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08070217 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT CON:TRAGTOR INFOT3MATI®,N BUJL NG. ODRESS: PERMI I'NO. 6.� F. ESTATES DR ALL SEASONS ROOFING SERVICEq 08070217 OWNER'S NAME: FERMrt ISSUE DATE KIN WONG 1720 SMITH AVE 07/30/2008 NE: SANITARY NO. CONTROL NO. ARCHIT fEHGINEER: BUILDING PERMITINFO RE-RF RMV 2LYRS EXTNG -BLDG ELECT PLUMB MUCH sop LICENSED CONTRACTOR'S DECLARATION I hereby alRrm that l and licensed under pmvisiooa of chapter 9(rommcrcint ^--__ . ,.__.._ ___.__ Iob.Descgiption with section 10(10)of Division 3 of die Issuances teal Professions Cade,and my license is ^_ a. infunfmceaMeffcc ?Ssoq r License CI _ Lk.Y Data CobcacNr vM tlARCHITECT'S DECLARATION 1 understood my P tl�i lum shall banned espublic rtcan& 6 g a G Licensed Pmfessiab,l 3 OWNER-BUILDER DECLARATION I hereby affirm Nu I am exempt from the Comocmrs License law roc the Enc c following muon.(Section 10313,Business and Profusions Coda:Any city dr county 5$tea which mqumet a permit to commeL atm,.impame,dem^ILN,m repair any struma Prior N its issuance.also requires the applicant for such permit or rile a signal sommenn Net he is Hamad puruabt to the prnvidons of the Contracmrs L3anm Law(Chgptm9 Sq.Ft. Floor Area Valuation ylt-$ (comm encingwiNScction1000)of Divuion3ofthe Busineuand Pmfesiam Code)or dust he u esempt 0erafmm and the basis fm the alleged exemption.Any violation of Seetian 1031.7 byany applicant fm a Permit subjccts use applicant to a civil Penalty of APN Number Occupancy Type nm mom than five hundred milms(gust). P Y YP L u owner of six Prnpmty,a my employcas with wages u da'vsale rompev,tiom will also Newodt,and the structure Y act Intended maRtmd foraale(Sec.1046,Bushtel\ and Predominates Coda:The Contractus Li.Law does MI apply to an antler of Required Inspections property who builds orimpmvea tiouncen,and who limssuchworkhimselfor through his own emplayeu,prcNmd that such improvements sure,and intended a desed fmsals.If. however,the building or improvement Is sold within ore yes of completion.the awrer- bailder will nave the WNan of proving Nn le did act ladle or barrow fm purpo¢of old.). ❑1,u owner of the prepay,am nulusively contracting with licensed ronsanan to construct the project(Sec.1014,Business and Professions Cider)The Contrcbrs U. cause,Law does not apply ban owner of property who Wilds or marmoset Hereon.and. who contracts for such projects with a com ssuou(3)Hamed purwant in the Consactdrs I leered low. Q l ver emmp,under See ,B k PC fm Nis¢van Owner Date WORKER'S COMPENSATION DECLARATION 1 busby a1Brm under Penalty of Perjury and,of the following declarations: I have and will maintain a Cardf neat Consent to self-insure fm Wmlm's Compere cation,as Provided far by section 3100 of the labor Code,fm the performams of the wart for which this Pc unit is heated. 1 have and will maintain Workers Compensation fico ant.,as Imputed by Section 310odithe Labar Code.fm the performanadfthe work for which this Permit Is issued. ' My Worker,s..QCCom�Pemc�aa�tion Insurance anicr and Pa1iq num r n �7 Carrier. s�_�.a l�Polity Nd.: 7- -CX7O� /L '� O / CERTIFICATE OF&EMP ION MOM WORKERS' COMPENSATION INSURANCE (Thu secdon recd mat co completed if do pcmnit is Jordan hundred dollars($100) or est.) I cutify that in Nc Performance of the work fm which this Permit is issued.I me]not employ mypermn in any manrerao u an became subject in the Warkme Compens,mn Laws of California.Data Appliant NOTICE TO APPLICANT:If,after making this Ccniticate of Exemption,you should become subject in the Worker's ComPmisktio s Provisions of the Labor Code,you mus .J z farNwith amply with such provisions m that Permit uMll Ne deemed revoked. Z CONSTRUCTION LENDING AGENCY [-+ I barely alim that them it a connotation lending agency for Ne ptrformarec of C' dm wort I.which thus Permit ts burned(St..3091,Civ,C.) 1 Q Leame,Name 7 z Lander,Add. V Q I ar ify and 1 have rad Us application W sac and the above Warmadon is U. ronccL 1 agree in comply with all city and county ordinsones,am sore laws relating no .C) building construction.and hereby authorial repmaenutim of Nis city m about upon an r a a Ww-mentimxd property For inspection Purposes (We)agree to saw,indemnify and keep harmlw the City of Cupertino against lF•l to Itabilialmjudgments,cats and expenses which may in any way¢nose against said City V Z in consequence of Ne graining of this parmil APPLICANT UNDEASTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date OURCE U NS S . p teaL)^ 1 Re-roofs Zi Signature of AppIbmUConsactor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the appliaat orfuture Wilding aoupantsmrt orNMk hevNonsmaourid - an mined by the Cupertino Municipal Code.Clarinet 9.13,ant the Health and Safety Code.semen 25532(a)1 / All roofs shall be inspected nor to an roofing material being r]Yen @sada P P Y 8 g installed. Wi1I Ne aPptiartorfuture Wilding occupant use equipmmtordevices which If a roof is installed without first obtaining an inspection,I agree to remove ha'rudons ar contaminants u defined by the Bay Area Air Quality Management all new materials for inspection. ct1 ❑Yrs 2� I have the haSectuts m onu unmrCTaPud.9y ese - d &Safety .Bmns255M33ralssslrsusndthnifdlebulklugoesrml<urenlly have a Sections dust 1,4myresponsibility adorallyshe W,ofac require be met pmrmisuanaafCenir,te. aapanaro3 Signatut of Applicant Date �� All roof coverings o be Class'W' OwnermauNomcd agent t Daou' g or better CITY OF CUPERTINO • 2 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36924017 . 00 DATE ISSUED. . . . . . . : 07/30/2008 RECEIPT # . . . . . . . . . : BS000005630 REFERENCE ID # . . . : 08070217 SITE ADDRESS . . . . . : 863 E ESTATES DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER KEN WONG ADDRESS . . . . . . . . . . : 863 E ESTATES DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4561 RECEIVED FROM . . . . : ALL SEASONS ROOFING CONTRACTOR . . . . . . . : GORSHTEIN, VLADISLAV LIC # 21035 COMPANY . . . . . . . . . . : ALL SEASONS ROOFING SERVICES ADDRESS 1720 SMITH AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 971-4455 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1.13SEISMICR VALUATION 7, 200 . 00 0 . 80 0 . 00 0 . 80 0 . 00 IREROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 364 . 80 0 . 00 364 . 80 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • CITY OF CUPERTINO LrK- REROOF •CUPEkTINO PERMIT APPLICATION APN # / 7 v U Date: Building Address: (03r.�e 5 fir. CA-) Owner's Name: Contractor: ooh s �S Phone #: (N,ov `'i—1 Fax #: °13Fs- `�1"1'1 Cupertino Business License #: `�� Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof -�K Asphalt Shingles ,2C Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) 13� Other (Specify) Number of existing coverings 0�— ❑ Provide I.C.B.O. Report # To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: C)-Q- 3oyC- C.OY-Ap \ .sB s,r.S�P�y Coo o.r.AAC,A-sec,. arm Residential Coinmercial Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the there are any restrictions: ❑ application or if applicable, include in plan set & the sheet index. Valuation: • 1 Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature CITY OF CUPERTINO REROOF COf •CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group IREROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Cormr nercial B 2� 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B IREROOFMRES Re-roofMulti-FamilyB 1MFDWLROOF • 1BSEISMICRE Seismic Residential B IBUSLIC Business License B 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 isir�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 1.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: Roofing Company Name: A\\\ Applicant's Signature7- AL,-_�� Date: • Greg Casteel Building Official Revised 11/2/04 r Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY Of Fax(408)777-3333 4UPER,TINO Building De artment JOB��3 ESS: � PERMIT�O � 6 2 ( 1 OWNER'S NAME: -e,.1 &Ounl PHONE #T-7 GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the followinginformation: 60 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 Owner/Contractor Signature Date