05060207 CITY OF CUPERTINO p...• ;ee�" »J .s 'x " `" ;
BUILDING DIVISION PERMITpR QNTRACTOR INFORMATION
BUILDING ADDRESS: MICHAEL LUNNEBORG ROOFING PERMITNO05060207
7838 MC CLELLAN RD
NEWS NAME: PERMITISSUEDATE
OW
YI ZHANG & WENDY HUA 1328 WHITE OAKS R 06/30/2005
NE: SANITARY NO, CONTROL NO.
(831) 278-1837
ARCHITECT/ENGINEER: BUILDING PERM R INFO
BLDG ELECT PLUMB MECH
0 0 0 0
°oC LICENSED CONRACfOR'S DECLARATION Job 10
rd I hereby affirm But 1 am IfMned under nd Protan of Chapter 9(commencing �S�Cr�I[ q��
nRl with Souerbyafir that Ia lithe Businder pr Protesalof Culor9(co(commencing
is e`r r�w`YV■■
to a mmnandeOq 2� REROOF W/ METAL TILE
L full force Class Lag Lic.N
Dam 40 Convector
i ARCHITECTS DEC
W U 1 understand my plans shall W used n 1 nr /L/
ZL,F Lkenmd Professional _� T �oo�'
O� OWNER-BUILDER DECLARATION ®®®
0 I Wrclt affirm that 11. exempt Imre the Cssionso License Law co the I B Imo'
_G3000 3 O O O
p O following achy (Soman t I Am Business and RoCmame es License
city w county ■6 tl■r/11
a$rZ which requires a permit to Construct,alto,improve,demolish.or rtpair any structure
—zi priono its issuance,also mquims the applicant forsuch Permit to fileasigMJ statement
E � thatheuth
lielm.Jpursuanuo .previsions.fthemr
Comnc .UMnelaw(Chapho9 Sq.Ft. Floor Area Valuation
u�3 (mmmcncingwith Section70Xdof Divuian3ofthe Businessand Professions CoCe)w
Into W u exempt therefrom and the hands for the alleged exemption.My violation of
Section 7031.5 by any applicant for a permit subjects the applicant in a civil pchafy ofQGGn C
not mom tve dons Ahundred dollars(x580). Occupancy Type
❑I,asowmsofthepmpeny,ormyemploycnwiNwagesuftkmleeompenuuon.
will do use work,and Ne swcture In not intended oroRcred forsak(So.8344,Business
and Proreasiun Code:The Convazlor's License Law does not apply in an owner of Required Inspections
property who builds or improve thereon,and who does such work himself or through his
Own.mployces,provided that such imprevemenuam not intended orofferW for sale.if,
however,the building or improvement is said within one year of completion.Ne owner,
builder will have Ne burden of Proving that he did not Wild or Improv fon puryme of
sale.).
❑1,As owner of the property am exclusively contracting with Helmand contractors an
contruct the project(Sec.7064.Business and Profecions Code:)The Comansor's Li.•
Close Law does not apply le an owner of Property who Wilds or improms thereon,and
who contact for such projects with a commewr(s)licensed pursuam Is the Camrutoes
Line.Law.
❑I am exempt under See. ,B&PC for this..an
Owner Date
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declaration:
1 have and will maintain a Certificate of Consent to elf-insure for Warkefs Compere
urian,u provi&d for by Section 37M of the Labor Code,fon the Performance of the
work for which this permit is issued.
have end will maintain Worker's Compensation ImumnM,As required by Section
37W of NC Labor Cade,for he performance of the work for which this Permit is stood.
My Welke/P Ca olosauon losuraorce Cartier W Polity number are
Cartier. l9P.wm,/ Policy No.: Z 7W/M—&`1'
CERTIFICATE OF MEMP71ON FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not W completed if the permit is for one hundred dollars(SIM)
or less)
1 Mildly that in thc perfwmaoe of the work fon which dais Permit u issued,I shall nut
employ any person in any manmrso u in become subject to the Workeei'Cou pcmntion
laws of California.Dau
Applicant
NOTICE TO APPLICANT:If, All making thu CeniOmm of Exemption,you should
become subject m the Wohu's Con somm ion prevuious of use la We Code,you mum
.JO forthwith comely with such pomvision or this permit shall W deemed evoked.
CONSTRUCTION LENDING AGENCY
(~ 1WMby afArm that Nem is a cowmctum lending agency,fon the perfur .of
C
the,work for which thu permit is issued(Sec.309?,Civ,C.)
ALendcfa Nam.
z lender's Address
V O 1 minify Nat 1 have orad thu applicM..and sum Nat the above informadon u
mMmL 1 agrM m comply with all city and m
county Ordinances and sum laws totaling
QU building c0nwnio0,and hereby auNodm rcprcunutivm of this city menkrupon the
cition
Ck1 ahavo-cs.judnndon,Cost forimpc.which May
Q. (We)agree to Marc.indemnify and keep harmless Ne City of Cupertino agaiut
Z in
of ueounand expresseswhich may in anyway¢ere Against City
V z Aconequ.nce of UNDERSTAND
of thispermit.
S PPRCE REGULDEONS.ND ND L COMPLY WITH ALL NO Issued by: 91Date
Re-roofs
t A lican n r Date
H ARDOUS 4 ATPJI AIS DISCLOSURE Type Of Roof
Will the appliMm or future bulMrg Occupant amm w studio hsurdous material
u
A. by Ne Cupertino Municipal Colo.Chapter 9.12.and the Health and Safety
ale.se
do..35532p)?
0NAll roofs shall be inspected prior to any roofing material being installed.
Will the applicant ar tort Wilding ocupam use,equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it haraodnm air conumi ons n defined by the Bay Ata Air Quality Management all new materials for inspection.
suie'?
'w ❑Yes �/ 'Nu
I have seed be hararddus ma ebalimquircmcnu undcrChMier G95 of he Ulifor.
nice Huldh&Safety COM.Secuwu 25Y)5,25533 nut 25534.I undersand thus if Je Wilding
Jots .1,6
not Currently have a tenon,that is u my responsibility m no'y the mcupant of dt V
myaimmentw h he a i noon of .7D. /igntlreofAcant Date
nonon mordzma t Due All overings to be Class "B"or better
Community Development
a10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
&UPEkTINO
Building De artment
JOB ADDRESS: PERMIT#
S6jC 02 o-7
OWNER'S NAME: PHONE#
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
60 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
i . City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
UPEkTINO
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 above stated policy on re-roofing.
Homeowner's Name: 7r 4NG C✓ tu� Nfp q
Job Site Address: 7ar3eM ' 1-ell / Q
Roofing Company Name: /YJrc e unnr i d . /�B E� � (nIJtne, S s
7 J
Applicant's Signature: Date: Lo 30
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO z
(C� REROOF
CUPEyo, PERMIT APPLICATION FORM
APN# O O D Date: ,-7 0
Building Address:
��09' ` .l
Owner's Name: Phone#:
Yl, L L,� I(D 6
Contractor: Phone#: 7�7,F IC-3 -7 License #:
Ll i - 7f_7ZW
Contact: Phone#: Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) Other(Specify) 4e�e �A1
Number of existing coverings /❑ Provide I.C.B.O.Report# (o'Z /,
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Descri tion:
w&-'� <. N J
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
�r
Qty. if
A licable Fee ID Fee Description Fee Group
NEEE Bldg Permit Fees BUILDING
Ener BUILDING Seismic Fee Res BUILDING Seismic Commercial BUILDING Plan Check Fee BUILDING Business License BUILDING
i