10090053 CITY OF CUPERTIN O BUILDING PERMIT
BUILDING ADDRESS: 7927 BELKNAP DR CONTRACTOR:R A CONSTRUCTION PERMIT NO: 10090053
OWNER'S NAME: TAITI CHENG 3851 R CHARTER PARK DR DATE ISSUED:09/08/2010
f NER'S PHONE: 4084643775 SAN JOSE,CA 95136 PHONE NO:(408)559-1877
❑ LICENSED CONTRACTOR'S DECLARrATION BUILDING PERMIT INFO: BLDG F ELECT r PLUMB F
License Class � [! Lic.# 6 -5y,7 MECH r RESIDENTIAL COMMERCIAL r.
Contractor m1f� Date f �d
JOB DESCRIPTION:RE-ROOF TEAR OFF OLD ROOF&INSTALL OSB
I hereby affirm that I am licensed under the provisions of Chapter 9
PLYWOOD
(commencing with Section 7000)of Division 3 of the Business&Professions INSTALL A NEW ASPHALT SHINGLE(ELK)CLASS A 29SQ
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.
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:$9950
permit is issued.
APPLICANT CERTIFICATION P/(?— APN Number:36208042.00 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, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the
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. f
Signature Date
�� Issued by: Date:
i
V 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
1,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:
1,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 in
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
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&
Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this 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 Owner suth d agent: /
become subject to the Worker's Compensation provisions of the Labor Code,I muse Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
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 relatinl; 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
-reify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
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
I understand my plans shall be used as public records.
9.18.
Signature Date Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36208042 .00
DATE ISSUED. . . . . . . : 09/08/2010
RECEIPT #. • • • • • • . • : BS000011410
REFERENCE ID # . . . : 1OC90053
SITE ADDRESS . . . . . : 7927 BELKNAP DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER TAITI CHENG
ADDRESS . 7927 BELKNAP DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM R A CONSTRUCTION
CONTRACTOR ANDREWS, RON LIC # 21382
COMPANY R A CONSTRUCTION
ADDRESS 38'31 R CHARTER PARK DR
CITY/STATE/ZIP SAN JOSE, CA 95136
TELEPHONE (4 )8) 559-1877
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
---------- ----------
---------- --
1BCBSC VALUATION 9, 950 . 00 1 .00 0 .00 1.00 0 .0
1BSEISMICR VALUATION 9, 950 . 00 1 .00 0 .00 1. 00 0 .00
1REROOFRES SQ FEET 29. 00 377 .00 0 .00 377 . 00 0 .00
---------- ---------- ---------- ----
TOTAL PERMIT 379 .00 0 . 00 379 .00 0 .00
METHOD OF PAYMENT AMOUNT --REFERENCE NUMBER
----------------- ---------------
CHECK 379. 00 #17157
---------------
TOTAL RECEIPT 379. 00
VOICE ID DESCRIPTION VOICE ID --------DESCRIPTION
-------
------ -----------
__ _
--
-- ----------
_
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
FEE ESTIMATOR--BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: *VALUATION: 1$9,950
xPERMIT TYPE: Minor Building Permit PL�,N CHECK TYPE: Re-roof
PRIMARY 7C?T,2L PENTAMATION 1SFDWLROOF
USE: SFD or Duplexl_C)<)t .� �l -�- PERMIT TYPE:
WORK
SCOPE
FEE ID ROO]z AREA
s.f.
1 REROOFFRES 2.900
_7 l Il_ i'i t Ch i
ED(:I<c
_L_
:Ife Yi. � 0"P('r P z mb hi'�l, Lj -I_ Ot/W kl(i h np
tl zh, law, 1"v: I"z,�itt�_ lo'/". FLIC l:ier iny, /�""
NOTE: These fims are based on the preliminary in ormation 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
P/an Check 1"(w:
,Step/. PC l;cC
Pfrzml�.%_11�c�h.il:f�c;Plazz C.7zec:k:
Permit Fee: $377.00
Sil1,14. 111'1p Fce
Pl;rrrzlt.;':tlifc Tz.:Z:lcc; !,'rzir 1�t�c:
Plzznztr.%;��ltrt•l�.,'1<lc�t 1't����tzrt 1-'c°�:
C'�,zzstt•rrcrr{qtr 1'cz:�
�tc�r,tzslic:cr1 t:ek�i���� f�'c°c�:
Work Without Permit? 0 Yes E) No 11;0.00
Platirting,
'11'w ci
Strong Motion Fee: IBSEISMICR `;1.00 Select an Administrative Item
BI�Stds Commission Fee: IBCBSC .51.00
SUBTOTALS: $379.00 $0.00 TOTAL FEE:` $379.00
Revised: 9/01/2010
M.Indoor Air Ouality and Finishes
1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes D
31AQ/Heahh pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQIHealth pts y=yes D
6.Use Exterior Grade Plywood.for Interior Uses 1 IAQ/Health pts y=yes 0
- 4IAQ/Health pts y=yes D
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House vacuum System 3 IAQ/Health pts y=yes 0
1 i 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.i/ae s .le�rr�s 4 Resource pts y=yes D
3.Use Recycled Content Ceramic Tiles 4 Resource pts yJyes 0
4.Install Natural linoleum in Place of Vinyl -5 IAQ/Haath pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
Total Points Available: I 140T.-1301 57
Total Points Project Received: 1 01 01 0
G:data1pmgs/gnsnbuildngguiderines/rem ale reenpant nmM12D4protectedxis
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•buildinga(Dcupertino.org
�� APN#
FPROJECTADDRESSff PHONI / ���� E-MAIL�/,w/�/ — v7
T _ ,�+ _ FAX
STREET ADDRESS (`�j�
LICENSE NU BU;p, LICENSE TYPE 7X "
CONTRACTOR NAM ^ , E-MAIL
COMPANY NAME
CITY,STA"E.ZIP PHONE 3F
/yam
STREET ADDRESS �/�� / (f�
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions 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)777-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please ca 1 for tear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any alLd all dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be availabl:within 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 Prop-ress roof inspection is required. Call fbr an in-progress roof inspection to verify building is
weather tight after installation of approximately 25% 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 from the building inspector when the re-roofing is
complete. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of per -oot of slope and must 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.
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-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 a d and agrce t� o comply with the re-roof policy stated above
I Date: � —
12,
Signature of Applicant/Agent:
Reroofpolicy_2010.doc revised 05/17110
CITY OF
CITY OF CUPERTINO
IsREROOF
MI
CUPERTINO PERT APPLICATION
APN # Date:
Building Address: 7 c 2 7-
Owner's Name: 1� �01_3�v��,y Phone #:
�"�
HOA: Yes ❑ No If yes, provide lett ar from HOA
Contractor: Phone #: C /1977Z
Fax#:
Cupertino Business License #: Contractor License #:
Type of R,)of Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles X Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: r"'`� /� 0115 pf-
r
C c ss
Residential Commercial ❑
Green Building: Please complete relevant portion of the Con.frmed Awth Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, i clude in plan set & the sheet index.
Valuation: ����
I Have Read, Unde tand and Will Comply with Cupertino's Tear-Off Policy:
Sign e
Revised 02/05/09