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12050200
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10369 LEOLA CT CONTRACTOR:DAN ELLIOTT'S PERMIT NO: 12050200 ROOFING CO OWNER'SNAME; MIKE WLI PO BOX 26878 DATE ISSUED:05/25/2012 OWNER'S PHONE: 6508592328 SAN JOSE,CA 95159 PHONE NO:(408)559-7327 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License ClassI.ic.H RE-ROOF27SQ- REMOVE ALL SHAKES,REPLACE FLASHING Contractor Date & VALLEY, INSTALL 15/32 OSB INSTALL LANDMARK PRO I hereby affirm that I am licensed under the provisions of Chapler 9 LIFETIME 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 penaltyof perjury one of the following two declarations: I have and will nminmin a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance ofthe work for which this permit is issued. Sq.F1 Floor Area: Valuation:$9794 1 have and will mainmin Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:37504023.10369 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct, I agree to comply with all city and countyordinancesand stale laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and herehy authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the s eZ granting ofthis permit. Additionally,the applicant understands and will comply Issued by: �;-vz Dale: with all non-point source regulalicos per the Cupertino Municipal Code,Section / 9.18. _ ROOFS: Signator Daleb All roofs shall be inspected prior to tonry roofing material being installed If a roof is installed without first obtaining an inspection.I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Appli© Date:�- 2_—/�. I hereby affirm That 1 am exempt from the Contractor's License Low for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole comry.msation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the properly,am esclusvely contracting with licensed contractors to DAZARDOUS MATERIALS DISCLOSURE; construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Ilealth&Safety Code,Sections 25505,25533,and 25534. 1 will 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: Health&Safely Code.Section 25532(a)should I 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 whichthis permit is issued. will maintain compliance"illi the Cupertino Municipal Code.Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the lleallh&Safety Code,Sectifins 25505,25533 a d 25534. 6-2,57-1-2-- Section 3700 of the labor Code,for the performance of the work for which this Owner or authorized egrnl• Dale: permit is issued. 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 Califomia. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGF-NCS' become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby alfimh that there is a construction lending agency for the perfommnce 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 APPLICANT CERTIFICATION Lender's Address I cenify that I have read this application and stale that the above information is correct.1 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 nhemioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the 1 understand my plans shall be used as public records. granting of Otis 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 Dale REROOF TEAR-OFF POLICY COMMUNITY,DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR;IP.E.. C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE-CUPERTINO,CA 950143255 CUPERTINO (408)'777-3228•-FAX.(408),777-3333•buildinaCa)cuoertino.ora PRO ECT ADDRESS APN a O RN ME t�jPON r E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX CONMRAMEz/h LICFfJS� PE BUS.LIC.a C PANY N�4/ E-MAIL r n FAX(ta-F'sa ^ X734 �J STRIZ .STA V l O( NUJ( r — < �2 / I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. 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.reguired., 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 notbe.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. Proeress Inspection is required when approximately 50% of roof covering is installed. 7. A Final Inspection and approval shalMe 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/4" 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 fora 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 istrue: 1 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 detector re required to be installed in accordance with Sections R314 and R315 of the 2010 California Reside 'a od s b (2 Signature of Applicant/Agent: Date: ReroofP olic_v_201 Ldoc revised 02/16/11 CITY OF CUPERTINO 3 ITEMS OF 15 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37504023 .10369 DATE ISSUED. . . . . . . : 05/25/2012 RECEIPT #. . . . . . . . . : BS000016921 REFERENCE ID # . . . : 12050200 SITE ADDRESS . . . . . : 10369 LEOLA CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MIKE WU ADDRESS . . . . . . . . . . : 4170 ALTA MESA CITY/STATE/ZIP . . . : PALO ALTO, CA 95014 RECEIVED FROM . . . . : DAN ELLIOTT CONTRACTOR . . . . . . . : DAN ELLIOTT LIC # 21466 COMPANY . . . . . . . . . . : DAN ELLIOTT'S ROOFING CO ADDRESS . . . . . . . . . . : P O BOX 26878 CITY/STATE/ZIP . . . : SAN JOSE, CA 95159 TELEPHONE . . . . . . . . : (408) 559-7327 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ----- --- ---------- ---------- ---------- 1BCBSC VALUATION 9, 794 .00 1.00 0.00 1.00 0.00 1BSEISMICR VALUATION 9, 794 .00 0.98 0. 00 0.98 0.00 1REROOFRES SQ FEET 27 .00 378 .00 0. 00 378.00 0. 00 --------- ---------- ---------- TOTAL PERMIT 379. 98 0. 00 379 .98 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF `'%0 REROOF PERMIT-APPLICATION q'�o1� I`" � rolmnnunurw ne.�7e�oP�nr_nn-oF.PARTnnEn(,•I�ull_rnnlc un%L>u>Nt R 10300 TORRE A,/EnIUE-CUPF_RTIPIO,CA 9'1014-3255 (A08)777-3228-FAX(408)777 3333•bulldiny(Welipel.[ino p,�g 1 _ _ ..q III! 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