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12090024 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20672 GARDENSIDE CIR CONTRACTOR:BRADSHAW ROOFING INC PERMIT N0: 12090024 OWNER'S NAME: HUANG REN11E AND WU BIN 1821 S BASCOM AVE PNIB 160 DATE ISSUED:09/102012 OW'NER'S PHONE: 4082469930 CAYIPBF:LL,CA 95008 PRONE NO:(408)246-9930 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG I— ELECT r. PLUMB License ClassC-39 Lie.4 `71�3 8C7 NIECII 1-- RESIDENTIAL _r. CODIDIERCIALr ContmclnfVC,LASt ,) acx:i l Date —} I16I12 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE EXISTING WOOD SHAKE ROOFING.INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions 1200 Code and that my license is in full force and effect. SQFT NEW CLASS A COMPOSITION SHINGLES(AGED BARK) I 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 Sq.Ft Floor Area: Valuation:$6000 permit is issued. APPLICANT CERTIFICATION APN Number:36232013.00 Occupancy Type: I certify that 1 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 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 dexpenses harmless the City of Cupertino against consequence judgments. WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence o(the granting of this permit. Additionally,the applicant underslands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Sectiwm 9.I8. � /� ,- \ 4F-/0-12_ Issued by: �t Lk) Date: Signalurc ' i D:uc 9�r��/2 ❑ OWNER-BUILDER DECLARATION RF-ROOFS: hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first oMoining an nspecuon,Iagree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sea7044, AA� p Business&Professions Code) Signature of Applicant:GV.- Date: / I.2 ho I,as owner of the property,am exclusiveiv contracting with licensed contractors to construct the project(Sce.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty,of perjury one of the following three declarations: IIA%ARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Ilealth&Safety Code,Sections 25505,25533,and 25534. 1 will maintain 1 have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 ofthc Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Ray Area Air Quality Management District 1 will I certify that in the performance of the work forwhich this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in my manner so as to become subject to the Worker's Health&Safely Coda Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I � ,7 become subject to the Worker's Compensation provisions of the Labor Code,I must f)s r or Yarm �genl: (/ forthwith comply with such provisions or this permit shall be deemed revoked. Date: CONS'IRIICI'ION LENDING AGENCY APPLICANT CERTIFICATION 1 certify that 1 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 county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city 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 accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCI IITECI"S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional i209oc)z9 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20672 Gardenside Cir DATE: 09/04/2012 REVIEWED BY: Sean APN: BP#: `VALUATION: $6,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Multi-Family Dwelling Buildina is I PENTAMATION 1R2ROOF USE: >3 Stories O Yes E) No I PERMITTYPE: WORKRemove existingwood shake roofing. Install new Class A composition shingles (Aged Bark). SCOPE FEE ID ROOF AREA s.f. 1REROOFMRES 1,200 Meeh. Plan Check Plumb, Plan Check Elec. Plan Check Meeh.Permit Fee: Phtmh.Permit Fre: - Elec. Penna Fra: Other,ilech. Insp; Other Plumb Insp. Ll Other Elec.Insp. Ll I .Vlach.Insp. Fec: Plumb. Insp.Fee: Elec.Insp. Fec: NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District,etc.). These eev are based on the preliminan information available and are ooh,an estimate Contact lire Dept for addn'l info. FEE ITEMS (Fee Resolution I1-053 F_lZ 7111!// FEE QTY/FEE MISC ITEMS Plan Check Fee: SnppL PC Fee PI nn!b.1,11 ech.1El ec Permit Fee: $180.00 .Suppl. Insp Fee e Plamb.lAlech.lEle c P1ttmb./A1ech.1E1ec Permit Fee: Consniiction Tax: Administrative Fee: Work Without Permit? O Yes (j) No $0.00 1 dvanceil Planning Fees: Travel Documentation.Feev: i Strong Motion Fee: IBSEISMICR $0.60 Select an Administrative Item Bldg Stds Commission Fee. IBCBSC $1.00 SUBTOTALS: $181.601 $0.001 TOTAL FEE: 1 $181.60 Revised: 07101/2012 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION >Y ' L 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C l3PERTINO (408)777-3228 • FAX(408)777-3333•buildinecDcuoertinD.orO PROJECT ADDRESS - 3Q O OwKe 1 HONE `1 ( �(•,�r 1 E-MAIL STREETADD S .} _fC lU ATE,ZI 1O FAX CONTACT NAME �j PHONE STREET ADDRESS CRY.STATE.ZIP FAX ❑OWNER ❑ OWN-M-51JMDER ❑ OlVNER.AGENrC llcroR ❑CONTRACTORAGENT ❑ Aaam-cr ❑ErGim ER ❑ De pER ❑Ter,wr CONTRACT RNAAfc LICENSE NUa�ER LICENSE TYPE 131MLiC.i j0� COMPANY NAME ,�A nG FAX hC U PHONE ST STREET ADDRESS Cffl', .ATE,�� t-c ARCHITECUENGINEER NAME LICENSE NUMBER BUS,LIC.C COAIPANY N.UfE - E.TAIL FAX 'STREET ADDRESS CRR',STATE.ZIP PHONE USE OF ❑ SFD or Duplex Mulfi-Family, ROOF AREA: //,'� VALUATION: c STRUCTURE. ❑ Conmercial Ir,(-� . \ 4 S C/j '. MSTINOROOFTYPE ❑BUILT{PROOF ❑ASPHALT SHINGLES aaw'OOD SHAKES ❑wooDSHINOLES ❑OTHER(SPECtFY, REMOVE IREPLACE 6941sS tF VO. /I� PLY:yOOD !S- ❑ PLYWD ❑ OSB PRCH: ROOF ❑ 0 cL Rc. j, NEc. ❑ 53' ❑fDX J2 I A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF 2 ASPHALT SHMOLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT 9 DESCRIPTION OF w'ORK: CAQC,�-, By my signature below,I certify to each of the fallo%ins: 1 am the property owner or authorized agent to act on die property owner's behalf. [have read this application and file infortnacion 1 have prop ided is correct. I have read the Description of Work and verify it is accurate. l agree to wmply With all applicable lac`I ordinances and state laws relating to bIn9 in/g cons/a-7M��on. 1 a�u//ddgqrt�/z.�r epresenmtives ofCuperdno m enter the above-idendf/ud property for inspection purposes. Signature of Applicant/AgenD CA�,(,(ii��[�L2..!�iyf/ Date:-2"I i nl P– SUPPLEMENTAL INFORh•LkTION REQUIRED . OFFICE USE ONLY _If buildin2g is associated with a Home Owners A;sociatioa,provide letter PLaNCTECKTTRE ROUTING SLIP ofapproval fTOm HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PUN REVCE`W _Provide Planning-approval to verify'if there any restrictions. ❑ EXPRsss ❑ PIaNNING PLAY AEyTER' _Provide copy of Manufacturer s Installation Specifications. ❑ STANDAARD ❑ FSE DEPT Provide signed copy of Cuperino's Teat-Off Policy. ❑ OTHER: Reroofdpp_2011.doc revised 03..I&II REROOF TEAR-OFF POLICY 2 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•buildingg(�cuoenino.org PROJECT ADD C\ APNN .. ` OI :S OWNER NAME e R / Ho U-),) J PHONEL-16 kt E-MAIL STREET ADD 1\C' CITY.STATE,2 FAX �nst Gr «o LA SO 1M 1CTO NA•IE, 1`t LICENSE NVMBE0. LICENSETYP BUS.LIC.N. Cj ^ C_. -, _ COMPANY NAME E-MAI \IV FAX 1) - _ nbel k- STREETADORF55 \ ' ` C� CITY.STATE,ZIP 1 HONE 1 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 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/4" 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. 4 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. 1 also understand that smoke detectors and carbon monoxide detectonl?are required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Code Signature of Applicant/Agent: ` Date:-77 _Q _ ji t RernoJPo1icv_201 Ldoc revised 02116111 Building Department City Of Cupertino 10300 Torre Avenue CUPERTINO 'i cicPl1Vuc:406-777-3'125 ' Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOBADDRESS: a PERMIT# OWNER'S NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: � S, Q CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCON RACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. —A4 I am not using any subcontractors: t Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum / Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic'Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date