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12120112CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7844 .IEANE'TTE C'I' I CONTRACI'012: hRAMMEI.I. ROOFING I PERMI T NO: 121201 12 OWNER'S NAME: 7'ZOII SEAN I I AND WANG LILLIAN OWNER'S PHONE: 4089731733 LICI',NSE.D CONTRACTOR'S DECLARATION x, License Class Lic. # / z- z' Contractor 1 Zh Z Date I Z % �Z 1 hereby affirm that 1 :ant licensed undo , provisions of Chapter 9 (commencing with Secron 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I 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 provi: ,:d 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 `,Yorker's Compensation Insurance, as provided for by Section 3700 of the Lah Code. for the performance of the work for which this permit is issued. I hereby affirm under nalty of perjury one of the following three declarations: I have and will maintai i Certificate ofConsent to self - insure for Worker's Compensation, as pro\ 1'PLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to coml 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 mentio:,- ! property for inspection purposes. (We) agree to save indemnify and keep ha - Icss the City of Cupertino against liabilities, judgments. costs. and expenses w1, may accrue against said City in consequence of the granting of this permit. :',dditionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. h provisions or this permit shall be deemed revoked. Signature- .�' -- Date��- ❑ O - BUILDER DECLARATION 1 herchy affirm that I ., t exempt from the Contractor's License Law for one of the following two reap s: L as owner of the propc: , or my employees with wages as their sole compensation, will do the work, and tl ° Artcture is not intended or offered for sale (Sec.7041, 1usiness & profession ode) I_ as owner of the prof, . am exclusively contracting with licensed contractors to construct the proieet (S 70,14, Business & Professions Code). I hereby affirm under nalty of perjury one of the following three declarations: I have and will maintai i Certificate ofConsent to self - insure for Worker's Compensation, as pro\ J for by Section 3700 of the Labor Code. for the performance of the wo or which this permit is issued. I have and will mainlar Yorker's Compensation Insurance, as provided for by Section 3700 of the L: Code, for the performance of the work for which this permit is issued. property for inspection purposes. (We) agree to save I certify that in the pci uuice of the work for which this permit is issued, I shall not employ any person - any manner so as to become subject to the Workers Compensation laws w ilornia. If, after making this certificate of exemption, I become subject to the i kegs Compensation provisions of the Labor Code, I must l'rtlimth onlply with h provisions or this permit shall be deemed revoked. Signawre Date PO BOX 3363 DATE ISSUED: 12/20/2012 FAIRFIELD, CA 94533 MONT NO: (707) 448 -7261 BUILDING PERMIT INFO: 13LDG ELECT PLUMB MECH RESIDENTIAL COMMERCIAL J013 DESCRIPTION: TEAR OFF EXISTING SI IAKI: RITLACE Wffl I COMP SIIINGLI:S 40 SQF "f- CLASS A Sq. Ft Floor Area: I Valuation: $12000 U'N' Number: 36217034.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: � _/ ----- Date: RI:- ROOFS: All roofs shall he inspected prior to any roofing material being installed If a rool' is installed without first obtaining an inspection, I agree to remove all 11 materials for inspection. Signature of Applicant: Date. ALL ROOF C E' S TO 13E CLASS "A" OR BE TTI:R IIAZARDOUS MATERIALS DISCLOSI RE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 Hill maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCI I herehv allirm that there is a construction lending agency for the performance ofwork's for which this permit is issued (Sec. 3097, Civ C l Lender's Name Lender's Address --- —_-- —_- ARC11,11?C "T'S DECLARATION 1 understand my plans shall he used as public records. Licensed Professional PPLICAN T CERTIFICATION I certify that I have re:� tis application and state that the above information is correct. I au'ree to cote vv tth all city and county ordinances and state laws relating to building construed( :id hereby authorize representatives of this cite to enter upon the above mend, property for inspection purposes. (We) agree to save tndemnif'\ and keep h. ess the City oh Cupertino against liabilities, judgments. costs. and expenses W may accrue against said City in consequence of the granting of this permi! ditionally. the applicant understands and will comply vwith all non -point sour regulations per the Cupertino Municipal Code. Section 9 18. Signawre Date PO BOX 3363 DATE ISSUED: 12/20/2012 FAIRFIELD, CA 94533 MONT NO: (707) 448 -7261 BUILDING PERMIT INFO: 13LDG ELECT PLUMB MECH RESIDENTIAL COMMERCIAL J013 DESCRIPTION: TEAR OFF EXISTING SI IAKI: RITLACE Wffl I COMP SIIINGLI:S 40 SQF "f- CLASS A Sq. Ft Floor Area: I Valuation: $12000 U'N' Number: 36217034.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: � _/ ----- Date: RI:- ROOFS: All roofs shall he inspected prior to any roofing material being installed If a rool' is installed without first obtaining an inspection, I agree to remove all 11 materials for inspection. Signature of Applicant: Date. ALL ROOF C E' S TO 13E CLASS "A" OR BE TTI:R IIAZARDOUS MATERIALS DISCLOSI RE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 Hill maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCI I herehv allirm that there is a construction lending agency for the performance ofwork's for which this permit is issued (Sec. 3097, Civ C l Lender's Name Lender's Address --- —_-- —_- ARC11,11?C "T'S DECLARATION 1 understand my plans shall he used as public records. Licensed Professional REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUPERTINO (408) 777 -3228 • FAX (408) 777 -3333 • building aacupertino.om PROJECT ADDRESS 7 i 1 4 r` A E -T-T6- C-7 - ! APN # J 1-7— �) OWNER NAME & I /' /+ Jj I Z O J PHONE o 7 / �3 3 1 E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME �1 ` ' 1-2 A mm j / �', PI ON 7 ' � - E -MAIL STREET ADDRESS Y 3_363 CITY, STATE, ( tf7- `� FAX ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME jZrZ NUMBER LICENSE TYPE BUS. LIC # COMPANY NAM] � � C � r /I'ry►MF� � t,vt E -MAIL ii STREET ADDRESS 30 CITY, f_ _L PHONE e ARCHITECT /ENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF IV or Duplex ❑ Multi- Family STRUCTURE: El Commercial ROOFAREA: / �T L4 000 VAL/U��(/gTION: ��T � -L/ ��` �✓_o EXISTING ROOF TYPE: ❑ BUILT -UP ROOF ❑ ASPHALT SHINGLES AWOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE YES ❑ NO IF NO, r #LAYERS: PLYWOOD ❑ %" ❑ THICKNESS: ❑ 5/8" PLYWD ❑ OSB TYPE: ❑ CDX PITCH: ' 12 ROOF CLASS E1 PROPOSED ROOF TYPE: ❑ BUILT -UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT DESCRIPTION OF WORK: v f r ^� `1 D �, I I Fr,7t m - A By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I hav 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 co n. I authori re r upe tno enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Date: ,2 E –2— SUPPLEMENTAL IN ATION RED _ If building is associated ' a H wner's Association, provide letterP of approval from HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturer's Installation Specifications. rovide signed copy of Cupertino's Tear -Off Policy. OFFICE USE ONLY N CHECK TYPE ROUTING SLIP ET OVER- THE - COUNTER ❑ EXPREss ❑ STANDARD BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ FIRE DEPT ❑ OTHER: ReroofApp_201 1. doc revised 0311611 l 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 • building(cDcupertino.orcg PROJECT ADDRESS j7 ` A/ C.7 TE_ G7 - APN # OWNER NAME ) ( / I T I PHONE I .y , E -MAIL STREET ADDRESS' r E A (` 71E C-% • CITY STATE, ZIP G U ptn�I�%(i. C k 9 sf✓l F ^ " BUS. LIC # CONTRACTOR NAME ` /�I� 11�' 1 Y LICENSE NUMBER '] �C--. LICEN� TYPE COMPANY NAME �� M L� � 1�( 1 E -MAIL FAX .7 ` .7417 STREET ADDRESS ��'° t 3x CI Y, STATE, ZIP ��-I _ z; �,� ��sj PHONE � r I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum 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 torn 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 performed. 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 I /4" 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 $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 complly .xai + z roof policy stated above. Signature of Applicant/Agent: Date: lZ/ ,/ —z_ ReroofPohcy_2010.doc revised 05117110 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 7844 jeanette ct. DATE: 12/20/2012 REVIEWED BY: bobs. APN: I BP#: *VALUATION: 1$12,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATIO 1SFDWLR00F USE: _T PERMIT TYPE: N WORK I tear off existing shake replace with comp shingles. SCOPEI Y NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, P ire, 'N an italy sewer DIS1111CI, 3 Cn 001 n.1-41 A 11 01% Cowart tho Dont far addnl infa. FEE ITEMS (Fee Resolution 11-053 tff.' 7/1112) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 4,000 s.f. $600.00 Re-roof IREROOFRES] Suppl. PC Fee: IF) Reg. OT 10. 1 0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.S Reg. Q OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? Yes (F) No $0.00 Advanced PlannjD,& Fee. $0.00 Select a Non-Residential Building or Structure Strong Motion Fee: IBSEISMICR $1.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $2.20 1 $ 600.00 TOTAL FEE: 1 $6 Revised: 10/01/2012 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408 - 777 -3333 JOB ADDRESS: q FAQ E -77[ -' PERMIT ZZ 7 2- 0 OWNER'S NAME: Li )A A/ ""'Z 00 PHONE y 4u ' "� 7-3- 1'73 -3 GENERAL CONTRACTOR: 1 P—/ry 1 o4 &-z— F4,r>-r-„J BUSINESS LICENSE # ADDRESS: 3N -3363 CITY /ZIPCODE: F:: --i izi =if-Li ?453_3 *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: Si a Date Please check applicable subcontractors and ple he following information: Owner / Contractor Signature Date 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