Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
12050056 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21557 TERRACE DR CONTRACTOR:R E ROOFING& PERMIT NO: 12050056
CONSTRUCTION INC
OWNER'S NAME: LIN WUUIYI LARRY TRUSTEE 15230 CLVDF,LLF.AVE DATE ISSUED:05/04/2012
OWNER'S PHONE.: 4082554099 SAN JOSE,CA 95032 PHONE NO:(418)626-9320
❑ LICENSED CONTRACTOR'S DECLARATION r r r
I �1 5 BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class rl.od 12 Lic.N 2 ! L
/�(�� / ,L' r MECH RESIDENTIAL r r
COMMERCIAL
\Contmcto /�!zO�K� Date
thereby affirmy affirm tha ed under the provisions of Chapter 9 JOB DESCRIPTION: RE
REMOVE EXISTING WOOD SI IAKE ANI)
(commencing with Section 7000)of Division 3 of the Business&Professions INSTAL ,NEW
Code and that my license is in full force and effect. I/2"COX,JOq FELT.AND"LIF GTIMH"COMPOSITION
I hereby affirm under penally 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 b) Section 3700 of 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 Sq.Ft Floor Area: Valuation:$15000
permit is issued.
APPLICANT CERTIFICATION APN Number:35620014.00 Occupancy Type:
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 stale 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 PERMIT EXPIRES IF WORK IS NOT STARTED
indcmni ly and keep harmless the City of Cupertino against Iiabil ities,judgments,
costs,and expenses which ma)'accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
gra ol'[his permit. Additional),the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
tlh all no -point spureefegulalions per the Cupertino Municipal Cod .Section ` �
,9.18. � � 7 r I I �/ Issued by: % ill Date: �• y •/�
tgnaturc / Date v� Ci
❑ OWNER-BUILDER DECLARATION
RF.-ROOFS:
1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roaring material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection.I agree to remove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,mrd(he structure is not intended or offered for sale(Sec 7044,
Business&Professions Code) Signature of Appli©nl: Date:
I,as owner ollhc property,am exclusively contracting with licensed contractors to
construe((he project(Sec.7044.Business&Professions Code), ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1 hereb)'affirm under penally of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's ILA%ARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the 1 have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Ileallh&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ileallh&
Section 3700 of the Labor Code,for the performance of work for which this Safety Code,Section 25532(a)should 1 store or handle hazardous material.
Additionally,should 1 use equipment or devices which emil hazardous air
permit is issued. contaminants irs defined by the Bay.Area Air Quality Management District 1 will
I certify that in the performance ordre work for which this permit is issued.)shall maintain compliance wilh the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in maty manner so as to become subject to the WEk,d
is leahh&Sefe v Code.Sections 25505,25533,and 25534•
Compensation laws of Cali fomia. II',after making this certi ftcate of eion,I ,
become subject to(he Worker's Compensation provisions of the Laboe,I must O r , ized ap`en1.
f aravvilh compl)'with such provisions or this permit shall be deemed . Date: li
APPLICANT CF.RTI FICATION CONSTRUCTION LENDING AGENCY
I certily(hat 1 have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ,ARCIIITEC'I"S DECLARATION'
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand m)'plans shall be used as public records.
Signature Date Licensed Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•building DDcuoertino.om
CUPERTINO
PROJECT ADDRESS �( I R- a 1\.�t APN a
OWNERNAME I A..�J J�I�I C/ fes,^,L\ - eeYY ONE 2_q _ f1CI E-MAR v
STREET ADDRESS �1 Ij 1!�i �'Y I VI M I' 1\NI CRY, STATE,ZIP //� i �7_' n, o FAX
CONTACT NAME PHONE I t��_V�1 f��I l713InV�M1lA1L Y?ro&n �LA �I, f \
STREET ADDRESS I1_�)fes,` G�,� s ` CRY.STATE,'ZIP VL ggl2 FAX I�`_626 -* I 1 I
❑OWNER ❑ OW'NFR`.Buruom ❑ OWNERAOENr CONTRACTOR ❑CONtRACroR/ADEM ❑ ARCHITECT ❑ENGINEER ❑"I D VT1.OPER ❑� IENjIANT
CONTRACTORNAM1 LICENSENUMBER �]�'ILQ LICENSETi\PE BUS.LIC.0 �7 L c) I (�
COMPANYNAME V N E-MAE-MAILYe(r(.�I�1/nl nnnLL @� aO ,II.0 UYI. FAX , ijr,_ 'Z6 -7/
STREET.ADDRESS //J3o �l 1,,, An./ CRY,STATE.ZIP C T PHONE VW 4` 62C-952
ARCHITECTIENGINEER NAME l 7\V� LICENSE NUMBER J \/ _I / BUS.LIC.0
COMPANY NAME E-MAIL FAX
STREET.ADDRES CRY,STATE.ZIP PHONE
USE OF S D0 Duplex ❑ Multi-Family. ROOF AREA: �']/ ( VALUATION: I� UU
STRUCTURE, ❑ onlmercial �).{. / / / (510
EXISTING ROOF TYPE: 13 BUILT-UP ROOF ❑ASPHALT SHINGLES �CalWOOD SHAKES ❑WOODSHWGLES ❑OTHER(SPECIFY,
REMOVE(REPLACE YES IF NO. PLYWOOD /�+\\l5' ❑ PLYHD ❑OSB PITCH
ROOF
❑ O aLAYE THI' ` d SB" T\PE. C Y '12 CLASS 'a
PROPOSEDKOOFTYPE. ❑BUILT-UPROOF AASPRALTSHINGLES ❑WOODSHAKFS 11 WOOD SHINGLES ❑OTHER ICC-ES REPORT
DESCRIPTION OF WORK T1rMd<- (S'(IO OIL_ WOV, '„I ,, e
By my signature be w,I certify t ach ofthe following: I am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information 1 ha provided is correct. I have read V Dec Don of Work and verify it is accurate- 1 agree M comply with all applicable local
ordinances and suit laws relating to riding ctio r 1 nu 'Ze epr s�—e D Cupertino m enter the abo enti Jed property for inspection purpura.
Signatureof Applica\rIt/Agem: / Dalt: 2
SUPPLEMENTAL INFORMATIO QUIRED OFFICE USE ONLY
_If building is associated with a Home Owners Association,provide letter PLAN CHECK TYPE .ROUTING SLIP
of approval from HOA. XO%TCR-TTiF_COUNTER - "eun.olNG PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS' ❑ PLANNING PLAN iii
_Provide copy of Manufacturers Insuillalion-Specifications. ❑ STANDARD f :❑ FIRE DEPT
Provide signed copy Of Cupertino's Tear-Off Policy. a, ❑ OTHER:
Reroofdpp_2011.doc revised 03/16//l
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
CUPERTINO
(408)777-3228- FAX(408)777-3333-buildina(aDcupertino.ora
PROJECTADDRESS L�K1�1CC� APN0
OWNER NAME I IPHONE E-MAIL
STREETADpRESS Lllel! �l' N � �N CITY. STATE,ZIP _)Lfl I FAA
CONTRACTOR NAM `I;J I i/VN•I LIC.•ENSE NUMBER 2_/1 r/JJ ILIC/ENSEf'4,• C BUS,LIC.
I'a� Z,\��/ I / I'/I
COMPANY NAME '/ IV / E-MAIL ,/kip/o1 l)l ��,I1,1 r UI.�✓✓V\ FAX
`w Vx--IIvI
STREET ADDRESS �I_n j,/` IIl� 1� CITU.STATIE,].I, `t' • PHONE
s:i Lt'�12 `� � -✓, _� -�1'��
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 can be scheduled up to 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.
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. Progress
and 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. Progress Inspection is required when approximately 50% of roof covering is installed.
7. 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/<" 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.
8. 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 bclo , I certify a of the following is true: I am the property owner or authorized agent to act on the
property owner's half. I understa d and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors a d carbon monoxid de re requir a Installed in accordance with Sections 8314 and R315 of
the 2010 Califomi Residential Cod
Signature of Applicant m: Date: I (�
Remo/Yohn 201 Lduc wwv,ed OJ[hq!