14030078 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21617 VILLA MARIA CT N TnR•' PERMIT NO: 14030078
OWNER'S NAME: XIAOLING SUN DATE ISSUED:03/13/2014
OWNS ' HONE: 4083133146 PHONE NO:
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
DETACHED GARAGE-TEAR OFF WOOD SHAKE,
License Class �'� Lie.# '7,�p INSTALL 30
LB FELT,BATTENS&LIGHT WEIGHT EAGLE TILE ROOF
ContrCA COACA Date --;�- 1 SYSTEM,CLASS A(3 PERMITS,ALL FEES ATTACHED TO
I hereby affirm that I am licensed under the rovisions of Chapter 9 „ e
I
(commencing with Section 7000)of Division 3 of the Business&Professions C1
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations: #03;V
I have and will maintain a certificate of consent to self-insure for Worker's 1 t 03 C)
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:$0
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:35623065 00 Occupancy Type:
V 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 D �CALL�EDINSPECTION.
indemnify and keep harmless the City of Cu ino against liabilities,judgments,
costs,and expenses which may accrue aga' said City in consequence of the 3 1
granting of this permit. Add' ' a ,the plicant understands and will comply Issued b : /
with all non-point source gulati s e Cupertino Municipal Code,Section
918.
i RE-ROOFS:
Signature Date' G�— All roofs shall be inspected prior an roofs material being installed.If a roof is
installed without first obtainin in cti I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERIN S 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(See.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(a)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 equ'umwnt or o ices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by t(2550
re Air ality Management District I
performance of the work for which this permit is issued. will maintain compliance with tht o cipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio and 25534. 7
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date` 7
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
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 o0
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 \ �V
CUPER;TINO (408)777-3228•FAX(408)777-3333•buildina(a)cupertino.orcl
v \
PROJECT ADDRESSrZ (0V144 kq �_kA ct
APN#
OWNER NAME �IE�(2 3 ,I E-MAIL
STREET ADDRESS <
) TY,STAT I FAX
CONTACT NAME_ ,�,VAIS ,VA� � PHONE E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
C 'OR A / LEN BUS.LIC.#
47
�N ^WCSI 754`43�,�
Bfi A Y t ` r P ONE I L Y 1
ARCHITECT/ENGINEER NAME LIC ENSE NUMBER g BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex Multi-Family ROOF ARE��� � VALUQTION:�
STRUCTURE: ❑ Commercial e �a4
or—
EXISTING ROOF TYPE{ 11BUILT-UPROOF ❑ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES 13 OTHER(SPECIFY)
REMOVE/REPLACE )EYES IF NO, PLYWOOD ❑ w, ❑ PLYWD ❑ OSB PITCH: ROOF
(ONO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX :12 CLASS: A
PROPOSED ROOF TYPE: ❑BBUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORKykool,
� l X030 0 ��-
By my signature below,I certify to each of fol win . 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 pr ded i o . I have read the Description of Work and verify it is accurate. I agree to c reply with all applicable local
ordinances and state laws relating to b ' ing.co on. I authorize representatives of Cupertino to enter the above-identified pr rtY for inspection purposes.
Signature of Applicant/Agent: Date:-V
SUPPLEMENTAL INFO ATION REQUIRED 0MCE USE ONLY f F
—If building is associated with a Home Owner's Association,provide letterA111`117191� 11 Al
SPL a1vHECKYPIE xoUTINLIr
of approval from HOA. LWU �GPLANREVIEIV
r
' F
_
Provide Planning approval to verify if there any restrictions. E� Es�,�, G FLAN
Provide copy of Manufacturer's Installation Specifications. ' ,` ❑�FIRE DEPT
1.440
Provide signed copy of Cupertino's Tear-Off Policy. "E"411
OTHER.
fr ..
ReroofApp_2011.doc revised 03116/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 21617 VILLA MARIA CT DATE: 03/13/2014 REVIEWED BY: MELISSA
APN: 356 23 065 BP#: 14030077 *VALUATION: 1$57,425
rPERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1 SFDWLROO
WORK [TEAR OFF WOOD SHAKE INSTALL 30 LB FELT BATTENS & LIGHT WEIGHT EAGLE TILE ROOF
SCOPE STEM, CLASS A (3 PERMITS, ALL FEES ATTACHED TO THIS PERMIT 58SQ TOTAL, 46SQ'S p
FEE ID ROOF AREA
s.f.
1REROOFFRES 5,800
v1��ch Pt�xrz C�reck 1'I-nwb. pl atr CFteck Chea. Nan c'�ir:r:1,
1t>i;r5. f'>rFtric C >c. k'tctmb.F'crrmif Fee,- hlo Pratt« T
f'Irtmlr oo4crn L 1 np" Li I
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These _f
ftes are based on the relimina information available and are onlyan estimate. Contact the Detor addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 711/13) FEE QTY/FEE MISC ITEMS
Pla"'i Chick'
Permit Fee: $928.00
Plunih. Permit Fee:
r� J12Lttt.S"L3"Ela?�'c?
Fe(":
Work Without Permit? ® Yes No $0.00
,qty,=rat cc°'r'1 zfcF.a,ent Fees: /i� � Q`l
7rai)eel 0t3cion<>ntation Fees:
Strong Motion Fee: IBSEISMICR $5.74 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $3.00
5
` $936.74 $0.00 TOTAL FEE: $936.74
Revised: 01/15/2014
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR,P.E.,C.B.O.,BUILDING OFFICIAL
C V PERTI NQ 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(a)cupertino.org
PROJECT ADDRESSI W( ( � 1 i � APN#
` /1/l -
OWNERNAME ® LAj
S4' I HO ..� L�/ _ EMAIL
STREET ADDRESS Y STATE,Z 4FAX
Lam, � F�iiprl�ER� Ltd E 7n BUS.LIC.#
C P NeOWA
[,
AD Y t1P
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2013 California Codes.
2. An inspection request can be scheduled up to one business day before the requested inspection date.
Please schedule inspections online or 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. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs)
and 7:30-10:30am and 12:30-2:30 (Friday). 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 1/"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 a to c ply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide det tors uired to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code.
Signature of Applicant/Agent: Z Date:
ReroofPolicy_2014.doc revised 01/15/14