15090084I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 20652 CHERYL DR I CONTRACTOR: CUPERTINO ROOF, INC I PERMIT NO: 15090084 1
OWNER'S NAME: WU JYH-HORNG J AND LIN S 11052 KELLY DR I DATE ISSUED: 09/14/2015
I OWNER'S PHONE: 4088898012 1 SAN JOSE, CA 95129 1 PHONE NO: (408)973-9427
LICENSED CONTRACTOR'S DECLARATION
License Class 3 l Linc. # rl� —6 J 7
Contractor Gcxl�eriro 6Za0�, 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
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
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.
�. 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
permit is issued.
APPLICANT CERTIFICATION
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 L
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
granting of this permit. Additionally, the applicant understands and will comply with
all non -point source re dations per the Cupertino Municipal Code, Section 9.18.
Signature Date / - �y 2615
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
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
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three declarations:
1 1 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.
2. 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
permit is issued.
3. 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
become subject to the Worker's Compensation provisions of the Labor Code, I
must forthwith comply with such provisions or this permit shall be deemed
revoked.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
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.
Date
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
TEAR OFF (E) WOOD SHAKE, INSTALL (N) OSB, 15 #
FELT, CLASS A COMP ROOF SYSTEM (31 SQ'S)
Sq. Ft Flour Arca: I Valuation: $20000
APN Number: 35916021.00 1 Oce upancyType:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 1 IT ISSUANCE OR
CALLED INSP7t,
ION.
a r
RE -ROOFS:
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. v
Signature of Applican. ate: ^ / c
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or auth nt: /����5�
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
Reroof.4pp_2011.doc revised 03/16/11
CITY OF CUPERTINO
0 FEE ESTIMATOR - BUILDING DIVISION
FEE ID ROOF AREA
s.f.
1 REROOFFRES 3,100
20652 CHERYL DR
DATE: 09/14/2015
REVIEWED BY: MELISSA
IlaADDRESS:
APN: 359 16 021
BP#:
*VALUATION: 1$20,000
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY
USE: SFD or Duplex
Plumb.lMech./Elegy°
PENTAMATION
PERMIT TYPE: 1 SFDWLROO ;
WORK
TEAR OFF E WOOD SHAKE INSTALL N OSB 15 # FELT CLASS A COMP ROOF SYSTEM 31
SCOPE
SQ'S)
FEE ID ROOF AREA
s.f.
1 REROOFFRES 3,100
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 preliminary information available and are onlv an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E(f' 711!13)
Afech. flan Check
Phimb. Plan Chcek
/ec. Plan Check
Llech. Permit Fete-
Plumb, Permit Feer:
151ec- Permit Fee -
Other Hoch. lns`r=
Other Plumb Iru,%
?ther Elec. Insp. E1__L_
Plumb.lMech./Elegy°
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 preliminary information available and are onlv an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E(f' 711!13)
FEE
QTY/FEE
MISC ITEMS
Plan ('heck Fee:
:SUI)pI. PC Fee
Plumb.lMech./Elegy°
Permit Fee:
$ .00
Suppl. Insp Fee
IF& U • v
Plum b.11'1 Tech. /El ec
Plumb.;glech./Flee Permit Fee:
Construction Tax:
Administrative Fee:
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Phinning Fees:
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICR
$2.60
Select an Administrative Item
so3.
Bldg, Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
1 $530.60
$0.00 TOTAL FEE:
1 $530.60
Revised: 07/02/2015
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 • buildino aQcupertino.org
PROTECT ADDRESS / f �
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OWNERNAME O
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E-MAIL
STREET ADDRES
CITY, STATE, ZIP /
FAX
CONTRACTOR NAME
LICENSE NUMBER
LICENSE ML Z
BUS. LIC.
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
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 7:3040:30am 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/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 2013 California Residential C Q
Signature of Applicant/Agent: Date:
ReroojTo1icy_2014.doc revised 01/15/14