11040104 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10340 PRUNE TREE LN CONTRACTOR:ADVANTAGE ROOFING PERMIT NO: 11040104
OWNER'S NAME: DAVID HWANG 1601 BEGONIA CT DATE ISSUED:04/15/2011
INER'S PHONE: 4085948352 ROCKLIN,CA 95765 PHONE NO:(916)772-1724
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL
License Class l'- y Lic.# i d /G 3 RE-ROOF 26 SQ, REMOVE TAR&GRAVEL INSTALL 40
YR
Contractor R n -FA,kg IeW r Zg G Date!/-/5-// COMP ON 3:12,TORCH ON FLAT,USING EXISTING
I hereby affirm that I am licensed under the provisions of Chapter 9 SHEATHING CLASS A
(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:$1100
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:31633029.00 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 1 S ERMIT 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 CALLED INSPECTI N.
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 Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature- o _ Date - 9 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.
OWNER-BUILDER DECLARATION
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 the performance of the work for which this
Owner or authorized agent: Date:
permit is issued. ' /S
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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
s,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
tinting 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: p 3 yD 4aclg zL ,j t PERMIT#
OWNER'S NAME: 0/,0 44-111i9i0 G PHONE # 31,49 SZ
GENERAL CONTRACTOR: p, ,j BUSINESS LICENSE#
ADDRESS: o .� c r CITY/ZIPCODE: zi,✓
*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:
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
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Codractor Signature Date
CITY OF CUPERTINO
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31633029. 00
DATE ISSUED. . . . . . . : 04/15/2011
RECEIPT #. . . . . . . . . BS000013199
REFERENCE ID # . . . : 11040104
SITE ADDRESS . . . . . : 10340 PRUNE TREE LN
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER DAVID HWANG
ADDRESS 10340 PRUNE TREE LN
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : ADVANTAGE ROOFING
CONTRACTOR SCOTT BERKE LIC # 25792
COMPANY . . . . . . . . . . : ADVANTAGE ROOFING
ADDRESS . . . . . . . . . . : 1601 BEGONIA CT
CITY/STATE/ZIP . . . : ROCKLIN, CA 95765
TELEPHONE (916) 772-1724
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 1, 100 . 00 1 . 00 0 . 00 1. 00 0 . 00
1BSEISMICR VALUATION 1, 100 . 00 0 . 50 0 . 00 0 .50 0.00
1BUSLIC FLAT RATE 1 . 00 115. 00 0 .00 115 . 00 0. 00
1REROOFRES SQ FEET 26 . 00 338 . 00 0 .00 338 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 454 . 50 0 .'00 454 .50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 454 .50 2589
---------------
TOTAL RECEIPT 454 . 50
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: 10340 prunetree lane. DATE: 04/15/2011 REVIEWED BY: bobs.
APN: BP#: "'VALUATION: 1$11,000
PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK tear off tar and gravel non removal of existing sheathing.
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 2,600
NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee.Resolution 09-051 Ef 7-1.-'10 FEE QTY/FEE MISC ITEMS
Permit Fee: $338.00
Work Without Permit? Q Yes No $0.00
Strong Motion Fee: IBSEISMICR $1.10 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $340.101 $0.00 TOTAL FEE: $340.10
Revised: 01/15/2011
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• building6lcupertino.orq
PROTECT ADDRESS `/ T-AFN#
/ d 11/_1 .r/L 7,ee l.�r.�1
OWNER NAME ^^ PHONE E-MAIL
/ 6
STREET ADDRESS CITY, STATE,ZIP FAX
CONTRACTOR NAME LICENSE NUMBERLICENSE TYPE BUS.LIC.#
�tf o4 Al -761-6-e 'erd �/d / 3 -
COMPANY NAME / E-MAIL FAX
o 7- zv-
STREET ADDRESS CITY,STATE,ZIP PHONE
A)e
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 roofmg 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 detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Cod .
Signature of Applicant/Agent: Date: - i S
ReroofPolicy_2011.doc revised 02/16/11
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•building(�cupertino.org
CUPERTt(�!Q `/O el0/D
PROJECT ADDRESS N �-l'APi/ ON# 2 ( n v
� V�� 'U
OWNER NAME VPHONE � eC_ Z-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
APPLICANT NAME �I t r PHONE D o z E-MAIL tea, Dz�
L O
STREET ADDRESS CITY,STATE, ZIP FAX
/ /,0 X 4 GT eCl /AI 9
Il OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBER LICEN TYPE BUS.LIC.#
et !/") /6 3
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCI-=CT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF FD or Duplex �'3Pl* ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial ,- 6, // a
EXISTING ROOF TYPE: BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE 1! Y S IF NO, / PLYWOOD ❑ /i ❑ PLYWD ❑ OSB y PITCH: ROOF
Ila& #LAYERS: THICKNESS: Cl 5/8" TYPE: ❑ CDX T� 3 '12' CLASS: `�
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF /9 ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK:
v� — le LIZ
/ !1 J Af 3 Z
ZI
-.7-1 1JG ltf�
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 building4onstructinn. I authorize representatives of Cupertino tc enter the above-identified propeft;for inspection purposes.
Signature of Applicant/Agent: C Date: � / S — //
SUPPLEMENTAL INFORMATION REQUIRED ._`
If building is associated with a Home Owner's Association,provide letter "xYPE'h
Pp E'ER TBE GOIIPI�L'R �LIIi]>ING I'I AIt RE�'IEFV =
of approval from HOA.
Provide Planning approval to verify if there any restrictions. (] Exrii�ss ❑ rravN>rrcPLAN REvnsw
N
Provide copy of Manufacturer's Installation Specifications. ❑ szariD�RD Q FIx�DErr
rovide signed copy of Cupertino's Tear-Off Policy. - M❑ oIR
-L
ReroofApp_2011.doc revised 03/02/11