12080240 CITY OF CUPERTINO BUILDING PERMIT
BUILDING,ADDRESS: 20669 GARDENSIDE CIR CONI'RACI'OR:BRADS]IAW ROOFING INC PERMIT NO: 12080240
OWNER'S NAME: WIDIAL\EDDY AND WANG KO 1821 S IIASCONI AVE"PNIB 160 DATE ISSUED:08232012
OWNER'S PRONE: 4089962945 CAMPRE.IA,CA 95008 PRONE NO:(408)2469930
/1.1 CENS�ED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r P L U NIR r
License Class (',L_ _ Lic.#_ C7
/,[//'�JS/J1,�_ n1Ecr1 r RESIDENTIAL r COMMERCIALtor
Contracr/� L—Dale
hereby affirm[hit( I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RWIOVE EXISTING WOOD SHAKE ROOF.INSTALL 12SQ
(commencing with Section 7000)or Division 3 of the Ilusiness& Professions NEW
Code and(hill nay license is in full force and effect. CLASS A ASPHALT SHINGLES-AGED DARK
hereby affirm under penally of perjury line of file following two declarations:
I have and will maintain a certificate of consem to seD=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 forhich this Sq.Ft Floor Area: Valuadun:$6000
permit is issued.
A1'PLIC,\NI'CEIfI'IPIG\'Ilf1N APNN'umber:36232021.00 Occupancy'1'}•pe:
I certify that I have read this application and state that the above information is
correct.1 agree to comply with all city and county ordinances and state Imes 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
indemnity and keep harmless the City of Cupertino against liabilities,Judgments,
costs,and expenses which may accrue against said City in consequence ol'the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting orchis permit. Additionally,the applicant understands mid will comply 18U D YS FROM T CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section 'f
9.18. �rZ�rJL
Z Issued b
Signature Dm }': U Date:
❑ OWNER-BUILDER DECLARATION
kF:ROOFS:
1 hereby adDrm that I am exempt frau(lie Contractor's License law for one of All roofs shall be inspected prior to any roofing material beiig installed.If a roof is
(he following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044, )
Business&Professions Code) Signaure ofApplic nc Date: Sh?
1,as owner of the propert),,ant exclusively contracting with licensed conlydclors to
construct the project(Sec.7044,Business&Professions Code). AL1,ROOF COVERINGS TO BE CLASS"A"OR BE'I'I'ER
herehv affirm under penally of perjury one of the following three
declarations: IL\%ARUOIIS NI,\"1'P:Rh\LS DISCLOSURE
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 1 have read the hazardous materials rcquirement.s 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(be Cupertino Nluiicipml Code,Chapter 9.12 and the I Iea11h&
Section 3700 of the Labor Code,for the performance of the stork for which this Safety Code,Section 25532(x)should 1 store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit i5 issued. contaminants ars defined by the Ray Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued.I shall maintain coal pliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safely Code.Sections 25505,25533,and 25534.
Compensation Imes of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions ofthc Labor Code,I must O mer r ar ize en(:
forthwith comply with such provisions or this permit shall be deemed revoked. Dale' C}
APPLICANT CERTIFICATION CONSTRHCI'ION LENDING AGENCY
t
I cenifi•that I have read this application and sure that the above in(ommation is I hereby aff rtn that there is a construction lending agency for the performance of work's
correct. I agree to comply with all city and county ordinances mid state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,mid hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property Ivor 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 ARCHITECI'•S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Dale Licenced Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228 •FAA(408)777-3333•building0cuDertlno.oro
PROTECT ADORE55 ('1 APN k
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O%`"FR NANjAtD PHONE C]�j r E-MAIL
STREET ADDRES CRY. ST TE,ZIP 1 1 b
CONTACT NMIE PHONE F.tA1L
STREET ADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OwNER-BtTLDEK ❑ O%vNERAGENT COrrIRACrOR ❑CONTRACTOR AGENT ❑ .ARCIaTECT ❑ENGB K ❑ DEVELOPER ❑TENANT
CONTIrACi RNAM1fc
LICENSENUMBER UCENSETYPE BUS.LIC.. 3c)
COMPANYNAME ENW �C n� F.AX .
,
STREET ADDRESSk
_ C{T}',STATE " PHONE
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ARCHITECTIENGOJEEK NAME LICENSE NUMBER BUS.LIC.0
COMPANY NAME E1!AIL FAX
1.
STREET.ADDRESS CRY,STATE,ZIP PHONE
USE OF ❑ SFD or DuplexD'lUld-Famil V, ROOFAREA: VALUATION:
STRUCTURE. ❑ Commercial 1�W }n'fi Q�
EXISTINGROOFTYPE::../CIBUILT-UPROOF ❑.ASPHALTSHINGLES RKWOODSHAICES ❑WOODSHTNGLES ❑O-IM(SPECIFY)
REMOVEIREPLACE LYYES IF NO. PLYS'000 :5" ❑ PLYWD ❑ OSBPRCH .I2 ROOF
❑ i R� Y THI'KC ❑ its• TYPE. ❑ f_DX
CLAM
PROPOSED ROOF TYPE: ❑BUILT.UP ROOF ASPHALT 5HINGLES ❑WOOD SNAKES ❑WOOD SRWGLFS ❑OTHER ICC ES REPORT
DESCRIPTION OF\YORK: -C I
By my signature below,I certify W each of the 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 I have provided is correct I have read the Description of NVork and verify it is accurate. l agree m wmply with all applicable local _
ordinances and state laws reladag to bbuil/Qi/ng cons/ry on. I au Ariz epresentatives of Cupertino to enter the Rho
/ve-idcn'11 d property far ilupection purposes.
Signatureof.ApplicanthkgenC�A/.!.!/Ci�l-� Date: 71a��/ ;Dn 12
SUPPLEMENT.ALINFORNLATIONREQUIRED _ omCEUSE ONLY
_If building is associated with a Home O\Aners Association,provide letter PLANCHECKT'PE pia ROUTING SLIP
of approval from HOA. -OVER-THE-COUNTER , `V1 BUILDING PLAN REVTEW
Provide Planning approval to verity if there any restrictions. ❑ EXPRESS - /❑_ PLANNING PLAN MY W
Provide copy of Manufacturers Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
Reroojlpp ?011.Joc revised 03116!11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20669 Gardenside Cir. DA'Z'E: 08/22/2012 REVIEWED Bl': Sean
APN: BP#: VALUATION: $6,000
*PERMITTYPE: Minor Building Permit PLAN CIIECKTYPE: Re-roof
PRIMARI' Buildina is PEN'I'AMATION
Multi-FamilyDwelling 1R2ROOF
USE: >3 Stories l� Yes Q No PERD119'T1'PE: A
11'ORK Remove existing wood shake roof. Install new Class A asphalt shingles: Aged Bark.
SCOPE
FEE ID ROOFAREA
(S.f.)
1REROOFMRES 1,200
Alech. Ilan Check PhunA.Plan Check Elec. Plan Check
Me& Permit Fee: Plumb. Permit Fee: raec.Pennit Fee:
Other Alech.Insp. Other Plumb Insp. Other Elce.Insp. Ll
Medi./nrp.Fee• Plumb. lisp. Fee: Elea Insp.Fee:
NOTE: This astimate does not includejees clue to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District, etc.). These ees ore hosed on the prefitninan information available and are only an esti nate Contact the De t or oddn 7 info.
FEE ITEMS (Fee Resohaion 11-053 EfC 711111) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Sappl. PC Fee
Plum h.hideclt.lElec
Permit Fee: $180.00
SuppL h).Vp T'ee
Ph imh.1,11ech.lEhee
Phmth.1X1ech.1Elec Permit Fee:
Consnvction Tax: 91
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
l dvemced Planning Fees:
Travel Documentation Fees:
Stone Nlotion Fee: IBSEISAUCB $0.60 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $181.601 $0.001 TOTAL FEE: $181.60
Revised: 07/01/2012
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(5cuoertino.org
PROJECT ADDRESS (J/ APNa - ! rl 1 3� _O
Cj \ J�( \
OWN R( ME PIJONFyo 1 E-MAIL
STREET AD 5 CITY,STATE,ZIP FAX
C CTONA. E LICENSE N'UMBE LICENSE IYP BUS.LIC.a
rk \ t 1 h
COMPANY NAME E-MAI
STREET ADDRESS ` , ; C� CG CITY.STATE ZIP I HONE
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 S 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: 1 am the property owner or authorized agent to act on the
property owner's behalf. 1 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: Date:_2LA
Rep-oofPolicv_20l Ldoc revised 02//6/11