12050201 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10371 LEOLA CT CONTRACTOR:DAN Ii1.1,10'F'I"S PF.RJIIT NO: 12050201
ROOFING CO
OWN'ER'S NAME: MIKE WU PO BOX 26878 DATE ISSUED:05/25/2012
OWNER'S PHONE: 6508592328 SAN JOSE.CA 95159 PHONE NO:(408)559-7327
❑ /+LICENSED CONTRACTOR'S D7bEC�—L^ARATION JOB DESCRIPTION- RESIDENTIAL COMMERC.L\L❑
License Class (..� Lic.N Q/3d RE-ROOF 27 SQ- 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 Chapter 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 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 whichlhis permit is issued. Sq.Ft Floor Area: Valuation:$9794
I have and will maintain Workers Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for Are performance of the work for which this
,\PN Number:77504023-10371 Occupanry'I'ypc:
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
coffee[.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 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 DAY"'-T�t'OM LAST CALLED INSPECTIOIN.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lf /
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicaunderstands and will comply Issued by:
nt Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signatur 1,// Dalc,S— 7� All roofs shall be inspected prior to any roofing material being installed.11'a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-RUILDER DECLARATION q
Signature of ApphDaIC:
121
1 hereby affirm that 1 nm exemptfrom the Contractor's License Law for one of crZ
the following two reasons: ALI.ROOF COVERINGS TO BE CLASS"A"OR BETTER
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,aid the sumclure is not intended or offered for sale(Sec.7044,
Business& Professions Code)
1,as owner of the proper),am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS ti DISCLOSURE:
construct the project(Sec 7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Ilealth&Safety Code,Sections 25505,25533,and 25534, 1 will
I hereby affirm muter penally of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Ilcalth&Safely Code,Section 25532(a)should 1 store or handle hazardous
I have and will maintain a Cenifcate of Consent to self-insure for Worker's material. Additionally.should 1 use equipment or devices which emir 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%lunicipaf Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance,as provided for by the Ilealth&Safety Code,S clions 25505,25, },and 25534. _ _
Section 7700 of the Labor Code,for the performance of the work for which this 9 '� _
Owner or authorized agent: 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 inmry manner so as to become subject to the Worker's
Compensation laws of California If,after making this certificate of exemption,) CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affum that there is a construction lending agency for 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
APPLICANT CERTIFICATION Lender's Address
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 propertyfor inspection purposes.(We)agree to save AR(:III'lF.C!'S DF.f.I.,\R,\TION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may aceme against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all nun-point source regulations per the Cupertino Municipal Code,Section Licensed Protcssional
9.18.
Signature Date
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
CUPERTINO
(408)777-3228• FAX(408)777-3333-buildina(a.cuoertino.org
PR J CT ADD FSS APN0
l G-1-
ER (�,2 3 E-MAIL
STREET ADDRESS CITY, STATE,ZIP \.J FAX
CON T013 NAM %2, LIC SE B LICSE r BUS.LIC.a
♦� ! 0
ANYNA /— n. MAIL It 0 n FV
ST R - . , / P ONE r /
C STATE
R ase rfQB -S 9- 73 2 7
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 canbe scheduled.up to the day before the inspection date. Please call (408)777-
3228 from 7:30 - 3i30pm`(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 roofiheathing 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 Nallin¢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 materialdown 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 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 oft/<•• 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,arrestofinstallation, 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 are-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: 1 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 R314 and 8315 of
the 2010 California Residenti I
ode.
Signature of ApplicanUAgenC Date:
Reron/Policr_?0/Lrinc rrrind/R/l6/ll
REROOIF PERMIT APPLICATION �yo .-'fit; �_qz 'A
COMMUNITY DEVELOPMENT DF_PARTMUIT•BUILDING DIVISION
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111300 TORRE Al/ENUF..^CUPF_R'TINO,CA 95014 37.55 R
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