02080094�• •EGULATIONS._' w`eLO jy//'s`s-nwn.ros..r
1 dGsJ Y q
Signoy� A c' onrmctor T '@ '� Dae'
...,,1•;:. HAZARDOUS MATERIALS DISCLOSURE;,:'
_ W ll rhe applicant or firm, Wilding occupant start or handle hares ems material
As de0nnd by Ne Cupcna. Mumnpal Code Chapter 9.12, ad he Health And Safely
Code 5 crioa 255320 tt
❑YM :.. n gi.❑No.� I 1TF�.f!.( r1'h'1,.
W01 N pylic t o furore W Idm`II'�noon pant usne,uipment o de roes whrch
m rd 1 M1 zas air contaminants u defined by the Bay Area Air Quality Management
-Di tract -I , i
0 Yea ❑Nn .
r
1 have mad the hmardom matenals nor mments under Chapter 6.95 of the
oeccunpanra gm or Inn mnremem, Ih,rh'most he met prior
OcI
caner or A ge '
Issued by Date
Re -roofs
Type of Roof..
Il 1 !'�l' it .'.6'S,;
All roofsstialLbe.il,petted prior,to.any_roofing.material.being installed._......_....._
If n roof Is insialled without first obtaining an inspection;`I agree to remove
all new materials for inspection. Applicant understands and.will comply with .
all moi-poim'source regulations, ., ,
Dam Si nae a icant Date
All roof coverings to be Class "B"
orbetter � ,
....,.._.. ...............'OFFICE-......_.._.......__..___.__.._..........._._. _
�- BUILDING DIVISION,v PERMIT
CONTRACTORINFORMATION:
I hereby affirm under penalty ofperjury, one of the following declarations:
BSt1IOD7sNbg"Ts�FORD DR.
MING YANG SHEN
PE rt02 080094
LAff&'TANG SHEN
Compensation. As provided for by Section 37W of the tabor Core, for fin
APPLICATiQN$11B M 002
2N5O.. lCONTROL
'perfnnnmce of Nfi work fur which this permit is issued.
'-
111 have and will maintain Woikcr's Compensation Insurance, ai iaryirtd by.Section
PHONE:
_
SANITARY NO.
O O
ARCHTEC (ENGINEER:
BUILDING PERMIT INFO
-
BLDG ELECT PLUMB MECH
114.�. '.1`� 11,!i. O..VS'
;......: _,. COMPENSATION INSURANCE..). _;. n_, ...
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0 Z c4
LICENSED CONTRACTOR'S DECLARATION
I thereby affirm that l am licensed under provisions of Chapter 9 (commencing
J (y� p rip[lon
� y
I, ih Section7000)and o rm'. inn l of he Business antl P ofe ions Code, end my license
I, in full forte and effect.
RE ROO F — — WOOD TO T I IL�e
v
� � � � � Mme ®
O u
31+Fn
License Class Lic. g
Date Contractor
..,.._.�:
l a,i the w�for is rs ed I
P pmt
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ARCHITECT'S DECLARATION
1 understand my plans shall W used as public records
SEP 12 2002
uu�
Cnm sannl iCehfnmomtDamof
/
=
Licensed Professional OWNER -BUILDER DECLARATION
m y
C ZF Q
1 hemby affirm that I am exempt from the Comment's License law for the
following mann 9 iorm Code: Any
BUILDING $ 8 0 0 0
•. r
city or county
est and morose,
which uireso rat uo
ennit t ons m r, alter, de cture
improvuch
become subject the Work o,Ien
pairiun pmvisions'of the liber Code: you must
C�
e
A.3
c applicant
vires Ne applicant for each permino file uigiud,nlemem
P ° 9 Permit fie a signnysmment
.... -- -- �
¢�•
T,3 3V �li �r,�f�a 5
{"(
• Valuation
CONSTRUCTION LPNDING AGENCY
thath0!lien4edeiss'6nttgthepm'visionsofdre Conmtoes Licenmul (C ou ,9
pu
with Section
(comm.. if, u )olgl of Division 3 of she Business and Professions Cade)
or the he is exempt ducrod rah and the basis for the alleged eicnp iii. Any violation
I C.: -r. C: I l+.i'. -.i t +.l Cs�,e -�s i tk;,t
wy
r
of the work fm which Ilii. permn a ,sued (Sec, 3097, Co. C.3
- of Section 7031.5 by any applicant fora permit subjects the applicant n n civil penalty
ernm mart Nan five handrce eeum (s56ne
3 0 5Al2N IURANE
: "' I, , Occupancy Type
-....-, ._ _._.._ .....__ __.. _- .._. .... .._._... __ .. ... ___ _... _..... .. __ ..... ._.. _._ _ ...... .
Las owner of the property, or my employees with wages As their sole compensation,
307 — INSULATION
IV" nr ai; rlf rq
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k➢
'do Ne work: and the swcmre is mol intended .1 offered far ..In (Sac. 1064,
Business Professions
601 - ROOF T �' Ins '
C f,J
and Code: The Comment's License Law does not apply to an
owner of property Who builds or improves thereon, and who does such work himself
q cations'-�
602 ROOF
W
�, M.
L
or through his own empleye,i. provided that such improvements Am not intended or
, offered for ole. 1 , however. the building 67 ilnpmvcment is sold -within one year of
- PLYWOOD NAIL
6 0 3—ROOF BATTENS-,
U .CA Z
completion, the ownecIvolder will have the burden of paving that he did not Wild or
impmvefmpmposenrsale.l.
604 - ROOF IN -PROGRESS
licensed e.Io
coLae ownerof Nepropertyoro udiness
i ,t .;c'
_
ovwn Ne project (Sec. ]616, Business and Cancoamor
dProming.. Codo:) The Co
-
-
License law docs not apply an owner of p sny whloos
who Wilds se improv. Nerton.
themon.
�._..._._..
=..and.
. mama
wilh.0 conmdor(,).licensed pursuant to.Ne..._.__.-...__.......—
who conwense
.... ..... _.__.............__.__........_.__-......._... .. .. ....._. _....___ _._...._... _._ ._..
Law.ch.pnjects
Cnmrunors License Law,
�B&PCfm
❑tom aempt under gee." "s�"
Nis rtmon
.. ... •. T'i;.:": '.
c"�p/'�
�s Date
S PENSAT ON D " 9EC( AR � den'.
KE 1ON
-
�• •EGULATIONS._' w`eLO jy//'s`s-nwn.ros..r
1 dGsJ Y q
Signoy� A c' onrmctor T '@ '� Dae'
...,,1•;:. HAZARDOUS MATERIALS DISCLOSURE;,:'
_ W ll rhe applicant or firm, Wilding occupant start or handle hares ems material
As de0nnd by Ne Cupcna. Mumnpal Code Chapter 9.12, ad he Health And Safely
Code 5 crioa 255320 tt
❑YM :.. n gi.❑No.� I 1TF�.f!.( r1'h'1,.
W01 N pylic t o furore W Idm`II'�noon pant usne,uipment o de roes whrch
m rd 1 M1 zas air contaminants u defined by the Bay Area Air Quality Management
-Di tract -I , i
0 Yea ❑Nn .
r
1 have mad the hmardom matenals nor mments under Chapter 6.95 of the
oeccunpanra gm or Inn mnremem, Ih,rh'most he met prior
OcI
caner or A ge '
Issued by Date
Re -roofs
Type of Roof..
Il 1 !'�l' it .'.6'S,;
All roofsstialLbe.il,petted prior,to.any_roofing.material.being installed._......_....._
If n roof Is insialled without first obtaining an inspection;`I agree to remove
all new materials for inspection. Applicant understands and.will comply with .
all moi-poim'source regulations, ., ,
Dam Si nae a icant Date
All roof coverings to be Class "B"
orbetter � ,
....,.._.. ...............'OFFICE-......_.._.......__..___.__.._..........._._. _
I hereby affirm under penalty ofperjury, one of the following declarations:
11�
O 1 have and will maintain a'Cenlficale of Consent to self-Insum for Worker's
Compensation. As provided for by Section 37W of the tabor Core, for fin
'perfnnnmce of Nfi work fur which this permit is issued.
'-
111 have and will maintain Woikcr's Compensation Insurance, ai iaryirtd by.Section
_
3700 of the Labor Cole, for the pesforinaace of the work for which Nis permit is
.:.
izsueo'My W9he/s Compensouon Insurance tamer and Policy number aR:
-
r'
Ca rler!�Pu1 'y No
, !CERTIFICATION OF EXEMPTION PROM.WORKERS�
114.�. '.1`� 11,!i. O..VS'
;......: _,. COMPENSATION INSURANCE..). _;. n_, ...
_.-._.__...—._.._.._._....___._......... ...—�_.._..___...,_..__........ _...... .._._._.....-
IThi,union needinm he enmple¢o if the is for one hundred dollen
permit
ISIIXI) nr less.!
..,.._.�:
l a,i the w�for is rs ed I
P pmt
..-. .. .._ _a .. ....... ., ...._.., _...... - ,.,-. .
cwhchsr, n iH
I n An e Workers
Irierva-� and
"ill.,
Cnm sannl iCehfnmomtDamof
/
Applicant id - J YJT'— / -=
NOTICP.TO—'Axl'A k giRISCIRf f Exemption, y should
•. r
become subject the Work o,Ien
pairiun pmvisions'of the liber Code: you must
Q O
fonhwirh comply with such pru,idmi, or this permit shall demand decnd revoked.
CONSTRUCTION LPNDING AGENCY
I heroda, a tlmn that them is continuation 1 nd'ng'agency for Ne performamn
I i
wy
r
of the work fm which Ilii. permn a ,sued (Sec, 3097, Co. C.3
A
C6-
lander', Name.. .. _ .:.... . . ..... .�• _ - —
.. y,_' �..
-....-, ._ _._.._ .....__ __.. _- .._. .... .._._... __ .. ... ___ _... _..... .. __ ..... ._.. _._ _ ...... .
z
'Adce, Address .. ..
n
IV" nr ai; rlf rq
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k➢
. 1 certify that I have read this application and srrc that the above information is
I agree to
C f,J
comply city and county ordinances and store low, rtlaring
to Wilding construction. and hereby authorize representatives ofrh 'ty to
th b
W
�, M.
L
yfoil
cnmr upon
the Wee) I neo progeny f nspemi n purpose .
perAgai against
eWet Agree ts. 'ndemmpe,sesl'y ad i hamay in the ity way am
liabilities, judgments. rosea d pease which may any y true against said
U .CA Z
City in conxouence of the mamina of this ruiai "
�• •EGULATIONS._' w`eLO jy//'s`s-nwn.ros..r
1 dGsJ Y q
Signoy� A c' onrmctor T '@ '� Dae'
...,,1•;:. HAZARDOUS MATERIALS DISCLOSURE;,:'
_ W ll rhe applicant or firm, Wilding occupant start or handle hares ems material
As de0nnd by Ne Cupcna. Mumnpal Code Chapter 9.12, ad he Health And Safely
Code 5 crioa 255320 tt
❑YM :.. n gi.❑No.� I 1TF�.f!.( r1'h'1,.
W01 N pylic t o furore W Idm`II'�noon pant usne,uipment o de roes whrch
m rd 1 M1 zas air contaminants u defined by the Bay Area Air Quality Management
-Di tract -I , i
0 Yea ❑Nn .
r
1 have mad the hmardom matenals nor mments under Chapter 6.95 of the
oeccunpanra gm or Inn mnremem, Ih,rh'most he met prior
OcI
caner or A ge '
Issued by Date
Re -roofs
Type of Roof..
Il 1 !'�l' it .'.6'S,;
All roofsstialLbe.il,petted prior,to.any_roofing.material.being installed._......_....._
If n roof Is insialled without first obtaining an inspection;`I agree to remove
all new materials for inspection. Applicant understands and.will comply with .
all moi-poim'source regulations, ., ,
Dam Si nae a icant Date
All roof coverings to be Class "B"
orbetter � ,
....,.._.. ...............'OFFICE-......_.._.......__..___.__.._..........._._. _
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Pax: (408) 777-3333
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
IMPORTANT:
1. Flat roofs must have a minimum of V" 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 of inspection
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: M IV G — Y14 N67 S hH S-A/
Address: JD�`os HA4*'DR13 D r L-tWZ-P7-lX110 CA , Wv/C/
Reroofing Company Name: EZ 4-W o 'A >
Applicants Signattlre:� r�y�_�Date:
�------
Joe Antonucci .
(Chief Building Official)
MUM
and manufactures specifications on reroofing.
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 reroofing 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) Preinspection 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 that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of V" 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 of inspection
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: M IV G — Y14 N67 S hH S-A/
Address: JD�`os HA4*'DR13 D r L-tWZ-P7-lX110 CA , Wv/C/
Reroofing Company Name: EZ 4-W o 'A >
Applicants Signattlre:� r�y�_�Date:
�------
Joe Antonucci .
(Chief Building Official)
MUM