10070151 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10360 SCENIC BLVD CONTRACTOR:R A CONSTRUCTION PERMIT NO: 10070151
OWNER'S NAME: ADAM YAO 3851 R CHARTER PARK DR DATE ISSUED:07/21/2010
NER'S PHONE: 4088915769 SAN JOSE,CA 95136 PHONE NO:(408)559-1877
❑ LICENSED CONTRACTOR'S DECLARATION r- �
(� BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# 6 3 3% (_
"",,,,,,,,��7� 7 '7 MECH RESIDENTIAL COMMERCIAL
Contractor /`/ Ovry6L. Date C 'G-� l d
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF TEAR OFF SHAKE&INSTALL ASPHALT
(commencing with Section 7000)of Division 3 of the Business&Professions SHINGLE
Code and that my license is in full force and effect. OVER EXISTING PLYWOOD CLASS A 35SQ
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.
1 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:$14950
permit is issued.
APPLICANT CERTIFICATION APN Number:35708043.00 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,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulation r the Cupertino Municipal Code,Section
9.18.
Issued bp.: Date: -�
Signature Date
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby ffirm that I am exempt from the Contractor's License Law for one o'' 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: ( vv
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). AL 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 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.
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
become subject to the Worker's Compensation provisions of the Labor Code,I mus Owner or t1rtTP ed agent:
forthwith comply with such provisions or this permit shall be deemed revoked. Dater
APPLICANT CERTIFICATION / CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is d,1ieFeby 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
unnn the above mentioned property for inspection purposes.(We)agree to save
unify 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
9.18. I understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OE' CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: B7.k: Lot:
APN 3E,708043 . 00
DATE ISSUED. . . . . . . : 0"/21/2010
RECEIPT #. . . . . . . . . : BS000010934
REFERENCE ID # • • • 10070151
SITE ADDRESS . . . . . : 10360 SCENIC BLVD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER ADAM YAO
ADDRESS 10360 SCENIC BLVD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : R A CONSTRUCTION
CONTRACTOR . . . . . . . : ANDREWS, RON LIC # 21382
COMPANY R A CONSTRUCTION
ADDRESS 3351 R CHARTER PARK DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95136
TELEPHONE (-608) 559-1877
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 14, 950 . 00 1. 00 0 .00 1. 00 0 . 00
1REROOFRES SQ FEET 35. 00 455 . 00 0 . 00 455. 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 456 . 00 0 .00 456 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 456 . 00 VISA
---------------
TOTAL RECEIPT 456 . 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$14,950
%PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY TOTAL PPLICATION
USE: SFD or Duplex ROOF AREA: 3,500 S f71T,
YPE:
� a
O �
3 �
FEE ID
1REROOFFRES
t
NOTE. Theseees are based on the preliminary in ormatior available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 09-051 1't' 7iL'09) FEE QTY/FEE MISC ITEMS
Permit Fee: $455.00
iI't'C'P?. Th'{" 1`t'(':
Work Without Permit? Q Yes No : 0.00
Strong Motion Fee: IBSEISMICR 51.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC 51.00
SUBTOTALS: $4;57.50 $0.00 TOTAL FEE: $457.50
Revised: 6/30/2010
CITY OF
CITY OF CUPERTINO
III REROOF
CUPERTINO PERMIT APPLICATION
APN# x� / Date:
, L
'? 1 - 2- 1 l o
Building Address: 3� V!i5evLc 9L fo
Owner's Name: / y1f 0 Phone #: c7g1_5�6�
HOA: Yes ❑ No If Yes, provide leiter from HOA
Contractor: Phone #: SSIF /
/\ 1T e0_;1V-5 r, Fax#:
Cupertino Business License #: Contractor License.43
#:
3
Type of Roof 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: v ®�� s r�� ` �j�-C( s��?'�T S
ev64
Residential Commercial ❑
Green Building: Please complete relevant portion of the Con-firmed 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: Z,/.
I Have Read, Understand and Will Comply witt Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
M.Indoor Air Quality and Mnishes
1IAQ/Health pts yges p
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yea D
Si -•
- � -�.�� 3IAQMealth pts y=yes - p
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6IAQ/Health pts y=yes p
B.Use Exterior Grade Plywood.for Interior Uses 1 IAQ/Heab pts y=yes 0
41AQ/Health.pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D
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 p
N.Flooring
l.-Select FSC Certified Wood Flooring_- -B Resource pts y=yes D - -
- 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
S.install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
Total Points Availa le: 1 1401 1301 57
Total Points Project Received: 01 or----0j
G:data/progsJg Benbwldingguiderinesfromodelerstgreanpointsfina1212D4proreDted.xis
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPAFTMENT•BUILDING DIVISION
ALBERT SALVADOR,P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINC, CA 95014-3255
CUPERTINO
(408)777-3228•FAX(408)777-3333•building(dcupertino.org
PROJECT ADDRESS 0?/ jl�/1/ ���/� APN#
OWNER NAME J b (t//v` \ PHHC NE ( E-MAIL c J
STREET ADDRESS `G CITY, S"ATE,ZIP FAX
v
CONTRACTOR NAME 4 f'^ LICEN NUMBER LICENSE TYPE BUS.LIC#
(If
COMPANY NAME Q v ' / E-MAIL FAX
STREET ADDRESS �f �/V I� CITY,STATE ZIP PHONE _ Jif
dl I UNDERSTAND AND .GREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicz ble 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)"77-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please c<<ll for tear-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 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-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 obtaining all inspections and written approvals
from the building inspector. Any roofing whicl is applied without first obtaining an approved inspection
will require the removal of all new material doyen 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'/4"per foot of slope and must demonstrate there is no ponding.
b. Listings from approved testing agencies foi 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 understandand agree to comply with the re-roof policy stated above.
_L
Signature of Applicant/Agent: — Date: 1-1 D
ReroofPolicy_2010.doc revised 05/17/10