06070016 CITY OF CUPERTINO c.?�Ikuax•'=s R' swv'w " Q.,
'BUILDING DIVISION PERMIT 4! ONMOT110�, Ir1FU�R�aTIQ N
BUILDING ADDRESS: TO M PERMIT N006O7OOI6
7482 DUMAS DR
PE
OWNER'S NAME: ItMR LSUEDATE
TOM KIM 07/05/2006
NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMITINFO
BO EO PLUMB O
Sop LICENSED CONTRACTOR'S DECLARATION Job Description
I u 1 Wo by tram Net 1 am lim nimi under provisions of Chapur 9(commencing
with Saban metro a Dlvhlon3of Ne Buslneh and PromMlaN Co o,mtlm iccnse is
+'1 mranfanaaee e ._ REMOVE SHAKE SHINGLES . APPLY 50 YEAR ASPHALT
5444 LI mCi s Lie.
Conuaaar_ SHINGLES CLASS A
Dam
3 � CHMECSDECLAIATIGN CALIFORNIA C&R INC. PAID FOR BL 7/5/06
f m I mWmatted my plans shall be used as formic.,.Na
>yU
Licensed Pm(chionel
a Oat lam eUILDERromfr front
Ce ContrON
Lay hereby.(Timm mel 11. exempt from the Conussroos !Anse Lew for Me
G fallowingrecwn.Permit
ID3str Biall sedove.de um Cade:ormcity or county
$ which requires•Acrania 1.construct, Abend hermdeermitth.Mr fie a siganyawnum
zY pAormiu iasuanee.Wu mquiaslW applicanafarwch Permit to Neaeignedauwmem
�O that he is licensed pursuant o the provisions of the Connector's License Law(Chapur9 Sq.Ft. Floor Area Valuation
9 (cammenang with Section 70010)of Division of the Business and Professions Code)or $10500Nat he h diameter,exempt dia
an the bub for me alleged exemption.Any violation of
Saban 7031.5 by my applicant for a permit subjects the applkana to a rnd penalty of APN Number Occupancy Type
not marc than fin hundred dollars(S700),
Q Las owner of Ne property.or my employm with wages u theirmle compensation,
will do the work,and the struems h Ml intended ar.flmm rhaam(Sa.1014,Buurch Required Inspections
and ProDaelone Cods:The ConhaemYa License law does not apply to an Owner of q P
property who buildsmimprawthemsn,stdwM1a doessuch wink himwlror Waughhb
own employees,provided that such improvements are not intended oralfamd forsale.If.
however.the building.improvement is sold within one year orwmidmor.the owner-
Wilder will have the burden of proving that he did or,build or Improve for purpose of
ask.).
Q 1,as owner of Me proputy..m reclusively wnoaaing wild licensed nacos,to
construct the pmjen(Sec.70",Business and Profusions Cade:)The Conm emes U.
caw law Mass not apply in an owner of property who Wilda arimprow s thereon.and,
who contracts for such projects with a onwcaor(a)licensed punuanl m the Contnaors
1 erniz an Law.
0
Q lam exempt under gee .B&PCfor this mason /
Owner Data w
WORKERS COMPENSATION DECLARATION fY/
I hereby aBlm under penalty of perjury one of the following deelarulom: /
I ham end will maintain a CeNOato of Consent to wdf-Insure far Worket's Camper. O
halon,h provided for by Somme 3700 of the labor Cade,for the performance of the
work for which this permit u iswe0.
Q 1 have and will maintain Worker's Compensation Insmana,as required by Sectio
3700 of the Labs Cade,for the performance of the wont fir,which this permit is Issued.
My Worker's Cam mad 1. cams Policy number am:
Csniee Paltry No. �Q 6
CERT G •0 EM ON FROM W ERS'
COMPENSATION INSURAN
(Tbuwatimoeedambecomplamdiftheparm Ionone hundrtdead (SIM)
or less)
1 certify Net in the performance of Me work for which this permla Is ihmd,l shell an,
employ any person In my mannerse u m become subject to the workers'compensation
Lam of Celifamia.Data
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should
become Subject m the Workers CompmuNan previsions of Me labor Code.you must
.,O fonsvith comply with such proisios or Nu permit dull be Moment ranked.
'Z'n CONSTRUCTION LENDING AGENCY
[.r I bemby affirm Net Nem b a coruuucdon lending.gamy for the perfortnmrc of
a Me work for which tbu permit is blued(Ser.3097.CW.G
WM Q Lenders Name
z lame.Andress
U O 1 au fy that 1 hate road this application and sum that the aWw intomaWa is
W F comm.l agree to comply with all city and county ordinances and state haps relating to
O U building construction.and hereby autboriw representatives of Nis city to mum upon Ne
136
mme-rormaincd pro,ay(Or inspcNon pmixt
t•^ (We)agree to saw,indemnify and kap baons the City of Cupertino against
In liabilida,judgmenu,cmm and eaparms which may In my soy accrue affunat said City y
U 7 in mnxque..of the granting of this Permit.
r7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON OINT Issued by: Date V
SOURCE ULATID
Re•roofs
Signature of Applican4Contrecmr DIU
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the appllaant ar future Wilding aaupantamre a handle hazardous mamul
as defined by dap Cupertino Municipal Cade,Chapter 9.13,and the Health and Safety
Coda,Somm.15533(a)? All roofs shall be inspected prior to any roofing material being installed.
QYa ONO 41
Will the applicant or future Wilding Occupant sew equipment of(CAMS which If a roof is installed without first obtaining an inspection,I agree to remove
emit hahndno air canuminmu h defined by the Bay A.Air Quality Management all new materials for inspection.
Disvict7
❑Yea ONO
I haw wad the haurdrusinsla brequhcmcnuunJerCNpwrb.93 afthe Callfao-
ria Hcalth&Safety Cnda,Sccdwu35505.35533and35534.1un&rswWth.11[Nc Wilding
does ret currently hew.mnmL this It u my responsibility m ratify the oaupant the
recut enuwbechmust IpriormissuanaofsCeNfo:emarocapanry. QignatureofApplicant Date .
Owner mmthmacd a gent Dow !J/g" All roof coverings to be Class"B"or better
CITY OF CUPERTII�O
sm 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35926011 . 00
DATE ISSUED. . . . . . . : 07/05/2006
RECEIPT # . . . . . . . . . : 35112
REFERENCE ID # . . . : 06070016
SITE ADDRESS . . . . . : 7482 DUMAS DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER TOM KIM
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : HYUNG SHIM
CONTRACTOR . . . . . . . p LIC #_ *OWNER*
COMPANY . . . . . . . . . . : TOM KIM
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . . :
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 11, 000 . 00 180 . 36 0 . 00 180 . 36 0 . 00
BSEISMICRE VALUATION 11, 000 . 00 1. 10 0 . 00 1 . 10 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 286 .46 0 . 00 286 .46 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 286 . 46 1000
TOTAL RECEIPT 286 . 46
•
Community Development
10300 Tone Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
OUPEkTINO
Building De artment
JOB ADDRESS: as, PERMIT #
6 ,50
OWNER'S NAME: lJ ea PHONE #
GENERAL CONTRACTOR Cd G //Z//Al F /
I am not using any subcontractors: c"
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
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 r/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: ,��2 � QfQ, /1,)4
Roofing Company Name: �/�,���
Applicant's Signature: / ffooli1 Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO Owm0li1p
REROOF
• CUPEkTINO PERMIT APPLICATION FORM
APN# �/,� liv'D I I Date:
Building Address: I V
Owner's Name: Phone#:
Contractor:Cd License#:
Contact: Cupertino Bu mess License #:
Type of Roof Covering:
Existin : Proposed:
❑ Built-Up Roof ❑/Built-Up roof
Asphalt Shingles V Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read,Understand and WillComply With C ertin 's Tear Otf Policy
Job Description: jib �Q -?S c[yt�05'
X01.f
Residential o ercia
Fire Zone: Yes 0 No Confirmed with Planning Dept. if
there are anrestrictions: LJ
Cost of Project: Type of Construction: Occu cy group:
V _ .�
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
•