10080136 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10575 GLENVIEW AVE CON'T'RACTOR:R E ROOFING& PERMIT NO: 10080136
CONSTRUCTION INC
OWNER'S NAME: EUGEN KIM 15230 CLYDELLE AVE DATE ISSUED:08/20/2010
ER'S PHONE: SAN JOSE,CA 95032 PHONE NO:(408)626-9320
LICENSED CONTRACTOR'S DECLARATION JOB I IESCRIPTION: RESIDENTIAL COMMERCIAL
r RE-ROOF 25 SQUARES REMOVE EXISTING 1 LAYER OF
License Class Lic.#
WOOD
ContractorDate u (J SHINGLES,INSTALL NEW 1/2" CDX 30#FELT
I her, rrm that Lam 1 Tensed under the provisions of Chapter 9
*wmihencingwtth 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.F Floor Area: Valuation:$12000
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 APN Number:36926020.00 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,
I costs,and expenses which may accrue against said City in consequence of the Issued b Date:
granting of this permit. Additionally,the applicant understands and will comply 3'
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. RE-ROOFS:
Signaty Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
l �� ithout first obtaining an inspection,I agree to remove all new materials for
inspection. _ Cy
a OCVNER-BUILDER DECLARATION '
G�
SigmAur4ofApp"c e:
I hereby affirm that I am exempt from the Contractor's License La for one of
the following two reasons: ,, AL1L, OOF COVERINGS TO BE CLASS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compeitsation, "
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I ha,,e read the hazardous materials requirements under Chapter 6.95 of the
Cali'ornia Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three main twin compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's matt rial. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air tori6a s as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain co liance with�� upe o Municipal Code,Chapte 9.12 alnd
I have and will maintain Worker's Compensation Insurance,as provided for by
the health afe pns 5505, 533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Ow�,er o authorize a t: J Date !v
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 CONSTRUCTION LENDING AGENCY
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 I hei eby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. wort's for which this permit is issued(Sec.3097,Civ C.)
Len Ier's Name
APPLICANT CERTIFICATION Len ier'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
T upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
'emnify and keep harmless the City of Cupertino against liabilities,judgments,
.s,and expenses which may accrue against said City in consequence of the I un Jerstand my plans shall be used as public records.
E,anting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licc nsed Professional
9.18,
Signature Date
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION
APN # ✓z Date:
(Q cf .2-(D 0�O . 6� S (Zv lu
Building Address: /
V 1 L1n/
Owner's Name: --e 11,
HOA: Yes ❑ No If yes provide letter fr[)m HOA C(Yti)
Contractor: �. � I\j '., C.L` Phone #:
�\,JC Fax #: 40�
Cupertino Business License #: � Contractor License #:
— -Z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles � sphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings I ❑ Provide I.C.C.E.S. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: G/f v sl? S i ► i (V- 5
'12-
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: ti
1 2, c) v v . I
I HavZA,ead, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
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•buildingc�cupertino.orq
PROJECT ADDRESS L2, I T1 V,L/1„ 4PN#
OWNERNAME �./Il./CJ��+ �/1'v �PH�O�NEE Ael E-MAIL
�u -� �"-
STREET ADDRESS�,� UI �` �,./S_I /kms.i ' CITY, 'S4T IP,� y I A,-) FAX
CONTRACTOR NAM> ,/ �•, LICENSE NUMBER 'I 2� LICENS TY Fj•_ BUS.LIC.#
C
COMPANY NAME 5 / U�� 5n1LU"L��1J �iC ` E-MAIL _� FAX
STREET ADDRESS ZI Z, 1 ''J��{ ( '1�` p CITY,STATE,ZIPS i PHONE
�I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code.
2. You must schedule all needed inspections a minimum c 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 tear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and all c ry-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 — 10:30 im and 1:00—3:30pm (Mon—Thurs);
7:30 — 10:30 im and 1:00—2:30pm (Friday).
4. If plywood is installed, a plywood nailing inspection Ii required.
5. In-Progress roof inspection is required. Call for an i i-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 the sheathing so a proper inspection can be
performed.
7. A final inspection and approval shall be obtained from :he 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 per foot of ;lope 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 in;pection 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 cert' each of the following is true: I am the property owner or authorized agent to act
on the property owner's behalf unrrstand an agrpc� ly with the re-roof policy stat`d above.
l ,
Signature of Applicit/Agent: �—/ Date: �� t
Reroo olicy_2010.doc revised 05/17/10
A.In oar Air QuaI4 and Finishes
wo
1 IAQ/He Oth pts yeses 0
2.Use Low VOC,Water-Based Wood Fnishes 2 IAQ/He in pts y--yes 0
_ 3 IAQ/He Oth pts y--yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resour.-e pts y--yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
B.Use Exterior Grade Plywood.for Interior Uses 1 IAQ/Health pts y--yes 0
- 41AQ/Health. pts y--yes 0
B.Use FSC Certified Materials for Hari or Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/H,;alth pts y-yes 0
N.Flaoring
1.Select FSC Certified Wood Mooring_ _ - B Resourc a pts Y--yes 0-— --— ——
2 the. 1�er�e�l_e�]oortxg 4 Resourc a pts y=yes 0
".
3.Use Recycled Content Ceramic Tiles 4 Resourc a pts y--yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/He filth 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
1 i 1
Total Points Avails le: 1 140 1301 57
Total Points Project Received: 01 0 0
G:da#alprogslgreenbwldinggu derines/remodelereJgreenpointgna121204protectedx1s
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: `VALUATION: 1$12,000
R��PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex �t{11<tL PENTAMATION 1SFDWLR00F
USE: 1 t C)t 11Z.t h f,t: PERMIT TYPE:
WORK
SCOPE
FEE ID ROOF ARES►
s.f.
1REROOFFRES 2,500
17,
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info.
FEE ITEMS (1W Resolution 09-051 Eff. 7/1/'10) FEE QTY/FEE MISC ITEMS
Phi)" C,11ec;1 /"ec:
Supp,[ PC'f-c>c,
1/wnh. Flec 'lair C`hcc1:
Permit Fee: $325.00
suppt, lash `(."c
Phljnh. l lc� b. Ffc:t: t 17iz f t"C'
Phfnih "Ilcr h 1�let' Pcrlm! F'cc:
,It r>td.5/tcxtl ict'/c1t.
Work Without Permit? 0 Yes 0 No $0.00
I;W� Cf` FCC's'_
I
Strong Motion Fee: IBSEISMICR $1.20 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC 1 $1.001 1
SUBTOTALS $327.201 $0.00 TOTAL FEE: $327.20
Revised: 8/17/2010
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: 10 I V PERMIT#
OWNER'S NAME: L i1J lM PHONE# LA(XJ- 2(0 - �2
GENERAL CONTRACTO G% Rojf, jh/ BUSINESS LICENSE# 2
ADDRESS: I X72-7c) IL�� CITY/ZIPCODE: U
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSP-CTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CI Y OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontgactors: �� t `�
,:
Sigh tute Date
Please check applicable subcontractocomplete th 2 following information:
V SUBCONTRACTOR BUSINESS NE\ME 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