11090024 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10270 BONNY DR CONTRACTOR: PERMIT NO: 11090024
OWNER'S NAME: LAI HUNG CHI AND CHOK K �� "P� �C (�,(( J 1 DATE ISSUED:09/06/2011
0--NER'S PHONE: 4088939638 1+►`1��'}.1 �� PHONE NO:
L LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class L' # �
MECH r— RESIDENTIAL COMMERCIAL F
Contractor Date
I hereby affirm that Ilicensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING ROOF&INSTALL 1/2 IN
(commencing with Sec on 7000)of Division 3 of the Business&Professions PLYWOOD,40LB FELT,LIFETIME ASPHALT SHINGLES
Code and that my license is in full force and effect. CLASS A 25SQFT
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.
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 Sq.Ft Floor Area: Valuation:$12000
permit is issued.
APPLICANT CERTIFICATION APN Number:35911039.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of upertino against liabilities,judgments,
costs,and xpenses hich may accrue g inst said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting o this pe,
e it. Additionally, a pplicant understands and will comply 180 DAYS FROM T CALLED INSPECTION.
with all n -poi source regulations er e Cupertino Municipal C e,Section ,
9.18.
` Issued by: Date:
Signature Date
a 1/
OW -BUILDER DECLARATION
"% RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first ob inin an inspection,I r 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(Sec.7044,
Business&Professions Code) Signature of Applican. Date:
1,as owner of theproperty,am exclusively contracting with licensed contractors to < /
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COV R NGS TO BE 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 HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
1 have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined b the Ba Area Air
y y Quality Management District I will
I certify that in the performance of the work for which 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 Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or authorized agent:
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is I hereby affirm 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
and expenses which may accrue against said City in consequence of the
ing of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
,,fi all non-point source regulations per the Cupertino Municipal Code,Section
9.18. I understand my plans shall be used as public records.
Signature Date 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(a)cupertino.org
PROJECT ADDRESS ti.. / APN# l I
n 1141
OWNER xAME
PHONE _�� E-IgA1.
STREET ADDRESS ! J CITY, STATE,ZIP -.0 /
FAX
/G� ci ��C%rte/ >l�I`--t i-
APPLICANT NAME C J/- /'� �/juij1 PHONE czkvm";?,/ E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT u CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME ^ LICENSE NUMBER LICENSE TYPE BUS.LIC.#
COMPANY NAME r� E-MAIL F
(aC61& A&Pi) ' /op
5 ADDRESS CITY,STATE,ZIP PHONE � Z^,w
ARCHITECT/ENGII� ME ER NALICENSE NUMBER BUS.LIC.# '�(f,[
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial
EXISTING ROOF TYPE: Q BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE eYES IF NO, PLYWOOD W, ❑ PLYWD 2f OSB PITCH: ROOF
❑ NO I #LAYERS: ,,/ THICKNESS: ❑ 5/8" TYPE: 11CDX 4:12 CLASS: A
IV
ASPHALT ROOF TYPE: ❑B=-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK
By my signature below,I certify o eap of the following: I am p erty owner or authorized agent to act on the prope owner's behalf. I have read this
application and the information h provided is correct I have cad escription of Work and verify it is accurate. I ee comply with all applicable local
ordinances and state laws relatin b ilding cons on. I au p ntatives of Cupertino is enter the above-id tifie property for inspection purposes.
Signature ofApplicant/AgentA)ftv Date: 6C
SUPPLEME AL INFORMATION REQUIRED 1 � - �
_If building is associated with a Home Owner's Association,provide letter " ' :. _ _a?73Sa??
of approval from HOA. —" �� M ;
p L�BI>mnm� i x7 W
—Provide Planning approval to verify if there any restrictions. ' — -_
�Qa'P1F.AZ�AF,G�re-N�rP1E�y
Provide copy of Manufacturer's Installation Specifications. _-may" �E r r
_Provide signed copy of Cupertino's Tear-Off Policy.
ReroofApp_2011.doc revised 03/02./11
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(d_)cupertino.org
PROJECT ADDRESS f�L n� A.
r APN#
OWNER NAMEeG,1 G `� I. PHONE y � '/ 81 E-MAIL
STREET ADDRESS L CITY, STATE,ZIP t j Z/ FAX
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP 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 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 t e: I am the property owner or authorized agent to act on the
property owner's behalf. I uncerst and agree to com ly it the re-roof policy stated above. I also understand that
smoke detectors and carbon m'n ide detectors are req ired be installed in accordance with Sections 314 and 8315 of
the 2010 California Residentia ode.
Signature of Applicant/Agent: Date:
ReroofPo1icv_2011.L revised 02/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10270 bonny drive DATE: 09/06/2011 REVIEWED BY: larrys
APN: BP#: 'VALUATION: 1$12,000
y°PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Du lex PENTAMATION 1 SFDWLROOF
USE: P PERMIT TYPE:
WORK remove existing roof, install 1/2 in plywood, 40 Ib felt lifetime asphalt shingles
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 2,500
NOTE: These ees are based on the prelindnary information available and are only an estimate. Contact the De t or addn'l in o.
FEE ITEMS (Cee Resolution II-053 Fff. 7/1.,"]1) FEE QTY/FEE MISC ITEMS
Permit Fee: $350.00
Work Without Permit? 0 Yes E) No $0.00
A
Strom Motion Fee: IBSEISMICR $1.20 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $352.20 $0.00 TOTAL FEE: $352.20
Revised: 07/04/2011
CITY OF CUPERTINO
3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 35911039. 00
DATE ISSUED. . . . . . . : 09/06/2011
RECEIPT #. . . . . . . . . : BS000014670
REFERENCE ID # . . . : 11090024
SITE ADDRESS 10270 BONNY DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER LAI HUNG CHI AND CHOK K
ADDRESS 10270 BONNY DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2906
RECEIVED FROM . . . . : A-1 CONSTRUCTION &
CONTRACTOR TBD - TO BE DETERMINED LIC # 00096
COMPANY TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 7, 000 . 00 1 . 00 0. 00 1 . 00 0. 00
1BSEISMICR VALUATION 7, 000 . 00 0. 70 0 . 00 0. 70 0 . 00
1REROOFRES SQ FEET 25 . 00 350 . 00 0 . 00 350 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 351. 70 0 . 00 351.70 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
309 EXTERIOR LATH 311 SCRATCH COAT
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF