08080123 (2) CITY OF CT PERTINO
Bu1LDINc•JIVI910' PERAUTCOO NTRACTOR INFORMATION
BUILDING ADDRESS: PERMIT NO.
1 -: E363 SHASTA SPRING CT LOS GATOS ROOFING 08080123
OWNER'S NAME: PERMIT 1411E DATE
JnMES TANG P 0 BOX 1726 08/18/2008
NE SANITARY NO. CONTROL NO.
ARCHITELTIENGINEER; BUILDING PERMIT INFO
RE-RF RMV EXTNG SHKRF INSTL aan EO PLUMB MECH
woo LICENSED CONTRACTOR'S DECLARATION lob Description
MI mostly afon Nat l we lived under proviaiom of Chapter 9(mmmendng
with Saaw70IB)wGiviaion 3 ofthe Business pd Profesvmu gpda,and my ties=is
M. afullfarts deQect.
3�3 Licen�Cntr
3 Dote GOmDECL
e ARCHITECTS DECLARA ON
y U 1 undersand my plms shall he need a public meninx
k ted Licenced professional
b OteIarBUILDER DECLARATION
COS thereby.(Tien m I em exempt from k Conuana oa Licenseyc Law o for dK
COO O fallowing wan.(Saito]m I3,Business m0 Rofaaitm Cade:Ana city or county
S$
which inquires a premie re cons da Jtec impmw,do permit
I err,sag any ummuml
pdmmsl Wusedpurmnthe to emovisios.1'car,far mchpennil ca filcense Law(Chapter
zp (thso.he commesiianeedpunumt7")ofDisicMa(theCon4inessmccnalaw(Chapur9 Sq.Ft.Floor Area Valuation
$ (commencingwithSagan 9md of must
l ni'the W Busal exception.
Prokeodon.Anynvi latdc)ion of
Nei k u exempt thmefrom and Ne bss4 for eek Jleged eumptian Any violation of
Sad.70313 by my ippllam fora permit subj cm the apPlicenl to•and penury of APN Number' Occupancy T
t mane than Eve hundred dollars(ism). Pane Y YPe
nor
0 1,u owner of the property,or my employes won m gen as met,win compensation,
will do the walk,and Ika rmuse 4 net intended oraRerod to,.1.(See.91116.Business
and Pmfesvom Cade:The Communes License Law does not apply to an comer of Required Inspections
property who builds m impmw mbereon,and who does such work himself of Nmugb his
awn employees provided that such improvemenu an not intended oroRcmd for tele.If.
however,the building orlmprowmant is mid within ane year of compliance,tee owner
builder will have use burden of proving that k did not build Or imprvae fa pumoee of
sale.).
. 0 1.as owner of tk Property.an=Wively contacting with licensed contractors m
construct the project(Sec.91316,Business and Profesvoas Cade)The Contractor's Li,
came law does not apply is not owner of property who builds or improves thereon,and,
who contacts for such projects with a comm m(s)licensed personal in the Contractors
Licenee law,
0 l an exempt under See ,B&PC fm Nis won
Owner Date
O
WORKERS COMPENSATION DECLARATION
I hereby affirm under petWty of perjury one often rW
te following declatne
1 have end will mainWn•Crstiftcelm of Cansem he self-ime re far Workeh Compere
mean,u provided for by Suction 3'100 of the tabor Code,fm the perfoenence of the
work far which this permit is issued.
❑1 have and will maintain Wall Compensation laureates,all mquimd by Section
3700af the labor Code.for On,performance of the work forwhich this Permit 4 iscued.
MY WoYarrier aM Poliry numW
Gorier. Poliry ry
CERTI GTEOP ONFROROM WOfIKERS
COMPENSATION
INSURANCE
(Thu methm need mtk completed I(Ik permit is i.e..hundred dellen($lee)
or las)
1 clrnfy eat in the performance of the work for which this permit Is Wood.l"I amt
employ my perms in my manner.as a become subject he the Workan'Conpenaatm
Laws Of Calif nouL Dau
Applicant
NOTICE TO APPLICANT:If,afar making this Ccnificam of Exemption,you should
become subject to the Workers Compensation pounboom of eek tabor Code,you mute
0 z forthwith comply with such provisions or this PermluhJl he dermal remand. -
zv'" CONSTRUCTION LENDING AGENCY
E14 I kmby aRlrm than dent U&couhmlimn lending agency for the performance of
.moi the work fm which the permit 4 Wad(Ser.3077,Civ.r—) '
aa Lender's Name
.7. z Undoes Address
rJ 0 1 certify that I haw mad this application and sum that use above inftmunon is
U, CPRCCL I agree he comply with JI city and aunty oNlpm u"and sae laws mladng to
0 building construction,and hereby mthonan mpmsmadm ofthis city to color upon the
W aW.-m ation d property for impeodon purposes
�,n gym (We)agree to am,indemnify and Imp harmuas as,City of Cupertino agdut 42
t„ fn Ilabilides.judgments.costs and eapmnu which may in my way acerae against said City
)z in cavepumce of the pressing of this permit.
AP LI hTf UNDERSTAN S AND WILL COMPLY WITH ALL ON-POINT Issued by: Date
50 REGULATION . \ r
/1J1j� �✓ Re-roofs
SitimiumufApplicamuCoomm, Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will de applicam or forum Wilding occupantnore m ou akle hasommo material
as de0nod by tete Cupertino Municipal Code.Chapter 9.11.and the Health and Safety
code.Section 155324)7 pJFo All roofs shall be inspected prior to any roofing material being installed.
it h2'❑Ya
Will the applicant or future building=open[um equipment or devicss which If a roof is installed without first obtaining an inspection,I agree to remove
us air conuminmu as defined by the Bay Area Air Quality Menagemenl all new materials for inspection.
DinrictT /
0Ya {]No
I haw mad the Installations;malorixl.requimmmu under Chapter 6.95 of the Cs if n-
.I.H.'4,k Safoyeode,Savor 25505.25533 and 25531.1 anlemeed the ifuns building
eeneY haw a t ane the u u tly rapomibility m muf the aeupant of tee U�yY/.0=r�CW
cnuwhichm b met riartoWuan O(aCcrdfKaO/O//].Lk�NmCy�7 Signature OfAppllCantp Date
w maam
oad]sd.gmt Date� - All roof coverings to be Class dT or better
CITY OF CUPERTINO
• 2 ITEMS OF 10 PERMIT RECEIPT OPERATOR:- patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36655028 . 00
DATE ISSUED. . . . . . . : 08/18/2008
RECEIPT # . . . . . . . . . : BS000005811
REFERENCE ID # . . . : 08080123
SITE ADDRESS . . . . . : 11863 SHASTA SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JAMES TANG
ADDRESS . . . . . . . . . . : 11863 SHASTA SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5107
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY . . . . . . . . . . : LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : P 0 BOX 1726
CITY/STATE/ZIP . . . : LOS GATOS, CA 95031
TELEPHONE . . . . . . . . : (408) 298-9399
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ----- ------
1.13SEISMICR VALUATION 6, 972 . 00 0 . 70 0 . 00 0 . 70 0 . 00
llREROOFRES SQ FEET 29 . 00 377 . 00 0 . 00 377 . 00 0 . 00
---- --------- ---------- ----------
TOTAL PERMIT 377 . 70 0 . 00 377 . 70 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
REROOF
•CUPERTINO PERMIT APPLICATION
APN#,3(vlo— S S—e2 rr O U Date:
Building 46 3
SCS r/✓1
Owner's Dame: Phone #:
JameSTJJ�.9 S/6) 2159-- 72,3 Z
Contractor: L p S CrQ.- �o S h 0o y I nq Phone #: yQ 8' 2 -,j3 .99
`J Fax#: YOF �Q - VL3
Cupertino Business License #: , / Contractor License #:
`7 .0 7 0
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles �9 Asphalt Shingles
�G Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) )� Other (Specify) TM �0
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ To be Removed a Provide Mfgr. Installation Specs.
Roof l_,j4 SS 1--�L�
Job Description: u
30 ���L�
Residential Commercial El
Fire Zone: Yes ❑ No PQ Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: b7 _22_
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Si re
CITY OF CUPERTINO
a]10F
REROOF
•CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
IREROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
c,;,2 F.
IREROOFRES Re-roof Residential B 1SFDWLR00F
' IBSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• Telephone: (408)777-3228
Fax: (408)7773333
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:
Job Site Address:
Roofing Company Name: S T
Applicant's Signature: T� 42Z-6 /, L Date: �Q
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torte Avenue
ry � Cupertino CA 95014
Telephone(408) 777-3228
CITY OF
�UPEI�TINO Fax(408) 777-3333
BuildingDe artment
JOB ADDRESS: ���(03 PERMIT #v 0 p a
0 � 3
_ OWNER'S NAME: _ zlo L1/J PHONE #
GENERAL CONT CTOR: S FAX #
I am not using any subcontractors:
Signature Dte-
Please check a22licable subcontractors and complete the followin 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
0 Co tractor Signature Date