12040100 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7653 SHADOWHILL LN CONTRACTOR:JIM KRAUSE PERNII'TNO: 12040100
ROOFING
OWNER'S NAME: TONY CHUNG 2310 DIANA AVE DATE ISSUED:04/18/2012
OWNER'S PUONE: 4083662210 MORGAN HILI., CA 95037 PHONE NO:(408)779-0704
X LICENSED CONTRACTOR'S DECLARATION r r r
BUILDING PER\ll'1'INFO: UhDG ELFC'I' PLIi.\IU
License Class C-5 7I.ic,P 5•5 L4 3 St r r r
y IZ NIECII RESIDENTIAL COMMERCIAL
Contractor � 1 FN KR/USt' Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOR DESCRIPTION: RI%ROOF 29 SQ- Il'AR OPT SI TAKE,RFSIIFI�F W/OSB
INSTALL LIFI51'IM COMP CLASS A
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent 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. Sq.Ft Floor Area: Valuation:S13000
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 th
APN Number:36225014.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and slate that the above in ation i PERMIT EXPIRES IF WORK IS NOT STARTED
correct.L agree to comply with all city and county ordinances and state Imus relining WITHIN l80 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DA FROM LAST CALLED INSPECTION.
indemnil-) and keep harmless the City ol'Cupertino against liabilities,judgments, / _
costs,and expenses which may accrue against said City in consequence of the
giranting0f1hispermit_ Additionally,the applicant understands and will comply Issue) by: %Z� Date:
with all non-pointsource regulations per the Cupertino Municipal Code,Section
9.18. J/
RF;ROOFS:
Signature Date —T �6 I All roofs shall be inspected prior to any roofing material being installed. Ifo roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OW'N'ER-B ' F.R DECLARATION L-llqlte
Signature of Applicant: Date:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALI.ROOF C .RIN S'10 BE CLASS"A"OR BE ITER
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)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Ileulth&Safety Code.Sections 25505,25533.and 25534. twill
1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
declarations: Ilealth&Safety Code,Section 25532(x)should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the labor Code,for the air contaminants as defined by the Bay Area Air Quality.Management District 1
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2550
Section 3700 of the labor Code,for the performance of the work for which this
Owner or authorized age
permit is issued, r Date:
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 Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONS'IRI1C"PION LF;NDING AGF:N'(:1'
become subject to the Worker's Compensation provisions of the Labor Code,I must I herebyaliinn thin there is a construction lending agcnc)'lir the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097.Civ C.)
Lender's Name
APPI.ICAN'I'CFR"1'IFICA"1"ION lender's Address
I certify that I have read this application and slate 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, ARCI II 1 l.(.1 S DECLARATION
ION
costs,and expenses which may accrue against said City in consequence of the I understand my plans slmdl be used to public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18,
Signature Date
CITY OF CUPERTINO
3 ITEMS OF 12 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36225014 . 00
DATE ISSUED. . . . . . . : 04/18/2012
RECEIPT 4 . . . . . . . . . : BS000016570
REFERENCE ID # . . . : 12040100
SITE ADDRESS . . . . . : 7653 SHADOWHILL LN
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TONY CHUNG
ADDRESS . . . . . . . . . . : 7653 SHADOWHILL LN
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : PERMIT SERVICES INC
CONTRACTOR . . . . . . . : KRAUSE, JIM LIC # 21415
COMPANY . . . . . . . . . . : JIM KRAUSE ROOFING
ADDRESS . . . . . . . . . . : 2310 DIANA AVE
CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037
TELEPHONE . . . . . . . . : (408) 779-0704
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---- - ----- ------ ------- --------- - ---- - - - --- ---------- ----------
1BCBSC VALUATION 13, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 13, 000 .00 1 . 30 0 . 00 1 .30 0 . 00
1REROOFRES SQ FEET 29 .00 406 . 00 0 . 00 406 . 00 0. 00
---------- - --------- ---------- --------- -
TOTAL PERMIT 408 . 30 0 . 00 408 . 30 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------ -- ---------------------------- -------- ----------------- -- - --------
3
- - --
309 EXTERIOR LATH 311 SCRATCH COAT
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
REROOF°TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O.,BUILDING OFFICIAL
L U P E RT I N D 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildina0cuoertino.ora
PROJECT ADDRESS C 1 1 I ' r APN e
OWNER NAME / W - PIIOCp -2210 E-.NAIL
STRLET ADDRESSCnYC'StTJA'{�LZ-IzP�r Iv ^ I FAN
CONTRACTOR NAME // Y� LIC AE/NSEN9 R lL-IICENSE=YP BUS.LIG n
COMPANY CITY,STATE
NAME2hJ5fIA� E-MAIL 1'A%, '�1/�
-STREET ADDRESS 2510 Y I oe AX
A .Z J H I � GA -1_5�7 PJ OL . .O '7O
I UNDERSTAND AND AGREE TO THE FOLLOWING: I
I. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code.
2. You must schedule all needed inspections aminimum of one day before the requested inspection date.
Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please,call for tear-off inspection after the roof is tom off and all
the nails/fasteners'have been removed. Any and all dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be available within one hour.
There are special hours for this service: 7:30 — 10:30am and 1:00— 3:30pm (Mon—Thurs);
7:30 — 10:30am and 1:00—2:30pm (Friday).
4. If plywood is installed, a plywood nailing inspection is required.
5. in-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is
weather tight after installation of-approximately 25% of the roofing material.
6. New roof coverings.shall not be applied without first obtaining all inspections 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.
7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is
complete. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of/4"per.foot of slope and must 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.
8. 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. Lundersta ee to comp) w' the rel-roof policy stated above.
Signature of Applicant/Agent: Date: 1 'v
ReroofPolicy_2010.doc rei-med 05//7//0
1 �
REROOFPERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPER 0 (408)777-3228•FAX(408)777-3333•buildingecuoertino.orcl
/ 0o/ao
PROJECT ADDRESS
265 7 6 53 35 O.<W1I`I I 'H1 I I RAPNN0
UCHERNAlE IPHq('2�( DCOMT/ILG/ N O f1 0
STRIETADORESS (
FAX
CONTACT NAME PHO E(q - 27, ,/�D 11-MAIL
STREET ADDRESS 10� (rI,'1 E CITY,STATE,ZIP r-� FAX
r Yr G� 9-f" /�7 o e/4 N5¢S
❑OIVNER ❑ OWNER-BUILDER ❑ OWNERAGFM 10 CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME JIM KRAUSE LICENSE NUMBER 554351 LICENSE TYPE C39 BUS.LIC.n
COMPANY NAME JIM KRAUSE ROOFING E-MAIL FAX 408-779-8807
STREET ADDRESS 2310 DIANA AVE.. CITY.STATE.ZIP MORGAN HILL,CA 95037 PHONE 408-779-0704
ARCI IITECTIEN'GINEER NAME LICENSE NUMBER BUS LICA
COMPANY NAME, E-MAIL FAS
S I'REFT ADDRESS CITY,STATE,ZIP PI IONIi
USE OF ASFD or Duplex ❑.Multi-Family ROOFAREAVALUATION,
sTRucruaE ❑ Commercial Ci
EXISTING ROOFTYPE: 11 BUILT-UP ROOF ❑ASPHALTSHMGLES AWOODSHAKES ❑WOOD.SS,HINGLES ❑OTHER(SPECIFY)
REMOVEIREPLACE )MYES IF NO. PLYWOOD ❑ x" ❑ PLYWD tgosa PITCH: ROOF
❑ NO p LAYERS THICKNESS ❑ alR" TYPF. LF-J• CDX 'I Z CLASX A
PROPOSED ROOF TYPE.: ❑BUILT-UPROOF ASPHALT SHINGLES 11 WOOD SHAKES ❑WOODSHINGLES 11 OTHER ICC-ES REPORT=
DESCRIPTION OF WORK:
❑y my signature below,1 certify to each of the following: 1 am the property owner or authorized agent to act on the property owner's behalf. 1 hax'e mad This
application and the information I have provided is correct. the Desuiplio it is accurate. 1 agree to comply with all applicable local
ordinances and state laws relating to building a Ion. laulhoriz atives of Cupertino to enter the above-identified properly for inspection purposes.
Signature of Appliconl/Agcm: Date: 4 <dl I
SUPPLEMENTAL INFO TIO..REQUIRED Iii;. 'I'; ''`:Y`OFFICE USE ONLY
Ifbuilding is associated with ner's Association,provide letter II''-..."'PLANCIIECkyTYPE I ROUTING SLIP.
of approval from HOA. ❑ OVER-TuE-COUNTER -,BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑llmr e aliiss R 1'I ,"" " -❑',.PLnnNlne IPCT�RevlEw
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ` 1 ;❑I FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. !\ , Ci' �! r. to -'� -e+I ❑ OTHER:.
ReroojApp_201 I.doc revised 03116111