05060098 (2) CITY OF CUPERTINOrw:l ? ce •a'g* ° "•` m ""`"°`
BUILDING DIVISION PERMIT �ACONTCTOR INT O1tMATTON:
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT ND05060098
98 RTANFORn PT.
OWNER'S NAME: PERMIT ISSUE DATE
SING SHEIN YANG 502 HORNING ST S/2009
ONE: SANITARY NO. CONTROL NO,
(408) 278-0330
ARCHITEC MNGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
u0c LICENSED CONTRACTOR'S DECLARATION Job Description
U 1 hereby affirm Nat I are licemad u under provisiaof Chapter 9(commencing
i wlN Salbn'!gp)of Divialan 3afNc 0ueinessW Prafcssiuiu Code,arW mylkense is
^< in fulllfauA j�ty� REROOF W/COMP.
? ? Licenlm9 Clue i(1�Lk.a
It Contra
,e As hall h use DECLARATION
y Ig 1 understand my plain shall be inti As public rtcords s,0
D IgU
k u Licensed!Professional
to
O OWNER-BUILDER DECLARATION
X I hereby alarm that 1 am exempt from the Conummes Ukenm Law for the
E O O follnwing mann.(Sectio"70313,Bulinus and Professions Cade:Any city or county
$ which requires a permit to construct almr.hnprow,demolish.or mpalr my structure
prior to its issuance,also requires the applicant formch permit to file a signed statement
F�F< that he is licensed pursuant t"Ne proviaiouof the Comenc's License U.(Chapter 9 Sq.Ft.Floor Area LValuation
S$ (commencing with Section 7000)of Division 3 ofthe Businessand Professions Code)or
3 dual he B exempt therefrom and the basis for that Alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects Ne applicant N a civil penalty of .51�Dfd'!13'tTberO 0 Occupancy
nm some Nan Bw hundred dollars(5500). Type
❑1.u owner of the pmpmy,a my employees withagesu dmir mk compemdm,
will do the worked the timcture Is notinianded orofferad forsale(Sec.7044.Budnhss Required Inspections
and Prom fessloCade:The Contrmme,Liam law don not apply m,n owner of q DS p
property who buildsor i mprowa Hereon,atm who does ouch work himse If or through his
own employees,provided that such Imprownscma re not Intended martamd fersale.if.
however,the building or Improwm mi la mid within ane Year of compledon.Na owner.
builde!will Mw the burden of proving that M did rot Mid or improve Ire purpose of
ask.).
❑1,As awns,a she Property.am exclusively contracting with licensed contractors Or
construct the Project(Sec.7044.Business and Professions Code:)The Coetracmrs Li.
cent Law docs not apply to an owner of property,who builds a hnprowa doemon,and,
who conmcta for such projects with a con racmr(O licensed pursuant in the Conmmars
License Law.
❑1 am exempt under Sec. .B k P C for Nis reason
Owner Dam
WORKERS COMPENSATION DECLARATION
1 hereby A fbm under pcwty of perjury ane of the following declatdons:
1 haw and will maintain a Certificate of Consent N w1f4bnum for Woftei Compen-
satlon.As provided for by Section 3700 of the labor Code,In,the performance of the
work for which this permit Is issued.
❑1 haw and will maintain Workers Compensation hearses,as required by Section
370D of she labor Code,for Ne performance of Ne work forwhich this permit i,Wad.
My Workers Co pemdon Inm—esmier and Policy number art:
CeM v Policy No:WeC67W6Y6ZL1,tX
CERTIFICATE 0•EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This aced..need not he can pieted if the launch is for ano hundred dnllan($100)
err les,.)
1 certify that in Ne performance of the work for which this permit Is issued.l Nall Not
employ any person in my mammr an as in become subject N Ne Warkem'Compemdon
laws of Cllif..IL Data
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become tubjcn to the Worker's Compcmtlon provision,of the labor Code,you must
.JO forthwith comply with such provisions or this permit te themed mvoked.
Z CA CONSTRUCTION LENDING AGENCY
[-+ Ther whichithi Nat Nem isacovN .3D97.ding aLeruy far dm perfulmanceof
the work fa which this permit V Wad(Sec.309'LCly.C.) '
GQ Lueders
.7 z landera Address
U Q 1 certify that I haw mad this application auW tete Wt she show Information is
Ip. correct.I apex to comply with all city and county ordinances and surd laws relating to
Q building convection,and hereby authorize mprommatims of this city to enter upon use
L37 'how-mendoned property for Inspection purposes.
G (We)agree N taw.Indemnify and keep harmless tint City of Cupertino ageiut
ww(YJ Ilabilides,judgmenu,corn and expenses which may in Anyway amus gatut mid if,
inconsequencoofthetrar
() APPLII ANT UNDER SftingoS Perot WILL COMPLY WITH ALL NON-POINT Issued by: Date 7�� ,�/)J`,6,
SO C RECULATIO
Re-roofs
iguture o pylic or Data
HAZARDOUS MATE IALS DISCLOSURE Type of Roof
II the applicant at future building Occupant store orlmndle hazardous material
As net by tint Cupertino Municipal Cade,Chapmr 9.11.and dm Health and Safety
sectio"
:,531(')7❑Yon 0N All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building Occupant us,equipment of devim which If a roof is installed without first obtaining an inspection,I agree to remove
It havafdous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes [I NO
I haw,and the hamokusmateriala requirements underClupter 6.95 of the C,lifor. -� _
nia Health k Safety Cade.Seadmu 13305,15533 Aral 25531.1 mucretand out ifdv:building /_/� _ �
does no ppY haw a inn I h'ts my rtapomihiliry m mdfY tM Occupw of Ne &
mems d�icb mu once ora CcrtiResm ofOmpancy. _ Signator of ApplicantZ Date
6-�� -61;_
All roof coverings to be Class"B"or better
Owner Or ouiladized Al - Dale
Community Development
10300 Torre Avenue
4 Cupertino CA 95014
i
Telephone(408)777-3228
p Fax(408)777-3333
�UPEkTINO
Building Department
JOB ADDRESS: PERMIT #
—7/p/26 (37,-4a4S2eeQ A os-0 G 60 9
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR FAX#
I am not using any subcontractors: 6 -15-05
Signature Date
Please check applicable subcontractors and com Tete 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
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
U P E�T I N O 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: /1/.t� c)ice Lala ,Q
Job Site Address: J)
Roofing Company Name: `Dl/.cam Ji33SIA. /]O141
Applicant's Signature: Date:
Greg Casteel
Building Official l vs�eeira✓ �,c -/�-OS AM
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
' ' REROOF ���
�CUPEf�TINO PERMIT APPLICATION FORM
APN# Date:
Building Address:
OwWJs Name: Phone#:
Contractor: Phone FjoB License #:
&04 -a 7 ZI0
Cont Pho 78 03-70 Cupertino Business License#:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )K_ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles O Wood Shingles
JC Other(Specify) ad"O ❑ Other(Specify)
Number of existing coverings 2 ❑ 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: ❑
J b Description:
D
Residen tal Commercial rJ
Fire Zone: Yes ❑ NoConfirmed with Planning Dept. if
there are any restrictions: LJ
C t of Project: of struction: Occupancy group:
yp
117
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
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