12060083 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10382NOEI,AVE CONTRACTOR - ____._._.....__ !F-RDIITNO: 12060083
OWNER'S NAME: SHI-I SWEY-YAN AND MAY CHEN - /(� DATE ISSUED:06/142012
OWNER'S PIIONE: 5106486908 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Cls
as '- � Lic.q 7& 7P/z-
M ECH r RESIDENTIAL r COMMERCIAL r
r
Contractor fi Date 2
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:T17AR OFF EXIS'T'ING WOOD SHAKE AND INSTALL NEW
(commencing with Section 7000)of Division 3 of the Business&Professions 12
CDA PLYWOOD 30q FELTAND NEW COMPO51'fION ROOFING
Code and that my license is in full force and effect.
CLASS A 25 SQ
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
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$12000
APPLICANT CERTIFICATION
I cenil} that 1 have read this application and state that the above information is APN Number:32617048.00 Occupancy Type:
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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. ,( �1/�/
Signature Id- ,�.'�t�Date &4/1441 Issued by: 7 /✓ h" f Deme:
❑ OWNER-BUILDER DECLARATION
I hereby affirm that 1 am exempt from The Contractor's License Law for one of RF:ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material bcug installed.Ira roof is
I,as owner of the properly,or my employees with wages as their sole compensation, installed without first obtaining an inspection.1 agree to remove all new materials for
will do the work,and the strmmrc is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the propcny,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health&
Safely Code,Section 25532(a)should 1 store or handle hazardous material.
permit is issued Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. 11',after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
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. Owner or authorized agent:
:11r - 40,14, Dale: aLh4/1Z.
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 state laws relating I hereby afiimn that there is a construction lending agency For the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec 3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
inden nify and keep harmless the City of Cupertino against liabilities,judgments.
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCI IFFECT"S DECLARATION
9.18.
1 understand my plans shall be used as public records,
Signature Date
Licensed Professional
r
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-M33•buildina(cDcuoertino.org
PROJECT ADDU
SZ4 V _ APN n�d/JU L�7 oy8
` OWNER NAME
PHON.r Q - 6 0 E-MAIL
STREET ADDRESS CITY, STATE ZIP FAX
CONTRACTOR NAME LICENSE NUMBER 012 LICQJSE TYPE BUS.LIC.a
747,
COMPANY NAME E-MAIL FAX
i
STREET ADDRESSCITY.STATE.ZIP PHONE
k C . 7 4-178 7 l
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 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 priorto 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.
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 I/A" 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: 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. 1 also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of ApplicanUAgent: J A - Date:—0"/—
_/Z
ReroolPolicv_2011.doc revised 02116111
Community Development
10300 Torre Avenue
IH
Cupertino CA 95014
Telephone(408) 777-3228
CITY of Fax(408)777-3333
CUPERTINO
Building Department
JOB ADDRESS: PERMIT #
103?2- WO& A VE
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: T �� pf �N FAX #
I am not using any subcontractors: /2.
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fendng
Flooring. Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32647048 .00
DATE ISSUED. . . . . . . : .06/14/2012
RECEIPT #. . . . . . . . . : BS000017067
REFERENCE ID # . 12060083
SITE.ADDRESS . . . . . : 10382 NOEL AVE
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SHEI SWEY-YAN AND MAY CHEN
ADDRESS 10382 NOEL AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : THATCHER ROOFING
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS . . . . . . . ... . :
CITY/STATE/ZIP . . . . ,
TELEPHONE . . . . . . . . :
FEE ID UNIT' QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--------- --- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 12, 000.00 1.00 0.00 1 .00 0.00
1BSEISMICR VALUATION 12, 000.00 1.20 0.00 1 .20 0 .00
1REROOFRES SQ FEET 25 .00 350.00 0 .00 350 .00 0. 00
- --------- ---------- ---------- -- --------
TOTAL PERMIT 352 .20 0. 00 352 .20 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 471.20 #1879
---------------
TOTAL RECEIPT 471 .20
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
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 10382 Noel Ave DATE: 06/14/2012 REVIEWED BY: Sean
APN: 326-47=048 BP#: 'VALUATION: $12,000
PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK Tear off existinq wood shake and install new 1/2" CDX plywood, 30#felt and new composition roofin .
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,500
d loch. flan('hark Plruub. Plnn Cbrek Iiler.. !'!na Check
mech. Perotil Fee: Plumb. Permit Fec: lilac. Pe"plil Foe.
Othe, Ih,b. Imp. Other Plumb/nsp. Oihe•r tiler. Imp. Li
.bhrh. hr,7p. For: Phanb. h),p. Fes: tiles.Insp. Fee:
NOTE: This estimate does not include jees,due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District,eta). Thesefees are based on the prelimina information available and are only an estimate Contact the De 1 or addn'I info,
FEE ITEMS (Fee Revohaior 11-053 E .-7/1/l I) FEE QTY/FEE MISC ITEMS
Plan Chuck Fee:
Supp/. PC Fee
Permit Fee: $350.00
Supp/. hncp Ice
/'hal h.id•/c•c/l./lilc•c
Phimh.8b/ech./1,'lee Permit Fe
Construciion Tax:
Arbniuisli alive Fee:
Work Without Permit? O Yes 0N $0.00
Arhvnn cd l'laruling rtes:
Tame/Documenlnlion Fees:
Strong Motion Fcc: IBSEISMICR $1.20 Select an Administrative Item
Bide Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $352.20 $0.00 TOTAL FEE: $352.20
Revised: 06/05/2012
I Ze> b C)
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTtNO (408)777-3228•FAX(408)777-3333•buildinG( cuoerlino.oro
PROTECT ADDRESS/0382 NOC f►VE APNa ter/ � LS
E-MAIL
`/ OwMER NAME PHON d rU U
STREETADDRESS O DGL //-�9 CIT STATE,ZIP v �O FAX
CONTACT NAME L PHONE E-MAIL
STREET ADDRESS CITY,STATE, ZIP FA%
❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONr0.ACTOR ❑COKTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NA ME LICENSENUMDER LICENSE TYPE BUS.LIC.q
THAICHS11 RA3kE.1AACr 7972/2, 41
COMPANY NAME E-MAIL FAX
N
STREET ADDRESS CRY,STATE,ZIP ^ PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.a
COMPANY NAME E-MAIL FAX
STREET.ADDRESS CITY,STATE,ZIP PHONE
USE OF [ SFD or Duplex ❑ MUhI-Family, ROOF AREA'. V,4LUATION. '}�}'/]
STRUCTURE. ❑ COnlnlerclal v �D /•• v v _•o-O `•
EXISTMO ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES R WOOD SH.1KEs ❑WOOD SHINGLES ❑OTHER(SPECIFYI
I REMOVE/REPLACE W YES IF NO, PLYWOOD (n" ❑ PLT— ❑ USB PITCH. , ROOF
/I /❑ NO a A R THI ❑ 53" 1"PE fD q '(– CLASS `a
PROPOSED RO,)F TYPE ❑BUILT-UP ROOF SPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT a
DESCRIPTION OF WORK'.
' AR O OL F G / d PLy ands, -S
/ 40
By my signature below,I certify to each of the following: 1 am the property owner or authorized agent to act on the property owner's behalf: I have read this
application and the information 1 have provided is correct. [have read the Description oC Work and verify itis accurate. I agree In comply with all applicable local
ordinances and state laws relating to building construction 1 authorize representatives of Cupenino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent_ ^ Date_ 00z—/44&'L
SUPPLEMENTAL INFORPoWTION REQUIRED OFFICE USE ONLY
_ If building is associated With a Home Owners Association,provide letter PLANCHECK TYPEROUTING SLIP
of approval from HOA. OVER-THE-COUNTT1ER r BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS PLANNING.PLAN REVIEW
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD I❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-OR'Policy. ❑ OTHER:
Reroojdpp_201 Ldoc revised O3'l6i l f