08100128 CITY OF CUPERTINO »,:,=• wq av7 Ya'la�
BUILVING DI'.46ION PERMIT ' CONTRACTQR INFOI.tMA IO.N,
BUILDING DDRESS: PERMIT NO.
7557 DE LA FARGE DR K H ROOFING 08100128
OWNER'S NAME: FERMrf SUB DATE
d1kJERRY CHANG 1556 LITTLE ORCHARD ST. 10/20/2008
WN E: (408) 293-2754 SANITARY NO. CONTROL NO.
ARCH1TECTtENGINEER: BUILDING PERMIT INFO
BLDG ELECT
� PLUMB MECH
I� I�
X00 LICENSED CONTRACTOR'S DECLARATION Job Description
I hereby affirm that 1 am liwmed under provawm of Chapter 9(commencing P
YuF� with Section70W)of DiAuon3of tha Businm and Prof=sWn$Cmde..dany Rc-com RE-RF T/0 WDSHK BLD DECK BY 1/2"OSB PLYWD RE-RF
=F in full fortM efie a
Liarom0.,s � Lm.10 X59 fBY
D� ow'6' tractor
ACH c li
RDECLARATION VILLA MONIER LIFETILES CLSA 27SQ
1 undermaod my pWu shall W used as public records
a
kap Licemed Pafeuiooul .
OWNER-BUILDER DECLARATION
ZOO Wreby alum that 11. xempt frim he Cra :My c Law for tK
ZOO following wan.(Section 11mad 1.aitaas and Professionsderli Code:Ants city or county
$ which its Tisa n pmmit re comwca altar.inform de permit
t fi mash any stsumure
dom heprior toitscensed issuance, reto threse
the applicant for such Cmumetnit m cense signedstatement
thmarrouihr,vvi pureaant alba of Division
of tide Conlmcrosand Professions
Coda)
Sq.FL Floor Area Valuation
y�o (eammes execoi dominant,mod
the
Divisionr oftWeged Business
exception.
My
Code)of $10000
y 8 ths,Sec io u esempr therefrom ad tom per for We alleged eempdao Any it pWuoy of
.1..1thas by any red doll for a permit subjects tise applicant m a civil pastry of Number Occupancy Type
let moa than fine hundred sultan(g500). 35926022 . P Y YP
0 1,u ownw of die property,m my employees withwage u Neo wle compensation,
wiRdethewmkwdthesuumumisnmimmndedwaRerdfarsale(Sec.] .Business Required Inspections
and Profcasians Cade:The,Cantmeafa Liccwe law don ml apply m an..of q p
propertywho buildsaimpmvea thereun,and who densurd work himse forthaogh his
own employees prowtim that such improleme s tie oolimeMed woRud hassle U, .
however,me,building or impawmerll is sold within am your of completion,the ower,
Wilder will haw the burden of paving that Im did not Wild or improves for purpose of
solo.).
❑1,as awmer of tW property,am eclusiwly cardwOng with li¢wed commumws to
eawtlRY Ills project(Sm.7044.BLLSInN ad Professions CdeJ The Caa4Ylaes U. .
cense Law does not apply as an mann of papery who Wilds or improve;theman,and.
who Contracts for such projects with a Con4wWr(s)licensed pursuant to me Contractors
License Law. `
lamaemptunda See ,B&PCfwmuieawn
Owner Dau;
PiWORKERS COMPENSATION DECLARATION
I locality affirm under penally of perjury nee of the following declarsu esu
now am will maintain accWBcate ofcovem in self-insure for WarkcrsCompen-
s selon.as providd foe by Section 3700 of tW Labor Code,for de,perfamnanae of the
wort for which this permit is issued.
X1 have and will maintain Workers Compare.lon Insurance,u required by Section
s of ma LAWS code.far the pealmonswe of the work far which this perm,is Wood.
My Wohers Compensation Insurance comes and Policy number are:
Carrier. � �rtin Policy No.: 2oo�Z
CERTIFlGTE'OF EXlbf PILON FROM WORKERS'
COMPENSATION INSURANCE
(This moms rood Mt W ecmpWYd lime permit as formac handled dollars($100)
or lei)
1 nenify the,in the Performance of the werk foe whim this perm,is Wood.I dal ma
employ anypermn in any munerm as m became subjeel to the Wohers'CompensWon
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If.&Aar making this Certificate of Excmpdon.you Amid
become subject to me Workers Comis madon provisions of the[AW,Code.you mus '
.JO fanawith comply with each pavivans or mis permit me]W domed mvnkcd.
zCONSTRUCTION LENDING AGENCY
E4 y tide work fwwyl�tlustlust thele is a conwunion leading agency for the performance,of
pennil ts Wood!(Sac.l(19'T,Civ.C.)
Lenders Name
TD' IM Lenders Address
fJ Q 1 c reify that I hue read that application and slam that the shove information is
tL E eomeeL I agree to comply with all city aM county ordinance and SNm laws slating w
C) Wilding construction,and hereby authorise lepaAoutodws of this city an enter upon the
aWva-mcnuand Propertycosts
foe inspection puryaes
y (We)agree m save,indemnify and keep harmless dm City of Cupertino against
rat in
of me oatsandof this .which may is soy way attvw against said City
V z A APPLICANT
NDER TAN of this permit.
r-1 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
HAZARDOUS
Signawrt of AppliuDam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WIII that applicant err funi Wilding atnole w ludk harmdons material .
u deRndefinedbCupertinoMM
e Cupertino Code.e.Chapter 9.13,and the Halm and Safety
Cade,section 39533(.)1 All roofs shall be inspected prior to any roofing material being installed.
❑Yat ON.
If a roof is installed without first obtainingan inspection,I agree to remove
Will the arccmtwfuts a Wilding by ft BayAcyulpmcamilyMceawhich P g
haLAaw lir Csarllinwts a dCGMd IIY dm Bay A.Air Gamily Man{gClnel all new materials for inspection.
DlatrlCl'/
❑Ye ONa
1 basicandthe c,S=6us materials5533le en3under Chapmrd.99oftWWilding
nia Heaith&Sntlyhow a euot.5t it ismy uW2953d.1 indetrythe . Wilding
dos not currently haw;a mems mu it is'my ce"i deme entry the..Wt.f the
requirements which muOWmet Lu lCmtifram of 0.'cupvuy.
,�- Signature of Applicant Date
Owmrm..mmbsdagcnl Data All roof coverings to be Class'no'or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN I . . . . . . . : 35926022 . 00
DATE ISSUED. . . . . . .. : 10/20/2008
RECEIPT # . . . . . . . . . : BS000006403
REFERENCE ID # . . . : 08100128
SITE ADDRESS . . . . . : 7507 DE LA FARGE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JERRY CHANG
ADDRESS . . . . . . . . . . : 7507 DE LA FARGE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4360
RECEIVED FROM . . . . : KHANH CONG TRAN
CONTRACTOR . . . . . . . : KHANH TRAN LIC # 26971
COMPANY . . . . . . . . . . : K H ROOFING
ADDRESS . . . . . . . . . . : 1556 LITTLE ORCHARD ST.
CITY/STATE/ZIP . . . : SAN JOSE, CA 95110
TELEPHONE . . . . . . . . : (408) 293-2754
• 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
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1REROOFRES SQ FEET 27 . 00 351 . 00 0 . 00 351 . 00 0 . 00
TOTAL PERMIT 462 . 00 0 . 00 462 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT -CARD 462 . 00 MC
---------------
TOTAL RECEIPT 462 . 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 "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::— �r TP,vr 1i
Job Site Address: �Q 7 D
Roofing Company Name:
Applicant's Signature: / Date: /(7 _2 p _ Cj jr—
• Greg Casteel
Building Official
Revised 07/30/08
DO/ a
CITY OF CUPERTINO
p` REROOF
CITY OF
�UPERTINO PERMIT APPLICATION
APN # Date:
Building Address: 7 5- y r 9e d
/ GwP�T.�v
Owner's Name: / Phone #:
rr 2t<v
Contractor: / Phone
Fax#:
Cupertino Business License #: O - / Contractor License
Oc
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify) M )25R �6
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: 65zq aec/,G 2,7- 1 0" S�
� v
Ye roor�� Ur/�- - M�.�,e� L���;&,
027
Residential 14 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: e 00
to goo
I Have Read, Understand and Wil Comply with Cupertino's Tear-Off Policy:
0
Signature
Revised 6/16/08
CITY OF CUPERTINO
aclof
REROOF
CUEIINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLR00F
/ 1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
IBUSLIC Business License B
Revised 6/16/08
•