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10100172
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1024 WESTLYNN WAY CONTRACTOR:CALIFORNIA ROOFING PERMIT NO: 10100172 INC ^ VNER'S NAME: KEITH WATANABE 159;S 10TH ST DATE ISSUED: 10/25/2010 �.vVNER'S PHONE: 4088028642 SArl JOSE,CA 95112 PHONE NO:(408)293-7977 ❑ LICENSED CONTRACTOR'S DECLARATION BU[LDING PERMIT INFO: BLDG F ELECT F PLUMB License Class �.—�G Lie.# t��-(,G 0� Contractor i MECH F RESIDENTIAL r COMMERCIAL F ��J c1^'n,+� ----Date I hereby affirm that I am licensed under the provisions of Chapter 9 JO13 DESCRIPTION: RE-ROOF REMOVE EXISTING SHAKE ROOF,INSTALL 1/2" (commencing with Section 7000)of Division 3 of the Business&Professions CD):PLYWOOD,ASTM 30#FELT&50YR GAF/ELK Code and that my license is in full force and effect. DIMENSIONAL SHINGLES(COLOR BARKWOOD)CLASS A 36SQ 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 wh h this Sq. Tt Floor Area: Valuation:$19000 permit is issued. APPLICANT CERTIFICATION APr'Number:35927005.00 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 WORT{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. S Date o I"ZS'' Issued by: Date: ❑ 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: insta led 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, inspe ction. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) nia •e of4� Date: I,as owner of the property,am exclusively contracting with licensed contractors to SiT I Z� 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: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I ha,.a read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. Calif Drnia Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by coml liance 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(a)should I store or handle hazardous material. Addi Jonally,should I use equipment or devices which emit hazardous air permit is issued. conti minants as defined b the Ba Area Air y y 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 Heah h&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 Own,, r autho�a . forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I here by 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 w rich this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lend!r's Name III 'he above mentioned property for inspection purposes.(We)agree to save i. aify and keep harmless the City of Cupertino against liabilities,judgments, Lend:r'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. I undr rstand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: AI N: BP#: *VALUATION: 1$19,000 RPERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY 7 r 11_I L PENTAMATION SFD or Duplex PERMIT TYPE: 1 SFDWLROOF USE: 1} )r)F, ��`s,,z, WORK SCOPE FEE ID ROOF AR EA s.f. 1REROOFFRES 3,600 Li I NOTE. Thesefees are based on the preliminary information avaihWe and are only an estimate. Contact the De t or addh 7 info. FEE ITEMS (Fee Resohition 09-051 E(f 7%7;10) FEE QTY/FEE MISC ITEMS slipp/. PC P111112h "1I(_=, h./E/ctP/(/;I Ch",A. Permit Fee: $468.00 Plufrll7 l k'ch. !Jc r C Uii�j.tt�t1r,t,+7 t t7. t %E_aJh�t}c'ttt yn`�'1c3tt d't';': Work Without Permit? Q Yes E) No $0.00 P�crytrt?tz�>J`t'E'�`: Ti r,n�c'I 1)o(1011C[110liml I Strong Motion Fee: IBSEISMICR $1.90 Select an Administrative Item Bldp;Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $470.90 $0.00 TOTAL FEE: $470.90 Revised: 10/17/2010 CITY OF CUE ERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35927C05 . 00 DATE ISSUED. . . . . . . : 10/25/2010 RECEIPT #. . . . . . . . . : BS000C11830 REFERENCE ID # . . . : 10100172 SITE ADDRESS . . . . . : 1024 V'ESTLYNN WAY SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : KEITH WATANABE ADDRESS . . . . . . . . . . : 1024 WESTLYNN WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : CALIFORNIA ROOFING CONTRACTOR . . . . . . . : HAPPEF: P CAMPBELL LIC # 28096 COMPANY . . . . . . . . . . : CALIFORNIA ROOFING INC ADDRESS . . . . . . . . . . : 1595 S 10TH ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) : 93-7977 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----- ----- ---------- ---------- ---------- 1BCBSC VALUATION 19, 000 . 00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 19, 000 . 00 1 . 90 0 . 00 1. 90 0 . 00 1REROOFRES SQ FEET 36 . 00 4:68 . 00 0 . 00 468 . 00 0 . 00 ----- ----- ---------- ---------- ---------- TOTAL PERMIT 4:70 . 90 0. 00 470 . 90 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -- ------------------ CHECK 1470 . 90 #9- 266 --------------- TOTAL RECEIPT 470 . 90 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 REROOF TEAR-OFF POLI(;Y COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDI JG OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CP 95014-3255 (408)777-3228• FAX(408)777-3333- builcingCcDcugertino.org PROJECT ADDRESS APN# J U OWNER NAME PHONE E-MAIL vi STREET A•]1D^DR_EESSS CITY, STATE_1P FAX t CO^RA' R NA LIt�EN1S`NUMBER LICENSE SE PE BUS.LIC.# CMAOS�,NY ,h NAME E`-1M•AIL FAX STRT ADDRESS CITY,STATE,Z IJ C,4- PHON I UNDERSTAND AND AGR:E TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable )rovisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-';228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call fc r tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available w thin one hour. There are special hours for this service: 7:30 — 10:30am and 1:00— 3:30pm (Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 250/ of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained fro n the building inspector when the re-roofing is complete. To receive a final sign-off, the following tems will be verified: a. Flat roofs shall have a minimum of'/4"per foot of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all fre-manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. 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-in,;pection 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 unders d nd agree to comply with the re-roof policy stated ablye. Signature of Applicant/A Date: �'� �Z--� ReroofPolicy_2010.doc revised 05/17/10 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 / SUB(±ONTRACTOR LIST JOB ADDRESS: 'Zy W CS PERMIT# Z6 10 OWNER'S NAME: k_p 1-� PHONE# 4LA' - gdZ" GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: ISgS S C $ It Z 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 SUBCONTRAul-ORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. / I am not using any subcontractors. Signat jr -- 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/Contractor Signature Date CITY OF CITY OF CUPERTINO IM REROOF CUPERTINO PERMIT APPLICATION APN # .,, Date: L-5 9 : G(): i o1-2-S 201 p Building Address: Owner's Name: (�,q k+k 1ii\ps+vk1\.✓+ Phone #: HOA: Yes ❑ No Z If yes, provide letter from HOA Contractor: C. � ,� ,�q ' �, CID Phone #: 1�4 v k "2_gi3- 7 q 11 i 9 ccS S - �G... S-� , S vim• ©� ; CA l�C • S t t Z- Fax#: 4o V-2A(-t - (0 t 3 Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ,W- Asphalt Shingles X_ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings (1-3 ❑ Provide I.C.C.E.S. Report # To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: ajm�,n,�o C-Dkq%A 00 ra) �- 3a a 4- V*T V-D is o �tZ ResidentialiRTCommercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the applic<<tion or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: 1R)O O 0 . I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09