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11060035 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20321 CLIFDEN WAY CONTRACTOR:JOSHUA CONSTRUCTION PERMIT NO: 11060035 &REMODELING OWNER'S NAME: HUI WU 10613 GASCOIGNE DR DATE ISSUED:06/03/2011 t R'S PHONE: 4088067224 CUPERTINO,CA 95014 PHONE NO:(408)725-3692 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# c / d Q MECH RESIDENTIAL COMMERCIAL� Contract orl� JOB DESCRIPTION:RE-ROOF REMOVE ROOF SHAKES&REPLACE WITH I hereby affirm that I am licensed under the provisions of Chapter 9 COMPOSITION SHINGLES CLASS A 29SQFT (commencing with Section 7000)of Division 3 of the Business&Profession Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two eclara ons: I have and will maintain a certificate of consent to self-insure for Wor is 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 Sq.Ft Floor Area: Valuation:$9500 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:36937002.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. 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. Issued by-,,. ��_._ Dater Signature c7 G` yj j �. Date t`/ L OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. [,as owner of the property,or my employees with wages as their sole compensation, C will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: f Dat Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized a ent: become subject to the Worker's Compensation provisions of the Labor Code,I mush 7 � /<-- Date:--cl-7--7- 7—� I forthwith comply with such provisions or this permit shall be deemed revoked. U �' CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address it' -nify and keep harmless the City of Cupertino against liabilities,judgments, Ad expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION gt;,..,,tng of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date 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 - building6i�cupertino.org PROJECT ADDRESSAFN# OWNER NAME 1 PHONE of—?2? E-MAII `.f ,r yVLA b L[ u 1(� STREET ADDRESS CITY, STATE,ZIP FAX Z � CONTRACTOR NAME J C y I' LICENSE NUMBER o G Z J LICENSE TYPE j� HUS.LIC.# COMPANY NAME ��/ v` E-MAIL � rf � FAX 12� STREET ADD�RES ` CITY,STATE,ZIP r_. t PHONE cAVw /y`{ Y®,�) th Q_ I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request shall be scheduled the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection. On the day of the inspection, a building inspector will be available within one hour for either a Tear-Off Inspection or Nailing Inspection if you call again on that day between the hours specified. 3. The following inspections are required: a. 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. b. If plywood is installed, a plywood Nailing Inspection is required. c. Progress Inspection is required when approximately 50% of roof covering is installed. 4. New roof coverings shall not be applied without first obtaining all 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. 5. 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. 6. 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 of$126.00. 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 2010 California Residential Code. Signature of Applicant/Agent: y> Date: l ! ReroofPolicy_2011.doc revised 02 6/11 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36937002. 00 DATE ISSUED. . . . . . . : 06/03/2011 RECEIPT #. . . . . . . . . : BS000013658 REFERENCE ID # . . . : 11060035 SITE ADDRESS . . . . . : 20321 CLIFDEN WAY SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . . HUI WU ADDRESS . . . . . . . . . . : 20321 CLIFDEN WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : HONGQI HU CONTRACTOR . . . . . . . : HONGQI HU LIC # 29352 COMPANY . . . . . . . . . . : JOSHUA CONSTRUCTION & REMODELI ADDRESS . . . . . . . . . . : 10613 GASCOIGNE DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : (408) 725-3692 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 9, 500 . 00 1. 00 0. 00 1 .00 0. 00 1BSEISMICR VALUATION 9, 500 . 00 0. 95 0 . 00 0 .95 0. 00 1REROOFRES SQ FEET 29. 00 377. 00 0 . 00 377 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 378 . 95 0 . 00 378 . 95 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 378. 95 MC --------------- TOTAL RECEIPT 378. 95 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO F12FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 20321 clifden way DATE: 06/03/2011 REVIEWED BY: bobs. APN: BP#: VALUATION: $9,500 °-PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof _____[PRIMARY PENTAMATION 1SFDWLROOF USE: SFD or Duplex PERMIT TYPE: WORK remove roof shakes replace with comp shingles SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 2,900 E3 NOTE. These fees are based on the preliminary in ormation available and are onl an estimate. Contact the De t or addn'l info. FEE ITEMS (lace Resolution 09-051 f;ff' ' 1.-IO) FEE QTY/FEE MISC ITEMS Permit Fee: $377.00 Work Without Permit? Q Yes E) No $0.00 t i Strong Mention Fee: IBSEISMICR $0.95 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $378.95 $0.00 TOTAL FEE: $378.95 Revised: 04/29/2011 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333 • building(cDcupertino.org PROJECT ADDRESS j yi �� vW rV APN# OWNERNAMEPHONE E-MAIL u" ,1Ui fth STREET ADDRESS ?03 24 / —gh 414CITY, STATE,ZIP FAX APPLICANT NAME D Y'p [ PHONE fj n b` �1 E-MAIL. O�L A0. �` Jr' STREET ADDRESS '`{(x 1 CITY,STATE, ZIP ;4 J L FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT K CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME He iV n I H U LICENSE NUMBER 1 Q-Z /.1 LICENSE TYPE & BUS.LIC.# z 3 T- COMPANY NAME jesLut CM7 E-MAIL a� o ,071 FAX STREET ADDRESSy CITY,STATE,ZIP , PHONE jk9W 644& f— 1 ARCH]TECT/ENGINEER NAME LICENSE NUNMER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF jq SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial a EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES I •NOOD SHAKES X WOOD SHINGLES ❑OTHER(SPECIFY) -[ REMOVE/REPLACE %YES IF NO, PLYWOOD El %" �I PLYWD OSB PTTCH: ROOF 13 No #LAYERS: THICKNESS: 135/8" TYPE: ElCDX '12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF IkASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: 51alnql-6 V-j W (J( n� ?/�� .-e '-Q r�1 �Q,��►� ti's i a� k • I i 1S - a S ,i !4S By my signature below,I certify to each of the followi : 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 building construction. I authorize representatives of Cupertino tc enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE[JSE't7 NI7 Vim,= "' _If building is associated with a Home Owner's Association,provide letter PIAN Cl OC TYPE r�'ROvTtNG SLIP of approval from HOA. ■ x TaE cQurtTiEx tI! BIJ1LDING PLAN REVIEW--:7. Provide Planning approval to verify if there any restrictions. [1 EXP"S ❑ PLANNING PLAN REVIEW- Pro copy of Manufacturer's Installation Specifications. ❑ sTANnaxu ❑ 7=DEPx Provide signed copy of Cupertino's Tear-Off Policy. ❑ 'oR-: ReroofApp_2011.doc revised 03/02/11