06060160 (2) F7537
TY OF CUPERTINO ✓^ +ear ' '
'BUILDING DIVISION PERMIT =. CONTRAG1T,0RJNFORMATION
s skrr4 tiP"^e "' .. ,-me^•: _a, ',m -.amu � "'i-s
DI NO ADDRESS: PRINCIPLE ROOFING & Pa'LMITNG06060160
RAINBOW DR
ER'S NAME: PERMIT ISSUE DATE
YAO HONG LU 1700 NORTH 1ST STREET.
NE: .6-
NO, CONTROL NO.
(408) 436-1681
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
UOO LICENSED CONTRACTOR'S DECLARATION Job Description
w 1 hemby affirm Nal 1 am licensed under provisions,of Chapter 9(eommuneing
�z wit&,tion7")ofDivision 3afdicBond essandProfessim.Code.shdmyIke=4
<m-
I.full REMOVE EXISTING WOOD ��AO F INSTALL COMP ,
%'q= a"mm Glans Lc" 1 6 3 SHINGLE CLASS A ((�
=Fo DaW Can=EC
ARCHITECTS DECIA ON k�1`t;a='
1 understand my plans shall W used a public records
'.0
o t;, Licensed Professional 11 1/ J�
OWNER-BUILDER DECLARATION JU /OaC
iN I herchy itt That I am exempt from to Commeres License Law for to e U
O O following mason.(SC'tm 703 1.5,Business and Professions Cale:Any city or county
i29 which requires a bursit W convect.shot.improve,demolW,or repair any s miclum rl
prior um its issuance,also requires she applicant for such permit to file a signed sidemen,
i Thal he isliccnsedpurater,tolmProvisions oftheConuseux'sL3ccmeLaw(Chaper9 Sq.Ft.Floor Area 4JW1y&ggfl J1#yIyUti%l?400
-x1 (Commencing with Section 7000)of Division 3 of the Business and Professions Code)or
Q 5 that W u exempt shomffom and to basis for to alle,Cd exemption.Any violation of
Section 7031.5 by any applicant its permit subjects the applicant to a civil penalty of 3 APN lumber Occupancy Type
ons ties nus mn five hundred dollars(SSW). 6 Z 3 0 018 . 0 0
❑I,u owner of Ne progeny,err is a inusules with wags,as Wev sole7W.Bus imeas
will dothewmt andt: ho Coaisrwtimm�dcd draw clews Out apply 70th,Bu sine ss Required Inspections
and Pro whe,W Cade:TW r.theream.License Law does nm apply Wan owner but q P
own
wW buildsorionp ones th imps and who arm not chended omselfor through hu
own employees,p Ing.,i rhes such improvements art not intended oaoRcmd founale.,
however,to building or improvement is sold within one year orimpro ve for the...,
will have the buNaW of proving Wet W did nmt Wild or improve far purpose of
sok.).
❑I,a owner of the Irpeny,am aulu ivoly cunuacting with licenu4 commixons in
cansouct the project(Sec.7(114.Business and Pmfesaav Code:)The Contncbr's U.
cove Law does not apply to an he,of progeny who Wilds as improves Wcmon,and.
who contracts for such projects with a comncmr(s)liuved pursuant W to Contractors
License Law.
Fl I am exempt under Sec ,B At P C pardon reason
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury are,of the fallowing destinations-
1 hire and will maintain.Canifscere of Covera m xlf-insure far WorkersCompcn-
usion,a provided for by Section 3700 of the Labor Code.for the performance,of to
work for which this permit is issued.
❑I have and will maintain Workers Compensation Insurance,as"W rOd by Section
37W of the Labor Cade,for the performance of the work for which this permit is issued
My Workers Campenntian Laurent¢esriu and Policy number ase:
Carrier. a- w,{1A�j Policy No.: 06
CWF!1 9OFEXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thiaxedan mW not W coned.ed if the permit u fa e.hundred dollar($100)
or less.)
I certify dons in tW p aformuice of the wart for which this Permit u issued.I shall not
cmpluy any person in any manner so a to thecoma subject 10 the Workers Compensation
Laws of California.Dau
Applicant
NOTICE TO APPLICANT If,of e,making this Cenificae of Exemption.you should
become subject W We Worked Compensation provisions of to Law Code,you mesa
0 O fOcthwith comply wit such pmviaans or this permit shall W deemed revoked.
ti in CONSTRUCTION LENDING AGENCY
E(•+ IWmby air.that then u.cinstsucd..lending agency,for We Performance of
the weak for which this Permit is Issued(sec 3097,Ci,C.)
1ELander',Name
Z;)
Z L.codera Address
U Q 1 certify(hat 1 have rad this application and sue Nat We shove information u
I, F cosrenagreW
.I e Comply wit all city and county ordinances and .in laws minting to
U building eonsometion,and hereby authorim mprescmatiWS of Wis city to enter upon the
0. a Wve-mentioned property for inspection purpwes.
(We) groc to save,indemnify and keep harmless to City of Cupertino against
h liabilities,judgments,Cosa andoxpe.which may in any way...against said City
V Z in consequence of IW granting of this permit.
"-' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date G/r /--G
SOURCE REGULATIONS.
h^ - oS ���� Re
ERI -roofs
Signature of Avppli.VCa=W, / Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the appliom in future building Occupant atom or handle haardoa material
ss defined by the Cupertino Muni' 1 Cade,Chirpier 9.12.aM the Heslth and Safety
code,Scctian 25532(a)7
❑Yes No All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtainingan inspection,I agree to remove
Will We air corm or ons a building occupant use equipment it Mona which P g
craft
District?
pair conuminsnu u defined by We Bay Arca Air Quality Management all new materials for inspection. _
E)Yes ❑�
1 have mad the hvardmusmuerials meximmenta under LTaper6.95 of the Califon
nia Hcald,h Safety Code,ScNav25505.25533 and 25534.1 understand thatifthe building
doer Out currently have.errant.that it is my responsibility W notify use Occupant M We
mquimmend which kh must beset pd.,W Issuance Of.Certifies,Or occupancy. Signature of Applicant Date -
�_ o7 Do.
Owner anuthorisd agent perm All roof coverings to be Class "B"or better
'
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36230018 . 00
DATE ISSUED. . . . . . . : 06/19/2006
RECEIPT 4 . . . . . . . . . : 34920
REFERENCE ID # . . . : 06060160
SITE ADDRESS . . . . . : 7537 RAINBOW DR
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : YAO HONG LU
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : PRINCIPLE ROOFING
CONTRACTOR . . . . . . . : DERECK LOI LIC # 27564
COMPANY . . . . . . . . . . : PRINCIPLE ROOFING &
ADDRESS . . . . . . . . . . : 1700 NORTH 1ST STREET, #154
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE (408) 436-1681
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 8 , 000 . 00 147 . 96 0 . 00 147 . 96 0 . 00
BSEISMICRE VALUATION 8, 000 . 00 0 . 80 0 . 00 0 . 80 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 148 . 76 0 . 00 148 . 76 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 148 . 76 MASTERCARD
TOTAL RECEIPT 148 . 76
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
*UPEkTINO
ByRding De artment
JOB ADDRESS: PERMIT #
7s3�- A�Z- &,(!! /
OWNER'S NAME: Lti PHONE # 64vo 5- 8
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: ►�_ - a���5/�6
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
Tile
Owner/Contractor Signature Date
DUMI o
CITY OF CUPERTINO
Sun REROOF
• oF
CUPERTINO PERMIT APPLICATION FORM
APN# I Date:
2.'
6176 z i 9/a6
Building Address:
�ba t-✓ p2
Owner's Name: Phone#:
,Ao {[aN� K - 3-
Contractor: License#:
P�vr iGi (e_ /[vu n cGrvs/xuGlS�n f'/ 4,3 91—
Contact: Cupertino Business License#:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ -ilt-Up roof
❑/I Ph all Shingles ® Asphalt Shingles
�r Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Nher of existing coverings 2 ❑ Provide I.C.B.O. Report#
7To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
J�G�toVG X;ST�/✓C7 WOOD S f/4([c - //�fF1 LL CON S7 7an/ S�r
Residential Y Commercial ❑
Fire Zone: Yes ❑ No t7' Confirmed with Planning DApt. if
there are any restrictions: LJ
Cost of Project: , Type of Construction: Occupancy roup:
71400 vZ-
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
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 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: Y`}G -q6"-V67_ /c.
Job Site Address: �� 3� Q�r� 6� d&_
Roofing Company Name: k'aa� o„ � Coy✓f/�uG�.
Applicant's Signature: Date: d6 / �p6
_• Greg Casteel
Building Official
Revised 11/2/04