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12100045 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRF,SS: 104201MPERIAL AVE CONT'RACT'OR:M&S ROOFING CO. PERMITNO: 12100045 O\VNER'S NAMG: YU ROBERT JUI-TEH AND SOPHIA 208 COPCO UN DATE ISSUED: 10/082012 OWNER'S PHONE: 4088571264 SAN.IOSE.CA 95123 PHONENO:(4o8kA4-0870 ❑ LICENSED CONPRAC1'OR'S DECLARATION BUILDING PERMIT INFO: BLDG C ELECT Cl PLUMB[: -- 1 Ll cense Class Lic.t NIECII r- RESIDENTIAL Cl COATIIERCIAL r Contractor C,� Date /n— hereby affirm than I am licensed tinder the provisions of Chapter 9 •JOB DESCRIPTION:TEAR 0I71:SHAKE,INSTALL I2"OSB AND CLASS A COhIP (commencing with Section 7000)of Division 3 of the Business&Professions 29 SQ 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 Compensalioh,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: Valuntion:$14000 Section 3700 of the labor Code,for the performance of the work for which this permit is issued. M H/[, ANN Number:31719092.00 Occupancy'I)pr. A PPLICANr CERTIFICATION 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 laws relating to building construction,mid hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for Inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of die 180 DAYS FRO LAST CALLED INSPECTION. granting of this pennit. Additionally,the applicant understands mid will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued by: Date: 1 Signature. Iti Dae c- � 2 ❑ OWNER-BUILDER DECLARATION RI:ROOFS: All roofs shall be inspected prior to any roofing material bciig installed.If a roof is 1 hereby affirm Hili( I nn exempt from the Contractor's License Lmv for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 1,as owner of the property,or my employees with wages as their sole compensation, � (� `• e will do the work,mid the structure is not intended or offered for sale(Sec.7044, Signature o(ApplicnnC , h (v Date: Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGSTO RE CLASS"A"OR BE ITER I hereby affirm tinder penalty of perjury one of the following three declarations: HAZARDOUSMATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's I hove read the hazardous materials requiremems under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code Sections 25.505,25533,and 25534. 1 will maintain performance of the work for which this pemnil is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 unit the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Jlunicipal Code,Chapter 9.1_and the I certify that in the performance of the work for which this permit is issued,I shall IleaRh&Safely Code.Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws ofCali(omia. If,after making this certificate of exemption,I Owner or au(hnrized agent: become subject to the Worker's Compensation provisions of the Labor Code,I must �`_�t Dine loriliwith comply with such provisions or this permit shall be deemed revoked. CONSTRIICI'ION LENDING AGENCY AJ'1'1-IC,\NI'CER"fIFIGVfION I hereby affirm that there is a constmetion lending agency for the performance of mork's I certify that I have read this application and stale that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(\Ve)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply, ,\RCII I'I'IiCI"S DECL.\R.VI'ION with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Dale REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 CU PERTIN O (408)777-3228• FAX(408)777-3333•buildino(ditcuDertino orrg PROJECT ADDRESS 7 11 ^ APB M ji OWNERNAME O 1[V\ PHONE. E-SIAIL a '01 STREET ADDRESS ©e� _ • /1�•^ - CITY, STATE,ZIP FAX ) 4�1CONTACT NAME i OC IY PHONIS�)� ` �/' n O E-MAIL STREET ADDRESS , ` '1 CITY,STATEZIP� FA% C N WNER - ❑ OWNtER-BUIWER ❑ OWNER AGENT CONTRACTOR ❑CONtRACTOR ADEM ❑ ARCFBTECr ❑ENGINEER ❑ OBtT10PER ❑TENANT, CONTRACTOR NA SIF LICENSE NUMB F.RI LICENSF.YPB BUS,LIC.p COSB'AN\'NAME Sr fA/� E-MAIL STREEI'ADDRFS rA/ CITY,STATE,ZII PHON 12D 4wI� cN2 L ARCHITBCTAINGINEER NAME LICE NSF-NUMBER BUS.LIC.F COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF +;-SFD or Duple% ❑ Niultl-Family ROOF AREA: VALUATION: /�/' STRUCTURE: ❑ Commercial 10 I . EXISTING ROOF TYPE: ❑BUILT-UPROOF ❑ASPHALT SHINGLES kwOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) R %LOVE/REPLACE YES IF ND. PLYWOOD ❑ w" ❑ PLy'W: ❑OSB PITCH: 2 ROOF 1 ❑ M LAYERS' TMI RNES ❑ /S- E' ❑ D% —'1 LASS' / ICC-ES REPORT 9 PROPOSED ROOF TYPE: BUILT-UP ROOF ASPIIALTSHINGLES ❑WOODSHA%ES ❑WOOD SHINGLES ❑OTHE.R DESCRIPTION OF WORK: T it r r J� By my signature below,I cenify to each of the following: I am the property owner or authorized agent to act on the property other's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building constriction. I awhorizetrepresentatives of Cupenino to enter the above-identified propeny for inspection purposes. 1 Signature of ApplicanVAgent: + J Date: SUPPLrNIENTAL INFORMATION izFQUI G❑Flc CD f.USE ONLY - 'YIAO'GIIEGR TYPE, ROIITINGSLIP' - _ If building is associated with a Home Owners• Association,provide letter _ _ ----._ of approval from IIOA. ❑, DYER-iuE-co .N-rEm' - �, BUILDING PLAN.REVIEW _Provide Planning approval to verify if there any restrictions. :p'LF:c�RFss ' 'O' PuNSINC PLAN REVIENV _Provide copy of Manufacturer's Installation Specifications., [3I XTANDAR i., 'OI LrnL nePP Provide signed copy of Cupertino's Tear-Off Policy, OTBER: Reroofl pp_20l Ldoc revised 03116/11 I31de Stds Cornmission Fcc: IBCBSC $1.00 SUBTOTALS: $437.401 $0.001 TOTAL FEE: 1 $437.40 REROOF TEAR-OFF POLICY GUmmVlurrr uevewl-moaT oC,nMTrdCNT. OUILDING DIVISION ALBERT SALVADOR,P.E., C.B.O.,BUILDING OFFICIAL CUPERTINO (408)777-3228•FAX(408)777-3333•buildinci cuoertino.oro PROJECT ADDRESS I r'. APNb Q 1 ire r:141 OWNERNA.\IF. PhIO\E/' EMAIL STREETADDRESS Y.STATE.ZIP FAX CONTRACTOR NAME 1 1 LICHNSE NUMBERNj11 y LICENSE TYPE BUS.LIC.b COMPANYNA�\IE � . )� • EMAIL Q,((�/// •) FAX STREET ADDRESS, r CITY.STATE.ZJP,. I\ PHON r tt I UNDERSTAND AND AGREE TO THE FOLLOWING: I. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a mininnun of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is tom off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: . 7:30 — 10:30am and 1:00—3:30pm (Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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 perfonned. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. 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 must 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. 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, 1 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. Signature of ApplicandAgenu Date: ReroofPolicv_2010.doc revised 05/17/10 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10420 Imperial Ave. DATE: 10/08/2012 REVIEWED BY: RDW \ APN: RP#: 121 O Do 4 y -VALUATION: $14,000 *PERMITTYPE: Minor Building Permit PLAN CIIFCKTYPE: Re-roof PRIMARY PFNTAMATION USE: SFD or Duplex PERMITTYPE: 1SFDWLR00 WORK Tear off shake install 1/2" OSB and class A comp. SCOPE FEE ID ROOFAREA s.f. 1REROOFFRES 2,900 Mech.Plan Check Plumb. Plan Cheek Elec.Plan Cheek Mech. Permit Fee: Plumb.Permit Fee: Elec. Permit Fee: Other Mech. Insp. Other Plumb Insp. Other Elec.Insp. Piech.Insp. Fee: Plumb. bly. Fee: Elec.Insp. Fee: NOTE: This estimate docs not include fees clue to other Departments(i.e. Planning, Public Morks, Fire,Sanitary Sewer District,School District,ere. . These feev are based on the prelitninan information amihtble and are onh,an estimate. Contact the Dept for adcbr'I in o. FEE ITEMS (Fee Resolution 11-053 E1L 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee Plumb./Alech./Elec Permit Fee: $435.00 Suppl. Insp Fee Plumb./dlech./Flee Phtntb./A•lech./Elec Permit Fee: Construction Tar: Administrative Fee: Work Without Pennit? O Yes 1E) No $0.00 Advanced Planning Fces: Trams!Docanncatution Fces: Strone Motion Fee: IBSFISHICR $1.40 Select an Administrative Item 131de Stds Commission Pec: IBCBSC $1.00 SUBTOTALS: $437.401 $0.00 TOTAL FEE: $437.40 Revised: 10/01/2012