10080152 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10408 DENISON AVE CONTI:ACTOR:KEITH ROOFING CO INC PERMIT NO: 10080152
OWNER'S NAME: YEA-IIWANG UANG 920 LINCOLN AVE DATE ISSUED:08/23/2010
'VER'S PHONE: 4082578849 SAN JOSE,CA 95126 PHONE NO:(408)295-8616
CJ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r— ELECT r— PLUMB
License Class � Lie.#
-� MECH[_ RESIDENTIAL I- COMMERCIAL�
Contractor G Date 0V,;2 D
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE SHAKE ROOF,INSTALL 7/16 OSB,30LB
(commencing with Section 7000)of Division 3 of the Business&Professions FELT CAMP ROOF CLASS A 33SQ
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 Sq.Ft 17oor Area: Valuation:$19630
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN N amber:31629071.00 Occupancy Type:
APPLICANT CERTIFICATION
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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
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 1F0 YS FRO IXST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non- ce regulations per the Cupertino Municipal Code,Section
Date:
9.18. Issued ti....
Sig ature Date
.r'
OWNER-BUILDER DECLARATION RE-ROOFS:
All roo's shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one of installe i without first obtainin spection,I agree to remove all new materials for
the following two reasons: inspect on.
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, Signat.re of AppKiant: Da
Business&Professions Code)
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 HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the Califon nia Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by 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 Additi rnally,should I use equipment or devices which emit hazardous air
contantinants as defined by the Bay Area Air Quality Management District I will
permit is issued. maints in compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
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 Owner ized agent:
become subject to the Worker's Compensation provisions of the Labor Code,I mustDate:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I beret y affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for wh ch this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
s,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
,ting of this permit.Additionally,the applicant understands and will comply
wita all non-point source regulations per the Cupertino Municipal Code,Section I unde stand my plans shall be used as public records.
9.18.
Licens ed Professional
Signature Date
CITY OF CUPER"INO
PERMIT RECE::PT OPERATOR: patg
3 ITEMS OF 3 COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 31629071.00
DATE ISSUED. . . . . . . : 08/23/2010
RECEIPT #. . . . . . . . . BS000011242
REFERENCE ID # 10080152
SITE ADDRESS 10408 DENISON AVE
SUBDIVISION . . . . . . .
CITY CUPERTIrO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : YEA-HWANG UANG
ADDRESS : 10408 DENISON AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM • ' ROGER BRIGHT
ROGER LIC # 21477
CONTRACTOR . . . . . .
COMPANY . . . . . . . . . . : KEITH ROOFING CO INC
ADDRESS : 920 LINCOLN AVE
CITY/STATE/ZIP . . . : SAN JOSS, CA 95126
TELEPHONE . . . . . . . . : (408) 29 -8616
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC- --NEW-BAL-
---------- -------------
----------
----------
0 .00 1. 00 0 •
00
1BCBSC VALUATION 19, 630 . 00 1 .00 0 .00 2 . 00 0 .00
1BSEISMICR VALUATION 19, 630 . 00 2 .00
1REROOFRES SQ FEET 33 . 00 429 . 00 0 .00 429. 00 ------ -- --
4_2 .00 0 .00 432 .00 0 .00
TOTAL PERMIT
METHOD OF PAYMENT AMOUNTF.EFERENCE NUMBER
------------
---------------
--
CREDIT CARD 432 .00 VISA
---------------
TOTAL RECEIPT 432 .00
VOICE ID
DESCRIPTION VOICE ID DESCRIPTION-- ----------
____
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
2-
CITY OF ( ?e
CITY OF CUPE'RTINO
REROO F
CUPERTINO PERMIT APPLICATION
APN # j Date:
C�� i �3 10
Building Address:
v� iel
Owner's Name: Phone 25 7
VII ,J t �'�
HOA: Yes ❑ No If es, rovide letter fro;n HOA
Contractor: Phone #:�o�s:
Fax#: o-;Lq /2
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles 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:- � � s I -7 'le, dS!3. ma Ib e �- �C►•�► ' dp-�-
Residential - Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the applica,:ion or if there are any restrictions:
applicable, include in plan set & the sheet index.
Valuation: n /31)"&V
IL
I Have Read, U tand and Will Comply with Cupertino's Tear-Off Policy:
Si tore
Revised 02/05/09
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING DFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO
(408)777-3228• FAX(408)777-3333•buildinc
1 @cupertino.orq
PROJECT ADDRESS De P1 APN#
10 q06
OWNER NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE,ZIP FAX
CONTRACTOR NAME LICENSE LICNSE T P BUS.LIG#,..�'��
r 1;
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE, h PHONE f
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable previsions 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 call for tsar-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and all (try-rotted wood shall be replaced prior to this
inspection. A building inspector will be available with in one hour.
There are special hours for this service: 7:30 — 10:3Cam and 1:00—3:30pm (Mon—Thurs);
7:30 — 10:3C am 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 25% of the roofing material.
6. New roof coverings shall not be applied without first o)taining all inspections and written approvals
from the building inspector. Any roofing which is app ied without first obtaining an approved inspection
will require the removal of all new material down to th,- 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 1/4"per foot 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-insp,-ction fee shall be paid before another
inspection can be scheduled.
By my signing below, I certify e of the following is true: I am the property owner or authorized agent to act
on the property owner's be understand and agree to comply with the re-roof policy stated a ove.
Signature of Applicant/Ag Date:
ReroofPo1icy_2010.doc revised 05/17/10