06080213 (4) CITY OF CUPERTINO + " ''#�
dUILDINC bIVISION PERMIT CONTRACT(IR INEORMA.TION
BUILDING ADDRESS: WESTSHORE ROOFING COMPANY PERMIT NO.06080213
10060 PHAR LAP DR
OW NER'S NAME: PERMIT IRSUE DATE
DAVID HWANG 2814 AIELLO DR 08/25/2006
TARC
E: SANITARY NO. CONTROL NO.
(408) 694-0060
ITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
ipLICENSED CONTRACPOWS DECLARATION Job Description
i uI Wmby A fro Nal 1 am licensed underprovisions of Chapter 9(commchming
Zection 70(10).(Diviam 3ofthc Business and Pmfs ons Codc,and my liccna i,
ro=Anderfeet 7g?2.2,( INSTALL GERARD STEEL TILE WITH FOIL BACK INSULA
Lima
— - Contractor wo�t-zMau,yP CLASS B ROOF .
i a
ARCHITECTS DECLARATION
1unticrsmnJ my plans shall Iseused as public records
�7�s
�npf Licensed Pmfeuiensl 0
OWNER-BUILDER DECLARATION !.0/ <
1.g 7 1 k.hy alum Not 1 am C.,,from the CanwMars Lkense Law for tW '_
.p O fallowing reason.Sectionres 90l¢
31st Business and Porfr_csiuu Code:Any city or county tl/00
which requia permit to clmum a"i n improve demolish,or repair any structure
3iyprior w its issuana.alxu mquira thcapplicam for such permit m fhm aligned statement
< that he is licensed Its...,to she Provisions Of the Controrle"'Leence law(ChaPmr 9 Sq.Ft.Floor Area Valu$16 6 4 5
i b-O
- (commencing with Section 7000)ofDivision 7 of the Business and Profmiom Code)or
$ that he is exempt n6ercfrom and the basis for the alleged esemptan.Any violatian of
Section 7071.5 by any applic on for a pewit subjects the applicant to a civil penalty of APN Number Occupancy Type
not mom man five hundred dollars(5500). 32618038 . 00
❑1,ss owxr ortW property,or my employees wire wages ss tm'vsele compenution,
will do tmw.&.and me rwcture is non intended or offered forsam(Sec.7014.Businces
and Pru(emens Cade:The Contractor's License License law Clem,ImI apply o an..of Required Inspections
property who builds serimpmva thereon,and who docssuchworkh(m elfor through his
awn employers,provided mat such improvements art not intended oroffeted forsale.If.
however.me Wilding of Wis....,is sold within one year of curepled.b.the owocr-
builder will have the Written of proving that Ie did not Wild or improve for purpose of
sale.).
O 1,as Owner of Be property,am exclusively contracting with licensed contractors to
coawct the project(Sec.7014,Business and Profen mos Codn)The Contractor's Li.
cease Law does not apply to an owner of property who Wilds or improv.Usamon.and
who contracts for such pink=wish a eontrxmr(s)licensed pursuant to the Contractors
License law.
0 1 am exempt under see ,B k P C for this reason
Owner Dao
WORKER'S COMPENSATION DECLARATION
1 hereby Nw under penalty of perjury ore or the following declarations: -
I have and will maintain a CcrtiBeam of Consent to self-insure for Werkars Compen-
Aid.n,ss provided for by Section 3700 of the lobar Code.far the performance of to
work for which this permit is issued.
M 1 have and will maintain Workers Compensation Insurance.u required by Section
37W of the LaWr Code,for no,perlarmana Orme won for which this permit Is issues. '
My W.,imeas C.Anpeman��We.artier and Policy number am: I
Cartier. S(Z.tP (KO'A - Policy No.:ILy'I0—
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE -
(Thu section need out W completed if the Permit H(moot Wadteddollars(SIM)
less.)
1 centifv that in the performance of the work for which this pewit A issued,1 shall not .
...ploy inyperaon in any maoncero u as become subject to the Workers'Compensation
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Ccnifies%of Exemption.you should
become subject to the Workers Compensation provisions of tm Labor Code,you must
Oforthwith comply with such provisions o mu Pewit shall be deemed revaked.
z� CONSTRUCTION LENDING AGENCY
P^ Ileeby affirm that tmre is a cia.inn leading Agency for the lerrowaue or
fY > f work for which this pewit u issued(See 3097.civ.C.)
Sn^- Lender,Name .
z lander,Address
U CD 1 certify that 1 have read this application sold sato mat the above informaiun is
L, E-^ correct I agree to comply with all city and County ordinances and sum laws mlating to
Q U building Communion,and hereby AuthorizetCPmaenlahea of this city to enter upnn the
r C[7 ahovcmcmionmd property for inspection whichpurposes,
(•" CL, (We)agree to ave,indemnify and Map harmless the City of Cupmrtin0 against
p) liabilities,jnce or the&=find expenses which they in any way eccrvc against said City
()z A APPLICANT
of thegranting of this pewit
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date •2 1F'—G�
SOURCE REGULATIONS.
I�, . 15-06V� Z� Re-roofs ------_
Signature of ApplicanUConuactor 1 Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding occupanmore or handle hazardous material
as defined by the Cupertino Municipal Case,Chapter 9.12.and tW Health and Safety
Cale.Section 255320)7
❑Ya tenth All roofs shall be inspected prior to any roofing material being installed.
Will the.Applicant Wilding oa. If a roof is installed without first obtaining an inspection,I agree to remove
Pp E pare use equipment hl dMana whish g
emit h.rardnns air contaminants u detinet by the Bay Arca Air Quality Management all new materials for inspection.
Distric4 .-,.(
❑Ya �2
I have real the Isommmsmaucrial,requimmcnts under Chvperii.95 eft.Califon, J�� �
nice Halm h Safety Colo,Sel.at,25505,25533 and 25534.1 undersand thsirthe Wilding 'It 1111 j b
does not curm remly have a tenant,that in is my mansdaihility to nouly me occupant Of the h•k=_
mqu�it�m''c9'IU, th It uv be met pnaroissuanmOra CeftficaeofOccupanry. SI atureofApplicant Date
IC.or./Wim Dow All roof coverings to be Class"B"or better
Ow r o authomcd agcm Dam'
Community Development
10300 Torte Avenue
Cupertino CA 95014
Telephone(408)777-3228
ZOO
CITY OF Fax(408)777-3333
gJUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
trjo4�0 Plea ria P d 0 6a (� a '2-(Z
OWNER'S NAME: \,& yAcL!n PHONE # 4,0$ 2--5�5--yRaq
GENERAL CONTRACTORper(} FAX #
I am not using any subcontractors: qyy
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
Owner/Contractor Signature Date
CITY OF CUPERTINO
�m 2 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 32618038 . 00
DATE ISSUED. . . . . . . : 08/25/2006
RECEIPT # . . . . . . . . . 35769
REFERENCE ID # . . . : 06080213
SITE ADDRESS . . . . . : 10060 PHAR LAP DR
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : DAVID HWANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . .
RECEIVED FROM . . . . : WESTSHORE ROOFING
CONTRACTOR . . . . . . . : FOWLER, PAUL LIC # 21417
COMPANY . . . . . . . . . . : WESTSHORE ROOFING COMPANY
ADDRESS . . . . . . . . . . : 2814 AIELLO DR
CITY/STATE/ZIP . . . : SAN JOSE, _CA 95111
TELEPHONE (408) 694-0060
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- - -------- ------------ - ---------- --------- - --- - -- ---- -- -- - - ---- ----- -----
BPERMFEE VALUATION 16 , 000 . 00 234 . 36 0 . 00 234 . 36 0 . 00
BSEISMICRE VALUATION 16, 000 . 00 1 . 60 0 . 00 1 . 60 0 . 00
---------- ---------- ---------- -------- --
TOTAL PERMIT 235 . 96 0 . 00 235 . 96 0 . 00
•
' p
CITY OF CUPERTINO u��U X213
UxQm REROOF
• CUPEF�TINO PERMIT APPLICATION FORM
APN# 3 lg -p�g Date:
46
Building Address: 0` 00/o P ✓�� , ,/
Owner's Name: ^ G� Phone#:
u Z Z a
Contractor: J� License#: 7 n Z�(
�, G�
Contact: PaA�,t Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ElAsphalt Shingles
VWood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ P/ -
Other(Specify) ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O. Report#
OV To be Removed . I O ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: o - �uJG� pvLi SI �i�
I Vk c� ck � G �C P
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: 1
6-6 i Type of Construction: Occupancy group:
� �>✓- foo SCK
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
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.
Homeowners Name:
Job Site Address:
Roofing Company Name: 1 '�A e&&�Qk 111�0�1�2 l V�C
Applicant's Signature: Date:
Greg Casteel •
Building Official
Revised 11/2/04