05080024 CITY OF CUPERTINO ;e '-`� '�` "•'
BUILDING DIVISION PERMIT CONTRACTORINFORMAT,ION
BUILDING ADDRESS: SABER ROOFING INC PERMIT No.05080024
1034
OWNER'S NAME: PERMIT ISSUE DATE
ALBERT ONG 2995 WOODSID - 08/03/2005
NE: SANITARY NO, CONTROL NO.
(650) 368-9220
ARCHDEC rENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
+O o LICENSED CONTRACTOR'S DECLARATION Job Description
wi I hereby affirm that 1 am fOc Bu under provisoes of Chapter 9(commencing P
n<� with Section 7IXN))of Division 3ofthc Business Said Professions Codc,and my Elmore is ]y-srprm
AK Li�l�c�ogvua^diff �g . e�� ]g!{ REROOF W/3 PLY MODIFIED BTTTUMAN 1FlI
-Fp Dale D- Convw7ar fJ Wy '1 '1"
ARCHITECTS DECLAR v W /fuaYa E//f77f`✓IIl//1
I undcrwnd my plans shall W mud u public records f�
Spy Liccesed Pmfessirnal
5 OWNER-BUILDER DECLARATION ,nn5
00 1 hereby remo .(Sere that 1exempt from tan Contractor's Co :Any c Lew for the
O O following mason.(Section 7031.5.Business and Pm.demolish.
em m Code:Any city or aced.
121
$on which ratio.ista a permit re quires On alley,impmw,h Per i i ri repair any auument (/ y ri i! �I ai I](y, 0 -85000
_iy pnorwi.issuance.a4u requires the applicant for such Permit in filcasigned scawmem v a
EEm< that he u licensed pursuant to the provisions of lW Contractors License law(chariot 9 Sq.Ft. Floor Area �� , Jf%Ip' Valuation
yFD (commencing with Section 7000)of Division 3 of Lite Business and Professions Code)or flY
y that he i exempt therefrom and the basis for the alleged exemption.Any violation of �'..✓
Section 7031.5 by airy applicant fora permit Subic..the applicant to a civil penalty ofMIN Ot.Gn araC
am more than Fixe hummr d dollars(ssDB). Occupancy Type
❑I,as owner ofthe property,in my employees with wagesas their sole compSmadon,
will On the work and the swcture u not intended m anered Tarsale(See.7014,Business
and Prafeuiav Cade:The Convector.License law does ret apply to an owner of Required Inspections
property who Wildaorimpmvu thereon,and who doessuch work himselforthrough his
own employees,provided that such improvements art notinlended or offered for tile.If.
however,the building ar improwmem is sold within ane year of completion,the owner.
builder will novo to Writer,of previa,Wt he did ret Wild ar improve far purpose of
Sale.).
❑I,as Owner of the prepenY,am exclusively comwcting with licensed conoutors to
construct Ne project(Sec.7014.Business and Professions Code:)The Common's Li.
come law does not apply to an owner of property who Wilds or improvss thereon,and
who contracts for such pmjeess with a convaemr(s)lieer.ed pursuant to the Committers
License La
I am exempt ander Sec. ,B&PCfar Odsmason
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby Orion under penalty of perjury^rte of the following declarations: .
1 hew and will maintain a Cenifiate of Cement w wif.houte for Worker'sCompem
cation,as pmvuled for by Section 3700 of the Labor Code.for the performance of the
work for which this permit is issued.
❑1 have and will maintain Workers Compensation Insurance.as mquined by Sccuon
3700 of the labor Cock.far the ref.m uce of Ne work for which this permit is tuned.
My Workers Compenmtiun Inwrance carrier and Policy number am:
Carrier. 5 PoHty No.: i�fa/b8n7-naps
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
cmisscctian need not beca^pkmd lithe permit is for one hearted dollars($100)
or less.)
1 unify Nat in the perfammnec of the work for which this Permit is wand.I shall not
employ any parent in any manner u as w become subject to the Wodc s,Compemauan
Laws of California.Can,
Applicant
NOTICE TO APPLICANT:If,alley making HIS CcniEare of Exemption,you should
heLemc Subic"in Use Wohcr's Compcnssuon provisions of the labor Code.you mush
.,O farthwith comply with was Pmvivarm it or Ni permshall be deemed revoked.
CONSTRUCTION LENDING AGENCY
F Ihereby affirm Nat there is construction lending agency for the performance of
Cv the work fur which Unix permit i iuucd(Sec.3097,Ci,C.)
ALenders Name
z Lenders Address
V Q I codify that 1 have read thin application and Sale Nat on show hopmensuun I.
IL E covca I agree w comply with all city and county Ordinances and scale laws mixing w
O U Wildingcm.muction,and hereby authority mpresen.tivtr of this city w coax upon to
III shove-mcnuoned property for barracuda purposes.
E'�"„ OL (Wo)agree to Saw,indemnify and Fecp harmless the City of Cupenhw against
y liabilities,judgmcn..cmu and captious which may in any way accwc agaiel=it City
L) Z in consequence of Ne geramr,of this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date ,�-o '�
SOURC 'x�TI,�NS.
L��' `— 3'OS Re-roofs �' t
Shgn pplhca^UConm"an" Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant ur future building occupant score ar handle mrrardaus ime rlal
az definer by the Cupertino Municipal Code.Charter 9.I2,and to Health and Safety
eek.
So
us3z(a)7 All roofs shall be inspected prior to any roofing material being installed.
r-1 ye, 'C:INa
�C If a roof is installed without first obtainingan inspection,I agree to remove
Will the applicant or future building arupont use equipment or devices which P
I(hamodom air cencaminants ss dcrined by tm Bay Area Air Quality Management all new materials for inspection.
wicti
❑Yes ANO
I have mail the h cardous materials requirements under Charter 6.95 of the Califon
ilia Health&SafnyCOtle,Satires 255a5.25533 and 75534.IUMcrvmW thaz Rise Wilding
U.ret currently h ant,Nu it i my responsibility w notify the eccurent or the
mgquite t prior w issrwcc of a C.rtEcam of Occupancy. Signature Of Applicant Date
owner ervedasem D,le All roof coverings to be Class"B"or better
x Community Development
10300 Torre Avenue
.' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building Department
JOB ADDRESS:[ PERMIT #
e.nV0,rLwAc-? S-DS-®w�ti
OWNER'S NAME: 4 es+ 00 PHONE # 6-50
GENERAL CONTRACTOR ,Topr Q FAX #
I am not using any subcontractors: ,�
Signature Date
Please check applicable subcontractors and complete the followinginformation
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 c ,N c y
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
Community Development Department
((t. Building Division
/ City of Cupertino
��VVV 10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408) 777-3333
UPEI�TINO
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 LC.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with theabove stated policy on re-roofing.
Homeowner's Name: W" e_r� 6Y-N q
Job Site Address: J Q.3 q 5 MI ey\Y\U(—+ "t_w
Roofing Company Name: c�C��G 9P11� h q n r
Applicant's Signature: Date:
Greg Casteel
Building Official
Revised 11/2/04
Printed an Recycled Paper
1 CITY OF CUPERTINO
REROOF osv
CUPEkTINO PERMIT APPLICATION FORM
APN # J 7- ZY- Date:
- rte
Build*n s:
Own ' Nae: Phoxe #:
( n -
CRono c or: Li
nG
Con r Cup rtigp�ueaLicense #:'
Type of Roof Covering: (J�
Existing: ,Pr000sed:
)< Built-Up Roof `,C� Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles 14,
❑ Wood Shakes + ❑ Wood Shakes y�
❑ Wood Shingles El Wood Shingles
❑ Other(Specify) 4' Other(Specify) jYtS.fl
Number of existing covering 1 '❑ Provide I.C.B.O.Repoli
)Er To be Rerr1oved ❑ Provide Mfgr.Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑
J b Description: I�
rc ova ,,l rave a P)LI Mi, ln
Residential 14 ommerdia „0
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: Type of Construct' Occupancy group:
Qty. if
A licable Fee ID Fee Descri ption Fee Group
BPERMFEE Bld Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
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