12070087 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10242 GLENCOE DR CONTRACTOR:JIM KRAUSE ROOFING PERMIT NO: 12070087
OWNER'S NAME: ALBERT CHU- 2310 DIANA AVE DATE ISSUED:07/12/2012
OWNER'S PHONE: 4087564671 MORGAN HILL,CA 95037 PHONE NO:(408)779-0704
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL
License Class Lic,q
7j3 RE-ROOF 29 SQ- .REMOVE 3 LAYERS ROOF MATERIAL,
�
INSTALL 30LB FELT,CLASS A
Commcto t ale 711; Y
I hereby affirm that I am licensed uncYcr the provisions of 46hapler 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect. ,
I hereby affirm under penally 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 whichthis permit is issued. Sq.FI Floor Area: Valuation:$11991
1 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
APN Number:32630028.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.1 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 properly for inspection purposes. (We)agree to save 180 DAYS M LAST CALLED INSPECTION.
indemnify and keep ham Icss the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the s,
granting of this permit. Addition,the ant understands and will comply Issued by: L c Date: --712,12
with all non-po3;9�5
uperlino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date .Z / � All roofs shall be inspected prior to any roofing material berg installed.If a roof is
installed without first obtaining an inspection,1 o remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION /1
Signature of Applicant: Date:
I hereby affirm that 1 em exemptfrom the Contractor's License Law for one of
the following two reasons: ALI,ROOF COVERINGS TO BE CLASS"A"OR BETTER
1,as owner of the properly,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)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Cade,Sections 25505,25533.and 25534. 1 will
I hereby affirm under penally of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety 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 Oualily 5 nsgement District
performance of the work for whichthis permit is issued. will maintain compliance With the Cuperf 6AI nicip de,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se ' as 2 ,.34.
Section 3700 of the Labor Cade,for be perfortnunce of the work for which this Owner or authorized ager!:. 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 my manner so as to become subject to the Worker's
Compensation laws of Cal ifomia If,after making this certificate of exemption,1 CONSTRUMON LENDING AGENCY
became subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm 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
1 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 ARCHITECT'S DECLARATION
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 non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
� �.. ,. 1r3+-„3+�.a:.+`.L.:�r :l*.'r^' r.� �r - � ...,.J-rrr„�y_5...wi'..fv-✓i.�^"cr.�>rr.•r._.•�.:'�+-...- �v.Lamer-^- �r.-=v��-„��..,
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION _
ALBERT SALVADOR, P.E., C:B.O.,.BUILDING OFFICIAL
10300 TORREAVENUE•CUPERTINO, CA 95014-3255
- CUPERTINOc' "
`(408)777-3228• FAX(408)777-3333•building(D.cupertino.org , ;
PROJECT ADDRESS /D �5 n �T� APN0
OWNER NAME "�n PHONE^ �- E-MAIL
Aj
STREET ADDRESS / nI, n CITY.STATE.ZZlP �(4FAX
CONTRACTOR NAME n / • li LICENSE NUM LICEN �P BUS.LIC.M
t I
COMPANYNAM�/ EMAIL I "` I L FAX
STREETADD�ESS� L O CITY.STATE.ZIP L�� PHONE// � 07
// I UNDERSTiANDIAND AGREE TO THE FOLLOWING: L
1. The re-roof project shall comply withiall-applicable provisions of the 2010 California Codes.
2. An inspection request cambe scheduled no 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 how window.
3. Tear-Off Inspectioe isrenuired. 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 plywoodNailing 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%�7of roof covering is installed.
7. A Final. Inspection and approval shall.,be obtained ifrom4lbuilding inspector when the re-roofing is-
completed. To receive a final sign-off, the following items wilhe verified:
a. Flat roofs shall have a minimum of/<” per foot ofslopeland 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:iime of ttie,� spection7
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-iiispection fee shall be paid before another inspection
can be scheduled.. i
a
v
By my signing below, I"certify each of the following is truer 1 am the property owner or authorized agent to act on the
property owner's behalf. Furiderstand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon mon xi detecto arerQ ired to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Cod I `
Signature of Applicant/Agent: Date:
Remo/PolicJ•_?01 L doe,eoiser102116111
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•buildine(ccuoertino.ora
PRL IIECT ADDRESS 2` ^ 7N /
OWNER NAME ) PHONE �fJ E-MAIL
STREET ADDRESS 1, CITY, STATE.ZIPS -7 FAX
CONTACT NAME 1p PHON L �-' EAIAIL ^d ' V/-
It ��t
STREET ADORES `v ,,rr FAX
/ I
ClOWNER ❑ OWNER-BUILDER ❑ OWNERAGENT A'DoNTRACmR ❑CONTRACTORAGENT ❑ ARCHITECT Cl ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME _ 7 LTCENSENUM®ERA LTC SETYP�� BUS LICA
COMPANYNAME %I EMLAB.. :T / ✓ FAX, 7lei
, r C)
STREET.ADDRESS r�i� CR\' T TE,21� ,(/. �j a��{ PHUNF,(/ - 0eY
ARCHITECT)ENGINEER NAME LICENSE NUMBER (�� r/[ J� BUS.LIC0
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF %1§ SFD or Duplex ❑ Multi-Family. ROOF AREA: VALUATION n ��
STRUCTURE ❑ ConunercialL)
EXISTING ROOF TYPE'. ❑BUILT-UPROOF --kSPHALTSHRJGLESl�❑WOOD SHAKES ❑WOODSHINGLES 11OTHER(SPECIFY)
REMOVE[REPLACE V YES IF NO, PLYWOOD O ;4 ❑ PLYWD 11OSB PITCH: ROOF
E3No a LAYERS THICKNESS ❑ vs- TYPE t91C,D. :12 LAS A
PROPOSED ROOF TYPE ❑BUILT-UP ROOF )4SPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER (CC-ES REPORT a
DESCRIPTION OF WORK
, -t�
By my signature below,I certity to each of dte followlince I am th property owner or authorized agent to act on Lite property owner's behalf 1 lave read this
appliedion and the information I hav provid e L I ead the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and stare laws relating to b Id' uthonze representatives of Cupertino to enter Ole above-identified pro yearyfor inspection purposes.
Signature of Applicant/AgenL Date: y f�
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_If building is associated with a Home Owners Association,provide letter CN CHF,CK TYPE ROUTING SLIP
of approval from HOA. OPER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupenino's Tear-Off Policy. ❑ OTHER:
Reroofdpp_101 I_doc revised 03/16/11