10080020CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1356 ROSEGARDEN LN I CONTRACTOR: WOODS ROOFING PERMIT NO: 10080020
OWNER'S NAME: SING WING HUI
QER'S PHONE: 4088610192
4131
� LICENSED CONTRACTOR'S DECLARATION
License Class G 3 ( Li, # 3 2-
Contractor Date
I hereby a irm cc under the provisions of Chapter 9
(comme ci with ctio 0) of Division 3 of the Business & Professions
Code an that my license is in full force and effect.
17700 SERENE DR I DATE ISSUED: 08/03/2010
MORG 4N HILL, CA 95037 ' PHONE NO: (831)637-5576
BUILItING PERMIT INFO: BLDG r— ELECT F PLUMB r—
MECH F RESIDENTIAL r— COMMERCIAL
JOB DESCRIPTION: RE -ROOF TEAR OFF OF 2 LAYERS WOOD SHAKE CLASS
A,
28SQ N -) RESHEET, INSTALL STEELL ROCK ROOFING
PANEL ;(SEE #ER -5218) -CLASS A
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
permit is issued. Sq. Ft floor Area:
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
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations er the Cupertino Municipal Code, Section
9.18.
Signature Date O
G OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1, 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,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
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
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
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
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
upon the above mentioned property for inspection purposes. (We) agree to save
mify and keep harmless the City of Cupertino against liabilities, judgments,
and expenses which may accrue against said City in consequence of the
gra.iting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date
APN Number: 36617041.00
Valuation: $17000
Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
1f;0 DAYS FROM LAST CALLED INSPECTION.
Issued by: Date: �—lL
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installeI without first obtaining an inspection, I agree to remove all new materials for
inspect ion.
Signati.re of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
Califo •nia Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compl ance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contae rinants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Heald & Safety Code, Sections 25505, 25533, and 25534.
Owne • or authorize ajsf :
J ate:
CONSTRUCTION LENDINGAGENCY
I heret y affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lende is
ARCHITECT'S DECLARATION
I unde stand my plans shall be used as public records.
Licen!.ed Professional
3 ITEMS OF 3
CITY OF CUPER"INO
PERMIT RECECPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36617041.00
DATE ISSUED.......: 062
RECEIPT #•••• .....: BS01000000001111
REFERENCE ID # •••
SITE ADDRESS .....: 1356 ROSEGARDEN LN
SUBDIVISION •••...: CUPERTIIdO
CITY ............
IMPACT AREA .......
OWNER SING WI:JG HUI
ADDRESS 1356 RO3EGARDEN LN
CITY/STATE/ZIP CUPERTIgO, CA 95014
OPERATOR: patg
COPY # : 1
RECEIVED FROM JEFF RAINEY
CONTRACTOR WOOD, LAWRENCE E LIC # 20810
COMPANY WOODS ROOFING
ADDRESS 17700 SERENE DR
CITY/STATE/ZIP MORGAN
HILL,
CA 95037
TELEPHONE .......
METHOD OF PAYMENT
CREDIT CARD
TOTAL RECEIPT
AMOUNT
---------------
366.70
---------------
366.70
VOICE ID DESCRIPTION
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
------- ------------
VISA
VOICE ID DESCRIPTION
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
QUANTITY
AMOUl[T
PD -TO -DT
THIS REC --NEW-BAL-
FEE ID UNIT
----------
---- ------
1.00
0.00
____----------
1BCBSC VALUATION
17,000.00
1.00
1 70
0.00
0.00
1.70
0.00
1BSEISMICR VALUATION
17,000.00
28.00
3,34.00
0.00
364.00
0.00
1REROOFRES SQ FEET
----------
---------
----------
____
3 56 .70
0.00
366.70
0.00
TOTAL PERMIT
METHOD OF PAYMENT
CREDIT CARD
TOTAL RECEIPT
AMOUNT
---------------
366.70
---------------
366.70
VOICE ID DESCRIPTION
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
------- ------------
VISA
VOICE ID DESCRIPTION
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
CITY Of
CITY OF CUPERTINO
REROO F
CUPS RTINO PERMIT APPLICATION
APN # Date:
f) 8-3-10
[Building Address:
1356 ROSE GARDEN LANE
Owner's Name: Phone #:
SING WING HUI 408-861-0192
HOA: Yes ❑ No 0 If yes, provide letter from HOA
Contractor: Phone #: 408-605-5115
WOOD'S ROOFING
Fax #: 408-267-9999
Cupertino Business License #: Contractor License #:
325131
Existing:
❑ Built -Up Roof
❑ Asphalt Shingles
❑ Wood Shakes
❑ Wood Shingles
❑ Other (Specify)
Number of existing coverings
❑ To be Removed
Type of Roof Covering:
Proposed:
a Built -Up roof
j Asphalt Shingles
❑ Wood Shakes
❑ Wood Shingles
❑ Other (Specify) STEEL ROCK ROOFING PANELS
❑ Provide I.C.C.E.S. Report # 52-1 -q
❑ Provide Mfgr. Installation Specs.
JOb Description: RE-ROOF/TEAR OF 2 LAYERS WOOD SHAKE/(:LASS A/ 28 SQUARES/ NO RESHEET
INSTALL STEEL ROCK ROOFING PANELS (SEE #ER -5218)
C l 6Xf /A_
Residential
Commercial
Gree=Please mplete relevant portion of the Confirmed with Planning Dept. if
Gree& attach it to the application or if there are any restrictions:
a lset & the sheet index.
Valuation:
$17,000
I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy:
Signa, ur,
Revised 02/05/09
I. Use Lowtw"ibC :Pairft
2. Use Low VOC, Water -Based Wood Finishes
3. Use Low/No TOC Adhesives
4. Use Salvaged Materials for Interior Finishes
5. Use Engineered Sheet Goods with no added Urea
Formaldehyde
6. Use Exterior Grade Plywood for Interior Uses
7. Seal. alllaardqr MIFF
B. Use FSC Certified Materials for Interior Finish
9. Use Finger -Jointed or Recycled -Content Trim
10. Install Whole House Vacuum System
N. Flooring
1. Select FSC Certified Wood Flooring
2. Use Rapidly Rer►ewable Flooring Mate_ rials
3. Use Recycled Content Ceramic Tiles
4. Install Natural Linoleum in Place of Vinyl .
5. Use Exposed Concrete as Finished Floor
S. Install Recycled Content Carpet with Low VOCs
Total Points Available:
Total Points Project Received:
1 IMM-lealth pts
y --yes
21AQ/iealth pts
y --yes
3IAO/ iealth pts
y=yes
3 Resource pts
y=yes
6 IAQ/ iealth pts y --yes
1 IAQ/ iealth pts y=yes
4 IAQ/ iealth. -ots v=ves
4 Resource pts y=yes
1 Resource pts y --yes;
3 IAQHealth pts y --yes
B Resource pts
y=yes
4 Resot irce pts
y=yes
4 Resource pts
y --yes
5 IAQ/1lealth pts
y=yes
4 Resooirce pts
y=yes
4 Resource pts
y --yes
1401 130 57
\'1 01 0 0
G:daWprogs►greenbwldng Iuidelinesframodelerslgreenpointsfina121204proteotebds
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMEN 7 • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 96014-3255
(408) 777-3228 • FAX (408) 777-3333 - buildinti(a.cupertino.org
PROJECT ADDRESS f � � % � � j �
.J
FAPN #
OWNER NAME �I Ai .� �A) G 1 , q I
PHONE� bt -0/ Z
E-MAIL
STREET ADDRESS (-356 r M r ' 1
ej �/` (LICENSE
CITY, STATE, ZIP I �v o
14
FAX
CONTRACTOR NAME /C /�
I L/� j�►'I 7
NUMB`EER't/,
Z 1
LICENSE TYPE
C_
BUS. LIC k
COMPANY NAME .0 �`, _
E-MAIL
STREET ADDRESSNE
y 7'700 ��A)r 12 Ll
CITY, STATE, ZIP
MaL6 , I eA e) ? .
P o
I UNDERSTAND AND AGREIF, TO THE FOLLOWING:
1. The re -roof project shall comply with all applicable pr )visions 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 ear -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 witl in 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 n -progress roof inspection to verify building is
weather tight after installation of approximately 25% c f 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 itc ms 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 prc -manufactured products used shall be available
on-site to review at the time of the inspection.
Proper spark arrestor installation.
8. NOTE: If you call for a tear -off or plywood nailing it spection 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 each of the following is true: I am the property owner or authorized agent to act
on the property owner's behalf. understa and agree to comply with the re -roof policy stated above.
Signature of Applicant/Agent:00�7 Date:
ReroofPolicy_2010.doc revised 05/17/10