12100170 CITY OF CUPERTINO 13UILDING PERMIT
BUILDING ADDRESS: 19899 LINDENBROOK LN CONTRACVOR:WING'S ROOFING INC PERMITNO: 12100170
OWNER'S NANIF: CHEN TAN PING AND NING C ET AL 3243 SYDNEY WAY DATE, ISSUED: 10232012
OWNER'S PRONE: 5108511278 CASTRO VALLEY.CA 94546 11110NENO:(510)989-9068
LICF,NSED CO\VRAC`fOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUNIB r
License Clazs �G�. Lie.q O L r r r rI
e � DIECIi RESIDENTIALCOhID1 COMMERCIAL
Contractor (� S ��C Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RI.ROOF 18 SO TEAR OFF WOOD SHINGLES,INSTALL
(commencing with Section 7000)of Division 3 of the Business S Professions 7/16"OSB AND INSTALL ASPHALT SHINGLE CLASS A
.Code and that my license is in fall 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.
I have and will maintain Worker's Compensation Insurance,as provided for by Sq. FI Floor Aren: Valuation:$6900
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
A I'N Number.36923018.00 Occupancy Type:
APPLICANT CFRTIFICATION
I certify that I have read this application and smte 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 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 80 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may acerae against said City in consequence of the 180 DA • F OM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicam underslmmds and will comply
with all non-point source egulations per the Cupertino Municipal Co e,Section
9.18. f Issued V: ° Date:
Signature Date Z
❑ OWNER-RUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing materialbeing installed.If a roof is
1 hereby affirm that 1 am exempt from the Contractor's License law for one of installed without first obtaining an in pection,I agree to remove nil new materials for
the following two reasons: inspection. O/2
I,az corner of the property,or my employees with wages az their sole compensation,vs ill do the work,and the structure is not intended or offered for sale(Sec.7044, Signmure of Applicant:
Business&Professions Code)
I,as owner of the property,'mm exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO IIF CLASS"A"OR BET[*k R -
1 hereby affirm under penalty of perjun.onerof the following three
declarations: IIAZARDO11S MATERIALS DISCLOSURE
I have and will maintain a Ceriifcate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health S Safely Code.Sections 25505.25533,and 25534. I will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code.Chapter 9.12 and the I Icalth S
1 have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should 1 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
contaminants as defined by the Buy Arca Air Quality\lanagement District I will
permit is issued. maintain compliance with the Cupertino plunicipal Code.Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall gcallh& afety Code.Sections 25505.25533,and 25534.
an
not employ any person in y manner so as to become subject to the Worker's
Compensation laws of Cali forma. If,after making this certificate ofexemption,I Ow'r r r uth cul agent:
become subject to the Worker's Compensation provisions of the Labor Code,I must Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERT'IFICA'TION I hereby affirm that there is a conSMIC6011 lending agency for the performance of work'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.(We)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 ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I underslmhd my plans shall be used as public records.
9.18.
Licensed Professional
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• buildinaOcuoertino.oro
PROJECT ADDRESS 89 Y I APNM
OWNER NAME PHONE E-MAIL
STREETADDRESS oil,
_P q CITY.STATE,ZD' FAX
CONTRACTOR NAME t �- G t ( LICENSE NUM.HER LICENSE TYP BUS.LIC.M
COMPANY NAME E-MAD. FAX -}-
STREET ADDRESS:3 L CITY,STATE,ZIP/Z,�'I&
-�( I UNDE STAND AND AGREE TO THE FOLLOWING: ✓/ l�� `
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 one business day before the requested inspection date.
Please call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pm (Friday) to schedule
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.
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 pioposed 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 f A
Ilowing is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and ee to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxi e Bete t rs are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Cod .
Signature of Applicant/Agent: Date: L/DZ
ReroaJPo1icy_2012.doc revised 1017112
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO r(i408)777-3228• FAX(408)777-3333•buildino(acuotartino.oro
PROJECTADDRESS -I�iI yI� APNM i� / /1I
OWNER NAA@ LI ,I PHONE �' / h� E-\TAIL (J
STREET ADDRESS I (J I r� /J✓* - ITY, STATE,ZIP ( FAX
CONTACT NAME -CiI �' PHONE �(v�A—I I^L7� E-MAIL
STREET ADDRESS CITY,STATE, ZIP U / ( FAX
❑OWNER ❑ OWi-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINCER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NUMBER �V'I LICENSETYPE �..� US.LIC.M
I
COMPANY NAME E-MAIL FAS
I )
STREET AD CITY,STATE,ZIP PHONE
ARCHI FFCTIE: INEER NA\E LICENSE NUMBER BUS,LIC
COMPANY NAME E.NIAIL FAX
STREET ADDRESS CITY.STATE-ZIP PHONE
USE OF FU or Duplex ❑ Multi-Family 0.00E AR�y/{� VALUATION:
STRUCTURE: ❑ Commercial O
EXISTING ROOF TYPE: El BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES El WOOD SHINGLES ❑OTHER(SPECIFY)
REMCDTIREPLACE OYES IF NO. PLYWOOD ❑ w- ❑ PLYWD sn PITCH: ROOF
❑ N MLA ERS' THICKNESS ❑ 5/S' TYPE. O CDX -('` CLASSA
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER IMES REPORT 9
DESCRIPTION OF WORK:
By my signature below,I certify to each of the Ilowing: I am the property owner or authorized agent to act on the propeny owner's behalf. I have read this
application and the information 1 have pr vide s coned. :have read the Description of Work and verify it is accurate. I agree t comply wi all applicable local
ordinances and state In,relating to bai i c utruction. I authorize representatives of Cupenino to enter thea ove-id}nuIII ry •(ar s ion purposes.
Signature of ApplicandAgent: Dam: !/
SUPPLrNIE '1'AL INFORMATION REQUIRED OFFICE USE ONLY
_If building is associated with n I Ionic Owners Association,provide letterIF:eK'rY'rF: ROUTING SLIT '
of approval from I-HOA. ovE:R:niF Con",
TFR flUII.DING PLAN REVIEW
_Provide Planning approval to verify if[here any restrictions. ❑ Em'RFSs ❑ PHdn:YTNG PLAN REVIEW
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DErr
Provide signed copy of Cupcnino's'I'ear-Off Policy. ❑ OTHER: '
ReroofApp_201 l.doc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 19899 Lindenbrook In DATE: 10/23/2012 REVIEWED BY: mendez
APN: BP#: 'VALUATION: $6,900
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTANIATION
USE: SFD Or Duplex PERMITTYPE: At
1SFDWLROOF
WORT: re-roof 18 sq- tear off wood shingles, install 7/16" osb and install asphalt shingle class a
SCOPE
FEEID ROOFAREA
(s.f.
1REROOFFRES 1,$00
Aloclr.Plan Check Plumb. Plan Check Flee. Plan Chock
htech.Permit Fee: Plumb. Permit Fee: F.lec•. Permit Fee:
Orher•Much.Insp. Other Plumb Imp. Other Flee.hap.
Mech.lap.Fee: Plumb. host). Fee: Flee.bap. Fee:
NOTE: This ectinmte doev not include jeer due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Server District,School
District,etc). Thesefees are baser/on the prelitninan•information available and are onli,an estimate. Contact[lie De t or addn'I info.
FEE ITEMS (Fee Resolution 11-053 EII 7/1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC FCC
Plumb.611e ch./Elec
Permit Fee: $270.00
Supp/. hlsp Fee
Plumb./jhlech./Elec
P/umh./Alech.Xlec Permit Fee:
Construction Tax:
Administrative Fee:
Work Without Penrrit? O Yes Q No $0.00
Advtinced Planning Fees•:
Travel Documentation Fees:
Strone Motion Fee: IBSFISMICR $0.69 Select an Administrative Item
Bldg Stds Commission I-ee: IBCBSC $1.00
SUBTOTALS: $271.69 $0.001 TOTAL FEE: F$271,691
Revised: 10/01/2012 -