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05060207 (2) 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