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07020008 -777777777. CITY OF CT.JPERTINO BUILDING D1vlsloN PERMIT � 'T�� � '1R N.FOR $4�117IfJIY• BUIL1 OAj2D ESS: PERMIT NO. 1ti RICHWOOD DR YOUNG JIM KIM 07020008 OWNER'S NAME: PERMIT ISSUE DATE YOUNG JIM KIM 02/02/2007 )NE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH i p a LICENSED CONTRACTOR'S DECLARATION Job Description tu F. I hereby affirm that I am licensed under provisions of Chapter 9(commencing z� withScction7ocxl)ofDivision3ofthcBusincssandProfcssionsCodc,andmylicenscis REROOF-- REMOVE EXISTING, INSTALL PLYWOOD, 30LB t a 0- in full force and effect. jZ License Class Lic.A FELT / COMPOSITION. ALL DRY ROT REMOVED Date Contractor ARCHITECTS DECLARATION ,2_, I understand my plans shall be used as public records )yU U.y Licensed Professional ti S OWNER-BUILDER DECLARATION a 1 hereby affirm that 1 am exempt from the Contractors License Law for the COO following reason.(Section 7031.5,Business and Professions Code:Any city or county Ii which requires a permit to construct.alter,improve,demolish,or repair any structure Zr prior to its issuance,also requires the applicant for such permit to file a signed statement _ that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation aF (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $4000 L that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Number Occupancy Type not more than rive hundred dollars(5500). 3 6 9 0 8 0-5 0 ,yP ❑1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractors License Law does not apply to an owner of q P property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of P.IA I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractors Li- cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. ❑I am exempt under Sec. B&P C for this reason Owner Date- WORKER'S COMPENSATION DECLARATIO I hereby affirm under penalty of perjury one of the following declarations: L]1 have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number are: Cartier. Polity No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to becmnc subject to the Workers'Compensation Laws of Califomia.Date =1 U A�- Applicant NOTICE TO A CA :If,a er making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. Z" CONSTRUCTION LENDING AGENCY Fr 1 hereby affirm that there is a construction lending agency for the performance of _ the work for which this permit is issued(Sec.3097,Civ.C.) ALender's Name ' a.z Lenders Address V C) 1 certify that 1 have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize representatives of this city to enter upon the nWi above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. Date APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b�: SOURCE REGULATIONS. — t iL. I �o Re-roof: signature or ApplicantlContractor Date Type of Roof MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roof;shall be inspected prior to any roofing material being installed. ❑Ycs 0< Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove ,mit hazardous air contaminants as defined by the Bay Area Air Quality Management all new i materials for inspection. District? C]Yes [yNo I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which must be met p. issuance of a Certificate of Occupancy. Signator'Of Applicant Date �?ad ? y All roof coverings to be Class"B" or better Owner or authorized agent 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 r,?-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 Citi, 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 per:'ormed. 7. NOTE: If you call for a plywood nail nspection 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: You V) Job Site Address: l C VR4 IQ(lwtJ u Y . Cu-PeY-K A-a , CA fr)t Roofing Company Name: Applicant's Signature: Date: a-/4.63L Greg Casteel Building Official Revis=_d 11/2/04 CITY OF' CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec: Twp: Rng: Sub: B].k: Lot: APN . . . . . . . . . 30908030. 00 DATE ISSUED. . . . . . . : 0,' /02/2007 RECEIPT #. . . . . . . . . . BS000000378 REFERENCE ID # . . . : 0'020008 SITE ADDRESS . . . . . : 1(1184 RICHWOOD DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . . YOUNG JIM KIM ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : YOUNG JIM KIM ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- BPERMFEE VALUATION 4, 000. 00 104 .76 0. 00 104 .76 0. 00 BSEISMICRE VALUATION 4, 000. 00 0.50 0. 00 0.50 0. 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 105 .26 0. 00 105 .26 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 105 .26 VISA --------------- TOTAL RECEIPT 105 .26 CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION FORM APN# S(001_ 08 —03 0 Date: 24 } Building Address: Owner's Name Phone#: 8) 3,6 -� Contractor: License M. Contact: Cupertino Business License #: a u h � Vv\ Type of 12oof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof Asphalt Shingles -'*t9k Asphalt Shingles "9, Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# 5, To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With C. ertino's Tear Off Policy: ❑ Job Description: P.eP wo-D4 3 o L 3 S -CAf 54,�Oy%- Residential S''t Commercial E] Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: U Cost of Project: Type of Constniction: Occupancy group: 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