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05090094CITY OF CUPERTINO k= «x�«+i.'� BUILDING DIVISION PERMIT CONTRACTnR,INFORMATI®N p.4?' BUILDING ADDRESS: MDC ROOFING PERMIT N0.05090094 10581 E ESTATES DR OW NER'S NAME: PERMIT ISSUE DATE SUNG JOON KIM 1612 TRIESTE CT 09/14/2005 NE: SANITARY NO. CONTROL NO. (408)271-9548 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECr PLUMB- MECH 0 0 0 0 LICENSED CONfRAC f)R'S DECLARATION Job Description 1 botchy affirm that l am licensed under provisions of Chapter 9 (commencing p wish Section7")of Division3ofthe Busineu dProfessions me, and my licensers in full and effect. O REROOF--T/O SHAKES/INSTALL SHINGLES License Class Lie o Dow Contractor P� ARCHITECTS DECLARA O 1 understand my plans Mall W used As public records Licensed Professional OWNER -BUILDER DECLARATION ��ppp qqq q t re License Law for the 1 hereby affirm that 1 hereby(Sian aurin from die Contractor's p ,�i j'�wizzzo (Section IOTA Business and inns Code: Any city or countythe following 1. C which requires a permit to construct, eller, improve, demolish, or repair any structure � gtl�a (fkY �}r_" 1 , $8250 prior W its issuance. also acquires the applicant forsuch Permit to file a signed statement that be, is licensed prnabouo the provisions or be Contractor's Uame, Law (Chapter 9 Sq. FL Floor Area Valuation (commencing with Section 7000) of Division 3 of the Business and Professions Cndc) or lirri y�nn& Nat he u exempt shcrtfrom and the bmu for the alleged exemption Any violation of Y'!' r ' `Occupancy Type Section 7031.5 by awry applicant for a permit subjects the applicant W a civil penalty of not mart Nan five hundred dollars (SSW). 1, as owner of the propcny, or my employes with wages as their mte compensation, - n Hk aus; yaa Reqruirea-4spectoflons will do be work and be structure is not intended or offered for sale (Sec. 70,114, Business and Professim¢ Cade: The Ci nuacmYs License Law does nm apply W An owner of property who buildsor improves thereon, andwho dues suchwod himself or through his own employ es, provided Nat such improwments are not amended oroffered forme. If. however. be building or improvement is sold within one or, of completion, be owner - builder will have the burden of moving that he did not build or improve for purpose of salt.). I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Sea. 7044. Business and Professions Code:) The Contractor's Li. cense law does not apply to an owner of property who Wilds or improves thc¢on, and, who eomracts for such projects with a contractors) licensed pursuant W the Convacsoh License law. ❑ l am exempt under Sec. . B k P C for Nis ..an Owner Date WORKER'S COMPENSATION DECLARATION I hereby afrtrm under penalty of perjury one of the following declarations: I haw and will maintain a Comilicale of Consent to self -insure for WmkeYs Compen- sation, As provided for by Section 37W of be Labor Code. for be performance of be work for which Nis penman is issued. ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 37 W of the labor Code. for be performance of the work for which this permit is issued. My Worker's Compo Gun Insumnm ca d Policy number are: I OS Cartier: Poll, Na.:lor)oa3l3—g CERnFlCA OF EKEMPITON FROM WORKERS'' COMPENSATION INSURANCE Mis xenon need not he completN if the permit is for one hundred dollars (SI W) or loo.) 1 certify that in the performance of be work for which this Permit u issued, 1 shall not employ any scrmn in any answer on, As W lissome subject to the Workers Compensation Laws mf California. Date Applicant NOTICE TO APPLICANT: V. refer making Nis CcniOam of Exemption, you should Wcome subjat W be Worker's comperuadan provisions of the, IaMr Cade, you muu foMwilh comply with such prnvismor car Nis permit Mall be demand revoked. CONSfRURION LENDING AGENCY 1 hereby affirm that there is a consum, inn lending agency for da performance of be work fur which Nis permit is issued (Sec. 3097, Civ. C.) Lower', Name ' Lcndcr's Addrtas I certify that 1 haw read this application and sum Nat tW above information is correct. I Agra to comply with all city and county Ordinances and sox laws retailing to Wilding construction, and hereby and aria eprexnmives of this city to enter upon the maw-rieno0ned progeny far inspection purposes. (We) Agree to saw. lndemnl fy Nd keep h mbleas the City of Cupertino againel lin bilides,judgments. costs and expenses which may to any way seethe against mid City in conxquenee of the granting of this permit. APPLICANT UIJDERSTA DS N L COMPLY WITH ALL NO -POINT Issued by: Date SOURC R Re -roofs Type of Roof �� Sigh re fAppbcamo Conoactor 7 lDate / HAZARDOUS ATERI DISCLOSURE Will tW applicant Or foram building occupant nae or handle Health Anmaenitl u defined be Cupertino Muniripal Code. Chapter 9.11. and de Health and Safety tion ak. Section z5532(a)7 ❑Yes � No All roofs shall be inspected prior to any roofing material being installed. /y'c� If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant o" future building oatrpant ax equipment or devices which it hanrmmx air contaminants as Joined by the Bay Area Air Quality Management all new materi Is for inspection. District? ❑Yes No s materials mquirtenu under Chapter 6 n I haw mail be hmalloum 95 of sec Califo / nia Health k SafctyCodc. Sectors; 21505.25533 And! 25534. l understand bar,ifthe Wilding does not currently hoe a ann, that it u my responsibility to notify Ne occupant of aw m / V requinCTemis which mLLµW mol pilar Wioo. ofa Certificate of Occupancy. SiEntueof Applicant Date All roof coveri gs to be Class "B" or better Owner or milmn.d agent Dere CITY 0, UPEkTINO JOB ADDRESS: Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department PERMIT # fo,0 FC-� OWNER'S NAME: � , In od nn vt � C I PHONE # qn 7 /-9 S 41k GENERAL CONTRACTOR .FAX # ( r),z v � G'nA .n 3 (n 7 I am not using any subcontractors: / / / //-(/ / C Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date 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 71kv� CITY OF UPEQ INO Community Development Department Building Division City of Cupertino 10300 Torre Avenue Building Department Subject: Re -roofing policy for the City of Cupertino Telephone: (408) 777-3228 Fax: (408) 777-3333 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: Sr t n A Szwc n k- i la^ Job Site Address: PC �j) C CP1pPCO, .9saN Roofing Company Name: ,�,/J Applicant's Signature: Date: 0- S Greg Casteel Building Official Revised 11 /2/04 Printed an Recycled Paper aTy or CUPERTINO CITY OF CUPERTINO REROOF !� PERMIT APPLICATION FORM APN # � / ^ � Bldg Permit Fees BUILDING Date: Q // Energy BUILDING / BSEISMICRE Seismic Fee Res Building Address: BSEISMICOM Seismic Commercial g�. BPLANCHK > Owner's Name: BUSLIC Business License Phone #: Soal Contractor: Phone #: License Contact: Phone #: Cupertino Business License #: ' u L Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles )K Asphalt Shingles ,Cr\ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings / ❑ Provide I.C.B.O. Report # ,K To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: Ge oy,,cf - 7o55m)o Residential Commercial ❑ 3a yca/ Stil Fire Zone: Yes ❑ No )RF Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project: o ,Type of Construction: Occupancy group: Qty. if AvOicable Fee ID PC Fee Descrintion Fee Groun 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 �1 g��