08020163 BUILDING DIVISION PERMIT g CU1)ITRACTORxINFQRMATN: :
BUILgING :OGRESSPERMR NO.
1176 PALM SPRING CT OMEGA CONSTRUCTION 08020163
OWNER'S NAME: PERMIT ISSUE DATE
lb SANG HO YU 451 FENLEY AVE 02/25/2008
ONE: SANITARY NO. CONTROL NO.
(408) 243-0404
ARCHf1ER/FNGINEER: BUILDING PERMIT INr0
BLDG ELECT PLUMB MECII
O O LICENSED CONTRACTOR'S DECLARATION IU Description
1 hcmby affirm Mass n at 1 am licensed under provisions of Chapter 9(mmmOCSCrIp
enclm;
ion Senate.70110)ofDividon 3 of that Bualnca and Profcaiun oda.mdmy'Eenaais RERF RMV WDSHNGLS, INSTL NW ASPHLT SHNGL RF,CLS A
^� in full fame and cflm
y Z Lieen¢Clea Lk:.N SQ
Dau - Contractor
ee CHMCrSOECLAR
Y I undemanJ my pas shall he used as public rteords '
U
5 Licensed Professional
OWNER-BUILDER DECLARATION
0 E 1 krubyam a1Ron Nal 11. exempt from the GontramrCode:LicenseA.y.Law for de
O o which m mason.(Section 71D L3,Bualness and Pmfewnn h.oAny city.,county
$ which requires n permit n enmlruel alter,improve.demolish.li mash ed structure
zy
inhale its issuance,puma cto Me me proAskicanlrar smhpermittoftica Law( hmua9
g < ainancat
thathelaRcenaJ pSeaant NW of Dialon o(W ConuatartLanmisons Cods)
Sq.Ft. Floor Area Valuation
�y
that
samwith Section 7000)Se Division3 or theBusiness and Professions Code)or 8O
— Nat M ts emmpt therefrom and Sea baa for thv alleged esempJon.Any violation of
Section]03 13 by any applicant far a permit subjects Ne applicant to a civil penalty ofNumber Occupancy Type
rot mart Nan Eve hundred dallm(5500} 3 6 6 5 4115 .
❑I,as owmr of the property,m my emplaycn with wages u theirmu compeassdon,
will do the work,and theatructute H mtinunded arartered fm We(Sm.7W.Business
and Pmldanm Cade:TW Contractors License Law does not apply to m
an owr of Required Inspections
property who buildsortmprorntimomm.and whodoessuch.,it Mmselfar Waugh his
awn employees,pmvided Nalmeb Improvements art not Intended oroQemd finale.IT. -
hnwever,Ne building or Improvem.t Is sold within am You of completion.Ne comer-
builder will have the boon.of proving Wt W did not build or improve fm purpoac of
saM.I.
0 1.u..of the property am.Gcm
exclusively uacring with licensed conuacmn to
.mtmet the project(Sea.70th,Business as Prefeaan Cade:)The Contractors U. t
cense Law don not apply to an owner of property who builds or improve Wman,sod
who contracts for such projects with•contractpr(s)licensed pursuant to the Contractors
License law.
❑I on emmpt under Sea .B&P C for NU mason
wmr Date
WORKERS COMPENSATION DECLARATION
1 bareby anion under penalty of peejury oro of the following decimations:
❑Iluvesnd NlmalnuinaCeNfinuo/Comemteself-Inwmfn Workers Compere '
warn, pro Secdav]l00 of Ne I�bm Cade,far that peAaoneot¢of tie
wart for which this permit is issued
❑I Tuve and will maintain Workers Compensation Insurance,as required by Section
3700 of the Libor Cede.for Ne performance,ofte work for which this cronit 13 issued. '
My Workers Ciga pent n Immance ani and Policy a
Caller. L Hey No.:
C RTIFI TE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
mals section nead not M completed If tad permit Is far am hundred dollars(510(r)
or less)
I sonify that in the perfooname of W wart for which this permit is laced.l shall.t
employ any perma in any maser an as to became subject to the Wark tri Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT.If,after making this Certificate of Exemption.you Mould
become subject In the Worters Compensation provisions of the Luber Cade,you am
'Z' fonbwith comply with such provision or this permit shall be Manned revoked.
Z O EN
CONSTRUCTION LENDING AGENCY
(~ Ihemby affima that them is a construction landingagency for tie parforma of
fY' > Me work for which this permit is mama(Sec.3097,Civ.C.)
0. Q Loaders Name ,
Lenders Add.
V Q I cenify Na I N.mad Nis appliwiam and suns that W above Information Is
li, .rmct.l agme to comply with all city and county ordinances and rote laws misting to
building convection,and hereby mthorlae rtptesenutivoa trams city to cuter upon W
Til above-mentioned property for inspection purposes
(We)agme in ave,indemnify and kmp hamlea the City of Cupertino against
Ibbilidea,judgments,costs and operon which may in any waya.0 against said City p
in conwq==of the
dof
V APPLICANT UN ERSTANDSNuD WILL COMPLY WITH ALL NON-POINT Issued by: Date 2 2l
;-�k.
LkA2s Re-roofs
t of App tnnUCantmcmr Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or(mute building eccupanutoro or handle haardoa material
Boa by W Cupenim Municipal Code.Chapter 9.12.and Me Health ad Safety
0y.zss32(aI7All roofs shall be inspected prior to any roofing material being installed.
❑Yn aWIII W applicant or(atom Molding oavpent use equipmrnl or Jevity whichIf a roof is installed without first obtaining an inspection,I agree to remove
hauodna air cantsmimnts a carload by the Bay Area Air Quality Mangemcnt all new materials for inspection.
ct7
❑Yn ANo
1 have mad W haaonaamaudatsnquimmanu underCMpur6.95af ate Califoo-
nixHmlth&See LyCade,Secdom25505,25533 and255M.1 uMantand Nalf W building
n Out can mal,have a tenant,Nat It u m Fees I sty to notify Nc occupant of Ne
M - µuMmetPrior I Signature of Applicant Date
n 2
Owmr or wNo agent DauAll roof coverings to be Class"B"or better
'
• CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36654115 . 00
DATE ISSUED. . . . . . . : 02/25/2008
RECEIPT # . . . . . . . . . : BS000004027
REFERENCE ID # . . . : 08020163
SITE ADDRESS . . . . . : 11676 PALM SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SANG HO YU
ADDRESS . . . . . . . . . . : 11676 PALM SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5142
RECEIVED FROM . . . . : OMEGA CONSTRUCTION
CONTRACTOR . . . . . . . : JUNG HUH LIC # 22317
COMPANY . . . . . . . . . . : OMEGA CONSTRUCTION
ADDRESS . . . . . . . . . . : 451 FENLEY AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95117
• TELEPHONE (408) 243-0404
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- --------- --
1BSEISMICR VALUATION 8, 000. 00 0 . 80 0. 00 0. 80 0. 00
1REROOFRES SQ FEET 25 . 00 325 . 00 0. 00 325 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 325.80 0. 00 325 .80 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 325 . 80 #5110
---------------
TOTAL RECEIPT 325 . 80
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------- --------------------------- -------- ---------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
•
D� CITY OF CUPERTINO 4oa0 3
REROOF
•CUPEkTINO PERMIT APPLICATION
APN # Date: Z5l O
3wpp ) irk � � b2
Building Address: I I p
J-�
Owner's Name: Phone #:
96 - QP3
Contractor: kF_6t/A Phone #: c4CP
Fax #:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles WAsphalt 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 o Provide Mfgr. Installation Specs.
Job Description: UR— (�,"`
�. 49t�j!) kS)
Residential Commercial
Fire Zone: Yes ❑, No�U Confirmed with Planning Dept. if
rh there are any restrictions: ❑
Valuation: by O
1
I Have Read, Understand and Will Comply with upertino's Tear-Off Policy:
•
Signature
CITY OF CUPERTINO
REROOF
OCUPEitTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2� 1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
IBUSLIC Business License B
•
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 Y4" 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: 5AKki H,l7 y U
Job Site Address: M(yn h
Roofing Company Name: D
Applicant's Signature: Dater L j�
• Greg Casteel v
Building Official
Revised 11/2/04
Community Development
e 10300 Torre Avenue
fA J Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
SEUPEkTINO
Building De artment
JOB ADDRES : PERMIT # n ;�,O I
OWNER'S AME: (x PHONE # S
GENERAL CONTRACTOR: erFAX #
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