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12080314 CITY OF CUPERTINO 13UILDING PERMIT BUILDING ADDRF-SS: 19756 VICKSBURG DR CONTRACTOR:WING'S ROOFING INC PERMITNO: 12080314 OWNER'S NAME: CHANG FRANK T AND DORA K 3243 SYDNEY WAY DATE ISSUED:08/302012 OWNER'S PHONE: 5108511278 CASTRO VALLEY,CA 94546 PHONE NO:(510)889-9068 LICENSED CONTRACT'OR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r (J PLUMB License Class Lic.tl II hIECH r RESIDENTIAL r COMMERCIALr Contractor ( 1 ate O �Z 1 hereby affirm that nm licensed un er the provisions of Chapter 9 30B DESCRIPTION: RE-ROOF 4 SQFT ABOVE GARAGE BUILT UP ROOF TEAR (commencing with ection 7000)of Division 3 of the Business&Professions OFF Code and that my license is in full force and effect. AND INSTALL NEW TORCHDOWN 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 b}•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.F1 Fluor Area: Valuation:$1450 APPLICANT'CER'1'IFICA'1'ION I certify that I have read this application and state that the above information is ANN Number:36910009.00 Occupancy Type: correct.1 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 w•hi may acerae against said City in consequence of the grantingof this permit. dditionally,theapplicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point sourcregulations per the Cupertino Municipal Code,Section 180 DAYS F OLAST CALLED INSPECTION. 9.18, Signature Date U �Z Issue b / U' ' Date: ❑ OWNF,R-BUILDER DECLARATION _ 1 hereby affirm that I am exempt from the Contractor's License Law fur one of RF:ROOFS: the following two reasons: NI roofs Shall be inspected prior to any roofing material beitg installed.If a roof is I,as owner of the property,or my employees with wages W5 their sole comp:nsation, installed without first obtaining an i spection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sce.7044, inspection. Business&Professions Code) - �- /^ 1,as owner of the property,am exclusively contracting with licensed contractors.to Signature of ApplicmL Date: construct the project(Sec.7044,Business&Professions Code). 1 hereby affirm under penalty of perjury one of the following three AL1,ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate ofConsent to self-insure for Worker's ILVLARDOUS MATFRIALS 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 25505,2.5533,and 25534. I 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& P Safety Code,Section 25532(a)should I 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. If,after making this cenificatc of exemption,1 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 nu h rued a ent: O // Dote• I APPLICAN-T 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 Imus relating I hereby affirm that there is a constriction 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 indemnify 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 ARCIIITFCT'S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 19756 Vicksburg Dr DATE: 0 913012012 REVIENVED BY: Sylvia 97S APN: BP#: 'VALUATION: $1,450 *PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARYPENTAMATION USE: SFD or Duplex PERIIIITTI'PE: 1SFDWLROOF 41 WORK RE-ROOF 4 SQ- ABOVE GARAGE BUILT UP ROOF TEAR OFF AND INSTALL NEW TORCHDOWN SCOPE FEEID ROOFAREA s.f. 1REROOFFRES 400 Much Plan Check Plumb. Plan Check Flee. Plan Check blech.Permit Fee: Plumb. Permit Fee: filen Pannit Fre: Odn•r'birch.Insp. Other Plumb Insp. Other Elec.Imp. Li I tech.Imp. Fee: Plumb. loop. Fee: Elec.Insp.Fre: !VOTE: This esrinmte does not include jeev due to other Departments(i.e. Planning, Public 11'orks, Fire,Sanitary Sewer District,School District, etc.). These ees are based on the prelintinan information available and are on&an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution I1-053 F_R' 7/I/I1) FEE QTY/FEE MISC ITEMS Plan Check Fce: Stipp/. PC Fee Phtmh./Mnch./Elec Permit Fee: $60.00 .Supp/. lisp Fee Plumb./A/ech./Elec P/nmh.hl•/ech./Flee. Permit Feet• Conan•uction Tar: Administrative Fee: Work Without Permit? O Yes (F) No $0.00 Advanced Planning Fees: Travel Documentation Fens: Strong Motion Fee: IBSE/Sh1ICR $0.50 Select an Administrative Item 13ldg Stds Commission Fee: IBCBSC $1,00 SUBTOTALS: $61.50 $0.00 TOTAL FEE: $61.50 Revised: 07/01/2012 1 .zc) o:�5 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•buildingecuoertino.org PROJECT ADDRESSAPrrrN��M'''[[[�� / `J U OWNER NAME % J4YI PHONE /may\/ rZ� E-hU1L CJ ' STREET ADDRESS ) � CITY, STATE,ZIP /^ � I FAX CONTACT NAME PHONE C� E-PIAIL STREET ADDRESS CRY,STATE, ZIP FAX ❑ OWNER ❑ OWTJER-BUILDER ❑ OWNERAGENT ❑ CONIAACTOR ❑CONTRACTORAGFM ❑ ARCHITER ❑ENGINFIII ❑ DEVELOPER ❑TENANT CONTRACTORNAME ' I �, - rl_ y(/ LICENSE NUAIBER/ / LICENSE TYPEi> BUS.LIC.0 l�J lui b CONIPANY•NAAIE E-MAIL I _ Its I{ I11 FAX 6, 1 (. W STREET D CITY,STATE,ZIP PHONE �/b a ARCHITECTIENGINEER NAh LICENSE NIR.®ER BUS.LIC.M COMPANY NAh(E E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE �� VALUATION: USE OF SFD or Duplex ❑ Multi-Family. a_�F AREAJ � STRUCTURE: ❑ Commercial [DUSTING ROOF TYPE: BUILT-UP ROOF ❑ASPHALT SHINGLES ❑W'OOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECffY� REMOVE/REPLACE K YES IF NO, PLYWOOD ❑ %- ❑ PLYWD ❑ OSB PITCH: ROOF ❑ No II L THICKNESS ❑ ILA- T' � ❑CDX :12 CLASS' A PROPOSED ROOF TYPE: �BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT b DESCRIPTION OF\YORK: 1] U) By my signature below,I certify to each of the following: 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 is correct. I have read the Description of Worn:and verify it is accue. I a vee to comply with all applicable local ordinance and stale laws relntin,to build' g construction. I authorize representatives of Cupertino to enter the above-ide Ified prope y for inspection purposes. Signature ofApplican ��D�<'� U 2�- -� SUPPLEhfENTAL INFORM ATION REQUIRED _ _ OFFICE useolvoY _ _if building is associated\vidT a Home wner's Association,provide letter PI-ON CHECK TYPE. - 'ROVr166SLIP of approval from HOA. - VER-THE--COUNTER ❑� BUILDING PLAN REVIEW' _Provide Planning approval to verify if there any restrictions.. ❑ EX'PRESS! ❑ -vunnlsc rLAN arvIew _Provide copy of Pfanufacmrer's Installation Specifications. ❑ arANDARD ❑ nREDCIT Provide signed copy ofCupertino's Tear-Off Policy. - ❑ OTHER:' Reroofdpp_2011.doc revised 03/16/11 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-building(aDcuperlino.oro PROJECT ADDRESS APNN OWNERNAME �,�/Ir/) / PHONE E-MAIL STREET ADDRESS (/ Vws/V I/V`r // /� (� CIN. STATE-ZIP^ FAX CONTRACTORNAME i^ s V� '>'` LICENSE NUMBER l)'� /], LICENSE TYPE /J•. BUS.LIC.a qi4 \ / l/ COMPANY NAME I `— / / / E-MAIL FAX STREET ADDRESS CITY.STATE.ZIP / „^ ^PHONE v ,-( e, 11 1 UNDERSTAND AND AGREE TO THE FOLLOWING: I. 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. 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/<" 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 S 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 rs are required to be installed in accordance with Sectio R314 an 315 of the 2010 California Residential Code. Signature of Applicant/Agent: / Date: ReroofPo1irv_2011.doc re•ised 02//6/1/