12080147CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22256 S DE ANZA CIR
OWNER'S NAME: CHAN KINKWAN AND YANG %IAODONG
OWNER'S PHONIi: 4082183089
❑ LICE:, §El) CONTRACTOR'S DECLARATION
License Class NC"T Lic. # O
Contractor a I I Qvl'N 1^ ^n `i I I tr Dot
I hereby oMrm that [:till licensed ander the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and than nnlicense is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certi licate 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 die work for which this
permit Is Issued.
Au'r1.ICAn r cl•:aru�ICYrum
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 properly for inspection purposes. (We) agree to save
indemnity and keep harmless the City of Cupenino 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.
Signature �� Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm Ilot I I :un exempt from the Contractor's License Law for one of
the following two reasons:
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
constrict the project (Sec.7044, Business & Professions Code).
I hereby afirnr 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
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 Insumnce, as provided for by
Section 3700 of the Labor Code, for the performance ollhe work for which this
permit is issued.
I certil'y that in the performance of die work for which this permit is issued, I shall
not employ anyperson in tiny manner so as to become subject to the Worker's
Conipensationlaws of Calil'ornia. If, aver making this certificate ofexemption, 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.
A PPLICA\NTCERTIFICATION
I certify that I have read this application and suite that the above information is
correct. I agree to comply with till city and county ordinances mid state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon [lie above mentioned property far 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
grunting of this pemrit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
CO\ FRACPOR: MILLERS ROOFING
PERMIT NO: 12080147
2246 LOS GATOS ALdIADIiN RD
DA'Z'E ISSUED: 08/142012
SAN JOSE. CA 95124
PIIONE NO: (408) 3.56:6211
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BUILDING PERDIFF INFO: BLDG
ELECT PLUMB
RIECII r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: REMOVE SHAKE ROOFING INSTALL NEW 7/16" OSB AND
NEW
COMPOSITION SHINGLES 1700SQFT CLASS A
Sq. FI Floor Area: I Valuation: $8000
APN Number: 35602020.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYSSj FROM LAST CALLED INSPECTION.
Issued by: ✓ /1/ f�47Z-,_,A1 Date: •%y%
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.
/
Signature of Applicant: Date: u/ r
ALL ROOF COVERINGS TO Illi CLASS "A" OR BE FfER
11,kZ,\IIDOIIS 9IA'1'1']RIAI-S DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California health & Safety Code, Sections 25505.25533. and 25534. 1 will maintain
compliance with the Cupertino Municipal Code. Chapter 9.12 and the health &
Safcty Code Section 25532(a) should I store or handle hazardous material.
Additionally. should 1 use equipment or devices which emit hw.ardous air
contaminants as defined by the Buy Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code. Chapter 9.12 mid the
Health & Safety Code. Sections 25505. 25533, and 2.5534.
Owner or mull!iz agent:
C(hNS'IRIICI'ION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of work's
I'or which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCIIITECl"S DECLARATION
I understand my plans shall be used as public records,
Date I Licensed
CITY OF CUPERTINO
lye/I FEE ESTIMATOR - BUILDING DIVISION
FEE 11) ROOF AREA
(S.f.)
1REROOFFRES 1,700
ADDRESS: 22256 so Deanze Circle
DATE: 08/14/2012
REl'IEII'ED BY: Sean
\
APN:
Mf:
'VALUATION:
$8,000
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TITE: Re -roof
PRIMARY
USE: SFD or Duplex
Dec. lisp. Fee:
PENTAMATION
PERMITTI'PE: 1SFDWLR00
WORK I
Remove shake roofing,install new 7116" OSB and new composition shingles 1700 sq ft).
SCOPE
FEE 11) ROOF AREA
(S.f.)
1REROOFFRES 1,700
NOTE: This estimate does not include jeev due to other Departments (i.e. Planning Public Works, Fire, Sanitary Stover District. School
District. ere.). These feev are based on the relitninarl information ation available and are onb, an estinzatc Contact the Dept for atltln'I into.
FEE ITEMS (Fee Resolution 11-053 L•fC 7/1/11)
dlech. Plan Check
Plumb. Pl(.. Check
Elee. Plan Check
Mech. Permit Fee:
Plumb. Permit Fee:
Elec. Permit Fee:
Other-Mech. Insp.
Other Plumb lisp.Ll I
Other Mee. Insp. Li I
Alech. lnvp. Fee:
Plumb, hcvp. Fee:
Dec. lisp. Fee:
NOTE: This estimate does not include jeev due to other Departments (i.e. Planning Public Works, Fire, Sanitary Stover District. School
District. ere.). These feev are based on the relitninarl information ation available and are onb, an estinzatc Contact the Dept for atltln'I into.
FEE ITEMS (Fee Resolution 11-053 L•fC 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
Suppl. PC Fce
Plum b.111ecl t./F.lec
Permit Fee:
$255.00
Suppl. lisp Fee
Plumb.lMech./Elec
Plumb./h-lech.Mec Permit Fee:
Contraction TILL:
Administrative Fee:
Work Without Permit? O Yes (D No
$0.00
Adveniced Planning Fees:
A
Travel Doemnantalion Fees:
Strong Motion Fee: IBSE1SMICR
$0.80
Select an Administrative Item
131h Sids Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$256.80
$0.001
TOTAL FEE:
F $256.80
Revised: 07/01/2012
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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 • building(a),cugertino.org
PROJECT ADDRFSSa)_)_56 S.
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CONTRACTOR NAMEN, t.
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
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.
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 below, I certify each of the following is true: I am the property owner or authnrized 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 ADolicant/Agent: � Date: D ZL7'1//
reviser/ 02116111
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01
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building(0)cuoertino.oro
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PROJECT ADDRESS / 19 �n r I�
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APNa/� �v Z� v'Z�
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OWNER NAME (C I
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E-MAIL
1TRn7 ADDRFSS�J oL C,11( CITY, STAG ZIPT FAX
CONTACT NAME ^7K� �Gy-\
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PHONE
E-MAIL
STT ERT ADDRESS
CITY. STATE, ZIP
FAX
❑ OWHER ❑ OWiJCfI.BlR-DER ❑ OWKERAGENT CONTRACTOR ❑CONTRACIoRAGENT ❑ ARCHTECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME \tv(\ \- \ \ A -It
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LICENSE HUMID ERQJOI
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LICENSETI'PE C3
BUS. LIC.9
COMPANY NAME
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EMAIL
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STREET ADDRESS )—q / �` V c�\ J M • 1-
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CITY, STATE. ZIPSO 'J e. C �
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ARCHITEtTJENGINEFR NAME
LICENSENUMIIER
BUS, LIC.a
OMPANY NAME�{1,� /,C ��
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E-MAIL
FAX
STREET ADDRESS
CITY, STATE. ZIP
PHONE
USE OF SFD or Duplex ❑ b1.1t.-Family
srRucruae: Commercial
ROOF AREA:
/7
VALUATIO
1: n
oOl'
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHq . ❑WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE JREPLACE 'RYES
❑ O
IF NO.
M G
PL\WOOD ❑ :5' i / Jt
THICI:NECS ❑ 516'
PLYIVD OSB
PPE' OX
PITCH:
�:1?CLASS'
ROOF
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF .ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT Y
DESCRIPTION OF WORK:
�1r1 C aS
1 Ol �rn
By my signature below, I certify to each of the follow•in¢: I am the propem• owner or authorized agent to act on de property owner's behalf. 1 have read Lha
application and die information I have provided a correct. I have read the Description of Work and verify it is accurate.. I agree to comply With ali applicable local
ordinances and state laws relating W buildi/ng constm •' I authorize re resentatives ofCupertino to enter the ]above-iden'fit W mpem• for inspection purposes.
Signature of ApplicanUAgent:'I- G � Date: `
SUPPLEMENTAL INFORMATION REQUIRED
_ If building is associated with a Home Owners Association, provide letter
of approval from HOA.
_ Provide Planning approval t0 verih' If thele July restrictions.
_ Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupenino's Tear -Off Policy.
- OF'F'ICE
Lice ONLY'.
-- 6IEcic'rvrs, _
ROUI ING SLIP
,N1-sN
YER-THC-COUNTER
EXPRESS
f ❑ STANDARD
BUILDING PLAN REVIEW 'L
PLAYYIFG PLAN REVIEtV'Gr )
FIRE DEPT J(1
OTHER.
Reroofdpp_?Ol Ldoc revised 03/16111
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