06090242 CITY OF CUPERTINO 11;7ar 7x:°" 11 a7El z-""re ."a' '% .dID3?zAe l
'BUILDING DIVISION PERMIT CC1IVTRACTO'RR�I,NNF,0RMATION
BUILDING ADDRESS: CD FING PERMIT N0.06090242
20252 CARTWRIGHT WY
OWNER'S NAME: PERMIT ISSUE DATE
JAMALK 383 HUCKLEBERRY DR 09/26/2006
NE: SANITARY NO. CONTROL NO.
(408) 898-6605
ARCHrIEC(ENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
�oa LICENSED CONTRACTOR'S DECLARATION Job Description
idF 1 hereby afllrm that I am licensed under provisions of Chapter 9(commencing
with Section TOM)of Db ace 3 of the Businm and Prafesdom Code,and license is
ii mfullresreeandefr � S;"e y 4 7j REROOF- TEAR OFF WOOD SHAKES, PUT OSB, PUT TL
'S^ Li"nseelas. "�" ip see'" PRESIDENTIAL. 25 SQUARES CLASS A
iDam Contractor
g ARCHITECTS DECLARATION
1 < 1 undersand my plans shall Ise used as public roods
u
e u, Licensed Professional
s0� OWNER-asompt RDE Ce,Communes
I hereby affirm
that 1 1. exempt sure the ConlrnctAny
Law for the
p O following reason.(Section 703 1.5,Business and Profu�inm CommCaAny city or county
f$ which hopo o a Permit to construct,alter.Improve.demoliah,or repair any structure
Prior mitse is censeax,ahan,to the lM applicant o for such permit mNcum LawdsuNmcm
<
that toitsecnsedp.altom ui.tbehe vpplic of NrCchpermitunMeuclgnad!stn mat Sq.Ft. Floor Area Valuat 0
p5 9 ter 9
(commencing with Section 7M0)of Division 3 of me Business and Profcaaione Code)or
` Nat he u exempt Ihcmfrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any appllesnt rest a permit subjects the appilunt m a civil penally of pp N 6 Occupancy ZYP
nut more than an bwdmd deslwa(ssoM). 316 4 2 f� ei O O ecu ane e
0 I,as owner of the property,a my employees with wages as their was compensation,
will cio the work and the uumum is not intended mortared fee ask(Sm.70".Busna•• Required Inspections
Nd Profession Code:Too,Cmawmes License Law does Wt apply m an owner of q P
property who builds or i m proven merman,and who does such wait himself or through his
own employees.provided that such Improvements art not loaded uroRered(oral,IL
however,the Wilding or improwmcot Is old within one year of cmnpletion,me owner-
builder will haw the burden of proving that he did not buim or improv for purpose of
build.
1.as caner of the pmpcny,am exclusively contracting with lima sed commcoors to
concoct the pmjm(See.7044.Business and Praressi"o Code:)The C lummes U- O
come Law docs not apply to an owner of property who builds or improves games,and, /
who contracts for such Pmjeeu with a contracmr(O licensed Forecast m the Contractor's (0
Limme,U,
❑l am escmpt under See ,B k P C for this mason
Owner Data
WORKERS COMPENSATION DECLARATION
1 hereby afRrm under peaty of perjury one of the following deelarnimor
❑Iha.euM will mainainscmtinoaof Camentmulf-imumfawoh SComPen-
.hen,as provided for by Section 3700 of the Labor Cade,for the Performance of the
work for which this permit is issued.
1 ban and will maintain Wortrr's Compensation Insurance,as rcqubed by Section
3700 of the Labor Cede,for the performance of the work for which this permit is issued.
My Worker's Compensation Insurance artier and Policy number are:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thu ceetice need ren be compkmd U the permit Is(mono hundred dollar(SIM)
or less)
I certify that in the per(ornance of the work for which this per olt Is Issued.I shall nm
employany penin in anyman esu m been cosi Ne Warted'Canpmeatiesn
Laws or Califomia.Dao
Applicant lM
NOTICE TO APPUC NL`IL after making thisCcalf1cau oo Exem
become subject to the Wmws Compensation provisions of the Lala Cede,you muse
.J Q roMwith comply with such Provisions a this permit shall be deemed remkcd.
.Zi► CONSTRUCTION LENDING AGENCY
Iherehy alRrm that them u a constriction lending agency for the performance of
lY� the work far which this permit is Wood(Sec.3097,Civ.C.)
I[7 Lendces Name
2 Lander's Address
(,7 0 I ttnify that 1 ban read this application and sum that the above information is
U, P correct 1 agree to Comply with all city and county ordinances and sum laws relating to
DU building concoction.and hereby authorin representatives of this city to enter upon sew
r t7d ahove.mcntiuned pnm,ty for inspection purposes.
gy
(Wo)agree to an.indemnify and keep harmlm the City of Cupertino against
rF.Nl liabilities,judgments,costs and expenses which may in any way accrue against old City
U z in consequence of the grating of this permit
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
CdI R Lt ( F -1\)O N r f L9 41 Re-roofs
Sigmmm of AppliamContranm I Dole
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the spplicam or future Wilding Gemput1101C ahandlc hazardous material
as dcOned by the Cupertino Municipal Code.Chapter 9.13,and Ile Had,and Safety
Code,Section 27532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes 4Nu
Will me applicant a future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hanorms air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection,
District?
❑Yes .(JjNu
I have mW the hazardous materials requirement,under Chapter 6.95 of the Califor.
nia Health e:SafctyCode,Suctias 2150.23533 and 25534.1 urdersund that if the building
does mt currently have a maul dent it u my responsibility to notify the muput of de
requirements hhplutrxmctpriorcumnommoracmdemamoramu("�cr. Signature of Applicant Date
c` ^^ FIZ
Owner or authorized agem a
Community Development
10300 Torre Avenue
aClOF
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408)777-3333
SFUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
e1 J.2 CA F— —V. T �x fry 6 C) % oc t 4 z
OWNER'S NAME: nn R 1< PHONE # 0 2S — d'% 8 — b 6 0
GENERAL CONTRACTOR ft l_ 'c ---..b u o N FAX #
I am not using any subcontractors: 1.4 q-16 r�
Signature DAte
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS 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
• � � D Q oY O
Owner/Contractor Signature Date
CITY OF CUPERTINO
•em 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : .31642012 . 00
DATE ISSUED. . . . . . . : 09/26/2006
RECEIPT # • • . . . . . . . : 36205
REFERENCE ID # . . . : 06090242
SITE ADDRESS . . . . . : 20252 CARTWRIGHT WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : JAMALK
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : LUONG NGUYEN
CONTRACTOR . . . . . . . : CHARLIE DUONG LIC # 28245
COMPANY . . . . . . . . . . : CD ROOFING
ADDRESS . . . . . . . . . . : 383 HUCKLEBERRY DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE . . . . . . . . : (408) 898-6605
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------ ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 8, 000 . 00 147 . 96 0 . 00 147 . 96 0 . 00
BSEISMICRE VALUATION 8, 000 . 00 0 . 80 0 . 00 0 . 80 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT : 148 . 76 0 . 00 148 . 76 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 148 . 76 VISA
TOTAL RECEIPT 148 . 76
•
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-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 comply with the above stated policy on re-roofing.
Homeowner's Name: T A M d4 l_ 1�-,
Job Site Address: I n of c�A Ty fL i r, H T w lck
Roofing Company Name: b R,,�o o ,�r i N fr
Applicant's Signature: C ry t/2,Date: It 1�4 / 0
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
• - REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
Building Address:
.;_ �- of GFl r--r v ?-1 G-+r T
Owner's Name: Phone#:
7-AMAL1L 4 0 /8-7 r
Contractor: b License#:
C+1-A F (,I U ON 4- 8' J o£ ' 9
Contact: Cupertino Business License #:
C,4-1 A F--L_ l — 2> v o nJ l'
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
I- Wood Shakes ❑ Wood Shakes
❑ Wood Shingles -0 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 Comply With Cu ertino's Tear Off Policy:
Job Description: auT as (5
-r 'rAF- Or' F 1coo_D S}I-Ak — S pUT —fL -PP—cS J tV llft ?
Residential [a Commercial ❑ _2�SQ t ciao ik
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions:
Cost of Project: Type of Construction: Occupancy group:
7Joo of Kr Pao i—
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•