03080137I
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CITY OF CUPERTINO
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BUILDING DIVISION PERMIT
1^�N.r.'°^TR=- MATION�
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BUILDING ADDRESS:
C.T CONSTRUCTION & ROOFING
PERMIT N003080I37
OWNER'S NAME:
CHU KIN
326 CHRISTOPHER AVE
PERMIT ISSUE DATE
NE:
(408)378-0797
SANITARY NO. CONTROL NO.
AREAMCfIENGINEER:
BUILDING PERM R INFO
BLDG ELECT PLUMB MECH
CJ o 0 0
LICENSED CONTRACTORS p DECLARATION
I affirm that 1 am Ilmved under provisions M Chapter 9
Job Descr{�L1�J�,
ion 7
with Section RNID) e! Division 3 of Nc Businces apq Professions Codc, and my liccnu is
my lice re is
full rer�
Y■�'.AM■ �®
in
c 2
REROOF
st Lir.#_-
Date Contractor
CHITECISDE6�/0.ATIOR�
Srtf�� 3
SEP 1 O �ooJ
1 derstand my plans shall W used as p hlic records
to
Licensed Poifession"'OWNER
-BUILDER DECLARATION
BUILDING
I hereby affirms that 1 cxcmpl from the Contractor's Law rte the
e: Any C county
following uiassn. (Section Wo 1. Business and Coot: Any city
m construct. alter improve, demolish, pair any
which requires a s r improve. demolish. furniture
e. also fie ttement
prierdsits icsuan¢,alsorequites thevision of for suchpermitm Glcssigned (Chapter
he it)icensed purseam to the the Contractor'sinessnd
Sq. Ft. Floor Area Valuation
co of Divisions
with Section ]find of Division 3 of the Business and Com) or
(commencingns CMc) or
n Professions
that k attempt
Nal he u exwpt therefrom and the bleu for die alleged cacmplims. Any violation of
on. Any
36227031.00
Section ]031.5 by any applicant for a parmil subjects she applicant o a civil Penalty of
APN Number
Occupancy Type
net mora Nam five hundred dollars fOOD).
❑ 1, as owner of the pmpcny, or my employcu with wages as Noir sole compensation,
will do she work, and the stricture is not intended or offered for aalc (Sec. ]Baa, Business
and Prorwions Code: The Conductodeo not apply to an owner of r, Licares Law
Required Inspections
property who builds or improves thereon, and who doessuch work himself orerough his
3 0 7 — I NSULAT 1 ON
own employcu, prodded that such improvements are not intended or offered for sale. It,
6O1 — ROOF TEAR OFF
however, Ne building or improvement it said within one year of completion, the owner -
builder will have dre, burden of proving that he did not build or improve for purpose of
602 — ROOF PLYWOOD NAIL
salt.).
603 — ROOF BATTENS
❑Las owner of the property, am exclusively comracdng wish licensed mnuumrs to
conswct the Project (Sec.?Baa. Business and Protrusions Cade:) The Contractor's Li.
604 — ROOF IN—PROGRESS
cave Law dao not apply to an owner o(prupeny who Wilds or improves durem , and
,
who contracts for such projects with a contrsmr(s) licensed Potsdam m the Contracmra
Liccnm Law.
O 1 am G(CmPI under Sac. . B & P C for this moon
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby aRnn under Penalty of pc jury one of the following declarations:
I hale and will maintain a Certificate of Consent to self -insure for Worker's Compen-
on, o provided for by Section 37W of the Later Codc, for Ne performance of the
Wfor which this permit is iasued.
Ica,
1 have and will maintain Worker's Compensation Insurance, o required by Section
W of NC La Wr Code. for the performainco of dre work for which this permit is issued.
Wnrkers Compensation Insurance carrier and Policy number am:
ng:a[ �A'LZ 1 -UN Polio Nod D
1 WORKERS'
%tr CERTIFICATEOMPE
SATION INS
COMPENSATION INSURANCE
(TTissection aced not heeomplr¢d if me permit is forenc hundred dollars(g ICO)
,if lass,)
I Certify that in the performance or the work for which this Permit is issued, l shall not
employ any person in any manner an as to Wcome subject to the Workers' Compensation
Laws of California. Dau
Applicant
NOTICE TO APPLICANT: If, after making Nis Certificate of Exemption, you should
become subject to the Workers Cempcnaetion provisions of IW Lahr Code. you must
faMwith comply with such provision or this Permit &hall he deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that Nene is a communion lending agency Tor the Performance of
the work for which this permit is asued (Sec. 3(YD, Civ. C.)
Lander'a Name
Lender's Add.
I ccnify that I have read this application and sale that the above information is
confer. 1 agree to comply with all city and county ordinances and sate laws relating to
building construction. and hereby auohorire rtpreunlati es of this city to enter upon the
abovementionedpropcny for inspection Purposes.
(Wc) agree to save, indemnify and trop harmlw the City of CuKnino against
may in any way accmc against said City
Habilinconsequenec
aspcnsill
(thews¢and
pewitch
APPLICANT uNDERSTing of WIL
AND
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Dale
SOU.1 REGULA ONS.
8 Zs
Re -roofs
o3
r c of ApplicanVCumacmr Dau
HAZARDOUS MATERIALS DISCLOS RE
Type of Roof
Will the applicant or future building Occupant store or handle hvudeus maurial
u dcfned by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety
ode. Section 25532(a)?
❑Yes Nn
All roofs shall be inspected prior to any roofing material being installed.
Will the -plimurit.1luwre be fingoccupantuse cquipmenlordevices which
'defined
If a roof is installed without first obtaining an inspection, I agree to remove
it I mardnds air conarrdu ts by the Bay Area Air Quality Management
viol?
all new materials for Inspection:
0Yet Nu
base Califon
I havelth
shehavaectio
Chaptechanter
I
k Sudel s 25505Hmquimmcnmundcr
snd255Ja.lt 0.1
dthm base Wilding
ma Hm,nimic
Codc. Sections25505,25533it
I�
��V\
i, syr
elms no, lly
mly have a tenant thio it i noddy
ne nodl'y Occupant of she
of a
Ll/11✓lfk-Za0 ti
d
uns nce ccity
issuance cr
reyuim nmwblrhmusl mertprionmissdanrebraecrdfraleerarupanrYS -S
nature of Applicant
ate
All roof coverings to be Class "B" or better
owneA ..thbrircdagent Date
�M-
WV
14CITY OFi
UPEkl INO
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.
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:
Job Site Address: lo76 W0,4 f i oil r4.
Roofing Company Name:
A plicant's Signature:
Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
Date:
Ila
CITY OF
CUPERTINO
CITY OF CUPERTINO o� J 3
REROOF
PERMIT APPLICATION FORM
APN # r Z- Z� 0-3I
Date: 8'u a3
Building Address: 1o7 (P
well 4W( G1,
Owner's Name:
i /j
Phone
Phone #: 2 !�_ 7 Lr17 d
Contractor: `.
#: 6$ t�
License #:Lf 6 f6 7
Contact:
Phone #:
Cupertino Business License #:
Plan Check Fee
MBUILDING
I
Business License
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
❑/ Asphalt Shingles
❑ Asphalt Shingles
Bf Wood Shakes
❑ Wood Shakes
❑ Wood Shingles
❑ Wood Shingles
❑ Other (Specify)
❑ Other (Specify)
N9mber of existing coverings
;
❑ Provide I.C.B.O. Report #
To be Removed
❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will ComplyWith Cu ertino's Tear Off Policy: ❑
Job Description:
tA<,-k C', J �/i y 6's P) J
aCommercial
Residential ❑
❑
Fire Zone: Yes ❑ No ❑
Confirmed with Planning De t. if
there are an restrictions: LJ
Cost of Project: i
Type of Construction: Occupancy group:
Qt�An tdabl
FPP rn
Lei
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E
YVJI.II LLUll
BldgPermit Fees
ree vrou
Ener
RE
Seismic Fee Res
MBSEISMICOM
Seismic Commercial
K
Plan Check Fee
MBUILDING
Business License