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07030264 CITY OF CUPERTINO BUILDING DIVIfi ON PER-MITC�1 T •CT'6RJ a PERMIT NO. BUILDING ADDRESS: 10129 MELLO PL ROOF ROOFING 07030264 PERMIT ISSUE DATE OWNER'S NAME: YEUNG KING—WAH AND WEI—WEI 5577 VIEEAR--DE n-1 /9619007 SANITARY NO. CONTROL NO. NE: BUILDING PERMIT INFO ARCHrrECr/ENGINEER: BLDG ELECT PLUMB MECH REMOVE EXISTING SHAKE AND © O O C7 CCMP i p Q LICENSED CONTRACTOR'S DECLARATION Job Description m I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is r a a in full forc�dc�L /Jr-6 OO► License CI Lic.# p Datc QA Contractor F w CHITECPs DECLA i aa < I understand my plans shall be used as public records )0.0 IL y Licensed Professional < OWNER-BUILDER DECLARATION V 1 hereby affirm that 1 am exempt from the Contractors License Lawar the .co following reason.(Section 703 L5,Business and Professions Code:Any city or county < which requires a permit to construct,alter,improve,demolish,or repair any structure prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation S Ft.Floor Area that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Q _ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or L 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 APN Number not more than five hundred dollars($500). ❑I,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.). ❑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 docs 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. F-1I am exempt under Sec B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑I 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. ❑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 om{lensauon Insurance carrier and Policy number arc: �. Carrier. " Policy No.:ZZ� CERTIFICATE OF MWMFTION 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,1 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 Worker's Compensation provisions of the Labor Code,you must ,J Q forthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY HI 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.) W QLenders Name 0, Lender's Address U Q 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 .J V building construction,and hereby authorise representatives of this city to enter upon the W above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against ,Hy rA liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the grantingof this it. Date �+ APPLICANT UND T DS WILL COMPLY WITH ALL NON-POINT Issued b'/: SOURCE RE Re-roofs Si u of Applican o r Date HAZARDOUS MATERIALS DISCLOSURE Type Of ZOOf 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. 0 Yes 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 contaminantsas deft by the Bay Arca Air Quality Management all new)naterials for inspection. District? C]Yes No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sectio 25 25533 and 25534.1 understand that if the building does not currently have a is ponsibility to notify the occupant of the rcgaircments which er a ce !°2PC�)� tgnatur e�.f App ;cant Date All roof coverings to be Class"B”or better Ow thorized agent Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Bl.c: Lot: APN 36 )05029. 00 DATE ISSUED. . . . . . . : 03 /26/2007 RECEIPT # . . . . . . . . . : BS)00000784 REFERENCE ID # . . - : 07)30264 SITE ADDRESS 10129 MELLO PL SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER YEJNG KING-WAH AND WEI-WEI ADDRESS CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3336 RECEIVED FROM RECEIPT INTERFACE CONTRACTOR HAVK OLOCKI LIC # 26739 COMPANY RODF ROOFING ADDRESS 5577 VASSAR DR. CITY/STATE/ZIP . . . : SA9 JOSE, CA 95118 TELEPHONE (408) 265-9270 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 9, 000 .00 158.76 0 .00 158 .76 0 .00 BSEISMICRE VALUATION 9, 000 .00 0. 90 0 .00 0 . 90 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 159. 66 0 . 00 159 .66 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 159. 66 19515 --------------- TOTAL RECEIPT 159.66 CITY OF CUPERTINO RE ROOF CUPER,TINO PERMIT APPLICATION FORM oab- APN# Date: 0-1 Building Address: ( Owner's Ph��e©: . `{ Contractor. License#: 669 5- Contact: Cupertino us ess License #: Type of hoof Covering: a( Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings t ❑ Provide I.C.B.O. Report# To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Com ly With Ci ertino's Tear Off Policy: ❑ Job Description: .e,rvou Residential Commercial ❑ � p Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: Er Cost of Proict: Type of Consttntcti _ Occupancy group: .e��C 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 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 applie i 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 anir 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:=irst obtaining an inspection, will require the removal of all new ma-:erial down to the sheathing, so a proper City inspection can be perfDrmed. 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 above stated policy on re-roofing. 9) Homeowner's Name: Job Site Address: 1 ��� 'LC_ Roofing Company Name: ��d Applicant's Signature: Date: 1'Z6 Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 -'UPEkTINO Buildin De artment JOB ADDRESS: PERMIT# ncZ� h.\L. Q�� 07v P3le�4f OWNER'S NAME: �)d-M i PHONE#Y�• s4 GENERAL CONTRACTOR: FAX# I am not using any subcontractors: . Sign e 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 oofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date