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07090141 CITY OF C7UPERTINO BUILDING DIVISION PERMITS '— PERMIT NO. BUILDINGdD�'EL LAC WAY PRINCIPLE ROOFING & 07090141 / /4 PERMIT ISSUE DATE OWNER'S NAME: WU SHUN J AND CHIACHU G 1700 N :-ST ST 09/21/2007 SANITARY NO. CONTROL NO. jNE: (408) 4311-1681 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p LICENSED CONTRACTOR'S DECLARATION Job Description Zim I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is RMV EX S`PNG WOOD SHAKE, I N S T L 0 S B SHEATHING, '.<Q. infullfarecande el 6, ASPHALT COMPOSITION SHINGLE t�? Liccnsc Class Lic.# p Datc Contractor :F RCHITECTS DECT WRAT143N i a< 1 understand my plans shall he used as public records )yU p y Licensed Professional n OWNER-BUILDER DECLARATION '> I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason.(Section 7031.5,Business and Professions Code:Any city or county $Pi which requires a permit to construct,alter,improve,demolish,or repair any structure "rn prior to its issuance,also requires the applicant for such permit to file a signed statementValuation ?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 ;>q.Ft.Floor Area $1000 1000 0 e.F=- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 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 3590400 5 Aftl Number Occupancy Type 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 dues 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.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contruwrs 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. ❑[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 Compensation Insurance carrier and Policy number are: Carrier: [J �'r^ Policy No.: CERTIFI ATE OF CEMPTION 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,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 O forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY E.r►�-� I hereby affirm that there is a construction lending agency for the performance of a> the work for which this permit is issued(Sec.3097,Civ.C.) L4 Q Lender's Name az Lender's Address U O I certify that I 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 Ubuilding construction,and hereby authorize representatives of this city to enter upon the U above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against Hfro liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date 2/ ►_-� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by SOURCE EGULATIONS. Re-roofs ,/Z--- Signature bf Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupantstore or handle hazardous material as defined by the Cupertino Munici 1 Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes ^ No 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 d rued by the Bay Area Air Quality Management all new rr aterials for inspection. District? y� ❑Yes Nu T Y I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.I understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements lxbich must be met prior to issuance of a Certifica f aZl /L Signature of Applicant Date r All roof coverings to be Class"B"or better Owner or authorized agent Date CITY OF CUPERTINO VREIZOOF CUPEkT1NO PERMIT APPLICATION FORM APN# Date: 9D UUf , () G--,) 2_1 0 Building Address: Owner's Name: Phone#: SHInrJ W14 N ) 25 7 — 2?17 Contractor: License#: fz-;0 e; L i>- J 6 3 G1' Contact: Cupertino Business License #: D��'- Gid Lcy.✓ lA Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ ,Asphalt Shingles Asphalt Shingles 2 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 Cu ertino's Tear Off Policy. Job Description: p�1K4 ve &;; iS T Av! WA- I/ 4C- a Residential ❑ Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Det. if there are any restrictions: LJ Cost of Project: Type of Constru-,tion: 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 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 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 apprcval. 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 irst obtaining an inspection, will require the removal of all new mat Arial 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'he job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: �' t/✓ WG I job Site Address: &,46-c- W4=:! Roofing Company Name: _9K�a16 Applicant's Signature: Date: 0/1Y Greg Casteel Building Official RevisE d 11/2/04 CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35904005 .00 DATE ISSUED. . . . . . . : 09/21/2007 RECEIPT #. . . . . . . . . . BS000002711 REFERENCE ID # . . . : 07090141 SITE ADDRESS . . . . . : 7747 LILAC WAY SUBDIVISION . . . . . . . CITY CUFERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : WU SHUN J AND CHIACHU G ADDRESS . . . . . . . . . . : 7747 LILAC WAY CITY/STATE/ZIP . . . : CUFERTINO CA, 95014-4208 RECEIVED FROM . . . . : DEFECK LOI CONTRACTOR DEFECK LOI LIC # 27564 COMPANY PRINCIPLE ROOFING & ADDRESS . . . . . . . . . . . 17CO N 1ST ST CITY/STATE/ZIP . . . : SAT JOSE, CA 95112 TELEPHONE (4C8) 436-1681 FEE ID UNIT QUANTITY IMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 10, 000. 00 169 .56 0. 00 169 .56 0. 00 BSEISMICRE VALUATION 10, 000. 00 1. 00 0. 00 1 .00 0. 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 170.56 0. 00 170 .56 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 170.56 MC --------------- TOTAL RECEIPT 170.56 Community Development 10300 Torre Avenue Cupertino CA 95014 11 Is Telephone(408)777-3228 CITY OF Fax(408)777-3333 7UPEkTINO Building Department JOB ADDRESS: PERMIT# p-7 n -e�'70 j OWNE 'S NAME: �„� v 1 PHONE # 6Z , GENERAL CONTRACTOR: =, - FAX # I am not using any subcontractors: Si;nature Date Please check applicable subcontractors and co m Clete the following information: 60 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 ';0' w4r/ Signature Date