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15070107CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7521 RAINBOW DR CONTRACTOR: CD ROOFING PERMIT NO: 15070107 OWNER'S NAME: CHANG YU-HUI AND JEWEL H 2909 WILBUR AVE DATE ISSUED: 07/15/2015 OWNER'S PHONE: 6504441160 SAN JOSE, CA 95127 PHONE NO: (408)898-6605 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL REMOVE (E) ROOF AND INSTALL NEW OSB AND License Class ' ':3 Lic. # _' q �/ ASPHALT ' /s� t j Contractor Date -or—SHINGLES I hereby a arm that 1604fitwd 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 Sq. Ft Floor Area: Valuation: $9500 pe ance of the work for which this permit is issued. and will maintain Worker's Compensation Insurance, as provided for by on 3700 of the Labor Code, for the performance of the work for which this APN Number: 36230016.00 Occupancy Type: 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 180D YS FROM LAST CALLED INSPE TI N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, 1 r costs, and expenses which may accrue against said City in consequence of the Issued by: Date: 1 granting of this permit. Addition all , the applicant understands and will comply with all non -point source re at' s per pertino Municipal Code, Section 9.18. Signature Date – / S — RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an insp I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: Zr� / S I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL RO F COVE 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(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 equipment vices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area r uality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupev mcipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Sections 25 , 33 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: 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 CONS TION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I 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 15g ©m. COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(d)cupertino.org PROJECT ADDRESS APN# OWNER NAME P ONE �� E-MAIL , L .. STREET ADDRESS CITY, STATE, ZIP FAX mss-, o 0- t n4t_- CONTACT NAME PHONE L40 d S`t 16 6 goS E-MAIL A STREET AD SS CITY, STATE_, ZIP _ / {'� FAX v \1G tl,NER ❑ O,!'NER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC. # COMPANY NAME E-MAIL FAX �_ Y.1 STREET ADDRESS ",� CITY, STATE, ZIP P ONE Q O ty f L 9 2L Li m ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME Z/� E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex L Multi -Family ROOF AREA: VALUATION: ❑ Commercial (� ��� -( _� �a 5- Q CD STRUCTURE: c� E3� ❑ EXISTING ROOF TYPE: BUILT-UP ROOF ❑ ASPHALT SHINGLES OOD SHAKES WOOD SHINGLES El OTHER (SPECIFY) REMOVE/REPLACE YES IF NO, 1 �� PLYWOOD L4" ❑ PLYWD M.,6SB PITCH: (,{ ROOF ElNO # LAYERS: THICKNESS: Cl5/8" TYPE: 1:1COX y' 12 CLASS: PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF SPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT;q DESCRIPTION OF WORK: 11 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 co ave r e ription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building c i. I auf o ize repr ntatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicanUAgent: Date: 72� — � 5 — SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY. PLAN CHECK TYPE '. ROUTING SLIP If building is associated with a Home Owner's Association, provide letter OVER-THE-COUNTER ❑ BUILDING PLA NREVIEW of approval from HOA. Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANizIVG PIAN REVhEw Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIREDEPT Provide signed copy of Cupertino's Tear -Off Policy. ❑ OTHER:; ReroofApp_2011.doc revised 03/16/11 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 (408) 777-3228 - FAX (408) 777-3333 - buildingacupertino.org PROJECT ADDRESS APN # J OWNER NAMEONE U v P �,Sb }f u 114 d E-MAIL STREET ADDRESS CITY, STAT , ZIP FAX CONTRACTOR LICEENUM2 LICENSETYP BUS. LIC.# COMPANY NAME E-MAIIJ% I�� FAX STREET ADDRESS CITY, STATE, ZIP PHONE 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 un 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 1/4" 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 c npl roof policy stated above. I also understand that smoke detectors and carbon monoxide detect u' d to be in ailed in accordance with Sections R314 and R315 of the 2013 California Residential Code. j of Date: ReroofPoligL2014.doc revised 01/15/14 CITY OF CUPERTINO Fm FEE ESTIMATOR - BUILDING DIVISION V V 191 ADDRESS: 7521 Rainbow Dr DATE: 07/15/2015 REVIEWED BY: Paul reit Foo'F,lec. APN: 362 30 016 BP#: 'VALUATION: 1$9,500 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: hisp. Fee: PENTAMATION 1SFDWLR00 PERMIT TYPE: i WORK Remove E roof and install new OSB and asphalt shingles 27 Squares) SCOPE Sul)pl. Insp Fee FEE ID ROOF AREA s.f. 1REROOFFRES 2,700 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 nreliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eft' 7i1/13) FEE QTY/FEE ,ec. Plan (.,heck reit Foo'F,lec. Permit 1'te __L_ Other ,ilech. Insp odder 1,ho i) lt't p. tither Glee Imp. El hisp. 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 nreliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eft' 7i1/13) FEE QTY/FEE MISC ITEMS Plan C'hecl i ,. Sup7)l..PC I ee PlumhJA,fech./Flee Permit Fee: $ 0 Sul)pl. Insp Fee Plumb./Mech.!Elec, Plumb./,ALfech. E,lec Permit Fee: C.;onstruction Tax Administrative Fee: Work Without Permit? 0 Yes Q No $0.00 Advanced Plunning Fees: 7�m,el Documentation Fees: Strong, Motion Fee: IBSEISMICR $1.24 Select an Administrative Item a .- Bldg Stds Commission Fee: 1BCBSC $1.001 SUBTOTALS: $461.24 $0.00 TOTAL FEE: $4 Revised 07/02/2015