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11110139CITY OF CUPERTINO BUILDING PERMIT BUILDINC ADDRESS: 10828 ALDBRBROOK LN I CONTRACTOR: M & S ROOFING CO. PERMIT NO: 11110139 OWNER'S NAME: KIM SUN M AND YOUNG 0 1208 COPCO LN I DA'Z'E ISSUED: 1123/2011 1 O +ER'S PHONE: 4089969983 1 SAN JOSE„ CA 95123 1 PHONE NO: (408)714 -0870 LT LICENSED CONTRACTOR'S DECLARATION � p License Class �/� Lie. H eo `01. ° Z Contractor 7� Date e/ I hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self - insure Ibr Worker's Compensation, 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 provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT'CF,RTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and coma), ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. ?I- IIssued by: f— 2 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r— RESIDENTIAL COMMERCIAL JOB D f.AM P'rION: REMOVE EXISTING SI IINGLES AND REPLACE WITH COMP SHINGLES Sq. Ft Floor Area: I Valuation: $9400 APN Number: 36920038.00 1 OccuponcyType: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. 0 OWNER- RUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: 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 & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penally of perjury one orthe following three declarations: I have and will maintain a Certificate of Conscnt to self - insure for Worker's Compensation, 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 provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of Cali loons. II', after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 stale laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, nd expenses which may accrue against said City in consequence of the ag of this permit. Additionally, the applicanvanderstands and will comply W1uL all non -point source regulations per the Cupertino Municipal Code, Section 9.18. �,r+, S ignamre Date bate: RE ROOFS All roofs shall be inspected prior to any roofing material being installed. ]to roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: �!ti� Date: ALI, ROOF COVERINGS TO Br CLASS "A" Olt BE ITER IIA %ARDOUS MATERIALS DISCLOSURE, 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will nurinmin compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality :Management District 1 will maintain compliance with the Qlperlino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or auk orized agent URIC ./%` CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed 0 • f� CITY OF CUPERTINO I rM I FEE ESTIMATOR - BUILDING DIVISION 111A -20q - -a• - 111 ____ ADDRESS: 10828 alderbrook In. DATE: 11/23/2011 REVIEWED BY: bobs. !Wch. Peru Fce: APN: BP #: "VALUATION: 1$9,400 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: ; PENTAMATION 1SFDWLR00F PERMIT TYPE: WORK re lace existing shingles replace with comp shingles. SCOPE - -a• - 111 ____ NOTE: This estimale does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. eta ). These fees are based an the nrelinina" information available and are aniv an estimate Contact the Dent for addn'/ info FEE ITEMS (Fee Resointion 11 -053 EN 711111,) 11, h 111,117 t hr, d 1' /euuh. Non t'herk Glee, 1'14111 Check !Wch. Peru Fce: 1'hmth. Permit Fee: €tec. Yermu Fee: UNle .11, elt.:>as/`� Other pLueh Heap. Othe,' T:h;r.. bup. Li ,Wech. Inva FeO: Plun!G, In.vp. Fer•; Fier, Inv. Fen: NOTE: This estimale does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. eta ). These fees are based an the nrelinina" information available and are aniv an estimate Contact the Dent for addn'/ info FEE ITEMS (Fee Resointion 11 -053 EN 711111,) FEE QTY /FEE MISC ITEMS Plain C'he<:6' f`<te: Suppl. 11C Fete FI e on In i A r(ech.,'F, I ec Permit Fee: $280.00 Suppl. /ns /, Fet? PGnnlr,itL(<och.: H'lec I'ltpnlr. %1le:ch.:'filerc Fa:rmitFee: Construction Ta.r . Adminishtttive Fee: Work Without Permit? ()Yes 0 No $0.00 Jdvanued Planning Fees: Travel Docstncriation Fees, Strong Motion Fee: /BSEISMICR $0.94 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $281,94 $0.00 TOTAL FEE: $2$1.94 Revised: 10/01/2011 • 3 ITEMS OF 3 lJ E CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 3692003,8.00 DATE ISSUED.......: 11/23/2011 RECEIPT 4.........: BS000015397 REFERENCE ID # ...: 11110139 SITE ADDRESS .....: 10828 ALDERBROOK LN SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: suew COPY # : 1 OWNER ............: KIM SUN M AND YOUNG 0 ADDRESS ..........: CITY /STATE /ZIP ...: CUPERTINO CA, 95014 -4606 RECEIVED FROM ....: M & S ROOFING CONTRACTOR .......: MIRSAD KRAJWIC LIC # 28360 COMPANY ..........: M & S ROOFING CO. ADDRESS ..........: 208 COPCO LN CITY /STATE /ZIP ...: SAN JOSE, CA 95123 TELEPHONE ........: (408)314 -0870 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL --- ---- -- ---- - - - - -- 1BCBSC ----- -- - - -- VALUATION -- ---- -- - - -- 9,400.00 ----- - - --- 1.00 -- -- -- - 0.00 - -- --- - -- - --- 1.00 - 0.00 1BSEISMICR VALUATION 9,400.00 0:94 0.00 0.94 0.00 1REROOFRES SQ FEET 20.00 280.00 0.00 280.00 0.00 TOTAL PERMIT ---- - - ---- 281.94 - --- --- 0.00 - -- - --- -- - - -- 281.94 - --- ---- 0.00 -- METHOD OF PAYMENT --------------- -- CHECK TOTAL RECEIPT : AMOUNT --------------- 281.94 --------------- 281.94 VOICE ID DESCRIPTION -- - --- -- -------------------- -- ---- -- 309 EXTERIOR LATH 601 ROOF TEAR OFF 604 ROOF IN- PROGRESS REFERENCE NUMBER --------------- -- - -- 2806 VOICE ID DESCRIPTION - -- -- --- ---------------- ----- - -- -- -- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 605 FINAL REROOF 6 I� UPERTINO 4 r L Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: 140 EIZ 1>;ZCX00if ERMIT # 1771-0 77 7 OWNER'S NAME: J P PHONE # GENERAL CONTRACTOR: A-7 BUSINESS LICENSE # ADDRESS: Z4o-& ca� r.► er. � CITY /ZIPCOD *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. �J — I am not using any subcontractors: vim' �� 'Z� e' Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date a 'I2'.?, SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date a 'I2'.?, CUP�O REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 (408) 777 -3228 - FAX (40B) 777 -3333 - building a.cuoertino.ota PROTECT ADDRESS ,v 2-9 r<, ��C• /� G// APNp- OWNERNAME • , �i%/ /� J C / PH E � �T J E -MAIL STREETADDRESS CITY, STATE, ZIP FAX CONTRACTOR NAME _ LICENSEN BEOR�� g �O LICENSE BUS, LIC.p COMPAN NA=E / E -MAIL FAX STREET AD_ZESS O �� 1, G� CITY, ST E.Z;P c / dp 12 3 PHONE � O� I UNDERSTAND AND AGREE TO THE FOLLOWING: The re -roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon- Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection. For Tear -Off and Nailing Inspections, you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. Progress and Final Inspections will be given a two hour window. • 3. Tear -Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails /fasteners shall be either completely knocked -down or removed prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. Progress Inspection is required when approximately 50% of roof covering is installed. 7. A Final Inspection and approval shall be obtained from the building inspector when the re- roofing is completed. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of Y<" per foot of slope and demonstrate there is no ponding. b. Listings from approved testing agencies for all pre- manufactured products used shall be available on -site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter /downspouts installed, debris removed. NOTE: If you call for a tear -off or plywood nailing inspection and the work is not complete, you will be charged a re- inspection fee of $126.00. The re- inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. 1 understand and agree to comply with the re -roof policy stated above. I also understand that smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections 8314 and 8315 of the 2010 California Residential Code Signature of ADDlicant/Aeent . Date: Reroo1P0licv_2011.doc revised 02116111 CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO. CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • buildina(EDcuoertino.orn R PILO=ADDRESS Dy (J a� _ do — U J y N 3 / GL G� 9APN �P(1%iU( W( -MAIL STIt=ADDRESS SSE CRT, STAID, ZIP [ a-r i ,-eil?7 /4ra ppX APPLICANT NAME r' / PHONE s � B. -�MAIL O STREET ADZ�D cr y��Y3 LC/ '7 Cf1Y ATE, O�G �� i�,�) FAX /y ❑ OWNE0. ❑OWNER- aUtLDE0. ❑ OWNERAOE cy CONiAACrOR Cl CON A=R AGENT ❑ ARCHRECf ❑ ENO ❑ DEVELOPER ❑TENANT CONTRACTOR NAME ^ Y' LICENSE NUMBER LICENSE TYPE BUS. LIC. X COMPANY NAME rSy— &MAIL FAX STREET �De;0 SA GAY CAMS �j CTTY. STA �� Cf C7 ARCHRECTIENGI FERN LICENSENUMBER Q 1 -,�' BUS. LIC.q COMPANY NAME E -MAIL FAX STREET ADDRESS CRT, STATE, ZIP PHONE USE OF 4_SFD or Duplex ❑ Multi- Family ROOF AREA. VALUATION: G`7 STBUCTURB: [I Commercial _ O L EXISTING ROOF TYPE: ❑ BUILT -UP ROOF AASPHALT SHINGLES ❑ W000 SHAKES r LOOD SHIIGLRs ❑ OTHER (SPECIFY) REMOVE (REPLACE AYES I ONO. i PLYWOOD ❑ ri" ❑ PLYWD KOBE PrTCH: ROOF ❑ No q L ❑ 5/S" E ❑ .]_Z S5. A - PROPOSED ROOD TYPE'. ❑ BUILT -UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAM ❑ WOOD SHINGLES ❑ OTFIDI ICC -ES REPORT V DESCRIPTION OF WORK - By my signature below, I certify to each of the fallowing: I am the property owner or authonzed agent to act on the property owners behalf. I have read this application and the information I have provided is correct I have reed the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authonu: representatives of Cupertin„ ;,, enta the above- iddDentfied propety, fur inspection purposes. Signature of ApplicanUAgent Date: SUPPLEMENTAL INFORMATION REQUIRED - arpFarT toss mnv - p1 =.0 ettEt�. L1Yk- ltmuru+�sLrP _ _ If building is associated with a Home Owner's Association, provide letter of approval from HOA. N1 -n " t.a=a- TNT. -61ff to I ,mwG Pr,AN itEV>LR> _ Provide Planning approval to verify if there my restrictions. _ '' t•' ' ' -- k`'i '1P14MS5= yrAwAE{F.Rr,Ai:F&NiEW -- _ Provide py of Manufacturer's Installation Specifications. 4 sEAnT, an , `s 5' RI DRPS . /�D (C1 _ ro"P vide signed copy of Cupertino's Tear -Off Policy, - y mrEDut -, 5, /�� e�oofApp_2011.doc revised 03/02/11