12100161 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19951 LA MAR DR CONTRACTOR:SONRISE ROOTING PI;RMITNO: 12100161
OWNER'S NAME: YU-I SU 37911 VON FUW CMN DATE ISSUED: 10222012
OWNER'S PIIONE: 4088734889 FREMON'T,CA 94536 Pl IONF.NO:(510)791-6457
LICFNSFD CONTRACT`OnR'S DFCLARA'1'ION •JOB DESCRIPTION: RF,SIDLN`FIAL El COIMF,RCIAL
IJ
License Class CSC' Lic.p �z7 I22 RE-ROOF 26 SQ-TEAR OFF EXISTING COMP INSTALL
CLASS A
Contractor Date
I hereby affirm that 1 am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business S Professions
Code and that my license is in full force and effect.
1 hereby affirm under penally 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.FI Fluor Area: Valuation:$13183
1 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.36910039.00 OccupancyType:
permit is issued.
APPLICANT CFR'I'IFIC TION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state Imus relating WITHIN DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY M LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the G /a
granting of this ermit. dditionalW a applic t understands and will comph. Issued by: Dale:
with all non-poi sour a gulatio s p the C «ino Municipal Code,Section
9.18.
U �,� �� RF:ROOF'S:
Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I gree to remove all new materials for
inspection.
0 O\YNER-BUILDER DECLARATION
Signature of Applicant Date:
1 hereby affirm that I am exempt from the Contractor's License Lawfor one of
the following two reasons: ALL ROOF OVERINGS TO III'.CLASS"A"ORBE'PTER
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 property,am exclusively contracting with licensed contractors to DA7,ARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code), I have read the hazardous materials requirements under Chapter 6.95 of the
C:difernia Ileallh&S:deh,Code,Sections 25505,25533,and 25534. 1 wi11
hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Ilcalth&Safety Code.Section 25532(a)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 the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District
performance the work for which this permit issued. will maintain compliance with he erial Code.Chapter 9
I have and millll maintain Worker's Compensation Insurance,as provided for by the Ileallh&Safety Code Sect m 2 .052. 3,a 25534.
Section 3700 of the Labor.Code,for the performance of the work for which this Owner or authorized agent: Date: It.
permit is issued.
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONSfRUCHON LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must 1 hereby affimt 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 Nrunc
APPLICAN I'CERTIFICATION Lender's Address
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
indemnify and keep harmless the City of Cupertino against liabilities.judgments,
ARCIII'1'FCI"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
`l REROOF PERMIT APPLICATION
ELM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION `OI
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �\
(408)777-3228• FAX(408)777-3333•building(@cupertino.org
CUPERTINO
PROJECT ADDRESS ' 2151A AAAL
n APN 11-3— /0 03y
OWNER NAME vtvtk SN \,u�.l Grt/` PHONE Lt*61 �` E-MAIL
STREET ADDRESS J r l cJt�l CITY, STATE,ZIP - D ` FAX
c hS ?/ I, CJPLaCTWO cR
CONTACT NAIVE PHONE E-MAIL
STREET ADDRESS CITY,STATE, ZIP FAX
❑OWNER ❑ OWNER-BUIIDER ❑ OWNERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTORNAAIE '/�`� V • � LICENSENUTIRGHT4Z�` LICENSat,
BUS.LIC,k 3 CL
COMPANY NASIE S9�^ r,� j'tl(� E-MAIL tt FAX C to
-M,(`%( -7
STREE7 ADDRESS 3�at� I(, `�Ol , ,�1� '_I_ •^ \ CITY.STA ZIP G� �jr r3 I PHONE S`D ,Q` le 45
ARCHMCTE GINEER NAME V N V4 V^_'^'wJLICENSE NUMBER _l`C ` BUS.LIC.6 1.
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF �SFD or Duplex ❑ nlultl-Famlly ROOF AR E: `
STRUCTURE: ❑ Commercial Zta74. E(31 ( '93-CkZ'
EXISTING ROOF TYPE��:..,,//❑BUILT-UPROOF �dSPHALTSHINGLES 13 WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIM
DOVE EPLACE PCYES IF NO. PLYWOOD CK%' ❑ PLY%VD C3OSB PITCH: ROOF
11No x ER � TI11CK ESS' 11 98" T1'PH� CDS '(-'7
CLASS'
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF XASPHALT SHINGLES ❑W'OOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT N
DESCRIPTION OF WORK: i�wuvE cw'JRNc, Cpm /-DO;F- SUbsZx N�iC
N97*-r1-A45?)%1 Gut-5S R C6.4. 2ooL AL4 E5-EJvTr%FAS
By my signature below,I certify to each ofthe following: 1 am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information 1 have provided is c ect. I have read the Description ofWork and verily it is accurate. I agree to comply with all applicable local
ordinances and state laws rebui
lating to l I g con, m ion. 1 u o ze re ives of Cupertino to enter the above-ide(ntilied 9roperty for inspection purposes.
Signature ofApplicanUAgenC Date: LO IZ2-1 T2_
SUPPLeMtiNTAL IN ' RMATION REQUIRED OFFICE psE ONLY.
_If building is associated with a Home Ow •t
ners Association,provide letter ' CHECK TYPE ROUTING SLIF
of approval from I10A. OVE:RAIIE:-CouN-n:R ❑ But[,DING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PIIAO;NING PLAN REVIEW,
_Provide copy of Manufacturers Installation Specifications. ❑ STANDARD ❑ FIRE:DE
Provide signed copy of Cupertino's Tear-Off Policy. ❑ 01'11E:R:
Reroofelpp_201 Lrfoc revised 03/16/11
REROOF TEAR-OFF POLICY
C
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• buildinar5cuoertino.ora
PROJECT ADDRESS /�(� / 1/ APNd
OWNER NAME 'tel t PHONE EMAIL
STREET ADDRESS CITY.STATE.EDG(.fir Zhb C,4- FAX
CONTRACTOR NAME ��Y Irl 1 A- e ,i/ LI[ENSE NUMBER,t��rt•� LICENSE TYPE O BUS.LIC.q 23 ef 3
COMPANY NAME CYN/tet. T`h- �y.�C�.J�__/ E-MAR "C 7 1• FAX/ 6`'FB�
STREET ADDRESS 3
J-/-I It . !p`I n/w/�•Tj_ - _ ( CITY,STA iP / PHONE^'(,O 11 ( bT
.J V SZ
I 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 un to one business day before the requested inspection date.
Please call (408) 777-3225 from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pin (Friday) to schedule
inspection. For Tear-Off and Nailing Inspections, you must also call on the day of the inspection on[),
after that phase of the work is completed. The building inspector Yvill be available within one hour.
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 pi-oposed 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. 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.
7. 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. 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 nionoxidg detectors are required to b installed in accordance with Sections R314 and R315 of
the 2010 California Residential Cod .
Signature of Applicant/Agent: Date: LD (ZZ cL
RerooJPo1icv_2012.doc revised 1WI12
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 1995 LA MAR DR DATE: 10/22/2012 REVIEWED BY: SM
\ APN: BP#: 'VALUATION: $13,183
*PERMITTYPE: Minor Building Permit PLAN CIIECKTYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION
USE: pPERMiTTYPE: 1SFDWLROOF
WORT:
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,600
blech. Plan Check Plumb. Plan Check Fl,,. Plan Check
.4lech.Permit Fee: Pharth. Permit Fac: F•Iec•.Permit Fee:
Other•M ch, Insp. Other Plumb lay. Other Flee.1,tv
A/rsch.Insp. Fee: Phunh. /nsp.Fee: Elec.Insp. Fec:
NOTE: This awinmte roes trot include jeev due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District. etc). These ees are baser/an Ore prelitninan information available and are on11'an estimate. Contact dee Deyajor addn'I info.
FEE ITEMS (Fee Resolution 11-053 EIL 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
suppl. PC Fee
Phimh./dlech./Elec
Permit Fee: $390.00
Supp/. /lisp Fee
Phntb./d-/ec/r./Flee •
Plabnb./hAech./Elec Permit Fee:
Consnrtction Tac:
Adinhiisirarive Fee:
Work Without Permit? O Yes 0 No $0.00
Advanced Planning Fees:
Travel Docionentation Fear: A
Strong,Motion Fee: 11ISF.ISMICR $1.321 Select an Administrative Item
13ldg,Stds Commission Fee: IRCRSC $1.00
SUBTOTALS: $392.321 $0.001 TOTAL FEE: 1 $392.32
Revised: 10/01/2012