10060093 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11205 MOUNT CREST PL CC NTRACTOR: E PERMIT NO: 10060093
rte;ED�JSk-_L r
OWNER'S NAME: GARY YUNG 'Li 125 !s7o g DATE ISSUED:06/16/2010
XNER'S PHONE: 4088921850 �S S Gbr-7PHONE NO:
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIALD
License Class Lie.#��j 7 2Z R E-ROOF REMOVE EXISTING CLAY TILE ROOF 2 PC
EXISTING ROOF DECK INTACT,INSTALL NEW CLAY
Contractors're-3 f IL—Date,, /�O TILE
1 hereby affirm that I am licensed under the provisions of Chapter 9 32 SQUARES
(commencing with Section 7000)of Division 3 of the Business&Professions
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. Sq.Ft Floor Area: Valuation:$42000
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 APN Number:35626005.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
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 Issued by:` � Date:
with all non-point source regulations per the Cupertino Municipal Code,Section _
9.18.
RE-ROOFS:
Signat /.-,4� Date G All roofs shall be inspected prior to any roofing material being installed. If a roof is
insi alled without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Sig iature of Applica Date j:g
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL R OF ERINGS O BE CLASS"A"OR BETTER
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,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I hive read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three ma ntain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's ma serial. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. wil maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent. 1,e— Dat
permit is issued. �T
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 CO UCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I he reby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. woi k's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lei der's Address
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
unon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
nnify and keep harmless the City of Cupertino against liabilities,judgments,
.s,and expenses which may accrue against said City in consequence of the I ur derstand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMEN.-• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE -CUPERTINO, CA 9`.')014-3255
CUPERTINQ
(408)777-3228• FAX(408)777-3333•buildina(a�cupertino.org
PROJECT ADDRESS )f ze56 •��'�� rt APN#
OWNER NAME // �-�L/ PHO EE-MAIL
e, � �le,* ne,66_�i� - J"- -C h
STREET ADDRES CITY, E,ZIP FAX
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CONTRA OR NAME LICENSE`NUMBER LICEN E TYPE BUS.LIC.#
COMP NAME E-MAIL + H F r
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•
STRET D C�Ty.STATE,ZIP^ PHONE
? or
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable p:-ovisions 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)777-3:?28 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and al: 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: Oam and 1:00-3:30pm(Mon-Thurs);
7:30 - 10::�0am 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 ar.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 which is applied without first obtaining an approved inspection
will require the removal of all new material down to i he sheathing so a proper inspection can be
performed.
7. A final inspection and approval shall be obtained froin 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 c-f 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-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
)n the property owner's be I understa=1eeomply with the re-roof policy stated above.
Signature of Applicant/Ag �atett► '�¢=�
RerooJPolicy_2010.doc revised 05/17/10
CITY OF CUPERTINO
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN 35626005 . 00
DATE ISSUED. . . . . . . : 06/16/2010
RECEIPT #. . . . . . . . . BS000010640
REFERENCE ID # 10060C93
SITE ADDRESS . . . . . : 11205 MOUNT CREST PL
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER GARY SUNG
ADDRESS 11205 MOUNT CREST PL
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-0047
RECEIVED FROM . . . . : BONSAI. BUILDER CONS
CONTRACTOR TBD - TO BE DETERMINED LIC # 00096
COMPANY TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . :
TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---- ------ ---------- --
1BCBSC VALUATION 42, 000 . 00 2 . 00 0 . 00 2 . 00 0 . 00
1BSEISMICR VALUATION 42, 000 . 00 4 .20 0 . 00 4 .20 0 . 00
1BUSLIC FLAT RATE 1 . 00 114 . 00 0 . 00 114 . 00 0 . 00
1REROOFRES SQ FEET 32 . 00 416 . 00 0 . 00 416 . 00 0 . 00
---- ------ ---------- ---------- ----------
TOTAL PERMIT 536 .20 0 . 00 536 .20 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- - -------------------
CHECK 536 .20 12173
---------------
TOTAL RECEIPT 536 .20
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- -----------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APP]-ICATION
IMOO 0
APN# Date:
Building Address:
Owner's Name: � 3►r� r c,��j� Phone #:
HOA: Yes ❑ No es, provide.letter from HOA
Contractor: Phone #:
Fax#: -
Cupertino Business License #: Contractor License #:
.5'
Type of Roof Lovering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles o Asphalt Shingles
❑ Wood Shakes o Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) C ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Refort#
a To be Removed o Provide Mfg. Installation Specs.
• 2 �
Job Description: \GSS —
�� S24
Commercial
Residential
❑
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 index.
Valuation:
I Have Read, Understand and ill Comply with Cupertino's Tear-Off Policy:
stature -`
Revised 02/05/09
CITY OF
CITY OF CUPERTINO
13 REROOF
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLR00F
1 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1 1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Mult:-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission'-Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
INPUT Rescxces Energy !
M.Indoor Air Quality and Finishes
1.Use LowNo-VOC Paint 1 IAQ Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ'Health pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAQ'Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AG'Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAG Mealth pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAC/Health. pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Re:ource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Re:ource pts y=yes 0
10.Install Whole House Vacuum System 3 IA(11Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 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
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1 b
Total Points Available: 1 1401 130 57
Total Points Project Received: 0 0 0
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