08100041 CITY OF CUPERTINO T�g,� s�s..a -rarcs,Rs
BUILDING DIVISION PERIVLt'rCONTRACTQR INFORMA'CIO
PERMITNO.
BUa�WTRBNEKNAP DR BECKS ROOFING 08100041
OWNER'S NAME: PERAm'ISSUE DATE
GENE ZHOU 6191 OCHO RIOS DR 10/08/2008
NE: SANITARY NO. CONTROL NO.
(408) 365-8979
ARCHITECT/ENGINEER:
BUILDING PERMR INFO
BLDG ELECT PLUMB MECH
20, LICENSED CONTRACTORS DECLARATION
rd m 1 hereby dlirm that I am Iicenad antler pmvisinen tui Gaper 9(.anmcming Job Description
t¢' NNSeefinal? D)ofDiAm 3 Budnessandpmressi u�I... RE-RF T/0 OSB TECHSHLD, #30LB FLT CLS A 27SQ 40YR
in Full roma aM ett d.,� G
jL5Z Lm..Class // Le.a 1 -ELK .
F Dam Contracpr
CHRECiS DECLAAATI
W6
1 utberwnJ my plata shall W used u public mN
car
k G t; Licensed Ptofestional
''N 5 a? OWNER-BUILDER.DECLARATION
�I I hereby rte Nat 1 am exempt from the Contractors License Law for IM
O O following moon.(Section 70313,Business and Pmo fesuvCade:Any city or county
3: which requiret a permit in comment,alter,improm demolish,or repair any stmetum
-zi prior to its issuance,also requires the applicant for such permit to file a signed summent
< dut he e licensed pom.m to the pmvi¢ans or the COmmmes Vceese Law 9 Sq.Ft. Floor Area Valuation
iso $10000
x .3 (cam me I,.,th Sectfrom7000)Of
and
In iafr of the Busineacuand Proferuoo="I
Q Nato u 31.5 b say applicants
and Ne aper for the ukge, exemption.Any efalaatun of
gecaw.thus by Ory red dont rte a permit subjects the applicant p a evil penalty of Number - Occupancy e
nm mtm than fiw hundred dolrrs($300). 36208033 . P Y�'P
I,u owner ar Ne pmperty.m my employer withwages o thekwk c=Nmdm.
will da Network,and the he Case mmesLnded Or Law
Cas for 1 apply 70N.Buumss
and Rorcmobu cads The Conuxcmrs and
Law Cases oat apply m an owms Of Required Inspections
property who buBd,ar impm es dmmon,acts sonoSasmelt wootimselrnr lMagb his
awo empltuym,proNdea Wtsmb impmwmoots>R notinrendM maRered fmsale.V. '
tackler the Wmsheorimp Of pon,trsolawithinore Year of cemow,for theoo of
Wilam will haw the When of paving those he did rose Wild ar improve far purpose of
rate.).
❑1,as Owner of the property.am exclusively contracting with licensed contractors to
coowct the project(Sec.7044.Business and Proresdam Cade:)The Contractor's l;-
C.law does tot apply an an owner of property who Wilds or improve•thereon,and
who codu mets for such projects wird a conuactons)liveredp tt mthe Contractors
L'uxnm law.
lamexempundmsen .BAPCrCatWamO
Owner Date
P1WORKER'S COMPPNSAnON DECLARATION
1 hereby of irm under lousily of perjury one,of the following declarations:
haw and strip munWo a Certificate orComent to self4same rte WorkersCmnpm-
saran,as pmrfdW for by section 3700 of the labor Coae.for the peRormance of the
work for which this permit is issued.
❑1 haw and will maintain Workers Compensation Insurance,u required by Section
37W of the Labor Code.for the performance often work for which this pe III i '
My Workers Compe W 4ttu race n m and Polity n mbm�e:; 9
Grtier. Polity No.: ✓ L
CEITfIFlG O f PRONPRAN ORKERS'
COMPENSATION INSURANCE
(ndin scNoe reed mu,Wcomplemd if the permit is fortune hundred dollars(SIOO)
or less)
1 Certify that in the perfmmence of the work for which this permit is Issued.l shall not
employ anyparson in any matter an as to become subject to the Workers'Compensation
Laws of Calfferel .Dam
Appficant
NOTICE TO APPLICANT:U.after making this CcnfnCete of Exemption,you shot
become subject to Nc Workers Compensation ptovinomu of the Ia!Wr Code.you must
.,z forthwith comply with such pmviduru Or this pcnoit shall he doomed tewked.
'Er"' CONSTRUCTION LENDING AGENCY
(-a��+ 1 hereby.from out dere e a coovuNnn lending agency I'm the performatxx of
lYi the work for which the permit is issued(Sec.3097.Civ,C.)
G0 Lenders Name
.1. z lenders Address
U 0 1 turfy that 1 luso reW the applkadan aM sum that the Show i dImmatiun is
cmmc.1 agree to comply with all city and county ordinances and some laws misting to
C) Wilding construction,and hereby amhorim mmC=rHmW$of this city to tutor upon the
L}
W me-m
ahentioned property for impaction purposes.., (We)agree to saw,indemnify and keep harmless the City of Cupertino agumt
`..r rjj liabilities,judgments,cam and expenses which may in any way acme all and City
U z in comou,senee of the granting of the permit.
^ APPLICANT UNDERSTANDS AND WILL MPLY WITH ALL NON-POINT Issued by:S Date
SOURCE REGUL 1A,7/7.�'N�S.
Re-roofs
Signature of Appfican cal/ nuacmr Dom HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or rutum building occupant amm or handle head..metrial
as defined by the Cupertino Municipal Cade.Charter 9.12.and the Heal and Safety
code.Sued.255324)7 1All roofs shall be inspected prior to any roofing material being installed.
0Y.
Will the applicant rar future Wilding aavp.t ase equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
m Westinua air comaminants as defined by tho Bay Area Air Quality Management all new materials for inspection.
Dimict7
❑Y.
IhocmWrhod.Smpumamrisistequvem MM.Tcr Clupmr G95oftha Cdifm-
niaHWWwe readhede.9srmts 25565.25577 ata125534.ImWerstsndths tfdp building
does rpt carmttiy haw a mmm&that it r my responsibility to notify de amupunt of the
requfmmc °'hien be met issuance of a Ocrdfmm ry.of Occapan
r � 1� Signature of Applicant Date
Owner or autharimda col Dam'
All roof coverings to be Class'W'or better
CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . . 36208033 . 00
DATE ISSUED. . . . . . . : 10/08/2008
RECEIPT # . . . . . . . . . : BS000006299
REFERENCE ID # . . . : 08100041
SITE ADDRESS . . . . . : 7851 BELKNAP DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : GENE ZHOU
ADDRESS . . . . . . . . . . : 7851 BELKNAP
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4905
RECEIVED FROM . . . . : CARL BECKS & SONS
CONTRACTOR . . . . . . . : BECKS, CARL LIC # 21908
COMPANY BECKS ROOFING
ADDRESS . . . . . . . . . . : 6191 OCHO RIOS DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE . . . . . . . . : (408) 365-8979
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- --- --------- ---------- ---------- --- ----
1BSEISMICR VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1REROOFRES SQ FEET 27 . 00 351. 00 0 . 00 351 . 00 0 . 00
TOTAL PERMIT 352 . 00 0 . 00 352 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 352 . 00 #25033
---------------
TOTAL RECEIPT ' : 352 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
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 2007 IBC Standards
and manufacturers specifications on re-roofing. All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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 complyy wwith� the above stated policy on re-roofing.
Homeowner's Name:
Job Site Address:
Roofing Company Name:
• Applicant's Signature: Date:/0�y
Greg Casteel
Building Official
Revised 07/30/08
Def 00o
CITY OF CUPERTINO
REROOF
OCUPEkTINO PERMIT APPLICATION
APN # {� D OjO Date: jn . D
Buildin ddress: j)
_ Lei '
Owner's Name. Phone #:
n ,
Contractor. Phone #: 2
I F65 Fax#: ,Z-Z !-6 d
Cupertino Business License #: Contractor License #:
3
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles >Q Asphalt Shingles
tb Wood Shakes /❑ Wood Shakes
o 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 Description:
C /o
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF
C1 OF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMIC0 Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLROOF
IBSEISMICRE Seismic Residential B
1RER00FMRES Re-roofMulti-FamilyB 1MFDWLROOF
1BSEISMICRE Seismic Residential B
IBUSLIC Business License B
Revised 6/16/08
•