06100161 CITY OF CUPERTINO :
BUILDING DIVISION PERMIT
IT
1BUILDING ADDRESS: PERMIT NO.06100161
22632 ALCALDE RD
OWNER'S NAME:
PERMIT LSSUE DATE
LEE WEN LI 10/23/2006
JNE: SANITARY NO. CONTROL NO.
ARCHiTECf/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
o p` LICENSED CONTRACTOR'S DECLARATION Job Description
I hereby affirm that I am licensed under provisions of Chapter 9(commencing
i�, with Section nd f of Division 3 of the Business and rofess'its ode, d my license is REROO F- WOOD SHAKES CHANGE TO COMPOSITION 4 0 YR
�y in full Cotce and eCfec
Zg? L;eensc Class LIC.+► O S B PLYWOOD ,
--o Datc Contractor , 20 SQUARES CLASS A
ARCHITECT'S DECLARA N
,a
2.U 1 understand my plans shall he used as public records
C y Licensed Professional
y OWNER-BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the
p O following reason.(Section 7031.5,Business and Profmsions Cale:Any city or county
COO
°m which requires a permit to construct,alter,improve,demolish,or repair any structure
Z y prior to its issuance,also requires the applicant for such permit to file a signed statement
=0 that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuati$6 0 0 0
u F- (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
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of A N ber Occupancy Type
not more than five hundred dollars(5500). 34216-1 3 . 00
❑1,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 forsale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law does not apply to an owner of (1 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 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 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.
❑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 Compensation Insurance carrier and Policy number are:
Carrier: 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.)
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 Californy Da1r �- T •%�
Applicant / {-/ if—
NOTICE TO APPLC ANT:If after makin/g th' Ccrt;ficate 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.
CONSTRUCTION LENDING AGENCY
�~i►�-. 1 hereby affirm that there is a construction lending agency for the performance of
Ri> the work for which this permit is issued(Sec.3097,Civ.C.)
W A Lender's Names
Z Lender's Address
U 0 1 certify that I have read this application and state that the above information is
LL► correct.1 agree to comply with all city and county ordinances and state laws relating to
F" building construction,and hereby authorizt representatives of this city to enter upon the
Wabove-mentioned property for inspccuon purposes.
a (We)agree to save,indemnify and keep harmless the City of Cupertino against
liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL N N-POINT Issued by: Date ��'Z3-z%4
SOURCE RE ULATIONS. — / /' _
( V Re-roofs
signature of Applic Can for Da
Az oar MATE LS DISCLOSURE Type of Roof
Will the applicant or uturc 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)?
❑Yes �No All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes e No
1 have mad the hear ous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building
does not currently have a tenant,that it is my responsibility to notify the occupant of the
requi in is which must be met pno to issuance of a Certificate of Decoy y. Signature of Applicant Date
i 1i O
Owner or auth •re d g me All roof coverings to be Class "B"or better
a � J D
CITY OF CUPERTINO
.m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN 34216103 . 00
DATE ISSUED. . . . . . . : 10/23/2006
RECEIPT # . . . . . . . . . : 36525
REFERENCE ID ## 06100161
SITE ADDRESS 22632 ALCALDE RD
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER LEE WEN LI
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . : ,
RECEIVED FROM YING CHU YANG
CONTRACTOR LIC #
COMPANY . . . . . . . . . . .
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 . 00 105 . 00 0 . 00 105 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 231 . 96 0 . 00 231 . 96 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
---- - ---- - - --- --- ---------- -- ------------------
CHECK 231 . 96 2505
TOTAL RECEIPT 231 . 96
10/10/2006 08:26 FAX 408 777 3333 CITY CUPERTINO @ 003/005
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
I. 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 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 fi•om 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 vaid before an giber inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of V4"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 s?tate�d-policy on re-roofing.
Homeowner's Name'
job Site Address
7
Roofing Company Name: % /�1— / C 1 lk
11" n �
Applicant's Signature: _ v�-Y _ Date: C� -61
� a
Greg Casteel
Building Official
Revised 11/2/04
10110/2006 08:26 FAX 408 777 3333 CITY CUPERTINO jt002/005
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION FORM
APN# ' n ( Date' -
Buildinig Addr :�_� Ca
Owner's Name: ., P
Owner's hone
Contractor: C /H / �� ,/� License
Contact://� fI
(/1(l ` /y `�--
1 Cupertino Business License#:
r r Type of hoof Covering:
Eidsting: Proposed:
O built-Up Roof ❑��w7t-Up roof
O Asphalt Shingles Q Asphalt Shingles
&' Wood Shakes ❑ Wood Shakes
O Wood Shingles O Wood Shingles
O Other(Specify) O Other(Specify)
Number of existing coverings 0 Provide I.C.B.O.Report#a&C-i
4 To be Removed O Provide Mfgr.Installation Specs.
I Have Read Understand and Will Comp_ ly With Cuv_ertino's Tear Off Policy: ❑
Job Description: r 1 ''
G
�� � Y1�
-
Residential ( Commercial ❑ S ,r L�
Fire Zone: Yes ❑ No - Confirmed with Planning De t. if
there are any restrictions:
Cost of Project: Type of Construction: Occupancy group:
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