13100200 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10122 BERKSHIRE CT CONTRACTOR:WING'S ROOFING INC PERMIT NO:13100200
OWNER'S NAME: LIN HANN P AND SHEAU P
3243 SYDNEY WAY DATE ISSUED: 10/29/2013
OWNER'S PHONE: 4082128188
GASTRO VALLEY,CA 94546 PHONE NO:(510)889-9068
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
# -'�
C i� Lic. ��
RE-ROOF 24 SQ-TEAR OFF,INSTALL ASPHALT
License Class n SHINGLES
r
Contractor rL Date CLASS A
I hereby affirm that am licensed 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 S Ft Floor Area: Valuation:$8900
performance of the work for which this permit is issued. q
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:34212108.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and sate that the above information is PERMIT EXPIRES IF WORK IS NOT STARTS
correct.I agree to comply with all city and county ordinances and sate 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 DAY FROM LAST CALLED INSP�E�C O
ION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, �
costs,and expenses which may accrue against said City in consequence of the Issued by: Date:
granting of this permit. Additionally,the applicant understands and will comply
with all non-point soukce regulations per the Cupertino Municipal Code,Section
41
9.18. 2 RE-ROOFS:
Signature Date ? 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.
11OWNER-BUILDER DECLARATION Signature of Applicant: pate: b'
I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERING TO BE CLASS", OR BETTER
the following two reasons:
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) HAZARDOUS MATERIALS DISCLOSURE
I,as owner of the property,am exclusively contracting with licensed contractors to Chapter
construct the project(Sec.7044,Business&Professions Code). I read the h
have
Health&Safety Code,azardous Sections 25505525533r and 25534.9I wi'he
al Code,
er 9.12
I hereby affirm under penalty of perjury one of the following three maintaHealth'&Safety Code,Section 5532(a)should In compliance with the Cupertino store or handle thazardou d the
declarations:
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 strict I
will m contaminants in ain omplia ce with he Cupertino Municipalas defined by the Bay Area Air niCode, hapter 9Management ,12 and
performance of the work for which this permit is issued. the Health&Safety Code,Sections 25505,25533,and 25534.
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 Owner or authorized agent: - Date J
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
at become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby
foaffirm
fir ch this permit isere is a �ssued(Secnstruction!3097 CrveC�for the performance of
th
forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Name
APPLICANTEC RTIFICATION Lender's Address
I certify that I have read this application and sate that the above information is
correct.I agree to comply with all city and county ordinances and sate laws relating
to building construction,and hereby authorize representatives of this city to enter ARCHITECT'S DECLARATION
upon the above mentioned property for inspection purposes.(We)agree to save
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 �(J
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �V
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildingQcugeqLg grq el
CUPERTINO \ /h
PROJECT ADDRESS
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OWNERNAME MAIL4v( , � �I/ J � PHONE v f�'1�Gf'1(i
_ (' (�?� CITY, STATE,ZIP^ FAX
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STREET ADDRESS �Z� / � �• GGG `�lNy �--�
CONTACT NAME PHONE E-MAIL
STREET ADDRESS CITY,STATE, ZIP FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBER (' LICENSE TYPO BUS.LIC.#
COMPANY NAME ` l� A•I E-MAIL 2� FAX
STREET ADDRESS ->� ' CITY,STATE,ZIP ! _ �� PHONE
ARCHECT/ENGINEER NAME ICENSE NUMBER U~LIC.#
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COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF, C4J'/ VALUATION:
STRUCTURE: ❑ Commercial v c 4 v
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE ❑YES IF NO, PLYWOOD ❑ %i' ❑ PLYWD ❑ OSB PITCH: tt ROOF
❑NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX '12 CLASS:
- ICC-ES REPORT
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ElWOOD SHAKES 13WOOD SHINGLES ❑OTHER
DESCRIPTION OF WORK J /J lfV v U� I'r��l/ 1A S
Lai: /,aG , 's A 1114
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 av pro {led 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 relatin o it onstruction. I authorize representatives of Cupertino to enter the OV_ entified operty for inspection purposes.
•b �
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED ,= oTCE irsE oNLx< 'R
CHECK TYPE i OUTING SLIP
If building is associated with a Home Owner's Association,provide letter :y r
of approval from HOA. OYER THl;<COUNTER .T BUILDING PLAN REVIEW E
4
_Provide Planning approval to verify if there any restrictions. 1❑3'E >st�ss' �;,m O4'r,n�vNIIVGrLAN tEXi
Provide copy of Manufacturer's Installation Specifications. :❑ STANDARD FIRE DEPT
Provide signed copy of Cu ertino's Tear-Off Policy.
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ReroofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10122 berkshire ct DATE: 10/29/2013 REVIEWED BY: Mendez
APN: 34212108.00 BP#: VALUATION: $8,900
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PENTAMATION 1SFDWLR00F
USE:
PRIMARY SFD or Duplex PERMIT TYPE:
WORK RE-ROOF
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,400
lJcG 1'lun(hick Plumb_Ploo Click 1'hr 4 Cheek
Lti'Ci'7. La<'YilN1�L'E''
PRrnh. Por7tN 7;t: F,7c. Pcrrttt!I��e.'
C)tlnf aleck. Irr,tiI>. t�tlrcr P'uml;lwp 011rcr /;i<+c. Ins )
11tch MP, t°cc Plumb, h!,p, F41" Imp,I'lec.Imp, ("'c_
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eft 711/13) FEE QTY/FEE MISC ITEMS
Pleat Check
S'llppl. PC Fee
Plzrrnfzi:i Ic t;Ir.;llec:
Permit Fee: $384.00
SuPp/. Irish 1-11C
Plttmh.;11�<�lr. Ilec
Plurrth.i:ldc i h.;Linc Pertstit FCC:
Construction.Tax:
�dtniaisu-atiic>f�ee,_
Work Without Permit? 0 Yes Q No $0.00
/l cl1,aucirtl P/a/mintr V('Cs:
1'rovel 00Cnln"rttutioll Fires:
Strong Motion Fee: IBSEISMICR $0.89 Select an Administrative Item
Bldy Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $385.89 $0.00 TOTAL FEE: $385.89
Revised: 10/01/2013
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
CUPERTIN O
(408)777-3228• FAX(408)777-3333•buildingCa-)cupertino.org
PROJECT ADDRESS APN#
/� �j I i tJ PHONE E-MAIL
OWNER NAME . /C,II .'L •�} `V Ll�
STREET ADDRESS 1� �� CITY, STPfTE, FAX
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CONTRACTOR NAME LIC SE NUMBER LICENSE TYPE BUS.LIC.#
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COMPANY NAME ` , E-MAIL FAX
STREET ADDRESS- CITY,STATE,ZIP THONE
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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 ResidentiCode. , � � Z
Signature of Applicant/Agent: I Date:
Reroo)Tolicy_2012.doc revised 10/7/12