10080025 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 921 SAGE CT CONTRACTOR:CD ROOFING PERMIT NO: 10080025
OWNER'S NAME: MAN FU&ALICE YANG 2909 WILBUR AVE DATE ISSUED:08/03/2010
NER'S PHONE: 4082104616 SAN JOSE,CA 95127 PHONE NO:(408)898-6605
❑ LICENSED CONTRACTOR'S DECLARATION BUILIIING PERMIT INFO: BLDG r- ELECT F PLUMB F
License Class C� 2> Lic.# XS Z- ' q F F
MECH RESIDENTIAL COMMERCIAL
Contractor 2 ty c Date 3 t
JOB DESCRIPTION:RE-ROOF FROM WOOD SHINGLE TO COMPOSITE
I hereby affirm that I am licensed under he provisions of Chapter 9 SHINGLE,30
(commencing with Section 7000)of Division 3 of the Business&Professions YEARS 2600 SF
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:$9500
permit is issued.
APPLICANT CERTIFICATION APN Number:35906006.00 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,
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,t applicant understands and will comply 180 DA ROM LAST CALLED INSPECTION.
with all non-point source regulation er the upertino Municipal Code,Section
9.18.
Issued by: l Date:
Signature / Date
r-
LJ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All root:shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installec without first obtaining anins ti ,I a ,.
ategve all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection. l
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signatui a of Applican /' / Date:
I,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:
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 have read the hazardous materials 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. 1 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&
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.
Additio rally,should I use equipment or devices which emit hazardous air
permit is issued. contain nants 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 Health.3: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 authorised aIyu ge
forthwith comply with such provisions or this permit shall be deemed revoked. Date:.? i CD
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 relating 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
•mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
s,and expenses which may accrue against said City in consequence of the
granting of this permit.Additio Ily,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point soumCre tions-per a Cupertino Municipal Code,Section
9.18. 1 unders and my plans shall be used as public records.
Signature/' Date-1� � License]Professional
G�
CITY OF
CITY OF CUP:ERTINO
REROOF
CUPERTINO PERMIT APPLICATION
APN # Date:
Building Address:
,e_ 4 v-� C
Owner's Name: �-�1J � Phone #:
HOA: Yes ] No ❑ If es, rovide letter fra m HOA - to IL
C� r
Contractor: e� P c�o` r`-' (r- Phone #: a �• 6 S
Fax#: 2S' 1 - 12
Cupertino Business License #: Contractor License #:
Type of Roof C c)vering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
V Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings Provide I.C.C.E.S. Report#
be"'To be Removed ❑ Provide Mfgr. Installation Specs.
�,,� r✓ o acr( aS t
Job Description: vjsj�z coc)v-
Residential - Commercial
Green Building: Please complete relevant portion cif 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 index.
Valuation 6'S o_o
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Revised 02/05/09
CITY OF CUPI:RTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 4qA C-4- TDA`rE: REVIEWED BY: GS
APN: a-0 l 0(0 BP#: U)Rccl� s "VALUATION: 1$9,500
R'PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Du lex TOTAL APPLICATION
USE: P IROOFAREA: 2,600 S f TYPE: OLREROOF
�4a
00
3U
FEE ID
1 REROOFFRE,c•
FT71
NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Hee Resolution 09-1151,F f.' 7.1:7)9) FEE Q'rY/FEE MISC ITEMS
Permit Fee: $338.00
ikIf �'.
Work Without Permit? Q Yes (F) No $0.00
rlirit,` V( l, .
Strong Motion Fee: 1BSEISMICR $0.95 Select an Administrative Item
Bldg, Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $339.95 $0.00 TOTAL FEE: $339.95
Revised: 7/27/2010
CITY OF CUPERTI:JO
PERMIT RECEIPT' OPERATOR: Traci(
4 ITEMS OF 4
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35906006 .( 0
DATE ISSUED. • 08/03/2010BS0000110 )9
RECEIPT #. . . . . . . . . . 10080025
REFERENCE ID # • •
SITE ADDRESS
921 SAGE -_T
SUBDIVISION • • • . . CUPERTINC
CITY . . . . . . . . . . . .
IMPACT AREA . • • • • •
OWNER . . . . . . . . . . . . MAN
WNERMAN FU & ALICE YANG
ADDRESS 921 SAGE CT
CITY/STATE/ZIP CUPERTINC), CA 95014
RECEIVED FROM
CHARLIE :)UONG
• ' CHARLIE OUONG LIC # 28245
CONTRACTOR • " ' CD ROOFING
COMPANY 2909 WILBUR AVE
ADDRESS . . : SAN JOSE, CA 95127
CITY/STATE/ZIP (408) 898-6605
TELEPHONE . . . . . . . •
UNIT QUANTITY AMOUNT' PD-TO-DT -THIS-REC_
--NEW-BAL-
FEE ID ----- ---
------ -00 1.00
_____ ---------- ---------- 0 .00 0 .00
0 .00
VALUATION 9, 500 . 00 :_.00 0 . 00 4. 00
1BCBSC 9, 500 . 00 114 . 00 0 .00
1BSEISMICR VALUATION 1.00 11.1 . 00 0 .00 0 .00
1BUSLIC FLAT RATE 0 .00 -338_00 ----------
26 . 00 333 .00
1REROOFRES SQ FEET ----
45 4 .00--- ------0 .00 ---
- 454 .00 0 .00
45
TOTAL PERMIT :
AMOUNT REFERENCE NUMBER
METHOD OF PAYMENT ---------
-------------
--------- --
454 .00 979285
CREDIT CARD --------
454 . 00
TOTAL RECEIPT VOICE ID DESCRIPTION
__
_ ____
VOICE ID DESCRIPTION __ _ ----------------------
_ ___ --------- 602
----- -_ ROOF PLYWOOD NAI
601 ROOF TEAR OFF
605 FINAL REROOF
604 ROOF IN-PROGRESS
MLU 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•buildingc9cugertino.orq
4PN#
PROJECT ADDRESS
PHONE E-MAIL
OWNER NAME q
A ` `
CITY, STATE,ZIP FAX
STREET ADDRESS 7]
G{ ,&0
CONTRACTOR NAME
LICENSE NUMBER LICENSE TYPE BUS.LIC.#
O i.� C/
E-MAIL � FAX
COMPANY NAME - ` �( L4 O
S2 oj�
co 'D 1' ~ "��'
PHONE
CITY,STATZIP
rS�;TRADDRESS ,�oE,E, S CZ 3C C71 (gyp O
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable prc 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)777-32 '8 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please call for t,-ar-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and all 4iry-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 — 10:3(am 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 .s 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 cbtaining all inspections and written approvals
from the building inspector. Any roofing which is apflied without first obtaining an approved inspection
will require the removal of all new material down to tl e 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 itl.ms will be verified:
a. Flat roofs shall have a minimum of per foot oi'slope and must demonstrate there is no ponding.
b. Listings from approved testing agencies for all pr,;-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 i lspection 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 folio g is._tn e am the property owner or authorized agent to act
on the property owner's behalf I and nd a e to cc y with the re-roof policy stated above.
Signature of Applicant/A _- -,_ Date:
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 RTI N O Fax: 408-777-3333
CONTRACTOR / SUBCDNTRACTOR LIST
JOB ADDRESS: q2t �'fi C -� PERMIT# / D 20 Z
OWNER'S NAME: �j �c PHONE# L-Q 0 6 --7 ) q ,
GENERAL CONTRACTOR: Kf 1 BUSINESS LICENSE #
ADDRESS: pCITY/ZIPCODE:
*Our municipal code requires all businesses working in the c ty 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 SUBCONTRA j�4�11S HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signer a Date
Please check applicable subcontractors and complete th 2 following information:
SUBCONTRACTOR BUSINESS NikME 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