06050081 CITY OF CUPERTINO *'* a
n
BUILDING DIVISION PERMIT >C'�l�i-T12ALC' 4RI1�TI+s`OXtMTI •N" T`
�fv.�,7-s' fik'. f e:a t�^I .
BUILDING ADDRESS: PERMIT NO.0 6 0 5 0 0 81
10510 LARRY WY
OWNER'S NAME: PERMIT ISSUE DATE
I CHENG CHOW 05/09/2006
NE: SANITARY NO. CONTROL NO.
ARCHTIECTYFNMIKEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MEd
lam . O t� D
pop LICENSED CONTRACTOR'S DECLARATION Job Description
I V I hereby affirm Nat 1 am Ikcocd umkr provision of Chapter 9 cars—ing P
'iNSudm70=of Div,t�./k-�n3ofN Busin wdProf .and mylkenseb
+ N infailfineeaweffea REROOF-REMOVE (E) WOODSHAKE/INSTALL ASPHALT
p c°�✓ c gra CLASS A B - YES BUI f`�/ LIC 5/9
CH CIS DECLARATI / INAU: /
t� I undemunJ my pew shall M1e used u public records
a Dg!Oky�� Licensed Pmfend...I
�7p OWNER-BUILDER DECLARATION MAYS- 2UUS
2 so
I hereby Aman that 1 am aacmpt from the commenoes License law faNe
r
COO following man.(Section 7031.5,Business and Professions Cods:Any city or County
e$� which mquhns a permit to construct,sba+.Improve.demolLM.or repair any suuctumlifth fib,
zy prior m its issuance.Alia requires dw applicant for such permit to file a signed summers
pp that he b licensed pursuant to the prevision,of the communes(Jame Lt.(chapter 9 Sq.Ft. Floor Area Valuat f�
u€� (commencing with Section 7000)or Division 3 of Ne Business and Profession Code)or
y Nat he Is eumpt therefrom and Ne half for the alleged eunplion.Any violation of
Section 7031.5 by any Applicant for a permit subjects the Applicant to a civil penalty ofppm�I�r�lber Occupancy Type
our mom dm Eva hundred dollars 3 00 s(5500). 1�0 3
❑I,
will do
owner of dw prolwny,a my employees MIN wages er Neo rale campensatim,
Pr Newark-and Ne he CambmtmLnded aro@redferns pply 0In Bninesf Required Inspections
and property
who os Cade:The Gaatrutor'a LI„"h-Law data set apply ir an awns of q p
own emywhe Wiprovidmpmtsuch I amanments mwhodoenowhw tied aro lred Nmugh his
own Ammer.
building
pr suchImprowmanwarcnot InwMWaraatmd for owner.
hwildn" Nebuildingoriroprowment4mid within amyeaofmproeforNeowner-
builder MII have the burden of proving that Ise did not build or improv for purpose of ,
am.). .I
❑I.An owner of the property,am exclusively contracting with licensed comacmm he
coatroct the project(See.7014.Business and Professions Code:)The Cmvumra Li-
sae Law does not apply to an owner of property who bulbs or Improves Nemm,and
who renew for such projects with a eommcaor(0 licensed pursuant in Ne Contractor's
Litems Law.
❑Iameaempamder See .B&PCfa Wsseamo
Owner Dam
WORKER'S COMPENSATION DECLARATION
40 1 hereby affirm under penalty of perjury am aides following daW Wma
❑1 ham and MII maintain a CeralOom of convent to whir-loam fawaraces Compo.
swim,as provided for by Section 37M of the,labor Code,fa W performance of the
work for which this permit is issued.
❑1 have and will muntain Worker's CompenWon Inmi a sx tired by Statim
3700 of the labs Code.for the parfam of Ne arms fa which this psmit u Issued.
My Wminer"C p nsetim Wag as and Policy number ars:
Cartier. PolicyNo.: r ZINI
CER11FICATEO+EX MON FROM 0
COMPENSATION INSURANCE
v
frills section need set be completed I f me permit Is forone hundred deBan(3100)
or Wv)
I amfy that in the performance of ma Mark for which this permit At load:I snail am
employ any person in my manarso As in became,subject to the Warkers'Compertal
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Ceniflcaw of Eaemption,you should
become subject in the Worker's Compensation provisions of the labor Code you muss
,J O forthwith comply with such provisions or Nu pemit shall he deemed invoked.
z a~� CONSTRUCTION LENDING AGENCY
.
(~ 1bi affirm that Nem 4 a conuuNnn lending agency for the performance of
gL dm work for which this permit is issued(Se,.3097,Or.C.)
Win~. Lender's Name
r7 z Lender's Actions;
U O 1 camfy Na I have read this application and naw that the shove infomadan is
U.F comet.I agree to comply with all city and county eminences and none laws rearing W
OtJ building conswetion,and hereby cuthorim mprexenutiwn of Nis city to cinr upon an
W above-mentioned property far inexcdon purposes.
(We)agree to gave,indemnify ad keep homeless Nc City of Cupertino against
i-r V3 liebilitin judgments,caw and expenses which may In my way we=gdest said City
V Z in consequence of the granting of this permit.
'-” APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGU ONS.
lir !Jfi!4/ -r�q_6 Re-roofs
SignourroAgIllitam/ConmWor f Data
HAZARDOUSINATERIALS DISCLOSURE Type of Roof
WIII Ne a Lucent a loom building a Chapter
9 1 mauntie hawdond Safety ety
As dented by the Cupeni"a Mu 'IP. Cade.Chapwr 9.13,and the HaIN and Sanity
cada.swdmx5s3xa17 All roofs shall be inspected prior to any roofing material being installed.
❑Yes N
sell Ne applicant or f tum Wilding ampant nee tquipmant or Jevias which If a roof is installed without first obtaining an inspection,I agree to remove
emit haamaus air conusni de0rca by Ne Bay Asea Air Quality Management all new materials for inspection.
DiSUM7
❑Yes N
Ihivemad Nehaam mmdabmquimmemsunder Clupwr6.95ofOw CWifor.
nis Health&Safety Cade,Safi 25505,35533 ami 25534.1 understand Na if be building
does act.one.My have A wnanl Nat it b my responsibility to rAVY Nc=upant of the
mgWmmal"hkhmanee Am.ofmwnaaeor.Corti ofa<apyyy. / Signature of Applicant Date
ow aa�/teat,a ga�/y, rip B/ All roof coverings to be Class "B"or better
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 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
�ab_ove stated policy on re-roofing.
� _
Homeowner's Name: /�,)
Job Site Address: ���0 GHQ
Roofing Company Name: /
Applicanfs Signature: �� Date:
• Greg Casteel `
Building Official
Revised 11/2/04
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 2
Sec: Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . : 31602023.00
DATE ISSUED. . . . . . . : 05/10/2006
RECEIPT #. . . . . . . . . : 34328
REFERENCE ID # . . . : 06050081
SITE ADDRESS . . . . . : 10510 LARRY WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : I CHENG CHOW
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : YES BUILDERS
CONTRACTOR . . . . . . . : LIC #
COMPANY . . . . . . . . . . :
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
TELEPHONE . . . . . . . . :
OE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
______ _____________ __________ __________ __________ __________ __________
BPERMFEE VALUATION 81000.00 147.96 0.00 147.96 0.00
BSEISMICRE VALUATION 8,000.00 0.80 0.00 0.80 0.00
__________ __________ __________ ----------
TOTAL PERMIT 148.76 0.00 148.76 0.00
METHOD OF PAYMENT AMOUNT NUMBER
_________________ ____________ ________________-_
CASH 148.76
TOTAL RECEIPT 148.76
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
efUPEf�TINO
Building Department
JOI Z5 DSS; PERMIT #D/����/
OWNER'S NAME: T PHONE #
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors:
6&ghaate
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
e /Contrac ignature Date
CITY OF CUPERTINO
REROOFcry F
CUPEFLTINO PERMIT APPLICATION FORM
APN # O 2 — Date:
;,I6 - Sb o6
Building Address: D SIV LA r% w Y/17I 1\EIO� C4 ,
Owner's Name:
= GI1ehl C Phone#:
- 9 L:
Contractor: License #:
lh
Contact: / _gsa ertino Busine e
�V
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ppp❑ Built-Up roof�Q,
❑ Asphalt Shingles Asphalt Shingles
Wood Shakes ❑` Wood Shakes
Wood Shingles ❑ Wood Shingles
O 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: i t„ AO-t fi1W
"�LQ Residenti ocImercial
Cf i3
Fire Zon • Yes ❑ No Confirmed with Planning a
there are any restrictions:
Cost ofProjec,: Type of Construction; Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
J 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