07010183 CITY OF CUPERTINO
BUILDING DIVISION PERMIT
C�1T �GT�1R INFC}RM�T�€�N
PERMIT NO.
BUILDING ADDRESS:
r
OWNER'S NAME:
SCOTT CHOU 11650 S. 7TH ST. 01/30/2007
SANITARY NO. CONTROL NO.
HONE:
(408) 661 —6501
BUILDING PERMIT INFO
ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH
0 0 o a
a p 0O LICENSED CONTRACTOR'S DECLARATION Job Description
a U C I hereby affirm that I am licensed under provisions of Chapter 9(commencing
__z 0- with Section 7000)of Div ion of the Business and Pr u C c,and my license is REROOF— REMCVE SHAKE, INSTALL 1/16 0 S B, 5 0 YR
w in full Corea and cCt q L�
j�z License ue•n PRESIDENTIAL, CLASS A
F p Datc — Contractor
ARCHITECTS DECLARATION
a< 1 understand my plans shall be used as public records
�yU
4 Wo H Licensed Professional
H 3 OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for the
00 following reason.(Section 7031.5,Business and Professions Code:Any city or county
K
.9 which requires a permit to construct,alcor,improve,demolish,or repair any structure
Z y prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation
< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Fioor Area $9500
zt= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
y 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 ARN Number Occupancy Type
not more than five hundred dollars(5500). 31629090.
Vv
0 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 Contractor's License Law does not apply to an owner of
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
sale.).
0 I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Cork:)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 Contractor's
License Law.
0 I am exempt under Sec. B&P C for this mason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
0 1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
0 I 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 Insu jnc�e,�'cr and Policy number am:� C11'
Carrier. _%�=) Polley No.: `
�TE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is formic hundred dollars($100)
or less.)
I certify that in the performance of the work for which this permit is issued,1 shall not
employ any person in any manner so as to become subject to the Workcrs'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
Oforthwith comply with such provisions or this permit shall be deemed revoked.
Z — CONSTRUCTION LENDING AGENCY
Er►Cn+ 1 hereby affirm that there is a construction lending agency for the performance of
fZ> the work for which this permit is issued(See.3097,Civ.C.)
W Q Lender's Name
0, Lender's Address
U 0 1 certify that 1 have read this application and state that the above information is
t-" correct.I agree to comply with all city and county ordinances and state laws relating to
Ubuilding construction,and hereby authorize representatives of this city to enter upon the
U
above-mentioned property for inspection purposes.
a (We)agree to save,indemnify and keep harmless the City of Cupertino against
�t C�j liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit. Date
APPLICANT UNDERSTANDS AND W1L PLY WITH ALL NON-POINT Issued b):
SOURCE REGULATI l �
Re-roofs
Signature of Applicant/Contractor Dare Type of I:oof
HAZARDOUS MATERIALS DISCLOSURE yP
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Muni' 0 Code.Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
0 Yes No
Will the applicant or future bttl�ding occupant use equipment or devices which
If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants�s'dcfincd by the Bay Arca Air Quality Management all new r iaterials for inspection.
District? /
❑Yes 0 No
1 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 �/
docs not currently have a tenant,that it is my responsibility to notify the occupant of the -
requirements which must met prior Wjssuancc of a Certificate of occupancy. � Signature:of Applicant Date
I �? All roof coverings to be Class"B"or better
Owner or authorized agent Date
CITY OF CUPERTINO
2 ITEMS OF 2 PERMIZ RECEIPT OPERATOR: amyw
COPY # 1
Sec: Twp: Rng: Sub: Blk : Lot:
APN 31E29090. 00
DATE ISSUED. . . . . . . : 01/30/2007
RECEIPT #. . . . . . . . . : BSC00000353
REFERENCE ID # . . . : 07C10183
SITE ADDRESS . . . . . : 1074 NORWICH AV
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . . SCOTT CHOU
ADDRESS . . . . . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2446
RECEIVED FROM . . . . : REC:EIPT INTERFACE
CONTRACTOR CHINS CASTILLO LIC # 27100
COMPANY AMERICA'S ROOFING
ADDRESS 1650 S. 7TH ST.
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE (4()8) 661-6501
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ----------- ---------- ---------- ----------
BPERMFEE VALUATION 9, 500. 00 169 .56 0. 00 169 .56 0. 00
BSEISMICRE VALUATION 9, 500. 00 1 .00 0. 00 1 . 00 0. 00
--------- ---------- ---------- ----------
TOTAL PERMIT 170 .56 0. 00 170.56 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CASH 170.56 CHRIS CASTILLO
---------------
TOTAL RECEIPT 170.56
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 agrE e 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 buildin€,inspector. A final inspection and
approval shall be obtained from the bulding 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 mat2rial 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: V 1
Job Site Address: 1 NO�i
Roofing Company Name: o S }
r�—
Applicant's Signature: Date:� j0 a
Greg Casteel
Building Official
Revise d 11/2/04
CITY OF C'UPERTINO 0�0 di 03
REROOF
CUPE�T[NO PERMIT APPLICATION FORM
APN# Date: / _
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Building Address: ��
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Owner's Name: C J Ph° �. I d
Contractor: License :
C� LLct
ContactCupertino Business License #:
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Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles jY Asphalt 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 ❑ Provide Mfgr.Installation Specs.
I Have Read,Understand and Will Comply With Cupertino's Tear Off Policy: ❑
b Description:
Residential Commercial ❑
C ,aA 2
Fire Zone: Yes ❑ No.❑ Confirmed with Planning Dept. if
there are any restrictions: U
Cost of Project• Type o onstru3tion: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERIVIFEE 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