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13110149 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10191 BRET AVE CONTRACTOR:CUPERTINO ROOF,INC PERMIT NO:13110149 OWNER'S NAME: YUN-TSAI PENG 1052 KELLY DR DATE ISSUED: 11/21/2013 OWNER'S PHONE: 4082537928 SAN JOSE,CA 95129 PHONE NO:(408)973-9427 B LICENSED CONTRACTOR'S DECLARATION r r ELECT PLUMB q, BUILDING PERMIT INFO: BLDG G 3 I Lic.# �^ J p f MECH License Class r RESIDENTIAL r COMMERCIAL Contractor 01;�R 2'j y eC- Date I hereby affirm that I am licensed under the provisions.of Chapter 9 (commencing with Section 7000)of Division 3 of.the Business&Professions JOB DESCRH'TION: Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one ofthe following two declarations: (18 SQ'S)TEAR OFF(E)COMP&INSTALL(N)COMP(NO t. I have and will maintain a certificate of consentto self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the NEW PLIC performance of the work for which this permit is.issued.. ' z. have and will maintain Worker's Compensation Insurance,as provided for by '­w-�Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is Sq.Ft Floor Area: Valuation:$8800 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 APN Number:37511030.00 Occupancy Type: indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ;ranting o this permit. Additionally,the applicant understands and will comply with all non-point s rce regulations per the Cupertino Municipal Code,Section 9.18. PERMIT EXPIRES IF WORK IS NOT STARTED Signature Date -W `� WITHIN 180 DAYS O IT ISSUANCE OR 180 DAYS A ALLED INSPECTION. ❑ OWNER-BUILDER DECLARATION >mrsab I hereby affirm that I am exempt from the Contractor's License Law for one of y' the following two reasons: t. 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 RE-ROOFS: sale(Sec.7044,Business&Professions Code) All roofs shall be inspected prior to any roofing material being installed.If a roof is installed ection. 2. 1,as owner of the property,am exclusively contracting with licensed contractors Without first obtaining ectiio�on,II agree to remove all new materials for insp to construct the project(Sec.7044,Business&Professions Code). Signature of Applicant:wmlo pl—� Date: ! 31 3 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the California Section 3700 of the Labor Code,for the performance of.the Work for which this Health&Safety Code,Sections 25505,25533,and 25534. I will maintain compliance with permit is issued. the.Cuperdno Municipal Code,Chapter 9.12 and the Health&Safety Code,Section 3. I certify that in the performance of the work for which.this permit is issued,I shall 25532(a)should I store or handle hazardous material. Additionally,should I use not employ any person in any manner so as to become subject to the Worker's equipment or devices which emit hazardous air contaminants as defined by the Bay Area Compensation laws of California. If,after.making this certificate of exemption,I Air Quality Management District I will maintain compliance with the Cupertino become subject to the Worker's Compensation provisions of the Labor Code,I Municipal Code,Chapter 9.12 and the Health&Safety Code,Sections 25505,25533,and must forthwith comply with such provisions or this permit shall be deemed 25534. revoked. Date: Owner or authorized agent• APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's for to building construction,and hereby authorize representatives of this city to enter which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the City of Cupertino against liabilities;judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address 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. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature_.. Date Licensed Professional Vk -- REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 \\ (408)777-3228• FAX(408)777-3333•building a()_cupertino.org CUPERTINO. \ PROJECT ADDRESS , 7APN# 3 I -30 OWNERNAME -co PHONE `fa q _2_S 3 MAIL STREET ADDRESS ' V l �n- CITY,STATE,ZIP FAX CONTACT NAME �C PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX 13 OWNER El OWNER-BUILDER ❑.OWNER AG� CONTRACTOR 11CONTRACTOR AGENT 13ARCHITECT ❑ENGINEER ElDEVELOPER 13TENANT CONTRACTOR NAME /` U ���1, � C LICEN$ J�iB LIC S BUS.LIC.# (y COMPANY NAME � � E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEERNAME tG` LICENSENUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF �Q SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial t EXISTING ROOF TYPE: ElBUII T-UP ROOF�B ASPHALT SHINGLES ❑WOOD SHAKES El WOOD SHINGLES ❑OTHER(SPECIFY) MOVE PLACE ❑YESIF NO, PLYWOOD El %a" 13PLYWD 11 OSB PITCH: ROOF ❑NO #LAYERS: THICKNESS: El5/8" TYPE: ❑ CDX -12 CLASS: APROPOSED ROOF TYPE: ❑Bu LT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ElWOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK q 0 O w _ C { , cc, 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 informatio ided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable 1 ordinances and state laws relating to b 'Idina �7nstruct,o�,aunorize representatives of Cupertino to enter the above-identifiediiproperty}for inspection p e . Signature of Applicant/Agent: Date: 1 _ SUPPLEMENTAL INFORMATION REQUIRED _ VWV If building is associated with a Home Owner's Association,provide letterNOW WIT of approval from HOA. � v kProvide Planning a roval to veri Ifthere an restrictions. _ a PP verify" Y - EXPRES � pI, TII_r'GP.LAIy;I2EVIE�i' 'F„ Provide copy of Manufacturer's Installation Specifications._ s DEPT ter. -_ Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/1.6/11, CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION 01 ADDRESS: 10191 BRET AVE DATE: 11/21/20131 ] REVIEWED BY: MELISSA APN: 37511030 BP#: VALUATION: 1$8,800 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROO USE: PERMIT TYPE: WORK 18 SQ'S TEAR OFF (E).COMP &INSTALL N COMP NO NEW PLY SCOPE FEE ID ROOF AREA s.f. 1RE.ROOFFRES 1,800 r t Mech. Plan Check Pliant, Plan Check Elec.Plan Check iLliech.1'ernrit 1%ee>• Plumb. Permit Fee: Elec. Permit Fee: Lk"','�h. ,Alech.Insp. Other Plumb Insp. Other Elec.Insp. EIF Ina p.Fee: Plumb. Insp.Fee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prelindna information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS(Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee Plurnb.Allech./Flee Permit Fee: $288.00 Supp/. Insp Fce Plurnb.iMech.lElec, P1umb./Mech.1Eleu Permit Fee. Construction Tax: _FT Administrative Fee: Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fees Travel Documentation Fees: Strong Motion Fee: IBSEISMICR $0.88 Select an Administrative Item Blda Stds Commission Fee: 1BCBSC $1.00 $289.88 $0.00 . �F - EE: $289.88 Revised: 10/01/2013 f` 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 CUPEIt•I`INO (408)777-3228 FAX(408)777-3333•building a(D.cupertino.org PROJECT ADDRESS �}-� APN# 2 f OWNERNAME (] T'> ^ ) PHONON Zs3 19 E-MAIL STREET ADDRESS j (-2X(� ©� CITY,STATE,ZIP < n T 61 ) Z 7 FAX CONTRACTOR NAME I ( Sr• V� LICENSE NUMBERS-6 S,7 r 7 LICENSE TYPE BUS.LIC.# COMPANY NAME C v�� ^v GC' E-MAIL FAX STREET ADDRESS ple CITY,STATE,ZIP I PHONF-46 j J 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-roofiAg 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,4-cCr-f1'fy e- cH_6fThe owing is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agre 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 Code. . Signature of Applicant/Agent: Date: ReroojPolicy_2012.doc revised 10/7/12