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07050252 CITY OF CUPERTINO BUILDING DIVISION PERMIT �+� Tj�1 1 �l�IUMxIQN� ....:.:::.. PERMITNO. BUILQIIj{rP�Dt2ES AN FERNANDO CT TBD - TO BE DETERMINED 07050252 OWNER'S NAME: PERMIT ISSUE DATE LESLIE LEUNG bt CINDER LAU 05/24/2007 WE: SANITARY NO. CONTROL NO. ARCHITECU ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH i o p LICENSED CONTRACTOR'S DECLARATION Job Description %m I hereby affirm that I am licensed under provisions of Chapter 9(commencing Q with Section 7000)of Division 3 of the Business and Profcssiont Codc,and my license is REROOF—:?0 S QUARE S, 3 0 LB FILL PAPER CLASS A TTK a a in full force and effect � ? License Class B Lica CONSTRUCTION PD FOR BUS LIC. :Ftp Date Contractor ARCHITECTS DECLARA ION i eke< 1 understand my plans shall be used as public records )WU ' U.ti Licensed Professional y OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county <m 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 _< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 iq.Ft.Floor Area $6000 Valuation 41–p (commencing with Section 7000)of Division 3 of the Business and Professions Code)or i that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by arry applicant for a permit subjects the applicant to a civil penalty ofNumber Occupancy Type not more than five hundred dollars(5500). 35712021) , ' ❑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 docs not apply to an owner of q P 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 Guild 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 comractor(s)licensed pursuant to the Contractor's License Law. ❑I 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: ❑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. ❑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 Cam enaction Insurance q and Policy number arc: Carrier. Q �� Policy No.: CERTIFICATE OF EX MPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars(S 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 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 [~i� 1 hereby affirm that there is a consuuction lending agency for the performance of (,rw 5 the work for which this permit is issued(Sec.3097,Civ.C.) Wit. Q Lender's Name r7Lender's Address U 0 I certify that I have read this application and slate that the above information is (1..r-r correct.I agree to comply with all city and county ordinances and state laws relating to CU building construction,and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. (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 U Z in consequence of the granting of this permit. r. APPLICANT UNDERSTANDS.6UD WILL COMPLY WITH ALL NON-POINT Issued by: Date `z t2,. SOURCE REGULATION q Re-roofs Signature ate HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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 Cede,section 25532(a)? All roofs,hall be inspected prior to any roofing material being installed. ❑Yes ❑No 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? ❑Yes ❑No I have read the hazardous materials requirements underChapter 6.95 of the Califor- nia C=--�— , nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building r �T� �� , a . �► docs not currently have a ten at it is my responsibility to notify the occupant of the �–_ requiremenswhichmus etp'ortoiss oraCcrtificateoroetupancy. Signature 3f Applicant Date All roof coverings to be Class"B"or better Owner o u mrzc agent pate CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot : APN . . . . . . . . : 35712020 . 00 DATE ISSUED. . . . . . . : 05/24/2007 RECEIPT #. . . . . . . . . BS000001461 REFERENCE ID # . . . : 07050252 SITE ADDRESS . . . . . : 10410 SAN FERNANDO CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER LESLIE LEUNG & CINDER LAU ADDRESS 10410 SAN FERNANDO CT CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : BILL ZHU CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 6, 000 .00 126 .36 0 .00 126 .36 0. 00 BSEISMICRE VALUATION 6, 000 .00 0 . 60 0 .00 0.60 0 . 00 BUSLIC FLAT RATE 1 .00 107 . 00 0 .00 107. 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 233 . 96 0 .00 233 . 96 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 233 . 96 VISA --------------- TOTAL RECEIPT 233 . 96 CITY OF CXPERTINO aeN REROOF CiY CUPER`TTiNC> PERMIT APPLICATION FORM APN# � � Date: Building Address: 10410 SArJ -C Nl1Nl�t) (1V _ U �'e TtNo CIS i-o! Owner's Name: Phone#: L ES L I E LLU.J 61 C W iDO U) Q /fid �-" - Contractor: .— e��'�L�� / License�s-c, �. Contact: ) Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof 1( Asphalt Shingles JSI 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 Cul>ertino's Tear Off Policy: ❑ Job Description: _ r 2v5 �d Residential ( Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning DeDt. if there are any restrictions: U Cost of,/ 0©Project: �` Type of Construction: Occupanc grow��: /V /V/�f � Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE 13ldg 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 afire 2 to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 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 f:rst obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be perfcrmed. 7. NOTE: If you call for a plywood nail irspection 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 t-ie job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: L/L°. �L// C�/7 _za Job Site Address: /a ° 5c_,,,� V e Roofing Company Name: ( �_�G C� Or✓ �' - �.. ZA4— Applicant's Signature: Date: Greg Casteel Building Official Revised 11/2/04 Community Development ;{ 10300 Torre Avenue n Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 "UPEkTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE # ( Vit- -gip GENERAL CONTRACTOR - FAX # I am not using any subcontractors: i€,na-ture Date Please check applicable subcontractors and com lete 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/Contractor Signature Date