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09070092 777777777777777 CITY OF CUPERTINO BUILDING DIVISION PERMIT IWOO1AtTI��1. BUILDING ADDRESS: PERMIT NO. 7454 DUMAS DR D & DC:)NSTRUCTTON n9070092 OWNER'S NAME: PERMIT ISSUE DATE iON : S CONTROL NO. (408) 666-5298 ARCHTTECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH O p LICENSED CONTRACTOR'S DECLARATION Job Description m C I hereby affirm that I am licensed under provisions of Chapter 9(commencing -Z m with Section 7000)of Division 3 of the Business and Professions Code,and my license is 'Z< in and effect. RE—ROOF TEAR OFF EXISTING WOOD SHAKE, PLYWOOD, j ? License Class Lic.k o Date Contractor INSTALL 3 0 SQ COMP. 4 0YRS UlARC5 CTS DECLARATION a< I understand my plans shall be used as public records �yU WO Licensed Professional n n OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the in O following reason.(Section 7031.5,Business and Profession Code:Any city or county 4$V which requires a permit to construct,alter,improve,demolish,or repair any structure Zy prior to its issuance,also requires the applicant for such permit to file a signed statement =C that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation yt- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 110 0 y 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 APN Number Occupancy Type not mere than five hundred dollars(s500). 35926014 . 00 ❑I,as owner of the property,or my employees with wages as their sale compensation, will do the work,and the structure is not intended or offered for We(Sec.7044,Business Required Inspections and Professions Code:The Contractors License Law does 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 build or improve for purpose of sale.). 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 co osE)licensed pursuant to the Contractor's License Law. ❑lam u n B&P C for this rem n Date WORKER'S C PENSATION DECLARATIO I hereby affirm under pen ty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compcn- 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 Worker's Compensation Insurance carrier and Policy number are: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section\d pot be completed if t is for one hundred dollars($100) or less.) I (Y_` 1 certify that inTho performanceofRtes work for hi Y'`o-per�tt is issued.I shall not employ any person in any man to sub' Ire rs'Compensation Laws of Califoroia.D Applicant NOTICE TO AREC 6IMPAr makin is enilicate of Exemption,you should become subject to the ogws Compensation grovisions of the Labor Code,you must ,J O forthwith comply with such provisions or this Vit shall be deemed revoked. Z"" CONSTRUCTION LENDING AGENCY (~.r►�� 1 hereby affirm that there is a construction lending agency for the performance of (Y, the work for which this permit is issued(Sec.3097•Civ.C.) WI.1.Q Lender's Name ]z Lender's Address U C) I certify that I have read this application and state that the above information is Li.r-' correct 1 agree to comply with all city and county ordinances and state laws relating to 0Vbuilding 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 V) liabilities,judgmens,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. Date APPLICANT UNDERSTANDS AND WIL LY WITH ALL NON-POINT Issued by: 74�4 47 SOURCE REGUtXMM. Re-roofs Sign of HAZARDOUS M DISCLOSURE Dale Type of Roof Will the applicant or future buil ng occupant store or handle hazardous material as defined by the Cupertino Municip ode•Chapter 9.12•and the Health and Safety Code,Section 25532(a)? / All roofs:;hall be inspected prior to any roofing material being installed. ❑Yes y/11 If a roof i:.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 m iterials for inspection. District? ❑Yes 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- niaHealth&Safety Code,Sections 25505,25533 and 75534.1 understand that if the building _. does not currently h nt lha is my responsibility to notify the occupant of the _!G_ reyuircnr i aancenraCertificate or cap Signature of Applicant Date ow rorauthomcd gem Dare Al oof coverings to be Class''}''or better CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35926014 .00 DATE ISSUED. . . . . . . : 07/08/2009 RECEIPT #. . . . . . . . . : BS000008159 REFERENCE ID # • • . : 09070092 SITE ADDRESS . . . . . : 7454 DUMAS DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER PAN LI-CHUAN AND CHYI ADDRESS . . . . . . . . . . : 7454 DUMAS DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4311 RECEIVED FROM . . . . : LIFE CORNERSTONE CONTRACTOR . . . . . . . : ENEE WU LIC # 23939 COMPANY D & D CONSTRUCTION ADDRESS 1447 HAMPTON DR CITY/STATE/ZIP . . . : SUNNYVALE, CA 94087 TELEPHONE . . . . . . . . : (408) 666-5298 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 1, 100 . 00 1 . 00 0. 00 1. 00 0 . 00 1BSEISMICR VALUATION 1, 100 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1REROOFRES SQ FEET 30 . 00 390 .00 0 . 00 390. 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 391.50 0 .00 391.50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 391 .50 1196 --------------- TOTAL RECEIPT 391.50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF Community Development 10300 Torre Avenue ` Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ,.UPEI�TINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: - PHONE # GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Si;nature 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 Roofing Z 3 Septic Tank C� Sheet Metal Sheet Rock Tile .r o Owner/ ntractor Signature D to . CITY OF CUPERTINO ' REROOF CUPEkTINO PERMIT APPLICATION APN # D av Date: 3i co ►�f. Building Address. Owner's Name:1 11 Trip I Phone #: HOA: Yes ❑ No N If yes, provide lelter from HOA �Oe 30 Contractor: Phone #: ..- Fax #: Cupertino Business License #: ? 3 Contractor License #: ,r > 6 y G Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles -Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles o Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. 7 0 4.4I Job Description: Residential V9 Commercial Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet ind-x. Valuation: I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF C'UPERTINO Qn, REROOF CITY OF CUPEkTiNO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group a 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F I 1 BCBSC Cal Bldg S-:andards B ALL PERMIT TYPES Commission Fee 1 BSEISMICRE Seismic Residential B 1 REROOFMRES Re-roof Mt Iti-Family B 1MFDWLROOF 1 BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissio:i Fee 1BSEISMICRE Seismic ReAdential B 1BUSLIC Business License B 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 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applic-d 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 Cit-i,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 nai' 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 peri 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 carp 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. Homeowner's Name: i)11( Job Site Address: 74 L ��h�� , , L 4�,�Z�tt�, � ��t 7 A Roofing Company Name: C . / ' c 7 vet- ' Applicant's Signature: Date: ��"�l v C1 Greg Casteel Building Official' Revised 07/30/08