11040080 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10830 NORTHOAK SQ CONTRACTOR:FOUR SEASONS PERMIT NO: 11040080
ROOFING
OWNER'S NAME: YUHUA WU PO BOX 1668 DATE ISSUED:04/12/2011
'NER'S PHONE: 4082521562 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
❑ LICENSED CONTRACTOR'S DECLARATION
qBUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class C- 3 ( Lic.# Y 7. �
OF
MECH RESIDENTIAL COMMERCIAL
Contractor Date Z ��
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF 14 SQUARES,REMOVE EXISTING CEMWOOD
ROOF
(commencing with Section 7000)of Division 3 of the Business&Professions INSTALL NEW 30#UNDERLAYMENT&GAF GRAND CANYON
Code and that my license is in full force and effect. ASPHALT SHINGLES
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:$4400
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:31641004.00 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 P IT 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 DAY F OM LAS Pr INSPEC 7,/1
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the �Z
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE- OFS:
Signature Date l Z l 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 remove all new materials for
inspection.
Ll OWNER-BUILDER DECLARATION 000,
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 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. 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.
Section 3700 of the Labor Code,for theerformance of the work for which this A'/ Y
p Owner or authorized agent: /'f7 � Date:
permit is issued. a �
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
--on the above mentioned property for inspection purposes.(We)agree to save
•mnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
_tests,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
Building Department
City Of Cupertino
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: $a. PERMIT#
OWNER'S NAME: y L,6.0 W U PHONE# 2S Z
GENERAL CONTRACTOR: S ye-- 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. Y Z !/
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
V 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
o ng
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
3 ITEMS OF 12 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31641004 . 00
DATE ISSUED. . . . . . . : 04/12/2011
RECEIPT # . • . • • • • • . : BS000013159
REFERENCE ID # . . . : 11040080
SITE ADDRESS . . . . . : 10830 NORTHOAK SQ
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER YUHUA WU
ADDRESS . . . . . . . . . . : 10830 NORTHOAK SQ
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : FOUR SEASON ROOFING
CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323
COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING
ADDRESS . . . . . . . . . . : PO BOX 1668
CITY/STATE/ZIP . . . : SAN JOSE, CA 95109
TELEPHONE . . . . . . . . : (408) 278-0330
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 4, 400 . 00 1 . 00 0 . 00 1 . 00 0 .00
1BSEISMICR VALUATION 4,400 .00 0 .50 0 . 00 0 . 50 0 . 00
1REROOFRES SQ FEET 14 . 00 182 . 00 0 . 00 182 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 183 .50 0 . 00 183 .50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 734 . 00 010747
---------------
TOTAL RECEIPT 734 . 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
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10830 northoak sq. DATE: 04/12/2011 REVIEWED BY: bobs.
APN: BP#: '"VALUATION: 1$4,400
RIPERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
USE: P PERMIT TYPE:
WORK remove existing shake replace with comp shingles.
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 1,400
ELI I-
NOTE: Theseees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info,
FEE ITEMS (F'ee Resolution 09-051 1; ': 7;1110) FEE QTY/FEE MISC ITEMS
_T
Permit Fee: $182.00
FT
Work Without Permit? 0 Yes E) No $0.00
A
Strom Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $183.501 $0.00 TOTAL FEE: $183.50
Revised: 01/15/2011
REROOF TEAR-OFF POLICY
ELM 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(a7.cupertino.org
PROJECT ADDRESS /a a— APN#
OWNER NAME �_i PHONE-?-s-
_l's G 4 E-MAIL
STREET ADDRESS CITY, STATE,ZIP FAX
CONTRACTOR NAME,/ LICENSE NUMBER U 7 /O TFENe`YPE BUS.LIC.#
( Z{ � �i
COMPANY NAME Q G / _ ' r� E-MAIL�L2 fl t J�L (
STREET ADDRESS /J o_/ lVf CITY,STATE,ZIP �[��j Q ` PHONE n fr�G 3a
A G v
b N..
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 shall be scheduled 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.
On the day of the inspection, a building inspector will be available within one hour for either a Tear-Off
Inspection or Nailing Inspection if you call again on that day between the hours specified.
3. The following inspections are required:
a. 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.
b. If plywood is installed, a plywood Nailing Inspection is required.
c. Progress Inspection is required when approximately 50% of roof covering is installed.
4. New roof coverings shall not be applied without first obtaining all 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.
5. 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 I/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.
6. 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 detecto s are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code. C�
Signature of Applicant/Agent: Date:
IV ReroofPolicy_2011.doc revised 02/16/11
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
I
CUPERTINO j (408) 777-3228 • FAX (408)777-3333• buildingaQcupertino.org or
yu
PROJECT ADDRESS o G /�/C�! tO�j� C'�l APN# I q •OD
OWNER NAME PHONE E-MAIL ..
STREET ADDRESS CITY, STATE,ZIP FAX
APPLICANT NANDp P ONE E-MAIL
U�S 3'�3 7
STREET ADDRESSrO z 1�I�i j` CITY,STATE, Q", ' te l/, FA Z A+
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT 34CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
COh'rRACTOR NAME Q� n LICENSE NUMBER LICENSE TYPE BUS.LIC.#
cJ t�j 2Vec Ll o
CONIPANY NAME E-MAIL FA�f rte_
_av( Sem�.,. �) _7,?-9
STREET ADDRESSfi CIT ,STATE ZIP PHONE
Se Z �ar,1►n S T. I C� `l J-// Z L- oSJ 27F-0336
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
LSE OF ❑ SFD or Duplex Multi-Family ROOF AREA. VALUATION:
_I--
;TRL.oT-t;RE El Commercial (jU
EXISTING ROOF TYPE 11 BUILT-UP ROOF ❑ASPHALT SHINGLES 1:1 WOOD SHAKES ❑WOOD SHINGLES ��R(SPECIFY)�M�w�
REMOVE REPLACE ,Ia.YES IF NO, PLYWOOD 1:1 'h" ClPLYWD ElOSB !PITCH: ROOF
❑ NO #LAYERS: THICKNESS: 135/8" TYPE C3 DX :12 CLASS. A
PROPOSED ROOF TYPE ❑BUILT-UP ROOF ;a-�PHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK.
h C7 Q-. C (54Al J�l9JC JC� Wit'
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 b ding Wristruction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED EUSEOutL
_ If building is associated with a Home Owner's Association,provide letter ,�', PP►L^^NCHECKTYP '� .;"I'" TINGSLIP
of approval from HOA. e-.--,--..THE-COUNTER - ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS' ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ EIRE])EPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑.'O'T'HER
ReroofApp_2011.doc revised 03102111