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10080162
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20103 NORTHCREST SQ CONTI.ACTOR:FOUR SEASONS ROOFING PERMIT NO:10080162 PO BO(1668 DATE ISSUED:08/23/2010 OWNER'S NAME: TA-KAI LI PHONE NO:(408)278-0330 SAN JOSE,CA 95109 4ER'S PHONE: 4087770762 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r 2 q License Class Lic.# / / MECH r RESIDENTIAL r COMMERCIAL r Contractor � Date Q JOB I/ESCRIPTION:RE-ROOF REMOVE EXISTING CEMWWOOD ROOF& I hereby affirm that I am licensed under the provisions of Chapter 9 INSTA_L A (commencing with Section 7000)of Division 3 of the Business&Professions NEW(LASS A COMPOSITION SHINGLE.GAF GRAND CANYON (COLC R)STONEWOOD 12 SQ 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 Valuation:$4400 Section 3700 of the Labor Code,for the performance of the work for which this rAPN Floor Area: permit is issued. APPLICANT CERTIFICATION Occupancy Type: I certify that I have read this application and state that the above information is Number:31638075.00 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 with all non-point source regulations per the Cupertino Municipal Code,Section [80 DAYS FROM LAST CALLED INSPECTION. 9.18. �� Date: Signature Date Issued by: [� 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: r my employees with wages as their sole compensation, Inst filled without first obtaining an inspection,I agree to remove all new materials or I,as owner of the property,o will do the work,and the structure is not intended or offered for sale(Sec.7044, insl ection. / Date: �'' 6 Business&Professions Code) Sig iature of Applicant: 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 I ave read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. Ci lifornia Health&Safety Code,Sections 25505 25533,and 25534. 1 r 9 12 and the ill Health&maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code, ChapteSafety 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. ntaminants as Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with h the Cupertby the Bay ino Municipala Air tCode,agementChapter District I will not employ any person in any manner so as to become subject to the Worker's H ealth&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 r ho dagent: Date: forthwith comply with such provisions or this permit shall be deem ENDING AGENCY ed revoked. _ � �— APPLICANT CERTIFICATION CONSTRUCTION L I certify that I have read this application and state that the above information is I herebyaffirm 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 to building construction,and hereby authorize representatives of this city to enter f)r which this permit is issued(Sec.3097,Civ C.)Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save inify and keep harmless the City of Cupertino against liabilities,judgments, bender'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 sou regulations per the Cupertino Municipal Code,Section 9.18. /' understand my plans shall be used as public records. Sigiiatwe (�' Date ® Licensed Professional CITY OF CUP&ZTINO PERMIT RECEIPT OPERATOR: patg 3 ITEMS OF 18 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lct: APN . . . . . . . . : 31638075 .00 DATE ISSUED. . . . . . . : 0800007.1254 RECEIPT #• • • • . . . . . : 1008011;2 REFERENCE ID # • • SITE ADDRESS . . . . . : 20103 14ORTHCREST SQ SUBDIVISION CUPERTLNO CITY . . . . . . . . . . . . IMPACT AREA . . . . . . . OWNER TA-KAI LI ADDRESS 20103 NORTHCREST SQ CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM FOUR SEASONS ROOFIN CONTRACTOR DIAZ, ALFRED LIC # 21323 COMPANY FOUR I;EASONS ROOFING ADDRESS PO BO): 1668 CITY/STATE/ZIP SAN JOSE, CA 95109 • • (408) :,78_0330 TELEPHONE . • • • • • • UNIT QUANTITY AMOUNT PD-TO-DT THIS REC --NEW-BAL- FEE ID ------- ---------- _ _ ------ 0 .00 ___ ---------- 1.00 ---------- 1 .00 0 .00 1BCBSC VALUATION 4, 400 .00 0 .00 0. 50 0 .00 4,400 .00 0 .50 0 .00 1BSEISMICR VALUATION 0.00 156 . 00 12 .00 156 .00 -- 1REROOFRES SQ FEET __________ ----- ---------- ---------- 157 .50 0 .00 157 .50 0 .00 TOTAL PERMIT ------- VOICE ID DESCRIPTION VOICE ID DESCRIPTION --------------------------- 602 ROOF PLYWOOD NAIL 601 ROOF TEAR OFF 605 FINAL REROOF 604 ROOF IN-PROGRESS CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISIONREV BY: DATE: ADDRESS: *VALUATION: $4,400 A BP#: PN: PLAN CHECK TYPE: Re-roof *PERMIT TYPE: Minor Building Permit PENTAMATION 1 MFDWLROOF Building is Yes No PERMIT TYPE. PRIMARY Multi-Family Dwelling >3 Stories ) USE: WORK SCOPE FEE ID ROOF AREA sS. 1 REROOFMRES 1,200 j0? f5ftlttt,i, li iti').7, 1`tr,, tact the Dept_f es are based on the reliminar in ormation availi�ble and are onl an estimate. ;.;_ ITEMS addn'1 in o. NOTE: These a FEE QTY/FEE FEE ITEMS (Fee Resolution 09-05/ Fff 711/10) f'Ir.�tt C"lte=c•�. i-'�'e.` r,r,j it PC !". $156.0(i Permit Fee: P.'J'JDI. 1tr I' I`CC f f ti Work Without Permit? Yes No $0.(10 1'zLittTiti7r,�"�{- %f`ir+<�t 1)<�c�f��r��7ltct€ r�t� �'`'`" Select an Administrative Item Strom*Motion Fee_ 1BSEISMICR $0.�0 Bld,Stds Commission Fee: 1BCBSC $1.00 50 $0.00 TOTAL FEE. $157.50 SUBTOTALS: $157 Revised: 8/17/2010 CITY OF Z CITY OF CU PERTINO [2REROOF CUPERTINO PERMIT APPLICATION Date: APN # , : ,, ! 23 /0 Building Address: Owner's Name: Phone #: �C(Ufs HOA: Yes ❑ No ❑ If yes, provide letter from HOA Phone 0 �Contractor: � Fax#: Fr ��7��Q333 Cupertino Business License #: Contractor License #: .213 Type of Roo f Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles 3r�- Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ;r Other (Specify) ❑ Other (Specify) Number of existing coverings / ❑ Provide I.C.C.E.S. Report # ;a---To be Removed ❑ Provide Mfgr. Installation Specs. (ZeJob Description/: ^C) ve ;xi '5 �`3"Q / ,C. NC( �,s `\,9- C ,`i,PGS t 4-�'a.1 c fr,`.�5 Ie - C�Al� 6 r`-✓ CA`:/ ° Residential Commercial Green Building: Please complete relevant portion of the Confirmed with_Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: applicable, include in plan set & the sheet indeii. Valuation: � yD0 o c. I Have Read, Understand and Will Comply with C'upertino's Tear-Off Policy: Signature Revised 02/05/09 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT • BJILDING DIVISION ., ALBERT SALVADOR, P.E., C.B.O., BUILDING OF=1CIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 U P E RT I N O (408)777-3228 • FAX(408)777-3333 • buildin c upert_ ino.or4 I PROJECT ADDKF.SS O t©� O r 4,c1le. StT• T^ �� 111 � `� PHONt ' �J/ E-MAIL i 1 FAX( CITY, STATE-IP _ LICENc' g BUS.IL1IC,N LICENSE NUMBER G COKTKAC; IE 7L ` aiyf FAX S/'%� Z� ! E-MAIL `AML Z PHONE CIT STATE,ZI 9 I UNDERSTAND AND AGREE TO THE FOLLOWING: --r , re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 1. l.i� �t p J 2 An inspection request shall be scheduled the day before the inspectione, Please call (408)77 3228 between 7:30 - 3:30pm (Mon-Fri) to schedule the next day inspection.ll the rotted wood has 3. Atter the roof is torn off and the nails/fasteners have ')eeninemnv and wall be available with one hour. been replaced, you must call for a roof inspection. A buildinP There ares ecial hours for the service: 7:30 — 10:30am and 1:00 _2:.30p ((Friday). hurs); p 7:30 — 10:30am and 1:00 Pm 4. if plywood is installed, a plywood nailing inspection is required. ;. New roof coverings shall not be app lied without first obtaining all inspection and written approvals from inspection will ili. building inspector. Any roofing which is applied without first obtaining e approved can be performed. require the removal of all new material down to the sl Bathing so a proper inspectorwhenthe re-roofing is 6. A final inspection and approval shall beobtained following item we ball beg erified: completed. To receive a final sign-off, a. Flat roofs shall have a minimum of per foot of slope and demonstrate there is no ponding. b. A listing from an approved testing agency shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. youand te job is nt ready, will be charged to a re- NOTE: If you call for a plywood nailing inspectio all beh aid before another inspection can be inspection fee of$126.00. The re-inspection fee sh scheduled. er or m signature below, I certify to each of the following: I am the property r of policy fated ab authorized Pgent to act on y property owner's behalf. I un er nd and agree to comply with t P Z / 0 — -- Date: Signature of Applicant/Agent: ReroofPolicy_20I0.doc revised 041141 10