11030115 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7572 LOCKFORD CT CONTRACTOR:KEVIN SULLIVAN PERMIT NO: 11030115
ROOFING
OWNER'S NAME: XIXI YANG 1696 VALLEY OAKS DR DATE ISSUED:03/28/2011
CC /M'S PHONE: 4088333225 GILROY,CA 95020 PHONE NO:(408)842-1057
Ifd' LICENSED CONTRACTOR'S DECLARATION
,t BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# r
�3�t J MECH f— RESIDENTIAL COMMERCIAL F
Contractor Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE 2 LAYERS OF COMP&NSTALL 30LB
(commencing with Section 7000)of Division 3 of the Business&Professions FELT,EXISTING SHEATHING,NEW COMP.,PARTIAL
Code and that my license is in full force and effect. PLYWOOD CLASS A 24SQ
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:$10000
permit is issued.
APPLICANT CERTIFICATION APN Number:36226047.00 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-point source regulations per the Cupertino Municipal Code,Section
9.18.
Issued by: Date:
Signature Date
L OWNER-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 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) Signature of Applicant. '��'�'� Date:
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS 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. 1 will maintain
I 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 OwnSpor authorize nt:
forthwith comply with such provisions or this permit shall be deemed revoked.
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
int' -nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
G nd expenses which may accrue against said City in consequence of the
grw...ng 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. I understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 7572 Lockford Ct. DATE: 03/28/2011 REVIEWED BY: larrys
APN: BP#: -VALUATION: $10,000
'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex 2nd Unit? 0 Yes No PENTAMATION 1 R3SFDREM
USE: I OTC. ()Yes GNo I PERMIT TYPE:
WORK remove 2 layers of comp install 30 Ib felt existing sheathing, new Comp., partial plywood.
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
R-3(Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00
TOTALS: 0 $0.00 $0.00
MECH,HOURLY 0 Yes 0 No PLUMB,HOURLY Yes Q No ELEC,HOURLY 0 Yes 0 No
NOTE. Thesefees are based on the prelintinary information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS 0I'ee Resolution 09-051 i.' '. 7111/10) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 2,400 s.f. Re-roof
Suppl.PC Fee: Reg. OT 0.0 hrs $0.00 $312.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl.Insp. Fee-.0 Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Acoustical Fee: 0 Yes G No $0.00 0
Work Without Permit? 0 Yes E) No $0.00 E)
Planning Fee: $0.00 Select a Non-Residential E)
Building or Structure 0
Strong Motion Fee: 1BSEISMICR $1.00 Select an Administrative Item
Bldg,,Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $2.00 $312.00 TOTAL FEE: $314.00
Revised: 03/01/2011
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY ## 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36226047.00
DATE ISSUED. . . . . . . : 03/28/2011
RECEIPT #. . . . . . . . . BS000012997
REFERENCE ID # . . . : 11030115
SITE ADDRESS . . . . . : 7572 LOCKFORD CT
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . . XIXI YANG
ADDRESS . . . . . . . . . . : 7572 LOCKFORD CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : KEVIN E SULLIVAN
CONTRACTOR . . . . . . . : KEVIN E. SULLIVAN LIC # 23810
COMPANY . . . . . . . . . . : KEVIN SULLIVAN ROOFING
ADDRESS . . . . . . . . . . : 1696 VALLEY OAKS DR
CITY/STATE/ZIP . . . : GILROY, CA 95020
TELEPHONE . . . . . . . . : (408) 842-1057
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 10, 000 .00 1. 00 0. 00 1.00 0. 00
1BSEISMICR VALUATION 10, 000 . 00 1. 00 0 . 00 1. 00 0. 00
1REROOFRES SQ FEET 24 . 00 312. 00 0. 00 312 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 314 . 00 0. 00 314 .00 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 314 . 00 VISA
---------------
TOTAL RECEIPT 314 . 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
`:5 0
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
49 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildingCQ-cupertino.ong
PROJECT ADDRESS ^,� APN# � ]L-,� -2- 2-' n
v �
OWNER NAME • PHONE E-MAIL
-1Z
STREET ADDRESS CITY, STATE FAX
APPLICANT NA a` PHONE E-MAIL
c
ST TAD SS vat CITY,
v y
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT VONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME ICENSE NU ER !� LICENS TYPE BUS.LIC.#
1
COMPANY NAME E-MAIL
T D_USS ^ CITY, TATE,Z PH
t4bf QA"
CA
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF FD r Duplex ❑ Multi-Family ROOF AREA: VALUATION: �p
STRUCTURE: ❑ Commercial ?/ � to,Q a
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE PLACE S IF NO, PLYWOOD ❑ 1/1 PLYWD 11 OSB PITCH: ROOF
O #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX I Z CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF HALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTIO.4 OF WORK:
30
A4-0�- nz 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 Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to ilding construction. tho a representatives of Cupertino to enter the above-' entified property for inspection purposes.
Signature of Applicant/Agen: Date:
SUPPLEMENTAL INFORMATION REQUIRED 'OMCE VSE OF 6I' T=
_If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYP><; RournvG SLIP
of approval from HOA. ❑ OVER-THE-COUNTER.- ❑' BUII DING PLAN REVIEW
_Provide Planning approval to verify if there any restrictions. ❑ I XPREss ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT'
Provide signed copy of Cupertino's Tear-Off Policy. ❑ orHER:
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
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
CUPERTINO
(408)777-3228• FAX(408)777-3333• buildingia�,cupertino.org
PROJECT ADDRESS H(7 �J APN#
•
OWNER NAME ♦ PHO 3' E-MAIL
I'Y
` V
STREET ADDRESS 1,5_477-
CITY, STATE,ZIP FAX
R�7AM � LICENSE � LICENSE�'YPE � BUS.LIC.#
COMPANY NAME EMAIL V
Q�./` F
STRH T DRESS / CITY,STATE IP � PHO _ O
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 Residential
Signature of Applicant/Agen . Date:
ReroofPolicy_2011.doc revised 02/16/11