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07110033 CITY OF CUPERTINO - BUF.:DING DI7/ISION PERMIT ��T��.�+C?� �� < ;.: . ,:. ..:: ..: .. . BUILDING ADDRESS: PERMIT NO. 1168 SCOTLAND DR ALL SE��SONS ROUFING SERVICES 07110033 .VER'S NAME: PIItMTT ISSUE DATE MINGHUNG CHANG & DIANE LU 172 ST 'lITH AVE � 11/07/2007 PHONE: SANITARY NO. CONTROL NO. ARCHITECCBNGINEER: RMU 2 ] ,YRS EXSTNG ROOF Sc BLDG B E��G PER P U S MECH � O p LICENSED CON7RACPOR'S DECLARAT[ON " � � � � i� v U 1 hcrcby af(irm Nat I am liccnsed umler provisions oC Chaptcr 9(commcncing ^^ -- Job Description _ z� with SecGon 7000) of Diviswn of Ihc Busincss and Profc�ions C e, and my liccnsc is �� y in full foree and ell �l D ,� Z Licensc Cl�s Lic. M ' � p Dam Contractor ARCHI'IECI'S DECLARATION �� V i undcrstanJ my plans shall 6c uacd u pu6lic rccorda 4 L O y Liccnsed Rufcssional n y ; OWNER-BUILDER DECLARATION �<� 1 hcrcby alTirm that 1 am excmpt from thc Can�ractor's Liccnsc Law Cor �hc p O following icason. (Scction 7U31.5, Busincss and Profcuions Ca1c: Any city or caunty e m � which requiccs s permit to conswc4 �� provc, dcmolish, or �cpuir any swcwrc y Z y prior lo ils istuancc, also rcquims II� applican� for such permit to filc a signcd su�menl �_ � ihat he is licenxd pursuent ta thC pmvisions o[ ihe Conuactors License Caw (Chaptcr 9 � iq. Ft. Floor Area Valuation y F- �(commencing with Section 7000) M' Division 3 of �hc Busincss and Professions Codc) ur L �., �hat he is exempt the�cfrom and the basis for the allcgcd eumption. Any violation ot Sation 7031.5 by arry applicant (or a pertnit subjects ihe applicam w a civil penaity of APN Number Oeeupancy Type not more than five hundmd dollars (5500� ❑ i, u owxr of the property, or my employcn with wages as We'v solc compensauon, will do �he work, and ihe suucwee is not intendcd ar offered for salc (Sec. 7044, Business and Professions Code: 71u Conuactor's License Law docs no[ spply to an owner of Required Inspections propeny who 6uilda or improves thercan, and who daes such work himselt or through his own emptoyces, provided that such improvemenu are not in�ended or offeeed for sale. If, hawever, the building or imp�ovement is sold within one yar of completion, ihe owner- builda will have ihe burden of proving Ihat he did not build or improvc for puryase of sakJ. � I, as ow�r of the property, am racclusively conuuting wi�h licenxd rnnuactors a conswct the projea (Sec. 7044, Businas and Professions Code:) The Contractnr's Li- ccnse L�w docs not apply W an owner of propecty who builds or improves Iheieon, and , who comracts Cor such pmjec�s with a conuacwr(s) licensed purswnt to the Convactor's Litense Gw. ^ I am eaeempi under See. , B dc P C fw �his rcason ev Date WORKER'S COMPENSA770N DECLARATION I hercby aflitm under penalty of perjury �ne of Uu following declarations: ❑ i hsve and will mainuin a Cenificate of Conaent to self-insure for Workcr's Compen- sation, u providcd for by Secdon 3700 at the Labor Code, far the peAarmance ot �he work for which Nis pumit is issucd. ❑ I have and will maimain Wwker's Compensadan lnsurana, as required by Scction 3700 of thc labor Codc, Cor thc perform of �he worlc for which �his pecmit is issued ' My Worker's �om�� o lnsunnce cr and Policy num r : O �� — O � Cartier: S�W/ 'C.- �� Poliry No.: � CER7TFICATE OF EXEMPI'ION FROM WORKERS' COMPENSATIONINSURANCE . (Ihis sectian �ed not bc complctcd if the permit is for onc hundred dollars (S 100) or less.) , I cenify lhat in t6c performance of Ihc wark for which Ihis pertnit is istucd, 1 shall not empioy any person in any manncr so az to become subject to ihe Workcrs' Compensation Laws of Cali[omia Da�c Appiicam N07TCE T'O APPLICAM: If, af�cr making ihis CcrtiCca�e of FaccmpGon, you should becane subjcct w �hc Workcr's Compensation provisions of �hc Lalwr Codc, yau muu � O forthwiih comply wiih such provisions or this pecmit shall be deemed revoked. z �'" CONSTAUCI70N LENDING ACENCY .� [-r � 1 hefeby a!T'irm Uut thcre is a consuuction knding agcncy Cor thc perfarmanix u! Oi � ihe work fur which ihis pem�it is iuued (Stx. 3097, Civ. C.) ' W� Q L.endcls Namc , � z Lender's Address V 0 I certify �hat I have resd this application snd statc thu thc above infomiatiun is w�"" cortcn. I a`rce to comply with all city and county oNinances and sute laws relaung to � H building conswcdon, and hcrcby sutho�a representauvcs of this city a cn�cr upon ihc w above-mcntioncd property for inspecuon purposes I (Wc) agiee to save, indcmnify and harmless �e Ci�y of Cuperuno against �� lisbiliuu, judgmcnls, cosu and expenscs ' h may in any way sccrue against seid City V,'� in consequence of the granting oC Ihis iL "'� APPUCANT UNDERSTANDS A WILL COMPLY WITH ALL NON-POINT Issued by: Date �' 7 � SOURCE REGULATIONS. • Re-roofs �� Signaturc of ApplianUConuac�or Datc HAZARDOUS MATERIALS D[SCLOSURE Type of Rc of �U �he applicant or futw+e building occupant storc or handlc ha•rardous matcrial -fincd by the Cupertino Municipal Codc, Chaplcr 9.12, and thc Healih and SaCcty :. Scction 25532(a)? All roofs sl►all be inspected prior to any roofing material being installed. ❑Ya c�fNo " If a roof is installed without first obtaining an inspection, I agree to remove Will thc a�licant or fuwre building accupant usc equipmcnt or dcviccs which cmit harardous air coniaminan�s az dcfincd by thc Bay Area Air Qualily Managcmcm all new ma:erials for inspection. District? ❑ Ya �Nu 1 havc read the hva�dous maicrials requi nls undcr Chap�cr 6.95 of �Mc Glifor- nia HcaIN dc SatcryCode, Scc�iong 25505, Z55 25534.1 undcrs�ind �hu iC ihc building dacs not cumently havc a �cnan4 U�at it is responsiAiliry w notiCy Ux oceupant of ihe rcyuircmcn�t which musl bc met prio �� or a c�,;r�a� ar o��P�ry. S ignature o E Appl icant Date Owncrorauthori�edascni o „� All roof coverings to be Class ��8�� or better CITY OF CUPERTINO 2 ITEMS OF 8 PERMI7' RECEIPT OPER.ATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Bl}:: Lot: APN ... ...... 36�28005.00 DATE ISSUED.......: 11�07/2007 RECEIPT #.........: BSC00003183 REFERENCE ID # ...: 07]10033 SITE ADDRESS .....: 11E8 SCOTLAND DR SUBDIVISION ....... CITY .............. CUF'ERTINO IMPACT AREA ....... OWNER . . . .. . . . .. . . : MIrfGHLTNG CHANG & DIANE LU ADDRESS ..........: 11E8 SCOTLAND DR CITY/STATE/ZIP ...: CUF'ERTINO CA, 95014-5026 RECEIVED FROM ....: ALI� SEASONS ROOFING CONTRACTOR .......: GOF'.SHTEIN, VLADISLAV LIC # 21035 COMPANY ..........: ALI� SEASONS ROOFING SERVICES ADDRESS ..........: 17�0 SMITH AVE CITY/STATE/ZIP ...: SA1`f JOSE, CA 95112 TELEPHONE ........: (4(8)971-4455 FEE ID UNIT QUANTITY �,MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 8,700.00 158.76 0.00 158.76 0.00 BSEISMICRE VALUATION 8,700.00 0.90 0.00 0.90 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 159.66 0.00 159.66 0.00 ��ll( �� CITY OF C+UPERTINO ��'�` ��F C U PEi�T1iVt) PERMIT APPL ICATION FORM APN # Date: Qd�� r�G� Building Address: . � ` °� r 5CG C� f' � ��'t� � �'�.o � 1� \ Owner's Name: Phone #: �� '�� CV\Gt.�`' �\C�►.�� LV ��IC�� G I� � � c . Contractor: License #: � -� ' - . - " �1C)�l Cont ct: , Cupertino Business License #: � � �� , a «, -.�-- Type of Raof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof �� Asphalt Shingles � Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes 0 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. I Have Read, Understand and Will Com ly With Cu ertino's Tear Off Policy: Job Description: ��,��.v � �- � �� ' � `�� -'�`� i'c�� S-� �-. �. � �� :�- i�' � ., _ Residential Commercial ❑ Fire Zone: Yes ❑ No �'' Confumed with Planning Dept. if there are any restrictions: U Cost of Project: Type of Construc�\on: Occupancy group: � ��c� �c��;� �- l`� 3 Qty. if A licable Fee ID Fee Description Fee Grou BPERlV�EE Bldg Permit Fees BUILDING BENERGY I;nergy BUILDING � BSEISMICRE Seismic Fee Res BiJILD1NG BSEISMICOM ;>eismic Commercial BUILDING BPLANCHK l'lan Check Fee BUILDING BUSLIC ]3usiness License BUILDING Community Development Departrnent Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 Fax: (408) 777-3333 Building ]Department Subject: Re-roofing policy for the (:ity of Cupertino 1. Prior to permit issuance, you must agrE e to comply with 1997 UBC Standards and manufacturers specifications on re��roofing. 2. New roof coverings shall not be appliec� without first obtaining all inspection and written approval from the buildin€; inspector. A final inspection and approval shall be obtained from the bu.lding 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 apprcval. 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 matE�rial down to the sheathing, so a proper City inspection can be perfcrmed. 7. NOTE: If you call for a plywood nail irspection and the job is not ready, you will be charged a re-inspection fee c�f $176.18. The re-inspection fee must be paid before another inspection can �e scheduled. IMPORTANT 1. Flat roofs must have a m;n;mum 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 tlie job site at the time on inspection. I understand and will comply with the above ;;tated policy on re-roofing. Homeowner's Name: � � �, �'� v �C1 1 ;�y�- �'� � `� � t � i �� v Job Site Address: �� C �-� \ G� � � r� .0 ('�,� �.,�--.-� �� Roofing Company Name: � �, � ��G'��t; �> ` � j C � � Applicant's Signature: ` � Date: � p � Greg Casteel Building Official Revised 11/2/04 Community Development . � .K'F �` �' 10300 Torre Avenue -�'` `;� : Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 CUPEI�TINO Buildin De artment JOB ADDRESS: PERMIT # �� SC O�'e2 N� �� l C �� OWNER'S NAME: l�� N ��v " 2 ti iaiv� PHONE # ?� -- Y1'1' GENERAL CONTRACTO : S F� # 3�'" -- 7� I am not using any subcontractors: Si;;nature Date Please check a licable subcontractors and com �lete the followin information: SUBCONTRACTOR BUSIrTESS 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 , r _ �y_ Owner/Contractor Signature Date