B-2017-0367CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0367
18931 BARNHART AVE CUPERTINO, CA 95014-3603 (375 09 021)
KENT ROOFING
COMPANY INC
CAMPBELL, CA 95008
OWNER'S NAME: SHENG MIKE AND YING YIQIAN TRUSTEE
DATE ISSUED: 03/06/2017
OWNER'S PHONE: 512-413-3879
PHONE NO: (408) 971-4042
LICENSED CONTRACTOR'S DEC A AATION
BU11LDING PERMIT INFO:
License Class CM Lic. #957398
Contractor KENT ROOFING COMPANY INC Date 05/31/2017
X BLDG —ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
MECH X RESIDENTIAL COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
PARTIAL RE -ROOF; TEAR OFF (NO PLY); INSTALL COMP ROOF
I hereby affirm under penalty of perjury one of the following two declarations:
SYSTEM (15 SQ'S)
u. 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.
z. 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.
Sq. Ft Floor Area:
Valuation: $15000.00
APPLICANT CERTIFICATION
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
375 09 021
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
PERMIT EXPIRES IF WORK ISNOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will comply with all non -point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CA SPECTION.
Signatures Date 03/06/2017
Issued b
Q1_______1)
OWNER -BUILDER DECLARRATION
Date: 03/06/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RF ROOF :
following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
c ; �� -•- . ...0 ...-A. .."
z. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicaxit.�" ""
contractors to construct the project(Sec.7044, Business &Professions Code).
Date: 03/06/2017
I hereby affirm under penalty of perjury one of the following three declarations,
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
u. 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.
HAZARDOUS MATERIALS DISCLOSURE
z. 1 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
Section 3700 of the Labor Code, for the performance of the work for which this
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Seciion 25532(a) should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
e=
be deemed revoked.`
M s ;.,.� .. '.r.."._"•_ ." `-'
Owner or authorized
APPLICANT CERTIFICATION
Date: 03/06/2017„
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction lending agency for the performance
'(Sec.
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date 03/06/2017
Professional
CUPI R•TINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 r FAX (408) 777-3333 • build inmDcu pertino.org'
R - Za l 9- -- n 3 � -�_
ReroofApp_2011.doc revised 03116111
1-1 - _ I
PROJECT ADDRESS�%^ I'-
OWNER NAME �- /� I 1 r _ HO LC/ P
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CITY, STATE, ZIP
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT 6PIpITTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LIC_*
LIC SE
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BUS. LIC. #
COMPANY NAME r
EMAIL ems.
FAX
C1111
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ARCHITECT/ENGINBERNAME
LICENSE NUI MER
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi -Family
ROOF AREA:
VALUATION:
STRUCTURE: ❑ Commercial
154
1
E>aSTING ROOF TYPE: ❑ BUILT-UP ROOF SPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE fltEPLACE 11 YES
IF NO,
PLYWOO /z" ❑
PLYWD ❑ OSB
PITCH:
ROOF
❑ NO
#LAYERS:
THICKI�ES9! u 5/8"
TYPE: ❑ CDX
12
CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF •rV ASPHALT SHINGLES ❑ WOOD SHAKES❑WOOD SHINGLES ❑OTHER
ICC -ES REPORT #
DES TION OF WORK:
Obm4 /-�"Shjo Clu,-Late, 6ow4; &
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3=t2 L4I t2
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 correct. I have read the Description of Work and verify it is accurate. I agree to comply with all, applicable local
ordinances and state laws relating to buildM' construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
'
Signature ofApplicant/A _ Date:
SUPPL - - FORMATION REQUIRED oFFTCE usE ONLY
If building is associated with a Home Owner's Association, provide letter PLAN CHECK TYPE ROUTING SLrP
Of approval from HOA. "aflVER-THE-COUNTER-BiIILDTNGPI.AN`REVIES'4
Provide Planning approval to verify if there any restrictions, L3 EaPREss IIPLANNING PLAN REti tEw
_ Provide copy of Manufacturer's Installation Specifications.] I❑ FIRS WEPT
Provide signed copy of Cupertino's Tear -Off Policy. HER.
ReroofApp_2011.doc revised 03116111
CUPERTINO
REROOF TEAR -OFF POLICY
COMMUNITY. DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B4O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 - building(aDcugertino.ora
PROJECT ADDRESS
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APN # �5 i O �
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OWNERN j
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FAX
CONT CTOR N ME ` _ p _
LICENSE N
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BUS. LIC. # -� - Z
COMPANY NAME
E-MAIL
FAX
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re -roof project shall comply with all applicable provisions of the 2016 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 7:30-3:34pim (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 replacedprior 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-imanufactured products used shall be
available on-site to review at the time of the inspection.
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 2016 California Residedital-Goole.— - / , n
of
Date:
ReroofPolicX}014.doc revised 12115116