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13040032 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10181 BONNY DR CONTRACTOR:THD AT-HOME PERMIT NO:13040032 SERVICES,INC. OWNER'S NAME: LIN WEN J AND WEN L 2690 CUMBERLAND PKWY STE 300 DATE ISSUED:04/04/2013 OWNER'S PHONE: 4086219375 ATLANTA,GA 30339-3913 PHONE NO:(5 10)731-1004 IC LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class 3 7 Lie.# 34-02-1 TEAR OFF(E)WOOD SHINGLE,INSTALL OSB&COMP �7- ;� '4441— t J '� SHINGLE(3400 SQ FT) Contractor I�J/17W1El�Ef Date T Y I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 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 provided for by Section 3700 of the Labor Code,for the performance of the work for which this,permit is issued. Sq.Ft Floor Area: Valuation:$23405 I 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:35912030.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 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 laws relating WITHIN 180 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 DAYS FRO ST 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 granting of this permit. Additionally,the applicant understands and will comply Iss Date: with all non-point source regulations per the Cupertino M Section 9.18. � 7 RE-ROOFS: Signatur Date `r / All roofs shall be inspected prior to any roofing material being installed If a roof is installed without first obtaining an inspection,I agree to remo ew materials for inspection. ❑ O ILDER DECLARATION14 '3 Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COV G BE CLASS"A"OR BETTER I,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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&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 I performance of the work for which this permit is issued: will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. ., 22 Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent Date: 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 CON TION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, 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 REROOF PERMIT APPLICATION \� COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 V (408)777-3228•FAX(408)777-3333•buildinga-cupertino.org CUPERTIM0: PROJECT ADDRESS I I i ) APN# (e OWNERN C :�� m PHON� Z' ' E-MAIL 4 STREET ADDRESS /019. 1 O .I �l V C STATE,ZIP FAX 2�1�� c� 9Soi CONTACT.NAME PHONE . E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME - I�2�2 LICENSE NUMBER LICENSE TYPE BUS.LIC.# COMP YNAME N E-MAIL FAX -1 Q Ar-1 O 7, A S O S Z 5 6 3 �-)Z G CITY,STATE.ZIP C PHONE 977-�/C 'o � 7J ARCHrrECT/ENGINEERNAME LICENSENUMBER BUS.LIC.# COMPANY NAME EMAIL FAX .STREET ADDRESS CITY,STATE,ZIP PHONE USE OF '0.SFD or DUpleX ' [I Multi-Family ROOF AREA: VALUATION: STRUCTURE: Q Commercial - 3400 �� -2 405 �-- EXISTING ROOF TYPE: ❑BUILT-UP ROOF: '❑ASPHALT SHINGLES ❑WOOD SHAKES WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE;Id.YES IF NO, PLYWOOD ❑ '%- ❑ PLYWD 'XOSB PITCH: TROOF ❑NO #LA THICKNESS: 135/8" TYPE: ❑CDX :12 CLASS: ICC-ES REPORT# PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES 13 OTHER DESCRiPTIONOFWORK r` •fli ' / 7 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 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 cons representatives of *^^^*^•*he above-identified prope for inspection purposes... Signature of Applicant/Agent: Date: SUPPLEMENTAL INFO UIRED If building is associated with a Home Owner's Association,provide letter - of approval from HOA. Provide Planning approval to verify if there any restrictions. !II` i Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10181 BONNY DR DATE: 04/04/2013 REVIEWED BY: MELISSA APN: 359 12 030 BP#: *VALUATION: $23,405 7PERMIT TYPE: Building Permit. PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Du lex PENTAMATION 1 SFDWL•ROOF USE: p PERMIT TYPE: WORK TEAR OFF E WOOD SHINGLE INSTALL OSB & COMP SHINGLE 34 SQUARES SCOPE Wech, Plan('heck Plumb.Plan C"heek Eler...Pl zn{"hack _ 1l:ch.Permit Fee: Plumb.Permit Fee: Elec. Permit Fee: tJther Aleeh.InsI3. Other Plumb Insp. Li Other Flee,Inds, 1fech.Ina}.Fere: Plumb.Ins/r.Tee: Flet.InsP,fee: NOTE:This estimate does not include,fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District;etc.). Theseees are based on the relimina information available and are onlyan estimate. Contact the Dept or addn'1 in a FEE ITEMS (Fee Resolution 11-033 E . 7�f ./1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 390 s.f. Re-roof Suppl.PC Feer (j) Reg. ®'OT 0:0 hrs $0.00 $510.00 1REROOFRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee:(E) Reg. ®`OT 00 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C onsitzrction :Tax: F T Administrative.Fee: Work Without Permit? 0 Yes (j) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Building or Structure 0 Travel Docuinentution.pees: Strong Motion Fee: 1BSEISMICR $2.34 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $3.34 $510.00 $513.34 Revised: 04/01/2013 REROOF TEAR-OFF POLICY is, 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 7777-3333-building(&cupertino.org PROJECT ADDRESS j) p ( f 6� l � APN# 35_Q _ I 2 _070 OWNER NAME (�Ij I PH 1 !710!94Z-1- !J37_5/ E-(MAIL STREET ADDRESS /©/!21h I ] CITY,,A CL�1�Q e-A 7 (, ,CF FA,x1 O •3S 3�S Q CONTRACTOR NAME C/ �J� LI ENS NUMBER LICENS > E I JBUS.LIC.# ovm E milcE S �aZ c. COMPANY NAME d / E-MAIL G J FAX n4p Ai STREET 4 5 4 S J LE- 4 GT CITY,s4n/STATE,ZIP R-b �A 14577 310° _50 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 the day before the inspection date. Please call (408)777- 3228 from 7:30- 3:30pm(Mon-Thurs)or 7:30 -2:30pm(Friday)to schedule the next day 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. Progress and 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. Progress Inspection is required when approximately 50%of roof covering is installed. 7. 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/"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. 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 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 R314 and R315 of the 2010 California Residential Code. Signature of Applicant/Agent: Date: ReroofPolicy_2011.doc revised 02/16/11 Building Department City Of Cupertino 10300 Torre Avenue < Cupertino,CA 95014-3255 LEE ,-�Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: I a /j D PERMIT.# 0 OWNER'SNAME: 4JF,JDK 0.4 PHONE# =O- X021 - 3 7 GENERAL CONTRACTOR: Hj') ,1.1 F 5-6ZACeS BUSINESS.LICENSE# ADDRESS: ?-4S4 ZAj A- c-7 CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of,Cupertina business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL QBE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINE�A;CITY OF CUPERTINO BUSINESS LICENSE. Y11 -S I am not using any subcontractors: 144 i ture Date Please check applicable subcontracto and com the following information: t/ 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