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11030153 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7819 LILAC CT CONTRACTOR:QUALITY FIRST HOME PERMIT NO: 11030153 IMPROVEMENTS O R'S NAME: BURKLUND DALE C AND MARGARET L 6545 SUNRISE BLVD STE 202 DATE ISSUED:03/31/2011 OWNER'S PHONE: 4082537965 CITRUS HEIGHTS,CA 95610 PHONE NO:(916)788-2921 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# �, -77 �- MECH f- RESIDENTIALCOMMERCIAL Contractor Date -2,131111 I hereby affirm t at am censed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING SHAKE(2 LAYERS)AND (commencing wit S ' n 7000)of Division 3 of the Business&Professions REPLACE WITH OSB, Code and that m dense is in full force and effect. 30YR COMP SHINGLESS CLASS A CAYMENT MINIMUM,AND A 30SQFR 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:$22610 permit is issued. APPLICANT CERTIFICATION APN Number:35903027.00 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 Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-points urce regulations per the Cupertino Municipal Code,Section 9.18. ture Date Tj 3 I /( Issued by: Date: ❑ OWI ,R-B J ILDER DECLARATION RE-ROOFS: I hereby affirm 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 obtaining an inspection,I agree 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) Si at r of ppl'cant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to l construct the project(Sec.7044,Business&Professions Code). ALL ROOF OV I GS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 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(x)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air 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 I iz nt: I r forthwith comply with such provisions or this permit shall be deemed revoked. Date: l OONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereb fi that is a construction lending agency for the performance of"ark'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.) `+uilding construction,and hereby authorize representatives of this city to enter Lender's Name n the above mentioned property for inspection purposes.(We)agree to save ...demnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional 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.org PROJECT ADDRESS-7811 I l e �y APN# OWNER NAME B, 0 AJ PHO ! X ��5-.3- '7q 6,3 E-MAIL STREET ADDRES ^ / rL� ^—r STATE Z lJ FAX CONT TOR a (�, r ns LIC SE�' Z LICENSE BUS.LIC.# �G COMPANY NAME E-MAIL. FAX STRF I�1SNiN �v^rC fC Q p 2_ TY CITY s TE.ZIP �� 2vs K��cKTs eA a 7 y 9-r( 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 detectors are required to be installed in accordance with Sections R314 and R315 of the 2010 California Residentiaode.'' Signature of Applicant/Agent: Date: ReroofPoli _201 .doc revised 02/16/11 `2 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333• building acupertino.org CUPERTINO PROJECT ADDRESS �jb//9 G/LQ C �1Jr APN# OWNER NAME K,' _KLV M PHONE �� /_ --MAIL STREET ADDRESS n b / Q G LAG G7 C� a( JUG/G TI0V U CA 701V FAX APPLICANT NAME /nQvA� F�l2S� )�a�c i�-I'rT PHOrige "0�S�',7�/1 E-MAIL (,� a �1 c TREET ADDRESS sLI 5,,,4 sUfG &(6d CITY,e�7 t YE76,q7-,S � (,��/!� FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT (/GI CONTRACTOR ❑CONTRA,ACCTJOR AGENT ❑ ARCHITECT (❑• ENGINEER ❑ DEVELOPER ❑ TENANT ENSE NUMrr7S- (^, LICENSE BUS.LIC.# .8 COMPANY N E E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARC=CT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CrrY,STATE,ZIP PHONE USE OF8--S-FD or Duplex ❑ Multi-Family ROOF AREA V UATION:/ STRUCTURE: ❑ Commercial �0 Y" �� 1pF�Q • EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLESA;1�OOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE YES IF NO, PLYWOOD /:" ❑ PLYWD OSB PITCH: ROOF ❑ NO I #LAYERS: THICKNESS: ❑ 5/8" TYPE: 11CDX I 12 CLASS: A PROPOSED ROOF TYPE: 13 BUILT-UP ROOF A HALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES 11 OTHER ICC-ES REPORT# DES TION OF WORK: i o v� ,ails s�n�� a LAI e.cs o--tt e/,ee /ace- wl 0546 41 A-6 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 provi 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 bui s 'ction. I authorize representatives of Cupertino tc enter the above id tified roperty for inspection purposes. Signature of Applicant lAgent: Date: SUPPLEMENTINF FMA ION REQUIREDo> cI _If building is associated wi a Ho e 0 er's Association,provide letterPL�AN ca>clt TYPE'` ROUT1x�sLiP of approval from HOA. L3"pveR TSE cQurITER >Ne PY Art REv1Ew Provide Planning approval to verify if there any restrictions. ExPitEss; ❑ PLANN7NGPLANREVIEW Provide copy of Manufacturer's Installation Specifications. ❑ sTArID:►in FIRM DEPT �, Provide signed copy of Cupertino's Tear-Off Policy. ❑ 'OTHER ReroofApp_2011.doc revised 03/02/11 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35903027. 00 DATE ISSUED. . . . . . . : 03/31/2011 RECEIPT #. . . . . . . . . : BS000013057 REFERENCE ID # . . . : 11030153 SITE ADDRESS . . . . . : 7819 LILAC CT SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : BURKLUND DALE C AND MARGARET L ADDRESS . . . . . . . . . . : 7819 LILAC CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4207 RECEIVED FROM . . . . : QUALITY FIRST HOME CONTRACTOR . . . . . . . : GC ANDERSON LIC # 30398 COMPANY . . . . . . . . . . : QUALITY FIRST HOME IMPROVEMENT ADDRESS . . . . . . . . . . : 6545 SUNRISE BLVD STE 202 CITY/STATE/ZIP . . . : CITRUS HEIGHTS, CA 95610 TELEPHONE . . . . . . . . : (916) 788-2921 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 22, 610 . 00 1. 00 0. 00 1 .00 0. 00 1BSEISMICR VALUATION 22, 610. 00 2.26 0. 00 2 .26 0. 00 1REROOFRES SQ FEET 30. 00 390 . 00 0. 00 390.00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 393 .26 0. 00 393 .26 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 393 .26 VISA --------------- TOTAL RECEIPT 393 .26 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: 7819 lilac ct. DATE: 03/31/2011 REVIEWED BY: bob s. APN: BP#: `EVALUATION: 1$22,610 RIPERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF USE: PERMIT TYPE: WORK remove existing shakes add new comp shingles. SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 3,000 T-7 Lj NOTE. Theseees 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 I.;f. 7,1,`10) FEE QTY/FEE MISC ITEMS Permit Fee: $390.00 Work Without Permit? 0 Yes No $0.00 Strom Motion Fee: IBSEISMICR $2.26 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $393.26 $0.00 TOTAL FEE:'' $393.26 Revised: 01/15/2011 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: LIGAc d.W- PERMIT# 03 C11 S OWNER'S NAME: v VOJ) PIJONE # 9d d- $-q- 7 leg y GENERAL CONTRACTOR: 261 011SINESS LICENSE# ADDRESS: 40 fS'�K45-e, 96,c( 0 tO Z CITY/ZIPCODE: c-rTWUS f{cr6F(?S 4S-G t'd *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: 3 CA ignature Date Please check applicable subcontracto' s nd o lete the following information: V SUBCONTRACTOR NESS 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