04070098J
L_p�CC
n�Z
Z�O
nFe�
U
3yU
yob
000
F se
a l -
w
nilpir
C[TY OF CUPERTINO�- "`'"' I&'"
�iCQY,r4U T-0R-INFQRMATIQN '
LIVESANITARY
BUILDING DIVISION PERMIT
,BUILDING ADDRESS:
0591 GLENIZIEW AV
A L RESIDENTIAL/COMMERCIAL
P�"MITN'04070098
OWNER'S NAME:
PERMIT[SSUE DATE
CARSON KUO
ONE:
N0. CONTROL NO.
408 729-
ARCHI7ECTIENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
P
I numb, afrom that 1 am licensed under p ovislons Of Chapter 9 (Commencing
w10r Section 7101)(1) of Division 3 of Use Business and Prafcssiem Chop. and my license is
Lfull e Class ercett
Class Lie. N
REROOF VA
�®
Dao: Cumrmbr
Dal
ARCHITECT'S DECLARATION
1 understand my plansshall he used as Public mxmC3
AUL 30.2004
Licensed Professional
OWNER -BUILDER DECLARATION
I hdmhy affirm than 1 am exempt from the Can...,'. Liecnm Law for the
7(01.5. Bmiams and Profession Code: Any cily or county
!�
D..gfl IIB. �Ne .
ssi Ul L ®
following mason. (Section
which requires a permit to C(mlmn, eller, improve, demolish, Or repair any l mcbm
prior an its issuance. abut requites the applicant for such permit to rile a tinned statement
Bectu, law(Chapter 9
Sq. Ft. Floor Area
Valuation
al he is licensed pursuant provisioof the Contrecmri
Nuns
(commencing with Section 70110) of Division 3 of the Business and Probagons Cade) or
that he is exempt lhemfmm and the basis for Ne alleged emmpdon. Any violation of
36'U*JRQu-aetO0
Occupancy Type
Section 7031.5 by any applicant far a permit subjects the appliCMLto a civil penally Of
not mom Nan rim hundred dolhn (S500).
t, '
❑I,asowrcr of the propmlY. or mY cmploycaswiN ragas asdmir utic compcnsstim,
ns
Required Inspections
q P
will do she reit and Om ordure isnot ingnded Oroffened Torsah(Sec. 7W, Businw
and Pmras d... Cade: The Contractor's License law dors act apply b in Owner OI
property who builds orim noses thereon, and whodoessuchwork himselfordtrough his
Own employms. provided Nal such improvements art not intended or offered for sale. If.
however. the building or improvement is sold within am you of completion. the owner -
builder will have the burden of proving Nal he did not build or improve far purprox Of
sale.).
❑ 1. as Owner of the property. em exclusively contracting with licensed eont»cbn to
Construct the project (Sec. 7014, Basin= and Pbfmsu ms Cade:) The Commcter's Li -
tense law docs ..,apply ban owner of property who Wilds Or impmves thereon, and .
who contracts for such pm)Cets with a eOaUaetOr(s) licensed pursuant to de, COnlmelOYa
Littnc law.
rl 1 am exempt under Sec. . B A P C for this won
Owner Dale
WORKER'S COMPENSATION DECLARATION
WORKER'S
hereby affnd under pcmlly of perjury one Of the fallowing declaradmo:
I ban and Will emmuln a f.'m4Ecule of eeriest l0 self-ImYm farWorkers C-.,..
sell... u provided for by Secdan 3770 of the labor Code. for the performance of dg
work fm which this Permit is issond
CD 1 ban and will maintain Walkers Compensation Insurance, as required by Section
3700 of the laWrcoul for the performance of she walk for which this permit is issued.
My Walkers Compemauon lnsumance carrier and Policy number sae:
Cartier. Policy No.:
CERTIFICATE OF UR it TON FROM WORKERS'
COMPENSATION INSURANCE
'
(Thu section meed not becomplened hiss permit is fororm hundmddolhm(S10()
or bis)
I certify Nat in the performance of One work for which this permit is issued. l shell not
employ any person in any meaner m ss to become subject to the Workers Compensation
Laws of California. Data
Applicant
NOTICE TO APPLICANT: If. after making this; Cenifeate of Exemption, you Should
become mbjcct to me Worker's Compensation phu,,Wons of the Labor Code. you must
rormwith comply with such provisions or this Permit shall W deemed corked.
CONSTRUCTION LENDING AGENCY
I hobby affirm Nn mem is a bonmaxim. lending agency for be Pmrarmmcc or
a the work far which mu permit u issued (Sec. 3097, Civ. C.)
Lenders Name
Lender's Addnm
s
1 ttnee 0-11 Mn read this application and sing Net u
SWn iws
mlauen
and stag huts l0
building I Agree to comply with all city and county o and
W
gives or r upon ft
building construction. and Acteby aumarim gpregnutives of mu city to cntene
aheve-mentioned property for inPemlon purpose•
.,i
L (we) agree b save. indemnify and keep harmless the City Of Cupertino against
p) lialoitics,judgmenu.costsandexpenacs Which may in anywaysecom againslsaid City
in consequence of the granting of this permit.
9 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NONPOINT
Issued by: Date
SOURCE REGULATIONS.
Re -roofs
Type of Roof
Sigm urc of Applica t/C.Moulmr Data
HAZARDOUS MATERIALS DISCLOSURE
Will IM applicant or future building occupant stub or handle hmard^us materis]
as derined by me Cupertino Municipal Code. Chapter 9.13, and de, Health and Safely
Code, Seeuon 15532(.)7
All roofs shall be inspected prior to any roofing material being installed.
❑Yes ❑Na
If a roof is installed without first obtaining an inspection, I agree to remove
Will me applicant or future building Occupant use equipment an devices which
craft haardous air contaminants as defined by me Bay Area Air Quality Manapeord
all new materials for inspection.
D'smicR
❑Yes [3 No
1 ban man the hamorms materials requirements under Chapter 6.95 of the Califor-
nieHealth atSafety Code. Sections 25505, 23533 and 25534.1 undenuM Naz irdg Wilding
docs not currently ban a Cenam. that it is my responsibility an Calory f aceupant of be
requirements which mug la mel prier on issuance or a cOmficate or Occupancy.
Signature of Applicant Date
All roof coverings to be Class "B" or better
Owner at delAOn]Ld agent Dag
x
CITY OF
�UPERTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS:
SUBCONTRACTOR
BUSINESS NAME
GENERAL CONTRACTOR: =
I am not using any subcontractors:
PIPasP rbPrlc nnnlicablP subcontractors and complete the fallowing information:
Date
r
o�
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
r
o�
Date
�CITY OF
UPEkTINO
•
•
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 inspectionand
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.
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: =�� r S Qh V t7
Job Site Address: I() 5-!J ( (n�11y ii k7
Roofing Company Name:
Greg (Zdteel
Building Official
Revised 1/30/03
Printed an Recycled Paper
4 (�
04
9
CITY OF
CUPEkTINO
CITY OF CUPERTINO o OY-
REROOF
PERMIT APPLICATION FORM
APN # 3 /'
Bldg Permit Fees
Date:
BENERGY
Energy
q O
Building Addr
BUILDING
O C
Ow is ame:
0r
tC
one #:
4�
v0
252- S
ontracto
Phone #: icense
L. C-1;o�
7i - 7 L
C ntact:
Ph n #: Cupertino Business Lic6nse #:
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
❑ Asphalt Shingles
)IKAsphalt 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 Will Comply
With Cu ertino's Tear Off Policy: ❑
Job Description:
0 3a�
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑
Confirmed with Planning Dept. if
there are anrestrictions: iJ
Cpst of Project: Type
of Constructio Occupancy group:
9 A. 77o in
-r0
Frr M
Fre- T)Pcrrintion
Fee Grout)
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
xDE
s
zgsoy
yFU
sQ�
3
eco
F? t
fro
z
F
UJ
a
U
U.O
U
CITY OF CUPERTINO
z,
`
7
Qlender's
CJ
I37
&
V CONTRACTQR�INFORM�N;:
BUILDING DIVISION ppR . _
- 3s,.,/a..a": sec ._.r... , ....,.. ? ,if°.•, d .z iy'
BUILDINGADDRESS:
A L RESIDENTIAL/COMMERCIAL
Pr'....04070098
10591 GLENVIEW AV
OWNER'S NAME:
PERMIT ISSUE DATE
CARSON KUO
14
E:
SANITARY NO. CONTROL NO.
(408)729-6100
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
I he cby aft,. Nn 1 am licensed under pmvisions Or LTaprr 9 (commerrinst
with SectionTOTB)of DNi,kn 7 ofthe Businusand Professions Cnde,and my license is
lob Descriptio
ti ®
LE
in full to a/effm•. ✓\
Z
REROOF d -V
Lie N
Date Co.. her
ECLaRATION
JUL 30 2004
ARCHITECTS
�undcamnd my Plans shall W used as ash' nrds
til tae
BUILDING II DING
Licensed Pndessinml
OWNER BUILDER DECLARATION
I x1by .(Here n I OI. exempt Imre Ile ConuanCo License taw for the
EU'
my
(Section I.S. Business and Profession Calc: Any city or county
following Recon.ermit703
ro improve. fie sig any swetuR
which requires a Permit re enmW,l, alter, improv,
a
its issuance. Ra h Permit t to asistneanammenl
forsucthe
:pions, lsw(Chode)
Sq• Ft. Floor Area
Valuation
purse nttreqo
thatto, pursuant to Re pr of Contractor's
that ton theeBusinessand
Pwiman
of Divioronf
or
with Section 700 0) of Division of the Business and Code) or
that
m. Any vi of
Rut u r Any
in, U axe InGefmm and the aper far the alleged eumant
et0 0
Occupancy Type
to it Penalty
io 31.5 b any' applicant fora pump subjecta a0) applicant to •civil penalty of
Seton
than fay
not more Nen 0)w hundred collars (SSM).
r. '
❑ L hW2forRte pmpaty, or my wagn ss thc wmpcns
Required Inspections
9 P
olime bedwro
will o the work. and the rs (Sen. ionut
an,ownerof
rs
Out apply to
law dors Out apply lf an owner
he Con tar's License Law do
and pecra Coll,: The
wstheetors hod he
his
n,wh build.., is
Own ertywha s.iprovi improves theRprove who are
not intendedSuch
own employees. provided that such Improvements an not rrA
arOf minho Me Owforests. r-
inenlishat within one year Of completion,Nenwncr-
however. thebuilding wit
builder the Wildingoide.
buildcr will have the burden of proving Nat he ala not Wild or improve for prep•.. of
of
sale.).
1, u Owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec. 7044, Business and Pmfrsemis Code:) The Contraclars Li.
emse Taw arcs Sol apply 70 eco Owner of property who builds or improves IbeRon, and,
who contracts for such pm¢cm with a contractor(s) ]!=mail pursuant m the Contraemra
License Law.
❑ Iamesemptunder Scc. ,B&PCfar UisreaSm
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declantions:
- I have and will maintain a Cc,,Rcoo of CoMenu0.1f.insureforWrrkcfaCompcn-
sation, u provided for by Section 37M of She Labor Code, for the perfrrmarae of the
work for which this permit is issued.
❑ I have and will maintain Worker`s Compensation Iaurace. ss required by Section
5Tn0 of On Labor Code, for the performance of the work for which this permit is issued.
.
My Workef Campcmattoo Insurance a its and Poli, number a0):
tI
f
,
.n
Carrier: PoIIe, Na.: .—Q
CERTIFICATE ATE OF EKEMVI 10N FROM WORKERS' -
///,/, COMPENSATION INS%i ANCfi
Y(Thr Section =it not Mcompleend lfthe Permit is faarc hundred Mllan(SIM)
rt nuJ
'
1 certify that in the Performance of ac work for which this Permit is issued. I shall not
employ any rKemn in any manner x n to become subject In the Workers COmpeaation
Laws of Califomia Dau
Applicant
NOTICE TO APPLICANT: If, after making this centricete of Eomption, you Should
become subject m the Worker's Compensation pmvisiom of the labor CMe. you men
forthwith comply with such provisions or this Permit shall tic deemed revoked.
LENDING AGENCY
donCONSTRUCTION
1 herby alfmn the mirt is cmat
30 lending asterry for the performance Of
s ed (See.
the work for which this permit r issued (Sec. 5091, Cin, C.)
Name
1<naefs Aaar,u
1 certify the I have read this application and sum that the above information is
1 agree to comply with all city and county ondimres and Sale laws relating to
Ftorten.
building construction. and hereby authorion repRsentnives of this city to enter Orion lW
aMvonimodeed propeny for inspection purposes
L. (we) agree to aw. indemnify and keep harmless the City MCupertino against
y liabiliacajudgmenta. casts and expepea which may in any way Beane agatnstaaid City
/
cc
z in con xgwncc of the Sang Of this permit.
APP CANT UND TAN AND WILL COMPLY WITH AL NON- I
Issued by: Dae
SO E S.
Re -roofs
Type of Roof
Si ere of App ManState
HAZA U ATERIALS DISCLOSURE
Wi111Mapplicantor 70 ildinst occupant smrc Orhantllc hamNaus material
as dcMed by the Cupertino Municipal Code. Chapter 9.13, and IW Health and Safety
Cale, Section 8552(a)TAll
roofs shall be inspected prior to any roofing material being installed.
Dy. '•-lf1Na
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building Occupant use equipment or devices which
it havmrdnue air contaminants as defined by the Bay Area Air Quality Management
ll w materials for inspection.
Disunc,
❑Yes �Nu
I h.cm"eW-W usma dalsrtquimmenuunder Chapmr6.95ofthc Csllfor-
nia HCOlth SSetYcode, Se 'ore B%5.n533eW 55N.1undusmndthuiftM Wilding
C /
4ignature
docs not ntly haw a ank Nat k is my Rapopelhittly to nnaf W occupant of the
Ryatrem which men m rr70issmnccOrICertfica0) a ,.
licrat e
jl'canL
All roof cov IT to be Class "B" or better
oOhoriu d ager Dam