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12050054CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22106 LINDA VISTA PL CONTRACTOR: PRINCIPLE ROOFING, INC PERMIT NO: 12050054 OWNER'SNAME: CHINIOYCIiH 10160 STERN AVE DATE ISSUED: .05/04/2012 OWNER'S PHONE: 4087804460 CUPERTINO, CA 95014 PHONE NO: (408) 898-7298 ❑ LICENSED CONTRACTOR'S DECLARATION r r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class 3/63y Lic.N Li r7Ei";2!w� -- r r r MECH RESIDENTIAL Conlructor �t— Dale 4915- / 0 ty / 17 _ COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter JOB DESCRIPTION: RE -ROOF REMOVE EXISTING WOOD SHAKE AND ,9 (commencing with Section 7000) of Division 3 of the Business & Professions INSTALL NEW Code and that my license is in full force and effect. OSB AND LIGHT WEIGHT TILE CLASS 28 SQFT 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. I have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $11500 Section 3700 of the Labor Code, for the perfomianec of (he work for which this permit is issued. APPLICANT CERTIFICATION APN Number: 35608009.00 Occupancy Type: I certify that I have read this application and stale that the above information is correct. I agree to comply with all city and county 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence ofthe WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature � :Date a9_/ys3 / L Issued by: �/� %�lG� Date: ❑ OWNER -BUILDER DECLARATION RE -ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, 1 agree to remove all new materials for h as owner of the property. or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: Date- I, as owner of the property, am exclusively contracting with licensed contractors ton construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1 hereby affirm tinder penally of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's HAZARDOUS MATERIALS DISCLOSURE: Compensation, as provided for by Section 3700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance, m provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(a) should I store or handle hazardous material. permit is issued. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health & Safety Code, Sections 25505, 25533, and 25534. Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must Owner or Ihorized agent: fi-'1� Dale: forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indenmify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address :osis, and expenses which may accrue against said City in consequence of the ;ranting of this permit. Additionally, the applicant understands and will comply wiih all non -point source regulations per the Cupertino Municipal Code, Section ARCHITECT'S DECLARATION 3.18. 1 understand my plans shall be used as public records. signature Dale Licensed Professional CUPERTINO 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 (408) 777-3333 - buildine(&cupertino.oro PROJECT ADDRESS 22-106 `" NI7R vl�,}� (� l_ �-c-� APN- OWNER NAME / ,, n O C C �'t /4 Jv PHONE EMAIL STREET ADDRESSCITY. 2z G �'nw� Vt b1 STATE. ZIP •% c;A q tTer,1 FAX CONTRACTOR NAME LICENSE NUMBER `dL 26 LICENSE TYPE v BUS ,LIC.- COMPANY NAMEfwLi E-MAIL FAX STREETA�5�` $ CITY. STA ZIP�f co4 / PH�Ee, 2� 9 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. 5. 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. 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/<" 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. 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. I understand and agree to comply with the re -roof policy stated above. I also understand that smoke detectors and carbon monoxide det tors are required to be installed in accordance with Sections 8314 and R315 of the 2010 California Residential Code. , _ / Signature of Applicant/Agent: Date: eS �t �`/ �L Rrruu/Toho 201Ldorw%i.,,,d011th/// F��q�� CITY OF CUPERTINO r�//.I FEE ESTIMATOR—BUILDING DIVISION iml ADDRESS: 22106 Linda Vista PI DATE: 05/04/2012 APN: BP#: REVIEWED BY: Sean 'VALUATION: $11,500 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: Elec. 1""wit Fee: PENTAMATION 1SFDWLROOF PERMIT TYPE: WORK Remove existing wood shake and install new OSB and light weight tile. SCOPE Phurrh. Grsp. Fee FEE ID ROOFAREA s.f. 1REROOFFRES 2,800 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These lees are based on the areliminary information available and are onlv an estimate. Contact lite Dent for addn7 info. FEE ITEMS (Fee Recahaian 11-053 E/f 711111) Aleeh. P/un Check P lwnh. Plon Cheek Elec. Plan Clark blah. Ila'mir Fee: Phnnh. Permit 1,"V: Elec. 1""wit Fee: Orhrr a/r•r6�. /n.ap. Oiher Plumb Insp,Li I Oiher Elev. /aiP. Ej Wo, h. Imp, F, c, Phurrh. Grsp. Fee lace. hnp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These lees are based on the areliminary information available and are onlv an estimate. Contact lite Dent for addn7 info. FEE ITEMS (Fee Recahaian 11-053 E/f 711111) FEE QTY/FEE MISC ITEMS Plan Cheek Fee. Snppl. PG Fee Plrnnh./jIlech./h /eC Permit Fee: $392.00 Sup/j/. fns/, Fee Phnnh.;:Meeh.nilet: Plunrh.Ghlrcl,.!Lilc•c Pei aril /' ia': Consa'ncrion 7a.�: ,lrhniniwrwive Fir: Work Without Permit? C) Yes 0 No $0.00 ;I r/rrai ed Pluming Fres: A I)octonew(iti n Ftteb7 Strong Motion Fee: IBSEISA11CR $1.15 Select an Administrative Item 131de Stds Commission Fee: IBCBSC $1.00 ' $UBTOTALS: $394.15 $0.00 TOTAL FEE: $394.15 Revised: 04/01/2012 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35608009.00 DATE ISSUED........: 05/04/2012 RECEIPT #.........: BS000016709 REFERENCE ID # ...: 12050054 SITE ADDRESS .....: 22106 LINDA VISTA PL SUBDIVISION ....... CITY CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 394.15 --------------- 394.15 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- MC VOICE ID .DESCRIPTION -------- --------- ---------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF OWNER ............: CHIN JOYCE H ADDRESS ..........: 22106 LINDA VISTA PL CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: DERECK LOI CONTRACTOR .......: DERECK LOI LIC '# 27564 COMPANY ..........: PRINCIPLE ROOFING, INC ADDRESS ..........: 10160 STERN AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 TELEPHONE ........: (408) 898-7298 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- 1BCBSC ------------- ---------- VALUATION 11,500.00 ---------- ---------- ---------- 1.00 0.00 1.00 ---------- 0.00 1BSEISMICR VALUATION 11,500.00 1.15 0.00 1.15 0.00 1REROOFRES SQ FEET 28.00 392.00 0.00 392.00 0.00 TOTAL PERMIT ---------- ---------- ---------- 394.15 0.00 394.15 ---------- 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 394.15 --------------- 394.15 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- MC VOICE ID .DESCRIPTION -------- --------- ---------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF CUPERTINO I zC)�s REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 - (408) 777-3228 • FAX (408) 777-3333 • buildinO &,cuoertino.om PRt?IECT ADDRESS22 , G ( t f u nA vl �,�� . YA. APN u (O• , OWNER NAME G L C PHONe �y1✓-446 JV� E-MAIL STREET ADDRESSZ I oOA_ V13+ _ CITY, STATE, ZIP ruJ ^ r 1 FAX CONTACT NAME P NE x�Z-/� E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ,y// ❑ OWNER 11OwNER-Buu.cEt 13OWNE'RAGENT 1-r CONfRACrOR ❑CONTRACORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NA h1E — (J LICENSEQ'h r LICEN. TPC, BUS. LIC.0 COMPANY NAME 2i rvci �/p E-MAM FAX STREET. DRESSY Tom/ CRY, STATE, ZIP */Lr (. (� U PCG S°1x -L ARCHITECTIENGINEER NAME LICENSE NUMB ER BUS. LIC.0 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF .•FD OT Duplex ❑ Multi -Family. STRUCTURE; ❑ Commercial ROOF AREA: Z(/q VALUATION: 1/— ( 11 15-C) 6J EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY, REMOVE /REPLACE ❑ NO IF NO. I OLAYERS.ITHICKNESS PLYWOOD ❑:r' ❑ ❑ %n-- PLYWD OSB TYPE ❑ COX PITCH: '(Z ROOF LAS A PROPOSED ROOF TYI`E: ❑BUILT-UP ROOF 13 ASPHALT SHINGLES 11 WOOD SHAKES ❑SHINGLES ❑OTHER �%� IMES REPORT aWOOD DESCRIPTION OF WOW : i r 101 k ' By my signature below, I certify to each of the following: I um the property owner or authorized agent to act on the property owner's behalf 1 have read this application and the information I have provided is correct. I have read die Description of Work and verify it is accumte. 1 agree to comply with all applicable local Ordinances and sate laws relating to building construction. 1 authorize representatives of Cupertino to enter the above -identified property for inspection purpose. Signature of Applieant/Agem: Date:Z- SUPPLEMENTAL INFORMATION REQUIRED 1J�aIf building is associated with a Home Owners Association, provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions/r4A5v ✓ Provide copy of Manufacturer's Installation Specifications. P71 , =pro V Provide signed copy of Cupertino's Tear -Oft Policy. `.' OFFICE Use ONLY PLAN CHECK TYPE ROUTING SLIP OYER -THE -COUNTER EXPRESS ❑ STANDARD • - ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ EIRE DEPT ❑, OTHER_ Rerooj4pp_1011.doc revised 03./16111 _ tiFx ti. �at5 t' i rr� �+2ir>d{✓ 10 w �,-