13080203 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18856 ARATA WAY CONTRACTOR:STONERIDGE ROOFING PERMIT NO: 13080203
OWNER'S NAME: KIMOON KIM&CHO MIN KYUNG 1672 RIDGETREE WAY DATE ISSUED:08/27/2013
OWNER'S PHONE: 4086904102 SAN JOSE,CA 95132 PHONE NO:(408)729-5101
Q____ LICENSED CONTRACTOR'S DECgLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
License Class_ Lie.# �S�5 S RE-ROOF 18 SQ,TEAR OFF,WOOD SHAKES,OSB CLASS
Contractor DA Jc !� Date a:�9� '[ A
I hereby affirm that I am ficensed under the provisions of Chapter 9
(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:$8800
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:37513007.00 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 WITHIN0 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 DOM LAST CALLED INSP CTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the 27
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
r .
9.18.
RE-ROOFS:
Signature �D � Date — J All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION ,;19 �� �' t
Signature of Applicant:�� � ����' Date: 2I
I hereby affirm that I am exempt from the Contractor's License Law for one of 1.11
the following two reasons: ALL ROOF COVERINGS TO 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 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain 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 material. 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. .. will 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 WZ5 Dater 2_ - ,7
permit is issued. 101
Owner or authorized agent/ 41e
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 CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender'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
upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand 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 PERMIT APPLICATION �t7
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 4V
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (gyp
(408)777-3228•FAX(408)777-3333•building(Dcupertino.org V
CUPERTIINO. 0
PROJECT ADDRESS /
Gc,
OWNER NAME ZI i PHONE ` 90 IQ EMAIL
STREET ADDRESS ZIP FAX
__7CONTACT NAME PHONE E-MA1L
STREET ADDRESS / CrrY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT E CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.#
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Inr I J
COMPANY NAME - E-MAIL FAX
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STREET ADDRESS, Ge i CITY,STATE,ZIP O Ln
CA J 1 3/ PHONE_ ?
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: //��
STRUCTURE: El Commercial Q (J
EXISTING ROOF TYPE: BUILT-UP ROOF ASPHALT SHINGLES ElWOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE eYES IF NO, PLYWOOD 0 ,/." ❑ PLYWD [IOSB PITCH: ROOF
❑NO #LAYERS: THICKNESS: 135/8" TYPE: 11CDX _'12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF yA ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER�rLQ_ ICC-ES REPORT it
DESCRIPTION OF WORK:
/ i c. CAMP.
y- /a.v t 6z&f mof6z& o =v l l,�e ynefnkoILC
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identifiedpropertyfor inspection purposes.
LS `
Signature of Applicant/Agent: Date: �
SUPPLEMENTAL INFORMATION REQUIRED r P. I, si olvL
_If building is associated with a Home Owner's Association,provide letter �M 11011 11 XIi,
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupertino's Tear-Off Policy. oT
.. ,�..... 'iia. .. � .... .,.
ReroofApp_2011.doc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 18856 ARATA WAY DATE: 08/27/2013 REVIEWED BY: MENDEZ
APN: I BP#: "VALUATION: 1$8,800
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF
USE: P PERMIT TYPE:
WORK RE-ROOF 18 SQ TEAR OFF WOOD SHAKES OSB CLASS A
SCOPE
FEE H) ROOF AREA
s.f.
1 REROOFFRES 1,800
M ..m.-
Mech. Plan('heck Phuub. Plurt Check- Elea..Pltrn('heck
k1ech.Permit Fee: Plumb.Permit Fire: Elec, Permit Fee:
FC)iher Hech.lava. Other Plumb Insp. Other r Elec.Insp.
Alech.Insp.Fee: Plumb. hisp. Fee: Elec.Insp, Fee:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS(Fee Resolution 11-053 E . 7( /f 1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Plut bAllech./IEec
Permit Fee: $288.00
Suppl. Insp Fee
Plumb.iMech./Llec
Plumb./Mech.11ec Permit Fee:
("Onswuciion :Tar:
r)dministrative.Fee:
Work Without Permit? ® Yes (E) No $0.00
,ldvanced Planning Fees:
Travel Documentation Fees:
Strong Motion.Fee: IBSEISMICR $0.88 Select an Administrative Item
Bldiz Stds Commission Fee: 1BCBSC $1.00
01 MA
$289.88 $0.00 . TOS F � $289.88
Revised: 07/01/2013
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•building(a.cupertino.org
PROJECT ADDRESS APN#
/oAsc Aro,h&
OWNER NAME PHONE E-MAIL
STREET ADDRESS �` CITY, STATE,ZIP U �, och FAX
CONTRACTOR NAME , Z LICENSE NUMBER p LICENSE TYPE BUS.LIC.#
COMPANY NAME C �v E-MAIL FAX
J /
STREET ADDRESS �t CITY,STATE,ZIPG � PHONEyg C1
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to one business day before the requested inspection date.
Please call (408) 777-3228 from 7:30-3:30pm(Mon-Thurs) or 7:30-2:30pm(Friday)to schedule
inspection. For Tear-Off and Nailing Inspections,you must also call on the day of the inspection only
after that phase of the work is completed. The building inspector will be available within one hour.
Final Inspections will be given a two hour window.
3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either
completely knocked-down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofing shall not be applied without first obtaining all prior inspection 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.
6. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is
completed. To receive a final sign-off,the following items will be verified:
a. Flat roofs shall have a minimum of I/4"per foot of slope and 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,vents painted, gutter/downspouts installed, debris removed.
7. 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. 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 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential ode. c� *�
Signature of Applicant/Agent: p�7 Date: iG _�? s
ReroofPo1icy_2012.doc revised 10/7/12