12070223CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS: 10052JUDYAVE
CONTRACTOR:' _... •-ri _
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PERJII'1'NO: 12070223
OWNER'S NAME: CHENG CHENG T AND NANCY S TRUSTEE
DATE ISSUED: 07(30/2012
OWNER'S PDONIi: 6503468488
PIfONE NO:
❑ LICENSED CON'TRACTT�O//R'SS DEICLARATION
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Classy-�_7- / Lic:H_ QV y (�� -'3
BUILDING PERMIT INFO: BLDG ELECT PLUMB
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Contractor,—ezi_ Date _11-A011 Z
NIECFI RESIDENTIAL COAINIERCIAL
1 herehy affirm that I am licensed under the provisions of Chepfer 9
JOB DESCRIPTION: REMOVE(2)LAYERS OF COMP, INSTALL 15 LB FELTAND
(commencing with Section 7000) of Division 3 of the Business & Professions
INSTALL NEW CLASS A COMPOSITION ROOFING WITH NEW
-I
Code and that my license is in full force and effect.
GUI ERS AND DOWNSPOUTS 22 SOFT
I hereby affirm under penalty of perjury one of the following twa 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: $6450
Section 3700 of the Labor Code, for the perfornnce of die work for which this
permit is issued
APNNumber: 37511013.00 Occupancy Type:
AIT LICANPCFRPI FI CATION
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 mrd 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 ofCuperrino against liabilities, judgments,
costs, and expenses which may accrue against said Cit' in consequence of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting ofthis permit. Additionally, the applicant Understands mid will comply
180 DAYS FROM LAST CALLED INSPECTION.
with all non-poim source r • tarn ns per the Cupertino Municipal Code, Section
9.18. _
Signature- - - -- - Date 7-Z �Z
1 ,
Issued by: �f}/✓ Data:
/%.9l GtZ 73
❑ O\\'NERARTILDER DECLARATION
RF. -ROOFS:
1 herehy affirm [halt I am exempt from the Contractor's License Lav formic of
A0 roofs shall be inspected prior to any roofing material being installed If a roof is
the following two reasons:
installed without first obtaining run inspection, I agree to remove all new materials for
1, as owner of the property, or Ory employees with wages as their sole compensation,
inspection.
will do the work, mid the structure is not intended or offered for sale (Sec.7044.
Business & Professions Code)
Signature of ApplicnC Date:
I, as owner of the. property, am exclusively contracting With licensed contractors to
consumer the project (Sec.7044, Business &. Professions Code).
AL1, ROOF COVERINGS TO BE CLASS "A" OR BE-TI'F.R
I hereby:d%rnr under penally of perjury one of the following three
declarations:
I have and will maintain it Certificate of Consent to seer -insure for Worker's
IL\%ARDOUS DLVTERIALS 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 & Safely Code, Sections 25505. 25533, and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance, as provided for by
compliance will] the Cupertino Municipal Code, Chapter 9.12 and the licallh &
Section 3700 o(the Labor Code, 1'or the per(ormmmee of the work for Which this
Saret• Code. Section 25532(x) should I store or handle hazardous inmerial.
permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the flay Area Air Quality Jlanagemem District I will
'the
I certify that in the performance of die work lbrwhich this permit is issued, I shall
mahnaln compliance withCupertino NImdclpal Code. Chapter 9.12 and the
not employ any person in may manner so as to become subject to the Worker's
Ilealth & Safety Code. Secdons25505, 25533, and 25534.
Compensation laws of California. If, after making this certificate ofesemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I [trust
Owner ' ,end igen l:
Unlr. 7s�� ./s_
forthwith comply with such provisions or this permit shall be deemed revoked.
AI'I'LIC.\N'I' CI?R'I'IFICA'I'ION
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 count ordinances mid state laws relating
for Which this permit is issued (Sec. 3097, Cir C.)
to building construction, mad hereby. authorize representatives of this cit' to enter
Lender's Name
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
Lender's Address
costs, and expenses which may acerae against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will connply
with all non -point source regulations per the Cupertino Municipal Code, Section
ARCIH,fECT'S DECLARATION
9.18.
1 understand any plans shall be used as public records.
Signature Date
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 • buildiro0cuoertino.ora
PROIECT ADDRESS
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OWNER NAME WE)
E-MAIL
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CI STATE ZIP
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L4CENSE NUMBERS
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STREEr ADDRESS
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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.
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.
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 Y<" 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 detect re required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential C de.
Signature of Applicant/Agent: Date:
ReroofPo1icv_201 Ldoc revised 02/16/11
CITY OF CUPERTINO
IY//I FEE ESTIMATOR -BUILDING DIVISION
y00'
ADDRESS: 10052 Judy Ave
DA'Z'E: 07/30/2012
REVIENVED BY: Sean
XMI
APN: 375-11-013
BP#:
*VALUATION:
$6,450
*PERMITTYPE: Minor Building Permit
PLANCFIECKTYPE: Re -roof
PRIMARY
USE: SFD Or Duplex
Elec. Imp. Fee:
PERMITTI'PE: 1SFDWLR00
WoizK
Remove 2 layers of comp,install 15 Ib felt and install new Class A composition roofing with new
SCOPE
gutters and downspouts.
FEE ID ROOFAREA
(s.f.)
1REROOFFRES 2,200
NOTE: This awitnate does not includejeev (lite to other Departments (i.e. Planning, Public II'orks, Fire, Sanitaq• Sewer District, School
n:or.:rr n,, 1 Thncn Gro urn hnoad nu tho ore/iminnn• in(nnu.nion anailahle and are nnh• nit e5(hN(ne. Contact the Den for addn'l into.
FEE ITEMS (Fee Resolution 11-053 E(f 7/1/11)
Mech. Wan Check
Phumh. Plan Check
Elec. Plan Check
Mech. Permit Fee'
Phanh. Permit rec.,
F.lec. Pennin Fee:
Other ,ifech. Insp.
Other Plumh Insp.Li
Other Dec. Insp.
Jlech. lay. Fee:
Phunh. hop. Fee:
Elec. Imp. Fee:
NOTE: This awitnate does not includejeev (lite to other Departments (i.e. Planning, Public II'orks, Fire, Sanitaq• Sewer District, School
n:or.:rr n,, 1 Thncn Gro urn hnoad nu tho ore/iminnn• in(nnu.nion anailahle and are nnh• nit e5(hN(ne. Contact the Den for addn'l into.
FEE ITEMS (Fee Resolution 11-053 E(f 7/1/11)
FEE
QTY/FEE
N11SC ITEMS
Plan Check Fee:
Suppl. PC Fee
Plumb./Meeh./Elec
Permit Fee:
$330.00
Suppl../nsp Fee
Phtmb./d/ech./Elec
P/umh./Alec/t./F.lec Permit Fee.'
Construction Tar:
Administrative Fee:
Work Without Permit? O Yes Q No
$0.00
Adveweed Plamrirtg Fces:
Travel Documentation Fees:
Strong Motion Fee: IBSEISHICR
$0.65
Select an Administrative Item
Bldg, Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$331.65
$0.00
TOTAL FEE:
1 $331.65
Revised: 07/01/2012
CUPERTINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 • buildinG(acuoertino.orG
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PROJECT ADDRESS ,OO I
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CONTACT NAME `
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STAEET ADDRESS ^^�� `
CRY. STATE, ZIP
FAX
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENr Er."ONrRALToR ❑ CONDUCTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRALTO AZ
LI,CENSENUMBER
(I5 TYPE
BUS. LIC.d
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COMPANY NAME j
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FAX
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CITY. STATE, ZIP
PHONE -
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2 C'W
ARCHITECUENGINEER NAME
LICENSE NUMBER
BUS. LIC.4
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY. STATE, ZIP
PHONE
USE OF ni ly.
ROOFAREA:
TION:
T767
STRULIORE. ❑Commercial
i�Gi
y
EXISTINGROOFTYPE:❑BUILT-UPROOF ��KIPHALT SHINGLES ❑WOOD SHAKES ❑WOODSHTNGLFS- ❑ OTHE�R(SPECIFY)
REMOVE REPLACE
PLYWOOD 11 vi-
PLYVD ❑OSE.
PITCH:
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ROL
F",A
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M A c
THICKNESS sB'
PE
PROPOSED ROOF TYPE ❑ BUILT-UP ROOF I ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT I
DESCRIPTION OF WORK:
Z.c, 'L Lu a... •n ,b -eft'iL�
By my signature below, l certity to each of the followine: I am the property owner or authorized agent to act on die property owner's behalf. I have read this
application and the information I have provided a a. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state lams relating w buildin stm un. 1 authorize representatives of Cupertino to inter the above-klemtfied property for inspection purposes.
Signature of Applicant/Agent'. Date:
SUPPLEMENTAL INFORMATION REQUIRED
- OFFICE
USE ONLY
PLANCHECKTYPE -
ROUTING SLIP
_ If building is associated with a Home Owners Association, provide letter
�T,,
OVER-THE-COUNTER
sem(
aV BUILDING PLAN REVIEW
/❑_
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
/❑ ExPaFss
PLANNING PLAN REVIEW
_ Provide copy of Manufacturer's Installation Specifications.
❑ STANDARD
❑ FIRE DCPT
Provide signed copy of Cupertino's Tear -Off Policy.
r❑ OTHER:
Rerwfdpp_201 Ldoc revised 03/16/11