06040077 CITY OF CUPERTINO
BUILDING DIVISION PERMIT xCONTRACTOIt I1�FORN A�CION ;
Buaowc ADDRESS: PINGPING SHAO & LIQING W ERMRNO.06040077
7505 PROSPECT RD
OWNER'S NAME: PERMIT ISSUE DATE
PINGPING SHAO & LI ING WAN 04/14/2006
NE:
SANITARY NO. CONTROL NO.
ARCH11ECf/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
iaa LICENSED CONTRACTOR'S DECLARATION Job Description
tmF I lertby affirm that 1 am licensed under provisions of Chapter 9(commercialsp
CZwith Scction7")of Division 3ofihe Burn...and Professiam Codc,and my license is
aid in full force and affect. REMOVE OLD WOOD SHINGLES; OSB. 15/32; PLYWOOD
3tg= L1CC1SCssa Le'g 15/32 ; ASTM #30 ; ASPHALT SHINGLES; GUTTER CLASS
_1 Dale canlfaelar
J ARCHITECTS DECLARATION OR B
9W. 1 undcrwnJ my Plana shall W axed u public records
"Vi O
eGH Cheesed ereb, ifinnal ® fy�,
5 OWNER-BUILDER DECLARATION L
1 Wmhy aRrm Not 1 am exempt from the Convacmra Liecnm Law far tic
p O following mason.(Section 7131.5.Business;add Professions Code:Any city or county
<m�+ which requires a Permit to ennsuuct,alter,improve,demolish,or repair my structure
Prior to its issuance.also requires tic applicant for Such permit to file a signed statement
< NaW4licensedpursumuoNeprovisionsoftheCanuacwriLicenseLaw(Chapmr9 Sq.Ft. Floor Area It IN 20%Valuation
EEC (commencing with Section 7")ofDivision 3ofOut Btableuand Professions Code)or $9600
E`c 9 dins be as exempt thcrtfmm and the,buns far dicealleged exemption.Any violation of s'
Section 7031.5 by any applicant for a permit subjects the applicant In a civil penalty of
not more than five hundred dollars(M). APN NumberJUVILL)i Type
1,u ownm of da propwy,m my mnployces with wage m shear role compcwtion,
will do the work and ue structure is not intended cur offered formic(Sec.7014,Business
and Profestloru Caec The Conuacmr'a License law does rot apply m an owrcs of Required Inspections
property who Milds or improves thereon.and who dacssuch work himself artluough his
awn employcv,provided that such improvements art not intended oroffemd formic.It.
however.the Milling or improvement is mid within one year of compledan.tie owner.
Milder will have tie Worked of proving oat W did not Mild or improve for purpose of
role.).
Q 1,as owner of the properly am emlusivcly convecting with licensed cenvectors re
construct the project(Sec.70x4,Business and Profusions Code:)The Ceovmmis U.
cove law does not apply ban owner of pmMny who Wilds or improves theman.ad.
who contracts for such projects with a convacmr(s)licensed pursuant to dee Consumes
License Law.
❑lamesem/jt underrg ,B&PCfwthismaso. `�
Owrcr J
Ting I/l/IY✓�-�Das t7y11�-2
WORKERS Is SATION DECLARATION
1 hcreby affirm under pmahy of perjury,one of the following declarations:
❑1hoveand will maintains Certificate.fOurscontoself.irtsureforWaf e.C.M.-
mtian,is provided for by scene.3700 of tie Labor Code,for the Md...of the
work for which this permit is house.
❑1 have and will maintain Warker's Compensation InRirsme,as required by Section
3700 of the labor Code,for tie Mricrmmee of the work for which this permit is Issued
My Worser's Compensation Insurance artier and Policy number art: -
Carrier. Policy No.:
CERTIFICATE OF EXEM MON FROM WORKERS'
COMPENSATION INSURANCE
(Thu account need notbo completed if the permit is foranc hundred dollars($100) a
nr le¢7
I certify that in the performance a the work for which this Permit is issued.I shall not
employ any person in any mmnerm as in become oubjeen m the Workers'Compensation
Laws of California.Dam
Applicant _ " c, _f
NOTICE'O A CANT:IL after mating this Celli tease of Exemption.you should
become subject Is the Wurter'a Campcuuion provisions of the Labor Code,you must
.J O forthwith comply wish Rich provisions or this permit shall bo doomed rewked.
Z
r D5 CONMUCTION LENDING AGENCY
(-+ I Wreby cErm then cert u sung(Se..307.
ding agency for the pcdormarrx of
ns.> tie war's for which this permit is issued(See 3097.Civ.CJ
QLender's Name
a Z 1<ndcrs Add=
V Q I certify that 1 have mad this application and sum shat tie above information is
U,U comem I agree m comply with all city and county aNivrcv and sum laws relating m
C) building construction.and hemby,ambortm representative of this city to enter upon tic
F yalmvomcn...ed Prol for ivpccdon purposes.
(wee)agree to save,indemnify and keep harmless the City of Cupertino against
to lubilides,Judgmcnta,eoasand'ape.which may in any.,seerucagalvlssd City
f„)Z in consequence of tie granting of this permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dale
SOURCE REGULATIONS
�OL!4 t4J" --5f' --C 3- vk a-roofs'.
Signature of ApplicanvConuactor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tic applicant or future Wilding occupant store or handle hauallov material
as dcRned by the Culandom Municipal Code,ehapmr 9.13,and the Health and Safety
Code.Section 25333(x)?40
-�Na All roofs shall be inspected prior to any roofing material being installed.
Will she applicant or future Wilding occupant use equipment or devious which If a roof is installed without first obtaining an inspection,I agree to remove
emit horaNnv air contaminants a defined by the Bay Arca Air Quality Management all new materials for inspection.
District?
❑Yes s v Nin -
1 have mad the h,S=no m 5505 s req 3m d 255 under&nm 0.95 of tie Califon
nix Hcalsh&Safety Catle,Sccdons 35505,25537 and 25334.1 understand thazifthe Milling
Jars rent currtndy Mw a tenant then it u my rtsponsilnlitY m notify Ue aceupmt of the
rtquiremcnta which must be met in,toivaanm ofa Cenriew of Occupancy. Signature of Applicant Date
4— ") p.G. �l - �fF 2f06
ownm cur au'hem u D,te All roof coverings to be Class"B"or better
CITY OF CUPERTINO
06m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36615002 . 00
DATE ISSUED. . . . . . . : 04/14/2006
RECEIPT # . . . . . . . . . 33983
REFERENCE ID # . . . : 06040077
SITE ADDRESS . . . . . : 7505 PROSPECT RD
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : PINGPING SHAO & LIQING WANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5241
RECEIVED FROM . . . . : LIQING WANG
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY . . . . . . . . . . : PINGPING SHAO & LIQING WANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5241
TELEPHONE . . . . . . . . :
*FEE ID UNIT QUANTITY AMOUNT 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 NUMBER
----------------- ------------ ------------------
CHECK 170 . 56 1704
TOTAL RECEIPT 170 . 56
•
.� Community Development
e 10300 Torre Avenue
! iy '� Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
9CUPEI,TINO
Building Department
JOB ADDRESS: PERMIT #
7505 Prds eve- Kd . � er E�, v q�o�q- 67 6 d 4K e-�o-7
OWNER'S NAME: n 7n 5AAp Q 6762 PHONE # a-4-2,5-2,V 32
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: t4jp-� 0�—�
Signature Date
Please check applicable subcontractors and complete 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
Owner/Contractor Signature Date
OWNER-BUILDER VERIFICATION
1. (Check one) I or my immediate family (parent,spouse or child) will perform
• A. _ All the work authorized by this permit
B. _ A portion of the work
C. X None of the work
If B or C is checked,complete 2 or 3 below.
2. A state licensed contractor will be hired to do:
A. _ All of the work
B. A portion of the work (complete section below)
Contractor Address/City Phone # State License # Type of work to
3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or
• portions of the authorized work. I understand that I may be an employer (see reverse side). A
Certificate of Insurance covering workers compensation must be on file at the City of
Cupertino Building Department office.
PersorVHrm Address/City Phone Number Type of work to be
erformed
.....................................................................................................................................................................................
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information (reverse side).
Property Owner's Signature: C� ��1E9 w - Date:
e
�5o'5 Pry � Ad , ape,-t«U CA q�°�`�
Job Address: P Permit#
Any changes to the information provided on this form shall be submitted to the City of Cupertino Build
Department.
•
yg.
p,&,, I
City of Cupertino Building Department
CITY OF 10300 Torre Avenue .
C U P[kT I N O Phone: (408)777-3228
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements specified.
For your protection you should be aware that as owner-builder you are the responsible party of record
on such a permit Building permits are.not required to be signed by property owners unless they are
personally performing their own work. If your work is being performed by someone other than yourself,you
may protect vourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all
permits for which they apply.
If you plan to do your own work,with the exception of various trades that you plan to subcontract,you
should be aware of the following information for your benefit and protection:
If you employ or otherwise'engage any persons other than your immediate family, and the work
(including materials and other costs) is$200 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
If you are an employer,you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding, federal social
security taxes,workers' compensation insurance,disability insurance costs,and unemployment compensation•
contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are
especially serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law,contact the Internal Revenue
Service (and,if you wish,the U.S.Small Business Administration). For more specific information about your
obligations under state law,contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale,property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees,without a licensed contractor or
subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder
building permit,erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing
their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors'State License
Board in your community or at 1020 N Street,Sacramento,California 95814.
Please complete and return the enclosed owner-builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
Building Department, •
City of Cupertino
Printed on Recycled Paper
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 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 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 theabove stated policy on re-roofing.
Homeowner's Name: s/ ly hh��� �Gn y WAS q
job Site Address: 7r;6 f f rat pe(� PA - of-binv a / 3vl q
Roofing Company Name: 713/
A pplicant's Signature: (Clan4 � _ Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO o(oo40011
G' REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# 3 u u - lb - oo a Date:
wilding Address:
'750 6 eve Rd . CvWe(" 0
Owner's Name:,,,,,, $ Z,J�?- Phone#: 32
Contractor: License#:
l
Contact: -(2- Cupertino Business License #:�r�' ��
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ( Asphalt Shingles
)(i 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: Pe nt ovp_ Old &voDd SA rn ej - U. g, /3 I5/3 z ---> " cx P5 3 1
.CASTS! P3J --> Fs z1,; a ey- L(aTrOr- Nor1E
Residential Commercial O
Fire Zone: Yes O No ®- Confirmed with Planning D�t. if
there are any restrictions:
Cost of Project: Type of Construction: Occupaancyroup:
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
•