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12100091 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22087 SAN FEERNANDO CT CONT'RACPOR:PRINCIPLE ROOFING,INC PERMITNO: 12100091 OWNER'S NAME,: CHEN DANIEL AND JEAN KU TRUSTEE 10160 STERN AVE DA'Z'E ISSUED; 10/11/2012 OWNER'S PRONE: 4089875488 CUPERTINO,CA 95014 PHONE NO:(408)898-7298 ram LICENSED COM'RACI'OR'S DECLARATION r r r. BUILDING PERMIT INFO: BLDG ELECT PLUMBLicense Class Lie.# QS669�7- p1EC11 r RESIDENTIAL(✓ COpIi\IERCLU, r1 Contractor — Date IO�It�IsL hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:SINGLE.FAMILY DWELLING TEAR OFF SHAKE AND (commencing with Section 7000)of Division 3 of the Business&Professions INSTALL Code and that my license is in full force and effect. 27 SQ CLASS A NEW SHINGLES 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. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of die work for which this Sq.Ft Floor Area: Valuation:$9000 permit is issued. .11'I'LICA\I'CIiR'I'IPIC,\l'IfhN APNNumber:35712061.00 Occupancy'1'cpe: 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 slate 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 and keep hamlless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. //ma�yy Issued Signature. - Date tri ❑ OWNER-BUILDIiR DECLARATION RE-ROOFS: hereby affirm that I am exempt from the Contractor's License Law formic of All roofs shall be inspected prior to any tooling material beiig installed.If a roof is the following two reasons: installed without first obtaining an inspection.I agree 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(Sce.7044, Business&Professions Code) Signature of Appli©nl: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to ! t 1 I Z construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO RE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self insure for Worker's IIA'LARDOUS\IATERIAIS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materinls requirements trader Chapter 6.95 of the perforidnce of the work for which this permit is issued. California Ilcallh&Safely Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ilealth& Section 3700 of the Labor Code,for the performance of the work for which this Safely Code.Section 25532(a)should I store ur handle hazardous material. Additionally,should 1 use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I terrify that in the performance of die 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 any manner so as to become subject to the Worker's Ilealth&Safely Code,Sections 25505,25533,and 25534. Compensation laws of Cal ifomia. If,a0cr making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must Ownernr enC forthwith aulhnrizcd agcomply with such provisions or this permit shall be deemed revoked, � % Urate: O t t ( Z Al'Pl,1CA,',"I'CER'f1F10VFION CONSTRUC11ON LENDING AGENCY 1 certify that I have read this application and state that the above information is I hereby aRrnm 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 acerae against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section .VRCIII'I'F.CI"S DECLARATION 9.18. 1 understand my pians shall be used as public records, Signature Date Licensed Professional Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O. Fax: 408-777-3333 CONTRACTOR /SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# 1 00z) OWNER'S NAME: PHONE # ?W 7-29,y ' GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS:. 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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: 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 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ' C ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX (408)777-3333• buildinD(8CLIDertino.org PROJECTADDRESS {��j, ?_ ��.r�rrC� J I)APNO �,J�� OWNER NAME �nf/o / qsi, 57 I E.MAR STREET ADDRF7S$ crrY.STATE,Zn' FAX l �- S/+ti f.r/vroelo I CONTRACTORN LICENSE NUFgR LICENSE E BUS.LIC.9 % b I L 3 COMPA N� E-MAIL FAX STREET ADDRYSV/6 G J�fir�t/6 v c'TM' Z ,u/ +�_�;v/L PHONE I 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 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 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. 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 1/4" 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. 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. 1 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 11314 and 11315 of the 2010 California Residential Cod Signature of Applicant/Agent V Date: Z Reroo)Tolic7+_2012.doc revised 10/7/12