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06060159 (2) CITY OF CUPERTINO �s„ � BUILDING DIVISION PERNIIT n�„`dl\j'rR�.CTORsINFURMATION y *bn-F: ad+`.+ 32.AtEi? vbu,d BUILDING ADDRESS: HU, Jp TIE HU PERMrr N0.O6O6O1S9 10250 JOHNSON AVE OWNER'S NAME: PERMIT MUE DATE DAVID A HU, JANE HU 06/19/2006 IVNE: SANITARY NO. CONTROL NO. ARCHr1ECT/ENGINEER: BUILDING PERMIT INFO BLDG 0 PLUMB MECH O 3p p LICENSED CONTRACTOR'S DECLARATION Job DeBDrI t100 1 bemby affirm WI 1 sm Beenned under previsions of Chapter 9(commencing p MwithScction 7IXI0)ofDiyision lofthe Business ash Profrssiom Code,and mylkenmt, m full force and effect. REMOVE OLD ROOF, PUT ON NEW PLYWOOD 15/32 OSB F y im— Li...Class Lk.a #30 ASPHALT SHINGLE. ON GARAGE REMOVE OLD ROOF E Use Contractor ARCHf1ECfS DECLARATION ON TAR FELT #30 TAR ASPHALT FELTS CLASS A Ss I uunderstand my phms.hall be reed as public maid$ ]d y G Licensed professional y Oat I am exempt ri DECLARATION Z a 1 heresy olriect that 1 1. exempt from the contractors Cc License Law for the i O O fallowing moon.(Saban 7fD 1.5,Business and Professions Cak:Any city or manly $f<i which mquims a permit to eombect,alter,imprew,demolish,nr mpsir any rMae. prior m its issuance.also faquire.the.pplicsot farwch Permit m Bk a signed ststemmt F G met t,licensed Pa..,to site pmvielom ofthe Canracmrkc e Lnx U.(Chaffin,9 .S q.Ft.Floor Area Valuation g $ (commencing with Section 7000)ofDivision 34rthe Business"Profeaiens Code)or .$10000 S that W Is exempt therefrom and cite but,for the alleged eeemption.Any violation of section 7031.5 by airy applicant fm a permit subiecu the applicant as a Civil Penally of APN Number Occupancy Type ret ream than five hundred da1Ws(3500). ❑I,as owrcs offt property.in my employees with"tan their solecompenndon, will do the",k,.nd lheamectam h not intended worsted kraa4(Sec.7014.Business Required I j ons and Prefesdau Cade:The Communes es Liana law dors not apply m an owner of q properly .provdcddm themon,wd u doenoueeade himselrarlhreugh his 8 �� awnerly who buldsoridthawsuesImPrewments arcnot hwork imselfadhinuh ��qCm however,the building or Improvement 0 sold within am year ofcompletion,the owner- bullder will haw the burden of praying that N did an,build or hnpme rte purpoee or rpis.). / ®1.met u aww of da property sm exclusively comensauji with homed mnommrs In JUL 0 ZOO6 conssthe project(Sec.7044.Buinea and Professiou Code:)The Contruloes W career law does not apply as an owner of prepeny who builds or Improves theaan.red. ®® who mntracufor such pmjecle with a mnu.mor(U Roared pursuant to me Cmuanoh ® ®�� LlcenselJw. g■gvget ❑I ate pt undo See .BAP far thin maso9. ly Owner Date WORER ATIONDECLARATION air,.1 hereby am under penalty of perjury can of the relkwing dect,ratiom: I law and Mll 1.by Smile. 3700 of ft LAWr Cook,for dic woher'sCompen- utian,repro h thi for by Section 3700 of the labor Code.for the performance of the worts far which this permit is t,ated. ' ❑1 haw and MII maintain Worker's Compensation Insurance,as finished by Secum 3700 of the Labor Code,for the performance of the work for which this PeMit is lamed. My Worker's Compensation lnsenna artier ash Policy number are: . Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section reed not be completed if me permit Is fame hundred dolt,m($100) or Ica.) 1 amfy that In the performance of the work for which this permit u issued,l sha i ret employ any person in any manmrmy m bcmme robKGt uethe workers'CompeasWm Lawsof Califored =/* / NOTICE TOAPD1te'ANT:a alarmaking this Cerdfis o of LaWar oil youaha= boomerh comp y Nc Wahero Compensation permit or the labor Cade,you mum .J O forthwith comply with such proyiaiau a mu permit Hill be damrd rewired. z r~yi CONSTRUCTION LENDING AGENCY (—t I hereby AMM that then is a construction lending agency for the performance of {Yi �: the wart for which this permit is issued(Sea.3097,CN,C.) mm LeMels Name .7 z lander',Addams U O I ceniry this 1 haw mad this application and sum mat the notes.i.fmass dim I- PP cormcl I agree a comply with all city and county ordinances;and auk laws mlating to p U building comomaim,and horcbyauthodn reprem moves of this city to cnmrupnn the La alwve-memiuned property for inspeenon pogeacs. fy (We)agree to save,indemnify and kap hamless the City of Cmpvnino against TatIiabillikajudgments.coas and expenses which may in any way amueagake cold Gly O z in consequence of the grunting of this permit APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date _ l:r- Re-roofs eco SOU[R��Ba�G�ULATIONS. attT�eatneUR Re-roofs Si{n of ppli _ anummr Data HAZARDOUS Wilding PULRO Lo handl Type of Roof WIII there Curietu efnium Munibuildinge.ChaptsmrcorandMle Health us and a defined by the Cuperum Municipal Code.Chapter 9.13,and site Halm and Safety Code,Section 355330)7 1 / All roofs shall be inspected prior to any roofing material being installed. Ir ❑Ya mile Will the.truces,ar future building mcupam um equipment or dcMaa which If a roof is installed without first obtaining an inspection,I agree to remove emit 1110=C'01air cmememsa lstermed by the Bay Ara Air Quality Maagcmcnl all new materials for inspection. DiuricR ❑Yea a I haw mal the Weard.materials requirements under Chapter 6.95 or the Califor. T / nia Hal"Safety Code,Section 35515,35533 and 35534.1 antlenued thairthe building � � V does ret cuncnlly Mw.tenant this It t,my mpanslMlily m mufy the oceupans nrthe requirements K ua be mel priorm issusueno(.curb sue ar 0�ccvpumy.� Date 6 O SignT�u Applican 1 o All roof coverings to be Class'B"or better Owner or au mi d agent Dote CITY OF CUPERTINO !m 1 of 1 . PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . 1 : 37525061 . 00 DATE ISSUED. . . . . . . : 06/19/2006 RECEIPT # • • • • • . . . . : 34919 REFERENCE ID # . . . : 06060159 SITE ADDRESS . . . . . : 10250 JOHNSON AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : DAVID A HU, JANE HU ADDRESS . . . . . . : . . . : CITY/STATE/ZIP . . . . , RECEIVED FROM . . . . : JANE MAGGY HU CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : DAVID A HU, JANE HU ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 10, 000 . 00 169 . 56 0 . 00 169 . 56 0 . 00 BSEISMICRE VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 170 . 56 0 . 00 170 . 56 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 170 . 56 1113 TOTAL RECEIPT 170 . 56 • PTY Community Development 10300 Torre Avenue J Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 •CUPEkTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: 9v of 9/,l t �T9re �`f/�ic� PHONE # OctF-3a07 49¢x' GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date 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 er/Contractor Signature Date 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: 6,9 V/ 9 � r' Iv-e yw Job Site Address: Roofing Company Name: / Applicant's Signature: Date: p d • Greg Casteel Building Official Revised 11/2/04 OWNER-BUILDER VERIFICATION 1. (Check one) I or my immediate family (parent,spouse or child) will perform: • A. All the work authorized by this permit B. A portion of the work C. None of the work If B or C is checked, complete 2 or 3 below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. A portion of the work (complete section below) Contractor Address/City, Phone # State License # Type of work to ' be —�zfo�u.ed 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or • portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City Phone Number Type of-work to be erformed ..................................................................................................................................................................................... I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information (rever side). Property Owner's Signatur Date: a Job Address: J6�?�O ,ya�jaSoh yri`Phke �'J �7/�d �%(? Permit# Any changes to the information provided on this form shall be submitted to the City of Cupertino Build Department. City of Cupertino Building Department CITY OF 10300 Torre Avenue • Phone: (406)777-3226 C U P E t�T I N O Dear Property Owner. An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner-builder you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself,you may protect vourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work,with the exception of various trades that you plan to subcontract,you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is$200 or more for the entire project,and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer,you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding,federal social security taxes,workers' compensation insurance,disability insurance costs,and unemployment compensation• contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers compensation insurance. For more specific information about your obligations under federal law,contact the Internal Revenue Service (and,if you wish,the U.S.Small Business Administration). For more specific information about your obligations under state law,contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale,property owners who are not licensed contractors are allowed to perform their work personally or through their own employees,without a licensed contractor or subcontractor,only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors'State License Board in your community or at 1020 N Street,Sacramento,California 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, Building Department, City of Cupertino • Printed on Recycled Paper o(taalon I ee CITY OF CUPERTINO • REROOF CUPERTINO PERMIT APPLICATION FORM APN# 375-a5 - NI Building Address: — /OaiO �ro/j SON �v Ji C Y h aq e C/ / q, Owner's Name: Phone#: 0,9 viof A Ac \rwue 61 40,r- JrR7 4YO- - Contractor: 64 License#: Contact: Cupertino Business License#: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles J@ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ® Other(Specify) r,OR 8 CAevP ❑ Other(Specify) Number of existing covering ❑ 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: Reh-0Ye O/ ?0 Of A oh ae40 9SpI ,9 /� /e, OV f,".0 P, >P Vl a p/c(ipu o , /amu/'Oh 69q, �rff#3o, Ao?, F.f/J.{A/� i�P/fS, C / J Residential gJ Commercial ❑ Fire Zone: Yes ❑ No © Confirmed with Planning Dept. if there are any restrictions: L1 Cost of Project: Type of Construction: Occupy t group: 10,00 0 Qty. if Applicable 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 •