06070014 CITY OF CUPERTINO
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BUILbING DIVISION PERMI _41c,
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BUILDING ADDRESS: MBROWN CONSTRUCTION, INC "'T"06070014
1222 BUBB RD
OWNER'S NAME: PERMIT ISSUE DATE
ANk YIMING LI 702 S . DANTE , WAY 07/OS/2006
NE SANITARY NO. CONTROL No.
(408) 260-1260
ARCHMCf GINEER: BUILDING PERMIT INFO
BLDGEIECr PLUMB NE61
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+fJ� LICENSED CONTRACTOR'S DECLARATION - Job Description
ae
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ix6 HN SsdmTIX1U)af DlrWvnJaf do Bvvncn and Prp(cviooa Codc,v4 my li-c�u
<�„ 4ranranxrad Hm /p �ZZ _REMOVE EXISTING SHAKE, INSTALL SHEATHING WHERE
— cewvaa« ,rrJ -NEEDED AND INSTALL CLASS A COMP APPROX 34 SQ.
'- - ARCHITECPSDECLARATION
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OWNER-BUILDER DECLARATION 1fg1 gNM6�
1 hcrtM1y.Rrm Nu I.. ....,q from de Contracm o 1:My low for Nc
-00 foil wing team(S.,d.7M I.5.Bud"-••and Pmfetdord Code:AOY city m nutty
$ which rtqulrea a pormii to corwrut.,ha•Ynl•ove,demaliah.or ropa4 any,a.mna
-�ssA prior N hcutliR�ym�wliw Nc mai�9°w dNcCau�ic�it liak�c law(a'�,rv�ms Sq.FC Floor Area �u� F Valua[ 17000
YFO (co bdrigmdbSeaim7000)orDiid.3.rNCBroiaandPrac�oruCrdc)or 2nU6
a`< Nat M 4 ea,mpa Naefrom and die buia for the alk{ed ammpdon Any vkladim of
smkat ro7l.sga,�Y+vWk+^�rQav=^namb�ma Nr.ppoamm.eru pa�.uya MN Number U cupancY TYPe
^m nae than Rw hurdred ea4rs(55001. 3 6 211053 . 0
❑4 u vaaer of the pnopmy.or my emp oym rN w,gea as Ne'm sole eampeadail_^,
"Ido no. and dranRmmoanoainterecderefraedfor,ne(s .row.Bmm RequiredIns Inspections
.nd PmfcNou Coda:The Caoaa no/s Liana low dm bot apply m.ae+e a P
IvopenywMWdsmimptmatmen^,+ndwmdw, wwthiwerord Shhu
owb empdym.provided Nu sate improa ri am not WatdN..Mb,dd for aaln R. .
bmwever,Ne boilding or L^pmv !Asad vIWn ane)earacamPlodon,Nea.ntcr-
boilder w10 bane de burden of proving that he did nor WW or inn nm for pap of
okl.
C)1,u awns a ft property.+.aeitmaely coni a ing w O naW mntnrmn to
canamnca de pmjaa(S 70W,Bmineaa trod Profession Code)The Coot a l U.
ata LAW dace mot apply m m owns of Prdii y who Wilda or Impmta dantma and.
who con.tz for such pmlcns wlN a ea,,r(a)li d,v Lmthe Coat/ W.
Lircnm IJV.
❑Iwo aanpt tmeQ See ,B SPC for th4 realm
Ona Due
WORKERS COMPENSATION DECLARATION -
1 bartby aR4m ortdcr peaalty a perjury mea the fnlbwing
❑1 e,.e ad w111 malntab,emil;om aeotaem m aariruwe ra wortdacompcn-
aatloa as pmridcd for by Semon J70r1 bf the Labor Code,In,da<puf.—a Ne
wont for whkh Nis p<noit 4 iaued.
❑1 ha.e rand will m+inuin W rkea Compebutiar Inrvr .u no Ioboil by Savar
3T00 of Ne Lwaa CoM,fa de vafapuac aNa sant for which Chia pemrii 4 incl
My Wbrtea Com/I�matior losini Corny/(and Polley mpmb�ayv�e: -
Urt{a -r .-��, F,1 Pb11cT No.: G?T 7/3DO/O 7/
CER77FlCATE OFE EMPr10N PROM WORKERS
COMPENSATION INSURANCE
Clhb cNm trod not be evnpkrd U Ne permu 4 foram hunArA doBsa(S I00)
a kat)
1 md(y the(bi the pafarmancc of Ne wort for whkit this permit 4 iSSux .I Shall m(
rnploy ao,pant in any manner.u to btrmne atb*t.Ne WarbaY G
luwa a Ca ifam4.O.rc
NOTICE
NOTICE TO APPLICANT:V.trey making this Certificate a th FLabor an,yen ahaud
hardb eacompy it W hpir Camp Or U63 pmiil."athe!Noor Code yaa mvu
,J 2 forNwiN mmPIY wIN mmM1 pmrisiam Or U63 Perml(ShalINC trsrtxA maNcd.
ZO CONSTRUCTION LENDING AGENCY
Pr Ibcmby aft that Nem 4acmmuNnn"in,.µ for dk pcdo...a
W> the wort for whkb dda pctmit 4 iraocd(Sec.lO4l,Ch.C)
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L rot es AilJ.
U 0 1 certify Na,1 h.read this applkadon and,tato dw tit/, a Iar..U.4
U. Hcarom.l agme to comply veldt all city and county aNiturcu and awe law.m41ing to
U buildingconunmtion,and hemhyauthorirt reprmnw1eof Niscitymenkrupm Nc
W ahoe-mcntiuncd prupcny fm imitation putpoar
(Wc)adore to Sart,indcmniry and amp harmloa No City a Cupmino,Pun r
Il.bllihu,fodi...cousartd eapemea whdM1 an,in any wayamuc aealmtsnd City
V Z in mm ...of the Branding or this permit. /
t-' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT IssuedbDate
SOURCE REGULATIONS.
L - ri 7 S- Re-roofs
Sienuum of App1kabKdro a dor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WUI site appliaot a(more balding oavputt ane a handle bu,Aom nuuial
v dwaed by dtc Cupeamo Muanpal Cod,CNpmr 9.11.and ale HNN aid SaINY
cmc.seetbo uSJ$o7
❑Yn ,/ : -/, All roofs shall be inspected prior to any roofing material being installed.
B To
Win Nc.ppl'tc.t m rmme bvildiog mvivm u.cRulpmrnt m M.+ima whkh If a roof is installed without first obtaining an inspection,I agree to remove
emit Wardnm ur oanwnioats a dented by Nc Bay Arta Air @way Mabalm allnew materials for inspection.
WakoYa �
1 Inas road thahaard,ms .^1a..mqufronntmutpvkrChavcr695ofdaCairor-
aa HnIN S Way Codc.Savona=.5.15577 and 25514.1 vadcrwd dm Bile Mu)Nng
dao not carramly hat•aunt that It 4 my r.VandilWitY n modify tic occupant or Nc
roaairtmma,ed,knmaaxmet .4aa.c of.Qrure.coro iiaay. Signature of Applicant Date
ome a� �agent Dau,Dau,. . All roof coverings to be Class "B"or better
D
CITY OF CUPERTINO
�m 2 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36211053 . 00
DATE ISSUED. . . . . . . : 07/05/2006
RECEIPT # . . . . . . . . . : 35106
REFERENCE ID # • : 06070014
SITE ADDRESS . . . . . : 1222 BUBB RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : YIMING LI
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : MBROWN CONSTRUCTION
CONTRACTOR . . . . . . . : CHRIS BROWN LIC # 25108
COMPANY . . . . . . . . . . : MBROWN CONSTRUCTION, INC
ADDRESS . . . . . . . . . . : 702 S . DANIEL WAY
CITY/STATE/ZIP . . . : SAN JOSE, CA 95128
TELEPHONE . . . . . . . . : (408) 260-1260
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
-- - - - - - - - - ------------- -- - - ------ -- ---- ------ - ----
BPERMFEE VALUATION 7, 000 . 00 137 . 16 0 . 00 137 . 16 0 . 00
BSEISMICRE VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00
--------- - ---------- ---------- -- --------
TOTAL PERMIT 137 . 86 0 . 00 137 . 86 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
- - - --- --- - - - ----- ------ ------ ----- ----- --
OTHER 275 . 72 VISA
TOTAL RECEIPT 275 . 72
•
Community Development Department
. Building Division
City of Cupertino
10300 Torre Avenue
• Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
� CUPEkTINO
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 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) ln-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 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 the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: )m Inclt l )
Job Site Address:
lao_D_ Nbc c��r haJ cA Asal �}
Roofing Company Name:
Applicant's Signature: Date: I�
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
Community Development
10300 Torre Avenue
Cupertino CA 95014
I Telephone(408) 777-3228
Fax(408)777-3333
46UPERTINO
Building Department
JOB ADDRESS: PERMIT #
1 x2213vb10 Rd, CV Pf r-h nu GA qso i D '-? p d l 4-�,
OWNER'S NAME: 1 Wilj 1-i PHONE # LW L ,5S 7
GENERAL CONTRACTOR-WorvWn Const COOn, Tvnc. FAX # K• ZL 0- 1 "()
I am not using any subcontractors:
Signature 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
Septic Tank
Sheet Metal
Sheet Rock
Tile
• 15 i
Owner/Contractor Signature Date
OF CUERTIO l O o I `
CITY000
I
CC - REROOF
SPUPEkTINO . PERMIT APPLICATION FORM
APN # ate: <?
Building Address' GR gSD1'�
2-in- �36bb M Cllr
Owner's Name: Phone#:
`I m. 9 Lt
Co4ntractor: Phone#: License#:
(�WDWh 0,0As.+VCAri 0 SnC. 44,2 o- 1Z40 K I DX1rL
Contact: Phone#: Cupertino Business License#:
Chris phlyt L{-D ,wo, 12-ub 7-SI D f(
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ .Asphalt Shingles Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
✓1 Other(Spec fy)r{}1 S��e ❑ Other(Specify)
Number of existing coverings Ll Provide L gr. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: El
Job Description: . p_emlo4L C,q(--961°�� r-
, ^� ht�I
11 4Thrl .uhvre Ind
1^54x11 Co^'�PtslNvr, c!-gSs � gPr°x•
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning D_pt. if
there are any U
Cost of Project: Type of Construction: Occupancy group:
Ul7
Qty. if Fee Grou
RCFe ID Fee Description
Bld Permit Fees. BUILDINGEner BUILDING Seismic Fee Res BUILDINGM Seismic Commercial BUILDING Plan Check Fee BUILDINGBusiness License BUILDING