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03010039 (3) CITY OF CUPEWI'INO �'BUILDING DIVISION DIVISION PERMIT CONTRACTOR INFORMATION:'
( BUILDINGADDRESS: YUANPENG ZHANG PERMIT NO.
21837 MONTE CT 03010039
OWNER'S NAME: APPLICATION SUB DATE
YUANPENG ZHANG 01/07/2003
ONE: SANITARY NO. CONTROL NO.
ARCHIIECDENGINEER: BUILDING PERMIT INFO
BLDG ELELT PLUMB MECH
t� t�
1400 LICENSED CONTRACTOR'S DECLARATION Job Description
Id I hereby affirm That 1 em licensed under provisions of Chapter 9(commencing P
U with Section 7(X10)of Division 3 of the Business and Professions G� Cale,and my license is mfmltnreaandeffea. REROOF OVER EXISTINtIG
Z O n= License Class Lic.N T� s � —
Dy— Date Commemr 1
F I'q ARCHITECT'S DECLARATION Y
�a a< I understand my plans shall be used as public records y _
O U
F 4 0 Licensed Professional „
OWNER—BUILDER DECLARATION
e. I hereby affirm that 1am exempt from the ConuannLicense Law for the
WH 0 following reason.(Section 71D1.L3.Business and Professions Codc:Any cityn,county
°'ode S which requires a permit to consumer,alter,improve,demolish.or repair any structure LA
row'^ prior to its issuance.also mri ims the applicants for such permit to file a signed statement
that be is licensed pursuant To the previsions of to Contractor's License Law(Chapter 9 Sq. Ft. Floor Area $2I1WO(iOn
y�0 (commencing with Section 7100)of Division 3 of The Business and Professions Craft)or
y la that he is exempt therefrom and the hasls for the alleged exemption.Any violation of
Section 7031.5 by any applicant fur a permit subjects the applicant in a civil penalty of 32JkWNi beP Occupancy Type
not more than fire hundred dollen(g50o).
❑ I,as owner often Pori ur my employees with wages as Their sale compensation,
will do the work,and the structure is not intended proffered for sale(Sec.7044,Business 305 as
and Professions Code:The Contractors License Law does not apply to an owner of3 0 7 - INSULAed Inspections
propcny who builds or imp..thereon,and whodmssuch work himself or through his
own employees.provided that such improvements are not intended mortared for sale.If. 601 — ROOF TEAR OFF
hswever.the building or improvement is to within rm year ofcompletim,the owner. 6O2 — ROOF PLYWOOD NAIL
builder will have the human of proving mat he did not Wild or improve for purpose of
sad.). 603 - ROOF BATTENS
91,as owner of The property,am exclusively contracting wit licensed contractors To 604 - ROOF IN-PROGRESS
consumer the project(Sec.71144,Business and Professions Code:)The Contractor's Lr,
cense law does nor apply in an owner of property who Wilds or improves former,and
who comment for such projects with a contracror(s)licensed pursuant in the Contractor's
cense law.
lam axe n rSce .B&PCIarthis rtuon
Owner Date —1-7-03
WORKER' C k ON DECLARA
I hereby affirm under penelTyofp ryoreoffoefNlowbe declarations:
1 have and will maintain a Cenlficaf,of Consent m sel4insure for Worker§Cont
canon,ss provided for by Section 37(X)of the Lehor Code.for The punfi mune of the
work fur which this pcnnim is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
3710 of the Labor Code,for me performance of the work for which this permit is issued.
My Workers Compensation Insurance carrier and Policy number are:
Cartier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need ant be completed true permit is forone hundred dollars(5110)
or Ices.)
I trolly that in the performance of The work for which this permit is issued.I shall not
employ any person in any manner sat as m become subject o the Workers'Compensation
Laws of California.Dart
Applicant
NOTICE TO APPLICANT:If,after making this Cenifiaste of Exemption.you should
become subject to the Worker's Compensation previsions of be ISWr Code,you must
Oz forthwith comply with such provisions or this permit shell he deemed revoked.
O CONSTRUCTION LENDING AGENCY
(r nth+ I hereby affirm mat there is a construction lending agency for the Performance of
(Y, 7 the work for which this Permit is issued(See.3097,Civ.C.)
aQ Lendcr'a Name
J z Lender's Address
V C 1 certify mat I have read This application and state that the aWvr information is
W F correct.l agree to comply with all city and county ordinances and some laws relating to
0 U Wilding combination,and hereby authorlle representatives of this city to enter upon The
W ahnvememioned properly for inspection purposes.
(We)agree m save,indemnify and keep harmless foe City of Cupertino against
y liahilitics.judgments,costs and expenses which may in any way&come against said City
of the granting of
V in APPL CAynceUNDERSTANDSthisNO WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURT�G ULATIONS, j I— 7 —3
Re-roofs
Sig ore of Applicm u n Dam
HAZAR ou ATERIALS DISCL Type of Roof
Will the applicant or future Wilding occunot me or handle hazardous material
Judefined by de Copartner Municipal Code,Chapwr9.12,and de Health and Safety
,Section 25532(&)7 / All roofs shall be ins ected rior to an roofin material bein installed.
❑Yes ©NuP P Y g gWill The applicant or future building occupant uw equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
haardous air contaminants a defined by the Bay Area Air Quality Management all new materials for inspection.
ict'!
❑Yes QNu /1
Y/(/f/11J//�_)t�/
Ihave
&Safet the hazardoumaterials 05,2533and2534,1 under understand
Out if a,Califnr. � `
ria Healthn Safety Cade.Sectiou 2atm o;myresnd25534.1 un demondeciectMWilding i -
dans not curmn have
a mn&nl,me,ire is my reser 'C of II notify eV smupanm of me
rcyuim ihmuslbemelpin iuvan 0faCenificnteof0.roupmc. I nature of Applicant Date
'sapr aathprtvee„ rat
oma All roof coverings to be Class "B" or better
Building Division
i 10300 Tore Avenue
iOct
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CUPE��'NO F= (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
and manufactures specifications on reroofing.
2. New roof coverings shall not be applied without first obtaining all inspection
Wand 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: f II In 1,1 A,q
Address: S -3 7 M dr y
Reroofing Company Name: 0-11)n •Pw
Applicants Signature: Date: ( ' — 0 3
J000,
oee
Antonucci
(Chief Building Official)
6/25/01