12090261 CiTY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 888CANDLEWOODDR CONTRACTOR:RBT CONSTRUCTION, PERMITNO: 12090261
INC
OWNER'S NANIE: CHIEN-PING LU R Cl-IARLENE LBE 2915 TOBIN DR DA'Z'E ISSUED;09282012
OWNER'S PHONE: 4086544001 SAN JOSE,CA 95132 PHONE NO:(408)261-2327
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class Lic.9 C? RE-ROOF 18 SQ-CLASS A ASPHALT SHINGLES
Contractor fC, Date.
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business& Professions
Code and that my license is in full force and effect.
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. Sq.Ft Floor Area: Valuation:$10000
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
APN Number:36919025.00 Occupancy Type;
permit is issued.
APPLICANT CER'T'IFICATION
I certify that I have read this application and state that the above infomlation is PERMIT EXPrRES iF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances mid state lases relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon die above mentioned properly for inspection purposes. (We)agree to save 180 F I ALLED INSPECTION.
indemnify mid keep harmless the City of Cupcnino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understmids mid will comply Issued by:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
,,,,,,��������n��txxxnnnnnn RF--ROOFS:
Signature Out c i7 All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,.I agree to remove all new materials for
�V inspection.
❑ OWNER-RII11,I)E t DECLARATION 1w
Signature of Applicant: Date:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COV- �•GS'1'0 BE CLASS"A"OR BF:ITF-R
1,as owner of the property,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 properly,am exclusively contracting with licensed contractors to HAZARDOUS MATERIAL,;DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read thehazardous materials requirements under Chapter 6.95 of the
California Ilealth&Safety Code,Sections 25505.25533,and 25534. 1 will
1 hereby affirm under penalty of perjury one of the following three mai main earn pliance with the Cupertino sI u nicipal Code.Chapter 9.12 and the
declarations: Health&Safety Code.Section 255312(x)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 die Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District T
performance of the work for which this permit is issued. will maintain compliance with the Cupertino dl unicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505.25533.and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorize)agent: Date:permit is issued
1 certify that in the performance of die Work for which this permit is issued,1 shall
not employ any person in any manner so as to become subject to the Worker's
Compensation Imus of California. If,after making this certifcatc of exemption,1 CONSTRUCTION LF:VDING AG I.,NCV
become subject to the Worker's Compensation provisions of the Labor Code,I must 1 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. w'ork's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CER'TIFICA'TION Lender's Address
I certify that I have read this application and state that the above in1'ornation is
correct.I agree to comply with all city and county ordinances mid stale Imus relating
to building construction,and hereby authorize representatives of this city to enter
upon die above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino ngainst liabilities,judgments, ARCHITECT'S DECLARATION
costs,and expenses which may accrue 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
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildingocupertino.org
PROJECT ADDRESS �n ANN
OWNERNAME PHONE E-MAIL
STREETq�n O k) CITY,IT I I C, K 6I FAx
CO. N �t, tU- I LICENSE NUS (��LIIC SE TYPE U BUS.LIC0
COMP 'N 1E lV7� -/(\J� E-MAI ��tA. V FAX
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STREETAUDRFSS I ` 11 L)\ I CI �(.7E�Z11�� Y� `J ` - PHONE
J tJ I UNDERSTAND AND AGREETOTHE 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$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 detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date:
ReroofPolicv_2011.doc revised 02/16/11
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255 v61a
CUPERTINO (408)777-3228• FAX(408)777-3333 •buildinard)cupertino.ora \�
PROJECT ADDRESS APN k
OWNER NAA PHON I / _ E-MAIL
STP Db Y Ole 41 CITI- TA Z.IQ,r/ O I FAX
CONTACT NAME r �.\ r U PHQ \ ��L� E-MAIL ��
STREET ADD S _ I l ^1��lJ 'L czf SUTAT/ ZIP ^ FAX
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❑ ou'NER ❑ OwNER.BuRDEB (❑`ou1"`'NERAGENr 40111AACTUR ❑CONTRACTOR AGENT ❑ AREBIECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONIRACTORN / LICENSE 18ER LICEN ETYP BUS.LIC_k
A 'NAAfE M �Y �. FAX
S_ ADO 1 _ _ _ _ CITY,STATE.ZIP — - _PHONE — —
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ARCHITECTNFNGINEER NMGE LICENSE NUMBER BUS.LIC.k
COSB'ANY NAME E.hWL FAA
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD or Duplex ❑ N'tulti-Family. ROttOF.AJ EA: VALUATION:
STRUCTURE: ❑ Commercial T O O u�'
EXISTING ROOF TYPE: ❑BUILT-UP ROOF AASPHALT SHINGLES 11 WOOD SHAKES ❑wooUSHINGLES ❑OTHER(sPECffY)
REMOVE/REPLACE ❑YES PLYWOOD :S PLYWD CI OSB PITCH: 12) ROOF
❑ THICKNESS ❑ Crix CLASS,
a RS
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑.ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT k
DESCRIPTION OF WON::
F�
G crs D
By nq signature below,I certify to each of the following: I am the property owner or audtorized agent to act on die property owner's behalf. I have read This
application and die information I have provided is correct. I have read the Description of Work,and verify,it is accurate. 1 agree to comply with all applicable local
ordinances and state laws relating to buildin ' nst etion. I authorize representatives of Cupertino to enter the abovc-ildentifiedproperry for inspection purposes.
Signature of Appllcant/Agenc Date:
SUPPLENIENTALINFOU TI ED _ OFFICE USE ONLY _
_If building is associated with a Horne Owners Association,provide tetter PLAN CHECKTYPEROUT'IN'G SLIP
of approval from HOA. GvcR-THE-COUNTS Buamdc PUN Recicw
_Provide Planning approval to verin-if there any restrictions. ❑ LWRESS ❑ PUdxnG PLAN REVIEW
_Provide copy of Manufacturers Installation Specifications. ❑ ;rANDeap ❑ DRE Derr _
Provide signed copy of Cupenino's Tear-Off Policy. OTHER: -
Reroojdpp_?011.doe revised 03.76/1/