9.@.antl the Neale and Sa(ety Code.Schon 25532(a)? ❑Yes All roofs shall be inspected prior to any roofing material being installed. Will ren applicant Or fu1 reobuilding Occupant sex equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove h haasrdous air com munanu es defined by the Bay Area Air Qualhy Mar.gemcnl all new materials for inspection. hit' ❑Yrs Nu I have met Nc hvndtasmaterials requirements..do,Chapter 6.95 ofthe Cable, ^ Q Id Health&SafetyCode,Sections 25505,25533 and 25534.1 undersand mu if Ne building s of curmnd haw a wa ant,that 11 k my rasp erwilily b odfy tine ecu Int of Ne umarn rah lhemm ria tmhssuano.r.conlfnmkofOccup y. Signature of Applicant Dat ncr or eulhoriv.d agenl r Dow All roof coverings to be Class'W'or better CITY OF CUPERTINO • 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36223007 . 00 DATE ISSUED. . . . . . . : 04/03/2008 RECEIPT # . . . . . . . . . : BS000004334' REFERENCE ID # . . . : 08040006 SITE ADDRESS . . . . . : 7770 ROBINDELL WAY SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JU KEN JEN-GOW AND WANG DAPHNE ADDRESS . . . . . . . . . . : 7770 ROBINDELL WY CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5013 . RECEIVED FROM . . . . : ALL PHASE RAINGUTTE CONTRACTOR . . . . . . . : LOUIS J. REBOZZI LIC # 27941 COMPANY . . . . . . . . . . : ALL PHASE ROOFING ADDRESS . . . . . . . . . . : 315 CLARKE LN CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037 TELEPHONE . . . . . . . . : (408) 779-3740 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- - ------------ ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 7, 600. 00 0.80 0. 00 0. 80 0. 00 1REROOFRES SQ FEET 30. 00' 390: 00 0. 00 390. 00 0. 00 _..,-------- ---------- ---------- ---------- TOTAL PERMIT 390. 80 0. 00 390. 80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 729 . 60 #9129 --------------- TOTAL RECEIPT 729 . 60 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ------- --------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 'FINAL REROOF • CITY OF CUPERTINO REROOF CUPEI,TINO PERMIT APPLICATION APN # -7 � Date: Building Address: 77720 P%06iV-, d -e0 Owner's Name: Phone #: Contractor: r Phone #: '7 -7c9'_,37yv 6 NA-se �L� n Fax#: 7 7 Cuperti o Business License #: ( Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ;K, Asphalt Shingles sr 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. Job Descriptip{n: U Fty= �'P 1Z 0-�� C�Y�e eO D NAY �� oZo Residential Commercial Fire Zone: Yes ❑ NON Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: 7 vc� I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: • igna re 4� CITY OF CUPERTINO REROOF CUPEiliTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1REROOFRES Re-roof Residential B 1SFDWLROOF 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B 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. Homeowner's Name: zo oL//,�� / ^,, Job Site Address: _7776 (!G6 (/off/V /e Roofing Company Name: C Applicant's Signatu Date: G Q • Greg Casteel Building Official Revised 11/2/04 J Community Development 10300 Torre Avenue R / Cupertino CA 95014 " Telephone(408) 777-3228 CITY OF Fax(408)777-3333 UPERTINO Building De artment JOB ADDRESS: v PERMIT # Wo aao OWNER'S NAME: -P PHONE # Q� GENERAL CONTRACTOR: 4-1( FAX # — �7 I am not using any subcontractors: / Signature fKate Please check applicable subcontractors and complete the followinginformation 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 Owner/Contractor lgnature Date SMOKE /CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION CIr GUPERTil 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228 FAX(408)777-3333+buildina(ftupertino ora �w0 � = Permit No. ® .. Address _ iia ( g #of Alarms Smoke /Carbon Monoxide rt_ PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions,alterations,or repairs to existing dwelling units exceeds $1000.00,CRC Section R314 and CBC Sections 907.2.115 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each leeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply:In dwelling units with no commercial power supply, alarm(s)may be solely battery operated. In existing dwelling units,alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl space.Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes.The alarms have been tested and are operational, as of the date signed below. i have read and agree to comply s and conditions of this statement Owne (or Owner Agent's)) Name.._ ... ...........................................................Date: ...... Contractor Name: Signature............ ......L1c.#.................... ....Date: Smoke and CO form.doc revised 03/18/14