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07080127 CITY OF CUPERTINO — BUILDINGDIN7SION PERMITC= �1T0I � AI1�1 PERMIT NO. BUILDIrb.pxs SCOFIELD DR MICHAEL LUNNEBORG ROOFING 07080127 ' L / / PERMIT ISSUE DATE OWNER'S NAME: FUK KWUN SIT & YING WONG 1328 WHITE SANITARY NO. CONTROL NO. ,E: (831) 278-1837 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description F. I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is TEAR OFF TWO LAYERS WOOD ROOF, FILL SHEAT ING AS in cull force and eel,, Lie n 7�j�2•�"' NEEDED 40 IBS FELT INSTAL METER STYLE CLASS A License iceClaa c_ Date jWf1g7 Contracto -� ARCHITECTS DEA OI00, - t understand my plans shall be used as public records Li Licensed Professional < OWNER-BUILDER DECLARATION a 1 hereby affirm that 1 am exempt from the Contractor's License Law for the ofollowing reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure y prior to its issuance,also requires the applicant for such permit to rile a signed statement 1'q.Ft.Floor Area Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 $13000 m (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of pp�� Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 5 912 0 0 3`�'UO Number Occupancy Type not more than five hundred dollars($500). ❑1,as owner of the property,or my employees with wages az 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.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor's 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. F1 I am exempt under Sec B&P C for this reason Owner Date WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insure for Workees Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,az 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. /AS 8C;M%o4_ Policy No.- 9f 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 become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Workers Compensation provisions of the Labor Code,you must O forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY sem+ I 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.) a Lender's Name z Lender's Address C) I certify that I 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 Ubuilding construction,and hereby authorise representatives of this city to enter upon the ahovc-mentioned property for inspection purposes. Ll. (We)agree to save,indemnify and keep harmless the City of Cupertino against y c/) liabilities,judgments,costs and expenses which may in any way accrue against said City in consequence or the granting of this permit. Date �-+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: O7 SOURCE REGULATION /7 'fRe-roofs c of Ap tcandcon or °are Type Of Roof HAZARDOUS MA S DISCLOSURE Will the applicant or future build occupant store or handle hazardous material az defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed. ❑YesFe If a roof i;installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contami::0:,NS--_ adefined b the Bay Arca Air Quality Management all new materials for inspection. District? ❑Yes I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Heal th&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building docs not c nd have a tenant,that it is my rcsporsi'' to notiry the occupant of the require nt whichmustbemelpno uance acerti arc ofOcclpan Signature of Applicant Date All roof coverings to be Class "B" or better ncr or out age Date Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 C1TY OF �'UPEI�TINO Fax(408)777-3333 Building Department JOB ADDRESS: PERMIT # 2771- ScJ cl ( vt- .76sfim OWNER'S NAME: PHONE # GENERAL CONTRACTOR: = FAX # -�y I am not using any subcontractors: - -7;fr-cJ7 Sigmaf Ce 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/Con ct ignature Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: B1_c: Lot: APN . . . . . . . . . 35912003 . 00 DATE ISSUED. . . . . . . : 08 /14/2007 RECEIPT #. . . . . . . . . : BS000002371 REFERENCE ID # . . . : 07080127 SITE ADDRESS . . . . . : 20'775 SCOFIELD DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : FUI: KWUN SIT & YING WONG ADDRESS . . . . . . . . . . . 20'775 SCOFIELD DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2922 RECEIVED FROM . . . . : MICHAEL LUNNEDORG CONTRACTOR . . . . . . . : MICHAEL LUNNEBORG LIC # 25896 COMPANY . . . . . . . . . . : MICHAEL LUNNEBORG ROOFING ADDRESS . . . . . . . . . . : 1328 WHITE OAKS RD CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (8;11)278-1837 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 13, 000. 00 201.96 0. 00 201 .96 0. 00 BSEISMICRE VALUATION 13, 000. 00 1.30 0. 00 1 .30 0. 00 ----------- ---------- ---------- ---------- TOTAL PERMIT 203 .26 0. 00 203 .26 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 203 .26 VS --------------- TOTAL RECEIPT 203 .26 CITY OF C'UPERI"IN CUPEkTI O PERMIT APPLICATION FORM -7U a APN# Date:1 Z 0&,� . a b �- Building Address: 0«vner's Name: P)lone#: � YvF ySG irz� Contractor: License,#: Contact: / Cupertino�Busl ss License #: 11,1114r, CQ Type of R)of Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles *tT Wood Shakes ❑ Wood Shakes .B" Wood Shingles ❑ Wood Shingles ❑ Other(Specify) .B— Other(Specify)/044A'V A Number of existing coverings ❑ Provide I.C.B.O. Report# "Z4 ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read,Understand and Will Comply With Cupertino's Tear Off Policy: Job Description: /A o� A.V.O "e" '.4s-ly tiewl „��,� ��f „�.�4a�.��•► it Residential � Commercial F-1 Fire Zone: Yes ❑ No ( Confirmed with Planning Dept. if there are any restrictions: ❑ Cost of Project: Type of Construction: Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE l',ldg 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 11101 to pen-lli Issu�incc, )Toll 11nist Bole k) cot piv ""101 1` li t 3L_ - L��'tlU_211C;>� and manufacturers specifications on re-goofing. 2. New roof coverings shall not be appliec 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',),e 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: Job Site Address: Z0771— J W7'••�� Roofing Company Name: `✓�/7f/�' K ',v s�r74 Applicant's Signature: Date: Greg Casteel Building Official Revisec 11/2/04