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14030079 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21617 VILLA MARIA CT aON RA t TOR: PERMIT NO: 14030079 OWNER'S NAME: XIAOLING SUN DATE ISSUED:03/13/2014 OWNER' ONE: 4083133146 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ L POOL ROOM-TEAR OFF WOOD SHAKE,INSTALL 30 LB License Class e,—-->70L_ Lic.# ot72 FELT,BATTENS&LIGHT WEIGHT EAGLE TILE ROOF [ , SYSTEM,CLASS A(3 PERMITS,ALL FEES ATTACHED TO Cor ar\ Date �� I hereby affirm that I am licensed unde;-ffi4rovisions of Chapter 9 11 (commencing with Section 7000)of Division 3 of the Business&Professions 03 S d O l r 4 o w, Code and that my license is in full force and effect. 0 50 a 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 l 7 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 V Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35623065 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 F D INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which ma rue a inst said City in consequence of the -?//-3 A v granting of this permit. Ad 'ion ly, applicant understands and will comply Is ate: with all non-point source gula ns the Cupertino Municipal Code,Section 9 18. ; 13 �� RE-It OOF Signature Date All roofs shall be inspected prior to y ro fin aterial being installed.If a roof is installed without first obtainingmspe on gree 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 � zv� the following two reasons: ALL ROOF COVERINGS O 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(a)sho I stor r handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equ' en or a ces which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay re it lit Management District I performance of the work for which this permit is issued. will maintain compliance with the C erti icipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 5505, 55 ,a d 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date 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 R R 00 PERMIT RMIT APPLICATION O E E COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO,CA 95014-3255 10300 TORRE AVENUE (408)777-3228•FAX(408)777-3333•building(D-gugertino.org CUPERTINO PROJECT ADDRESSCI / APN# � ,,,.. OWNERNAME SA.U4 4)r -- i G — l lL E.MATL l!/ STREET ADDRE S L yy 0 FAX CONTACT NAME ONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CAUX LAIM I �fCTM BUS.LIC.# MadNI �o I ±LT T I A&Y-14 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or DuplexMulti-Family Rt AREA: \/1 VALUATION STRUCTURE: Commercial / 3-ee ey-r l�� EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLESWOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACEYES IF NO. PLYWOOD 1:1w, ❑ PLYWD El PITCH: ROOF NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX :12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGL ❑WOOD SHAKES ❑WOOD DSSHII-NGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WOR( �� _ o 5�6K!V, AA ",DAV,yt5 Lo An t-e By my signature below,I certify to each of ollowin . am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I havepro de co I have read the Description of Work and verify it is accurate. I agree to co y with all applicable local ordinances and state laws relating to b g on. I authorize representatives of Cupertino to enter the above fled pr a for inspection purposes. Signature of Applicant/Agent: Dater" SUPPLEMENTAL INFORMATION REQUIRED >I i�B's � i If building is associated with a Home Owner's Association,provide letter \ ©UTING sLrn of approval from HOA. '❑ pvE iT Q M'MJT� E ❑ BUTLDIL GI'TANREVTI�W Provide Planning approval to verify if there any restrictions. ❑' 71r�zEss Provide copy of Manufacturers Installation Specifications. � A7� \� ❑ FDEP1' // � �� Provide signed copy of Cupertino's Tear-Off Policy. x '✓5' /31 ReroofApp_2011.doc revised 03/16/11 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 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1SFDWLR00 A WORK TEAR OFF WOOD SHAKE INSTALL 30 LB FELT BATTENS & LIGHT WEIGHT EAGLE TILE ROOF SCOPE SYSTEM, CLASS A (3 PERMITS, ALL FEES ATTACHED TO THIS PERMIT 58SQ TOTAL, 46SQ'S p FEE H) ROOF AREA s.L 1REROOFFRES 5,800 41 Mbrf7i b. 11-lan('1ie(:A Pj"':. PrW Chcclll' '.77il Fee: 1 t:mb. T c'imI I��er: F: Ordre' 3I(_r('Ii. Insn- Orhf r I'irernb Iris„n. E1__L_ oih'€-r tr. b?"p. Srt�xt C:�s1�, f� C Phv)ib MSp. Fc2e: 1 imc.Ir y) NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn7 in o. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS Suppl. PC 1"'c PtU;J,'-iil,%"det1P).f.EtE' Permit Fee: $928.00 A�),I,d�f 7_tii• Z}},9'�1.�'�t'G' /(emit Fet`.• :k�,lt;zlftt.�li•c�ti�'e /''c's:': '(�'` Work Without Permit? 0 Yes (F) No $0.00 v crl��unC•c'e/f'l<rnninti h �c�s: 1)0clonen'lolion Fees: Strong;Motion Fee: IBSEISMICR $5.74 Select an Administrative Item 131da,Stds Commission Fee: IBCBSC $3.00 $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 CUPERTINO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (408)777-3228-FAX(408)777-3333-building cuaertino.om PROJECT ADDRESS1 / APN# + r 0(S 6AIA OWNER NAME O H _ E-MAIL STREET ADDRESSV CITY, STATE,ZIP FAX CONTRACTOR LICENCitgnaQ LICfSE BUS.LIC.# v N I A�,aego ( IZ 4-57 T SSA Y,STTE, IP' -IZILONE Z 1 YQ/ v 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 I/"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 4grFe to omply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide de ct s agrequired to be installed in accordance with Sections R314 and 315 of the 2013 California Residential Code. Signature of Applicant/Agent: Dater ReroofPolicy_2014.doc revised 01/15/14