05040035 CITY OF CUPERTINO *t' ^•- - �� �"'�
BUILDING DIVISION PERMIT CONCRACTOR INFORMATION
BUILDING ADDRESS: ROBIN SUNG PERMIT No 05040035
OW NER'S NAME: PERMIT ISSUE DATE
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ONE: SANITARY O. CONTROL NO.
ARCHITECUENGINEER: BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
0 0 0 0
000 LICENSED CONTRACTOR'S DECLARATION
I hereby.firm that 1 on licensed under provisions of Chapter 9(Commencing Job Description
with Section 101M))of Division 3 of the Business and Professions Codc.and in,license is _ 'I
_p y in foil faree.nd effete. y i •• 1
oq= Ini3O. l ue.a 8 �i REROOF-ASPHALT SHINGLES L ��
z g O Dau Contractor„
�ii',f` ARCHITECTS DECLA ATI 1
W Iundersandmyplanashallkusedaspublicrecords Z�rS
3aG Lkenmd Pndcssionel w l{
5 OWNER-BUILDER DECLARATION
1 herehy.1Gnn 0.1
1 on exompt from the Contractors License law for the
a
00 following reason.(SGon Rq I.S.Business and Professions Cede:Any city or county
K m which requires a Permit to Consmer.alter,improve,demolish,or repair any sumeture
u�'^ prior In its issuance.also requires the applicant for such permit to Glc a signed suument
that he is licensed forward to the provisions of the Contractor's License Law(Chapter 9 Sq. Ft. Floor Area Valuat on
C,– (commencing with Section moo)of Division 3 of me Businesand N.F.imu Coeur)or
i $ Chad he is exempt tMrcfrom and the beau for the alleged eaemption.Any violation of
Sector 1031.5 by any applicant fon permit wbjccu One applicant to a civil penalty of 39"ft"grpp Occupancy Type
am mom than fisc hundred dollars($500).
❑1,as owner of the property,Or my employees with wages as their sole compensation,
will do the work and de swcture u not intended maRered for salt,(Sec.1011,Bulinus
and Professions Cade:The Canuxtars License law does eat apply Or in owner of Required Inspections
property who builds or improves thereon,and who docs such worthimself or through his
Own employ=.provided Nat such improvements are not intended oroRemd for We.IL
however,the building or improvement is sold within one year of completion,the Comer.
builder will have the burden of proving that he did mat Wild or improve for purpose of
sale.).
p 1.as owner of 1Le property,am exclusively contracting wish licensed contractors to
construct the project(Sec.7W,Business and prerca ions Code:)The Contractor's U.
ccuse law docs not apply to an owner of property who Wilds or improves themon,and,
who contracts for such projects with a contractons)licensed pursuant to Be Convacmr's
License law.
lam eat under See .B It P C for or,mason
Owner Dade
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of Be following dedaratimu:
1 his ve and will maintain a Certificate ofComent to ulf-insum for Workers Compere
10317',W
tion.M provided for by Section 37W of the Labor Code.for me performance of the
rk for which this Permit is issued.
I lout and will maintain Workers Compensation Insurance,as required by Section
ofthe LaWr Code.far me performance of t e work for which this Permit is isued.y Wmkee,Compensation Inwoame Gamier and Palley number art:rrier. Polity No.:
CERTIFICATE OF EXEMPTION MOM WORKERS' '
COMPENSATION INSURANCE
OTu scomih need not kcomplemd if the permit is for one hundred dollars($100)
m hem)
1 certify mot in Oc Performance of the work for which this Permit is isoed,l shall not
employ any fcrson in a man cr 4 /n ubjecuo dM1e Warkeri Comfensavon
Laws of Calif D
Applicanr D o Y�.r
NOTICE AP LIo Os If,after m ng Chu Cenons of of Exemption,you should
kcomeh suhicet tic Os %;10-this provisions of inelabs vodc,you mus
,J O forthwith comply with such provisions or this fermis shall k deemed¢voted.
Z CONSTRUCTION LENDING AGENCY
EI hereby aRhm that mem is a eommuction lending agency for me performance of
(Y 7 the work for which this permit is issued(Sec.3091,Civ.C.)
I[7 A Lenders Name
D. Landcr's Address
U Q 1 certify that 1 have mad this application and sure mat the aWw information is
IL P carted.l gree to comply with all city and county ordinances and sure laws relating to
C U building construction.and hereby aumorim mpmmuottiwc ofmis city to enter upon she
W above-mentioned property for inspection purposes.
(~ gy (We-)agree to save,indemnify and keep harmless the City of Cupertino against
N liabilities,)udgments.costs and expenses which may in any way we=against said City
U Z in consequence of OC roaming of mis permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURC� GO ONS
Re-roofs
Si rare of Applh Cee r ate
H AR OUS MATERIALS DISCLOSURE Type of Roof
Will de applicant or tum Wilding occupant sore mhawlc harardous material
as defined by tic Cupertino Municipal Code.chapter 9.12,and Bic Health and Safety
_WLCwC.gewon 25532(a)1 All roofs shall be inspected prior[o an roofing material bele installed.
❑Yes )d Na P P Y g g
Will the applicant or future building occupant use equipment or devicu which If a roof is installed without first obtaining an inspection,I agree to remove
it hazardous air conuminanu as defired by the Bay Area Air Quality Management all new materials for inspection.
lsuictl I,
p Yes R No
1 have mad the havardu���sCCCmaterials ro,immeru under Chapter 6.95 of the Califm-
niaHeath S Safety Code.Seedons 25505.25533 and 25531.1 undersuw ms if the Wilding
docs rwt euerentlY h a u it u my rexpomihility w nwfy the mcupant of the
requi hi u ren p' r w issom¢of a CcnlOcau of Oc upancy
4D1 Signature of Applicant Date
nee ter aatnosixed ase Date All roof coverings to be Class"B"or better
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
ppCITY OF A I Telephone: (408)777-3228
U f E�1 I I�I 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.
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. There:inspection fee must
` lie 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.
__ ._. . . _ -.. k .
_.-__Homeowner's Name: � T'y ��h /M%��e Ark } /
job Site Address: �S,J� /oe�C C�) r G1
Roofing Company Name:
Applicant's Signature: r Date:
Greg Casteel {� 16038
Building Official AP/�
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
SIN- REROOF
�CUPEkTINO PERMIT APPLICATION FORM
5� %U�3S
APN # 37 2 „ 2— (D 3 Q- Date: (
Building Address: 75-)-5 ,LocJJx"41J C�/ �� ey`'i�di C/ re eve"/
Owner's Name: J e Perk Phone #:
X 0)v) /0_ �
Contractor:- _ Phone#: License #-
Contact, /�� �h Phon(• ��6e� 3p Cupertino BDusi_n s'License#:
b �G/ Type of Roof Covering: /
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles Asphalt Shingles
.- Cl Wood Shakes _ - ❑ Wood Shakes
❑ - Wood Shingles '- ❑ Wood Shingles
❑ ` Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
0 T be Removed - - - - - ❑ Provide Mfg. Installation Specs.
T Have Read, Understand and-Will/Comply With. C/u ertino's Tear Off Policy::
Job Description:
Residential i7_- . ow,Co ercial - ❑
Fire Zone:,. -..Yes ❑- No ❑ Confirmed with Planning Dyt. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
Qty. if-
A licable 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
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36226038 .00
DATE ISSUED. . . . . . . : 04/07/2005
RECEIPT #. . . . . . . . . : 29231
REFERENCE ID # . . . : 05040035
\\\
SITE ADDRESS . . . . . : 7525 LOCKFORD CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SIN WAN & MIHAE PARK
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5047
RECEIVED FROM . . . . : JINWAN/MINAE PARK
CONTRACTOR . . . . . . . : ROBIN SUNG LIC # 26088
COMPANY . . . . . . . . . . : ROBIN SUNG
ADDRESS . . . . . . . . . . : 5946 BOLLINGER RD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95129
® TELEPHONE . . . . . . . . : (408) 257-1827
IEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
______ _____________ __________ __________ __________ __________ __________
BPERMFEE VALUATION 7,000.00 137.16 _ 0.00 137.16 0.00
BSEISMICRE VALUATION 7, 000.00 0.70 0.00 0.70 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 137.86 0.00 137.86 0.00
METHOD OF PAYMENT AMOUNT NUMBER
_________________ ------------ _---------_____---
CHECK 137.86 2892
TOTAL RECEIPT 137.86