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07060157 777777777777777777 CITY OF Ci;PERTINO � Qjt .dl'rQ .' BUILDING DIVISION ' PERMIT PE cylT�r . rOWNER'S 1c�VtESAONRCVIA ST C & C RO)FINr 0�U68157 l U O 11 PERMIT ISSUE DATE NAME: 8 9 S 21 ST 06/19/2007 HONG PANG & MEI LENG NG SANITARY NO. CONTROL NO. NE: (408) 298-1868 BUILDING PERMIT INFO rARCHITEcT/ENGINEER: BLDG ELECT PLUMB METH p QLICENSED CONTRACTOR'S DECLARATION Job Description Veby affirm that I am licensed under provisions of Chapter 9(commencing REMOVE MAXI TILE & INSTALL G.A.F. GRAND CANNON Z wn 7000)of Division 3 of Ute Business and��professions Co .and my license is ! N in full force and eff Z 4? ASPHALT SHINGLES CLASS A 28 SQ. z License C s Lic.A i2 p Datc - Contractor tf G w A CHITECI'S DECLARATION i C< I understand my plans shall be used as public records >Lu U.l- Licensed Professional a OWNER-BUILDER DECLARATION 1 hereby atTirm that 1 am exempt Crum the Contractor's License Law or the p O following reason.(Section 703 1.5,Business and Professions Code:Any city or county 0 which requires a permit to construct,alter,improve,demolish,or repair any structure Valuation prior tit its issuance,also requires the applicant for such permit to file a signed statement 'j Ft.Floor Area $10280 ?a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 (1 G H (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 Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 35623 0 2.: Number not more than five hundred dollars($500). 0 Las owner o[the property,or my employees with wages as their sole compensation, Required Inspections will do the work,and the structure is not intended or offered for sale(Sec.7044.Business and professions Code:The Contractors 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.U, 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 1,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 Contractor's License Law. B&P C for this reason 0 I am exempt under Sec Owner_______; �Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: L]I 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. 0 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 Workers Compensation Insurance carrier and Policy nu : ber are Cartier. f� ✓fir r Policy 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.) 1 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 Z forthwith comply with such provisions or this permit shall be deemed revoked. Z R CONSTRUCTION LENDING AGENCY F-t Lnr I hereby affirm that there is a construction lending agency for the performance of p(,> the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name az Lcndees Address U Z 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 authorize representatives of this city to enter upon the ahove-mentioned property for inspection purposes. >4 W (We)agree to save,indemnify and keep harmless the City of Cupertino against Liabilities,judgments,costs and expenses which may in anyway accrue against said City o� U z in consequence of the granting of this permit. Date ►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued ba: 6- SOURC GULATION . �& r._ - G -O'1, Re-roofs Signature of Applicant/Contractor Dare Type of hoof HAZARDOUS MATERIALS DISCLOSURE YP Will the applicant or future building occupantstore 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. 0Yes 2M If a roof is 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 contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? 0 Yes G}No 1 have read the hazardous materials requirements under undhaptererstand 6.95 of the Calding nia Health&Safety Code,Sections 25505,25533 and 25or- 534.1 understand thaz iCthc building docs not currently have a tenant,that it is my responsibility to notify the OccupantUte of -+' Date rcymrc a which must®el nor to" uance of a Cenirtcate of Occupancy. Signatu)e of Applicant � 4Z44 - , 6yD Q� All roof coverings to be Class"B" or better Owner or authorized agent CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: Patg COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 35E23022 . 00 DATE ISSUED. . . . . . . : 06/19/2007 RECEIPT #. . . . . . . . . : BSC00001694 REFERENCE ID # . . . : 07C60157 SITE ADDRESS . . . . . : 21_`,06 MONROVIA ST SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CHONG PANG & MEI LENG NG ADDRESS . . . . . . . . . . . CITY/STATE/ZIP RECEIVED FROM C AND C ROOFING CONTRACTOR OS'TALDO CAMARA LIC # 22982 COMPANY C x C ROOFING ADDRESS . 89 S 21 ST CITY/STATE/ZIP . . . : SAA JOSE, CA 95116 TELEPHONE (438)298-1868 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL _ ______ ___ ---------- ---------- ________ ---------- ----- BPERMFEE VALUATION 10, 280.00 180.36 0.00 180.36 0. 00 BSEISMICRE VALUATION 10, 280. 00 el.10 0. 00 -----1_10 ------ -- --T TOTAL PERMIT 181 .46 0. 00 181.46 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 181.46 VISA --------------- TOTAL RECEIPT 181.46 07 0 CITY OF CUPERTINO 42 REROOF "!I CUPERT{NO PERMIT APPLICATION FORM _7 All 1&, Date: .�� Po�. �01 • v v - D 2 Building Address: Zl G v S T Phone#: —/5`� Owner's Name: y0� Contractor: ��'c�� License#: Contact: Cupertino Business License#: Type of F.00f Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles DK Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings 0 Al ❑ Provide I.C.B.O.Report# AL To be Removed E3 Provide Mfgr.Installation Specs. . I Have Read,Understand and Will Comply With Cl.pertino's Tear Off Policy: Job Description: M C 0V Residential [ Commercial LJ P.4j9 t —Sh)N6-��S Fire Zone: Yes ❑ No Confirmed with Planning Dept. i there are any restrictions: U Cost of Project: Type of Constniction: Occupanc group: O . Z 3 Qty. if Fee Group D Fee Description p Applicable Fee I BPERMFEE Bldg Permit Fees BUILDING BUILDING BENERGY Energy 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 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 ani.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 ma-:erial down to the sheathing, so a proper City inspection can be perf ormed. 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 car.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 abov L-stated policy on re-roofing. Homeowner's Name: _J�fG_r �— job Site Address: Roofing Company Name: cf Applicant's Signature: ja �� Date: 6 / 9— D 7 Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY OF '-UPEkTINO Buildin De artment JOB ADDRESS: PERMIT # 215-a6 OWNER'S NAME: PHONE #moor-- - r GENERAL CONTRACTOR: a FAX # o I am not using any subcontractors: G Si;nature Date Please check applicable subcontractors and complete the followinginformation: 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