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08100116 CITY OF CUPERTINO BUILDINGDlV%ION PERMIT CONTRz1C QRINFURMATION BUILDING ADDRESS: PERMIT NO. 7863 CREEKLINE DR LOS GATOS ROOFING 08100116 OWNER'S NAME: PERMIT ISSUE DATE 4D.WNHONG DOMINIC P AND WENDY W P 0 BOX 1726 10/20/2008 E: SANITARY NO. CONTROL NO. ARCHnECf7ENGINEER: BUILDING PERMIT INFO RE-RF RMV EXT SHKRF__INSTL BLDG ELECT PLUMB MECH. 0 0 0 0 18p LICENSED CONTRACTOR'S DECLARATION �U C I Mmby affirm thus 1 am li¢vW uMer pro isioat of Chapter 9(coessummg Lib-Description Lt Wih��nTIXp7 nrorvivon7orue Budnea,M Prorrstlom Code.W mrBcensu ;fid in f.11 fmee.dert j�i txcnso Qat tr.a 00 f 7 . ,,e p 1.4.9) Cnvmmumr ,'1HRECIS , TO! ?W U I understandPlans sha my ll W wa oro ed public rds 6 k Lu ented PNRasl...I OWNER-BUILDER DECLARATION 1 'm'y alum that i am exempt rose the Cnnvactara License Law far the 00 following moon.(Section 7l Pd 1.5,Business and Professions Code!Any city or county which requires a permit to corsmut.ager,inform,demolimh,nr repair.y structure °iy prior n its issuance.also require the applicat for such permit HE file a signed SU=CnL ss< tharheltlicensed pursuantuNeprovns isiooftheContacm'sLicoeLaw(Cltspser9 Sq.Ft. Floor Area Valuation yt—$ (commencing with Session 7000)is'Division 3 of thin Business and Professions Code)Or y — Nat he u comma therefrom and dic bolt fa the silegcd eaemptam.My violation of Section 7031.5 by any applicant for a permit subjects Ne applicant in a civil Iwnairy of APN Number Occupancy Type mot mom Wafisc n bundmd dollen(5500). p y yen ❑I,as owner of the property,or my wPloym with Wage as Neo sole mmpemadon. will do the work,and she smesure is not intended or offered for ask(Sm.1041.Bummss 1ud Pofe ions Cade:The Contranurs License Law dm rot apply u a owner of Required Inspections property who builds or im proves thereon,and wbo dues such work himself or though his ownemploym,pervaded Nasuchimpraw Uamnotinsende moffertdfor.le.if. however.the building or impmwment is sold within one year of rompkuon.the owner. builder will bare this burden of proving that he did net Wild Or impow for purpose of ale.). t]1.as Owner of she propos•am exclusively contacting with licensed contactors in commht the project(Sec.7044,Business and Profcssbns Cade:)The Ccomches u. cense Law dm out apply in ao owner of property who builds Or Lmpromes Nemo..and, who contract,for such projects witha emoussumis)licensed Pmamnt to Ne Contractors uceme Law. ❑Iamuemptunder See ,B&PCfardeisrtswn . Owner Dau WORKER'S COMPENSATION DECLARATION 1 he eby of lon under penslry of perjury am of the following declarauwu: I ban and will maintain a Cenifhicam ofCooent to self-imm for WorkersCompen- .don,u povimd far by Section 7700 of Ne labor Cade.for the Perfamace of the work for which this permit is issued. IT 1 have and will munuin Workers Compensation Imuran.,u required by Section 3700 of NC labor Code.for the perrarmoo ofthe work for which Nis permit u issued. ' My Wmkers qp. mato.lsuran amuand Policy number am: Carrier J��/ice' N Polley No.: C FICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ' (This section msW rotbecanpkxd If the permit is rams hundred dollars($100) or 4as) 1 aniry that in the performance m Ne work for which this permit is imbed.i shill not employ any person in my m se mer so as u become.bject in Nm Workers'Canpemtion Laws of California.Dau Applicant NOTICE TO APPLICANT:If,after making this Ceniftcah Of Exemption.you should become subject in sbe Worker's Compensation provisions of the LIha Code,you must .JO forthwith comply with such provisions a NU Permit shall W deemed revoked. Z N CONSTRUCTION LENDING AGENCY (-� I hereby affirm Nasi Nem isaronsvucunn lending agency far the performanx of D: Ne work fa which this permit I,issued(Sec.3077,Civ,C.) 1 Q Lenders Name 0.z Lagers Add. U O 1 caury that I Whin Mad this application dud muse this,thc above wormation is [t, F coned I agree m comply with all city and county aJinares,and sus laws rousing In O V Wilding cowmcuo,and hereby amhaine repmsentalivns of Ns city in enhrupon the r above-mentioned property,for inspection purposes. 0. (We)agree u saw,indemnify and keep Moulins,the City of Cupertino against rvFi V) Iimtitm.judgments.emu and aPeoea which may In any Way scone agsinsL said City U Z in consequence of the Swung of this permit, �-t APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Re-roofs SignawM of AppliaHAZARDO Doc HAZARDOUS MATERIALSDISCLOSURE Type of Roof Will Oen a Cant or(oboe building e.Chapter from a fuddle baamons material u defined by the Cuprnim Municipal Dude.Chapsr 9.11 and the Health and Safety Com.Section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes 0 N If a roof is installed without first obtaining an inspection,I agree to remove Will the applicator funm building by ft B use Area Air equipment ft dMana Which g .i havardnns air conumionu u mOmd by to Bay Are Air Quality Management all new materials for inspection. Disvict7 ❑Ye ONO I haw read the haardousmahrialtmquiremcnLl under Chapterd.95 of Ne Califon nia Hmhh&Safety Com.Sroum75505.25533md15534.Imuk dthaiNn Wilding dm rot currently ban a heart.that it is my mapooibility to notify to occup.t of tit mquiremrnu which muss W met priors Luuancc ora Ceniricah of Occupancy. Signature Of Applicant Date Owner amthorixd agent Dau' ' All roof coverings to be Class'1?a'or better I CITY OF CUPERTINO 2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . : 36217047 . 00 DATE ISSUED. . . . . . . : 10/20/2008 RECEIPT #. . . . . . . . . : BS000006404 REFERENCE ID # . . . : 08100116. SITE ADDRESS . . . . . : 7863 CREEKLINE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : HONG DOMINIC P AND WENDY W ADDRESS . . . . . . . . . . : 7863 CREEKLINE DR CITY,/STATE/ZIP . . . : CUPERTINO CA, 95014-4155 RECEIVED FROM . . . . : LOS GATOS ROOFING CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481 COMPANY . . . . . . . . . . : LOS GATOS ROOFING ADDRESS . . . . . . . . . . : P 0 BOX 1726 CITY/STATE/ZIP . . . : LOS GATOS, CA 95031 TELEPHONE . . . . . . . . : (408) 298-9399 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 6, 897 . 00 0 . 70 0 . 00 0 . 70 0 . 00 1REROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 . 00 0 . 00 ---------- ---------- ---------- TOTAL PERMIT 364.70 0 . 00 364 .70 0 . 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 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-inspectlon.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 Y4" 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: 3 Roofing Company Name: L )S Applicant's Signature: _Z I j, � �Z�� Date: /0/z/O p Greg Casteel Building Official ' Revised 11/2/04 Community Development tt' —]' a 10300 Torre Avenue J':' Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 UPEkTINO Building De Artment JOS ADDRESS: �� PERMIT n OWNER'S NAME: P/i PHONE # GENERAL CONTRACTOR: FAX r I am not using any subcontractors: Signature D 'e Please check a22licable subcontractors and complete the followina information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE u 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 Owne Contract Signature Date a CITY OF CUPERTINO o REROOF CUPEk�TINO PERMIT APPLICATION APN# Date: Building Address L41jeek Own 'we�r'ss Name: Phone #: eeny NMy11 30- 2-32.3 Contractor: J_ Phone#: 'z/6) `J Fax #: Cupertino Business License#: , / Contractor L�iicense #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles �>K Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) !p' Other (Specify) e� /Id S2fer t�L� Number of existing coverings ) ❑ Provide I.C.B.O. Report# To be Removed )d Provide Mfgr. Installation Specs. JA Description: Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: •I Have Read, Understand and.Will Comply with Cupertino's Tear-Off Policy: Signature