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11100103 CITY OF CUPER' INO BUILDING PERMIT BUILDING ADDRESS: 10208 AMELIA CT CONTRACTOR:WILLIAMS ROOFING PERMIT NO: 11100103 OWNER'S NAME: WAYNE CHEUNG 42683 BRANTWOOD CT DATE ISSUED: 10/14/2011 ,'NER'S PHONE: 4088626138 FREMONT,CA 94538 PHONE NO:(510)8824642 b LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALE] License Class Lic.# 017 RE-ROOF 22 SQ-TEAR OFF SHAKE,INSTALL 7/16 OSB, l INSTALL COMP SHINGLES CLASS A Contractor Date 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:$6500 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:32617025.00 Occupancy Type: permit is issued. (^ APPLICANT CERTIFICATION 7 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 M LAST CALLED INSPEC IO . indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the �� /l granting of this permit. Additionally,the applicant understands and will comply Issued by: C(i Date: with all non-point source regulations per the C o Municipal Code,Section 9.18. RE-ROOFS: Signature / Date? 411 All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I ee to remove all new materials for inspection. OWNER-BUILDER DECLARATION Signature of Applicant: �to_Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO 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. 1 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(x)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 whichthis 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,ano 25534. / / Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agentko� 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 CONSTRUCTION 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 '-demnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION ts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. o.anting 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 Building Department City Of Cupertino La 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: [� C PERMIT# l l I Ob OWNER'S NAME: PHONE# 5zo 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 BCONTRACTORS HA TAINED A CITY OF CUPERTINO BUSINESS LICENSE. V - 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 ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(&-cupertino.orQ PROJECT ADDRESSe>�A 6 �� -r7__ APN# C/ r/t C OWNERNAME j� IJl PHONE �"J/ (O% 3 E-MAIL STREET ADDRESS ,(J rl/�Yy CITY, STATE,ZIP FAX CONTRACTOR NAME J u LICENSE NUMBER 9/ LICENSE TYPE,,r BUS.LIC.# COMPANY NAME 7 A / /C E-MAIL FAX STREET ADDRESS e,—( 1J ! [.�✓l,�Q�,L l� , CITY,STATE.ZIP ��iJ ,�..�.v?1'� 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 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 b installed in accordance with Sections R314 and R315 of the 2010 California Residential Code. Signature of Applicant/Agent: Date: O Reroomolicv 2011.doe revised 02/16/11 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 32617025 . 00 DATE ISSUED. . . . . . . : 10/14/2011 RECEIPT #. . . . . . . . . : BS000015052 REFERENCE ID # . . . : 11100103 SITE ADDRESS . . . . . : 10208 AMELIA CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER WAYNE CHEUNG ADDRESS 10208 AMELIA CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : STEVE WILLIAMS CONTRACTOR STEVE WILLIAMS LIC # 32413 COMPANY WILLIAMS ROOFING ADDRESS . . . . . . . . . . : 42683 BRANTWOOD CT CITY/STATE/ZIP . . . : FREMONT, CA 94538 TELEPHONE (510) 882-4642 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 6, 500.00 1. 00 0. 00 1.00 0. 00 1BSEISMICR VALUATION 6, 500 .00 0 .65 0 . 00 0 .65 0. 00 1REROOFRES SQ FEET 22 .00 308. 00 0. 00 308. 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 309.65 0. 00 309.65 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 309.65 VISA --------------- TOTAL RECEIPT 309. 65 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 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10208 amelia ct. DATE: 10/14/2011 REVIEWED BY: bobs. APN: BP#: `EVALUATION: 1$6,500 RIPERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF USE: PERMIT TYPE: WORK tear off wood shake and install comp shingles. SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 2,200 T7 ee 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 relinina information available and are o an estimate. Contact the De t or addn'l in o. FEE ITEMS (I,',-,e Resolution 11-053 Eff '1.'IIZ FEE QTY/FEE MISC ITEMS Permit Fee: $308.00 Work Without Permit? Yes No $0.00 A Strong Motion Fee: 1BSEISMICR $0.65 Select an Administrative Item 131dyStds Commission Fee: IBCBSC $1.00 SUBTOTALS: $309.65 $0.00 TOTAL IFEE: $309.65 Revised: 10/01/2011 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINC} (408)777-3228• FAX(408)777-3333 • building(d)cupertino.org t- 1 1 QblO,2j PROJECT ADDRESS ® '7 ,El 7— '�# ?j 2 t.jJ I ! O OWNER NAME ) PHONE `/_ / t E-MATT. STREET ADDRESS l 4!', 5L A_ �� CITY. STATE,ZIP FAX APPLICANT NAME / _ .� J l PHONE E-MAIL STREET ADDRESS (, CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME A / LICENSE NUMBER LICENSE TYPE` BUS.LIC.# COMPANY NAME E-MAIL FAX �} STREET ADDRESS TATE / CITY,S ] �" V PHONE 9 4 � ARCHITECT/ENGINEER NAME b (LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial Z �� EXISTING ROOF TYPE: ❑BUILT-UP ROOF In ASPHALT SHINGLES O�ZOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE eYES IF NO. PLYWOOD ❑ A- I OS PLYWDTSB PITCH ROOF #LAYERS: THICKNESS: El 518- TYPE: /❑ CDX 12 CLASS: ll PROPOSED ROOF TYPE: ❑BUILT-UP ROOF HALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK � O �N3/_77':l/ �S 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 DescHpdon o Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildinEocopStruction. I authorizrepresen es f Cupertino tc enter the above-identified pr elr;For inspection purposes. Signature of Applicant/Agent: Date: d l SUPPLEMENTAL INFORMATION REQUIRED If building is associated with a Home Owner's Association,provide letter _ ofroval from HOA. aPP —Provide Planning approval to verify if there any restrictions. `sir , Provide copy of Manufacturer's Installation Specifications. —Provide signed copy of Cupertino's Tear-Off Policy. _s ReroofApp_2011.doc revised 03/02111