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07080223 ----------- CITY OF CUPERTINO ��, �fTQR jNF ��1VI�TION BUILDING DIVISION PERMIT PERMIT NO. BUILD 6 KESS: T D ROOF::NG 07080223 1 U�b MILKY WAY pERMTr ISSUE DATE OWNER'S NAME: 08/0-7 /200 7 WANG SHIOU-YU AND TAI-LING 6 7 5 TULL't RD SANITARY NO. CONTROL NO. NE: (408) 892 -8872 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH ZO LICENSED CONTRACTOR'S DECLARATION Job Description U I hereby affirm that I am licensed under provisions of Chapter 9(commencing FT OF with Section 7000)of Division 3 of the Business and Professions Code,and my I'arse is REMOVE 2 LAYERS WOOD, INSTALL 2 9 SQ i<a in full fort and cff t '.� C 1 Lic.# `�`'' `� DURAL I TE z Licen C Contractor a Date CONCRETE/CLAY TILE 30# FELT CLASS A Aau� ARCHITECTS DEi.. -1 I understand my plans shall be used as public records iy6 u.ti Licensed Professional O< OWNER-BUILDER DECLARATION 1 a1 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 which requires a permit to construct,alter.iliant for such permit to mprove,demolish.or repair any structuret ,Ft.Floor Area Valuation i" prior tri its issuance,also requires the appcfile a signed statement tq $13350 Tz a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 ` i ts- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or Occupancy Type 3 R E that he is exempt therefrom and the basis for the alleged exemption.Any violation of ��nr��r�Number Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3622000 r V v not more than five hundred dollars(5500). 0 I,as owner of the property,or my employees with wages as their sole compensation, Required Inspections will do the work.and the structure Isnot intended or offered for sale(Sec•7044,Business 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.It, 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 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 Contractor's License Law. B&P C for this reason 0 1 am exempt under Sec. Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I ave and will maintain a Certificate of Consent to self-insure for Workers Compen- as provided for by Section 3700 of the Labor Code.for the performance of the or which this permit is issued. avcand will maintain Workces Compensation Insurance,as required by Section f the Labor Code,for the performance of the work for which this permit is issued. orkers Compensation insurance carrier and Policy nufbe :r: J Polity No.:CERTIFICAT P EX nON NSURROOM WORKERS' COM(This section need not be completed if the permit is for one hundred dollars(S 100) s.) fy that in the performance of the work for which this permit is issued.I shall not oy any person in any manner so as to become subject to the Workers'Compensation 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 ',Z forthwith comply with such provisions or this permit shall be deemed revoked. Z� CONSTRUCTION LENDING AGENCY 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.) rS]QLender's Name - r3, Lender's Address U 0 1 certify that I have read this application and state that the above information is Ucorrect.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorise representatives of this city to enter upon the above-mentioned property for inspection Purposes. �'•' W (We)agree to save,indemnify and keep harmless the City of Cupertino against 7 liabilities,judg cuts casts and expenses which may in any way accrue against said City Date �— Z •` '� in consequcnc of the ting of this permit. U APPLICANT t)N E STANDS AND WILL COMPLY Wl ALL N IN Issued E y: SOURCE REtU NS. r� O Re-roof Signature o ApplicanUContractor Dale T e of Roof HAZARDOUS MA LS DISCLOSURE Will the applicant or future building pant store or handle hazardous material as defined by the CupertinoWO ' al Code.Chapter 9.12,and the Health and Safety Code,Section he Cupertino All roo s shall be inspected prior to any roofing material being installed. C]Yes If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or turc building occupant use equipment or devices which emit hazardous air contamin defined by the Bay Arca Air Quality Management all new materials for inspection. District? Yes ONO 1 hav ad th hazardous materials requirements under Chapter 6.95 o(thc Califor- 1 nia Hcalth& afe C c,Sections 25505,25533 and 25IRFF ' does not cu n a tenant.that it is my respons ]cantDate rcyuircmcn ch ripey issuanceofaSignatL re AppL/��`il All roof c erings to be Class"B"or better Owner or authorized agent CITY OF �UPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36220007 .00 DATE ISSUED. . . . . . . : 08/27/2007 RECEIPT #. . . . . . . . . : BSC00002477 REFERENCE ID # 07C80223 SITE ADDRESS 1056 MILKY WAY SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA OWNER . . . . . . . . . . . . : WANG SHIOU-YU AND TAI-LING ADDRESS : 10`_►6 MILKY WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM T J) ROOFING INC CONTRACTOR LE;3LIE HOANG LIC # 23155 COMPANY T D ROOFING ADDRESS . . . . . . . . . . 675) TULLY RD CITY/STATE/ZIP . . . : SAQ JOSE, CA 95111 TELEPHONE (4J8) 892-8872 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL _____________ ---------- - --------- ------- BPERMFEE VALUATION 13, 350. 00 212 .76 0. 00 212 .76 0. 00 BSEISMICRE VALUATION 13, 350. 00 1.40 0. 00 1.40 ----- - ---------- ---------- ---------- TOTAL PERMIT : 214 .16 0. 00 214 .16 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ---------------- CREDIT CARD 214 .16 VS --------------- TOTAL RECEIPT 214 .16 Community Development 1q, 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY OF CUPEkTINO Buildin De artment JOB ADDRESS: PERMIT # 1 n r`i C. �� PHO # OWNERS NAME: « �11' GENERAL CONTRA OR: i I am not using any subcontractors: �' l Signature Date Please check applicable subcontractors and complete the fo EmBUSINESS LICENSE # SUBCONTRACTOR BUSINESS NAM 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 I CITY OF C UPER`IINO CUPERTINO PERMIT APPLICATION FORM AJ Date: PN# 77-1 �. Building Address: 00 q 6itil , 1 k �j �,� . Phone# Owner's N tt I t - -- Contractor: License JUC �`� G i i1� Cupertino Busine Li Contact: cense #: �� C ZIs�s" Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes L1Wood Shingles L1 Wood Shingles ' ElOther(Specify) Other(Specify) Lu' l umber of existing coverings ❑ Provide I.C.B.O:Report# To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cul)ertino's Tear Off Policy: ❑ r Job Description: ( ` tC Commercial ❑ ;� 1 L�' C ��' t-� _3'`� # Residential Fire Zone: Yes F] No Confirmed with Planning Dept. if there are any restrictions: ❑ Cost of Project: Type of Constructi . Occupancy grip: Qty. if Fee Group Applicable Fee ID Fee Description p BPERMFEE 3ldg PerFees 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 C:_ty of Cupertino f_. I'ri�r Lo pE�riziit issuance,You must �lorc( to con-11 - �vzLl) and manufacturers specifications on re-ioofing. 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 appro gal. 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 f rst obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be perfc rmed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee :)f$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 he job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: �'. , i 1 c i,'V i) c- Job Site Address: Roofin Com any Name: l7 L g p Applicant's Signature: t y�.l\ Date: Greg Casteel Building Official Revised 11/2/04