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09120093 (2) CITY OF CUPERTIN O BUILDING PERMIT BUILDING ADDRESS: 11220 TERRA BELLA DR CONTRACTOR:YUH-SHENG TSUEI PERMIT NO:09120093 OWNER'S NAME: YUH-SHENG TSUEI 1220 TERRA BELL DR DATE ISSUED: 12/15/2009 NER'S PHONE: 4088321245 CUPERTINO,CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION 3UILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# MECH f— RESIDENTIAL� COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 IOB DESCRIPTION:RE-ROOF TO CHANGE THE OLD ROOF TO 40 YEARS (commencing with Section 7000)of Division 3 of the Business&Professions 'OMPOSITION CLASS A 20SQ 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 pen-nit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by iq,Ft Floor Area: Valuation:$4500 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. CPN Number:35621007.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 - Issued by r' - — Date- —/S7—C1 Signature Date_71 JI ��y OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant: Date: Business&Professions Code) 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 1 hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety 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 contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized agent; 1pd become subject to the Worker's Compensation provisions of the Labor Code,I must '� g _Date: I r forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a constriction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address i lify and keep harmless the City of Cupertino against liabilities,judgments, cc- ,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. ` ( -) Licensed Professional llT� Signature Date aM_ CITY OF CUPERTINO RE ROOF CUPEkTINO PERMIT APPLICATION APN # Date: Building Address: v Te rrCk r-f �c; C- cc /�� v ?�'1 l / ` Ll Owner's Name: ,}.- S �� ) -�5 Lk_ U ` Phone #: HOA: Yes ❑ No [0 If Yes, provide leiter from HOA Contractor: Phone #: i/w we ✓ i - ✓' Fax #: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles )< Asphalt Shingles Wood Shakes ❑ Wood Shakes '❑ Wood Shingles ❑ Wood Shingles o Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: le-1 i f7s, >�c� "�,��� 19 G G rs Cc �oS, o� � � 2-© 43G f 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 index. Valuation: I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature' Revised 02/05/09 CITY OF CUPERTINO a R.ER.00F CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Stindards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1REROOFRES Re-roof Re:idential B 1SFDWLR00F 2� 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES l Commission Fee / 1BSEISMICRE Seismic Residential B 1 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Stindards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1 BUSLIC Business Li Sense B Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the buildvlg inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the Ciy,the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed,a plywood nail inspection is required. 6. Any roofing which is applied withoul�first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/ " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be ori the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: Job Site Address: Roofing Company Name: Ot,y/ern 6UC")2d,:�-✓' t � l Applicant's Signature: Date: (S Greg Casteel - Building Official Revised 07/30/08 OWNER-BUILDER VERIFICATION 1. (Check one) I or my immediate family (p gent,spouse or child) will perform: A. V All the work authorized by this permit B. _ A portion of the work C. _ None of the work If B or C is checked,complete 2 or 3 below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. _ A portion of the work (complete section below) Contractor Address/City Phone # State License # Type of work to be performed 3. _ I will utilize unlicensed person(s) odter than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City Phone Number Type of work to be performed ..................................................................................................................................................................................... I declare under penalty of perjury that the abo-v a is true and correct. I have read and understand the Owner-Builder Information(reverse side). Property Owner's Signature: Date: r J � ( Job Address: ( Zai err:.. (D Y z ��� Permit# 2vv Any changes to the information provided on this form shall be submitted to the City of Cupertino Build Department. INSPECTION WORK LOG - ONE PER PAGE DETAIL FORMAT ��� PAGE-001 PRINTED ON 03/23/10 PERMIT NUMBER: 09120093 11220 TERRA BELLA DR CUPERTINO PERMIT TYPE: 1SFDWLROOF SINGLE FAMILY DWELLING RE-ROOF USAGE CLASS: N/A NON APPLICABLE SPECIAL :RE-ROOF TO CHANGE THE OLD ROOF TO 40 YEARS PERMIT :COMPOSI'T'ION CLASS A 20SQ**SEE NOTES** CONDITIONS: AND NOTES : PARCEL ID: 35621007.00 LOT: BLOCK: SUBDIVISION: OWNER NAME: YUH-SHENG TSUEI OWNER ADDRESS: 11220 TERRA BELL DF. CONTRACTOR ID: OWNER CONTRACTOR NAME: YUH-SHENG TSUEI CONTRACTOR PHONE: * NOT ON FILE * INSPECTION TYPE: 604 ROOF IY-PROGRESS INSPECTION AREA: SCHED DATE: 02/19/10 INSPECT TIME: CONTACT INFO: INSPECTOR: BG GREGORY, BOB INSTRUCTIONS: A.M. PLS - 650-333- 8303 MIKE COMMENTS: INSPECTION NOTES: 02/19/10 PALM PILOT notes by GREGORY, BOB PAPER AND CLEARANCE AROUND CLASS B FLUE PIPE O,K, SHINGLES NOT ON JOB SITE IN EARLY A.M. RESULTS: PASS FAIL CANCEL RE-FEE FAIL CODE: NOTES: PRIOR INSPECTION RESULTS: 601 ROOF TEAR OFF 02/17/1.0 P JG 602 ROOF PLYWOOD NAIL 02/18/1.0 P JG 604 ROOF IN-PROGRESS 02/19/3.0 I. BG 604 ROOF IN-PROGRESS 02/18/2.0 C JG i TEMPORARY CERTIFICATE OF OCCUPANCY FORM RMENT--DEPARFMEf4T—BtffLDfNB DiViS-iDN - 10300 TORRE AVENUE•CUPERTINO CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333• )uiidinoCcupertino.org APNL5 /—"/_an� SITE (� DATE G/ / ADDRESS: OWNE 'S NAME: PHONE Ls e �'U�`.i FAX#: MAILING ADDRESS if differentf{{om site address): TerYa C_ UY. C_'t -*—A7 CONTRAC OR: 11017 rHONE#: &,.j'0-.3.3__;3-9303 FAX#: CONTACT: PHONE#: FAX#: TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION TYPE OF Q SURETY BOND AMOUNT OF / � TCO FEE: BOND: CASH BOND BOND: $// Uo $253.00 SPRINKLER SPRINKLERS BU LDING TCO EXPIRATION REQD?: INSTALLED?: CCDE EDITION: DATE 30 DAYS): PURPOSE OF REQUEST/APPRO,X.TIMELINE OF PROJECT COMPLETION: r r DESCRIPTION OF BUILDING USE AND AREA(S) FOR--HIS CERTIFICATE: USE TYPE OF FLOOR OCC LEVEL COMMENT CONSTR AREA LOAD Cb MONS OF COMPLETION: C� U6✓/f TI" /w172 <<seLs; TEMPORARY CERTIFICATE OF OCCUPANCY PROCEDURE f!)EPAFTMENT-13UrLDtt4G--oIVrsrON 10300 TORRE AVENUE•CUPERTINC, CA 95014-3255 CUPERTINO (408) 777-3228•FAX(408)777-3333•building@cupertino.org BACKGROUND The Building Division's policy and procedure on considering and approving requests for Temporary Certificate of Occupancy (TCC)) for a portion of a building is as follows: The authority for the Building Official to issue a TCO for a portion of a building prior to its full completion is authorized by the California Building Code Section 110.3, which states in pertinent part: `The building official is authorized to issuo a temporary certificate of occupancy before the completion of the entire work covered by the permit, provided that such portion or portions shall be occupied safely. The bu,lding official shall set a time period during which the temporary certificate of occupa-7cy is valid." This Temporary Certificate of Occupancy applies to all occupancy classifications including single family residences, and m ist be requested in writing by the owner of the property through a TCO application form. If approved, an owner will be permitted to make use of any specific portion or all of heir facility for a 30 day period while completing the remaining construction we rk. (If additional temporary occupancy is needed beyond the first 30 days, an additional $253 will be required per 30 day period.) The City of Cupertino can authorize a Temporary Certificate of Occupancy on a case- by-case basis, using the following standa-ds: • All construction activity will be completed in the immediate vicinity of the area proposed for occupancy including activity overhead and access to and egress from the area. All construction activity above ingress and egress must be complete. • All life safety aspects of construction are complete in the immediate vicinity of the area proposed for occupancy sucf as fire protection, fire prevention, fire alarms, means of egress, emergency lighting, emergency vehicle access and similar safety features. • Electrical work must be complete or at the very least, covered in the immediate vicinity of the area proposed for occupancy. • Sanitary facilities are complete serving the area proposed for occupancy. • Heating and cooling facilities are cDmplete in the immediate vicinity of the area proposed for occupancy. • There is an accessible path of travel to every area proposed for occupancy. • A $253 fee is submitted to the Building Construction Services Division for each request for a Temporary Certificato of Occupancy. - Except unusual circumstances deemed by the Building Official. - Multi-unit buildings such as apartments or office space with separate addresses or permit numbers will be regarded as a single project for the purposes of a Temporary Certill icate of Occupancy. TempOccProc_2010.doc revised 03/24/10 PROCEDURE 1 . Temporary Certificate of Occupancy application forms must be submitting to the Building Division 48 hours in advance. Applications can also be found at the permit counter. 2. All final trade and Certificate of Occupancy inspections must be conducted and approved for a Temporary Certificate cf Occupancy at least two working days prior to the issuance of a Temporary Certificate of Occupancy. 3. The applicant shall indicate why tempc rary occupancy is needed and the expected time period to complete the remaining items. The Inspection Supervisor and the appropriate inspector(s) will review the request and, based on the inspection report and correction list identified in the final inspections, determine if a Temporary Certificate of Occupancy may be issued. The applicant will be notified should additional items need to be completed before a Temporary Certificate of Occupancy may be issued. When those items are completed and firm dates are established for completion of all items the Temporary Certificate of Occupancy may be issued. 4. Separate Cash Bond or Surety Bond is required for a Temporary Certificate of Occupancy. A separate cash or Performance bond is required for a Temporary Certificate of Occupancy. The amount of the cash bond is 1% of the valuation of the project. The minimum bond is $1,000 ,and the maximum $10,000. 5. All Special Inspections must be completed prior to the request. All Special Inspections must be completed and approved by the City of Cupertino prior to issuing a Temporary Certificate of Occupancy. 6. TCO fees will be charged. The Tem:)orary Certificate of Occupancy fee of $253.00 (per permit/address) is due at the time of the Temporary Certificate of Occupancy request. The fee includes the required initial inspection and one (1) re-inspection prior to the issuance of the final certificate of occupancy. 7. A Temporary Certificate of Occupancy will be issued for a period of 30 calendar days. If the applicant wishes to request an additional Temporary Certificate of Occupancy for an additional 30 days, the applicart will be required to make the request in writing and again pay re-inspection fees for the remaining required inspections. If the Temporary Certificate of Occupancy Expires, the bond may be forfeited and the non- compliance may result in an enforcerr ent action. Te77p0ccProc_2010.doc revised 03/24/10 CITY OF CUPERTINO RECEIPT--NUMBER BS1000-01Q023 RECEIVED BY: SUEW PAYOR: YUHSHENG E TSUEI TODAY'S DATE: 03/24/10 REGISTER DATE: 03/24/10 TIME: 16:00 2 REFUNDABLE DEPOSIT TEMP OCCUPliNCY BOND $1, 195.00 PLAN CHECK FEES TEMP OCCUPINCY APPL FEE $253 .00 ---------------- TOTAL DUE: $1,448 .00 CHECK $1, 195. 00 REF NUM: 2502 CHECK $253 . 00 REF NUM: 2503 TENDERED CHANGE $1,448 . 00 $.00