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10050166CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10338 COLD HARBOR AVE OWNER'S NAME: WOO WILLIAM K HO AND YAN Y ;ER'S PHONE: 4086058855 IM LICENSSEEjD CONTRACTOR'S DECLARATION License ClassL1/ �' ( Lie. # 3 170 3 Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty 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 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 for which this permit is issued. 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 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 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 , V Date LA OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, 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) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty 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 Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall 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 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. 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 upon the above mentioned property for inspection purposes. (We) agree to save i- -mify and keep harmless the City of Cupertino against liabilities, judgments, 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 re F lations per the Cupertino Municipal Code, Section 9.18. /-\( .^ ( \I n Date" oj�tV CONTRACTOR: TBD - TO BE DETERMINED PERMIT NO: 10050166 DATE ISSUED: 05/21/2010 ... PHONE NO: BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH F RESIDENTIAL f- COMMERCIAL F JOB DESCRIPTION: RE -ROOF APPLY I LAYER OF 30LB BASE FELT DOWN, APPI Y PRESIDENT TL ULTIMATE COMP SHINGLE WORK CLANS A 35SQ Sq. I t Floor Area: APN Number: 36909029.00 Valuation: $14000 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR :[80 DFROM LAST CALLED INSPECTION. Issued by: 2 /- b Date: RE -ROOFS: All profs shall be inspected prior to any roofing material being installed. If a roof is insta led without first obtaining an inspection, I agree to remove all new materials for inspection. Sign: iture of Applicant: Date: 512 1 _ ( C ALL ROOF COVERING TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I hai a read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safely Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authoriz d �:/ <_ �' — Date: c7 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Len( er's Name Len( er's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO RECEIPT NUMBER: BS000010458 RECEIVED BY: PATRICIAG PAYOR: JOYCE YI PAK TODAY'S DATE: 05/21/10 REGISTER DATE: 05/21/10 TIME: 12:26 4 1BCBSC 10050166 1BSEISMICR 10050166 1REROOFRES 10050166 BUSINESS LICENSE TAX PAK'S ROOFING INC TOTAL DUE: CREDIT CARD: $571.40 ]2EF NUM: VISA 'GENDERED $571.40 $1.00 $1.40 $455.00 $114.00 $571.40 CHANGE $.00 CITY OF CUPERTINO 3 ITEMS OF 4 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: ]got: APN ........: 36909029.00 DATE ISSUED.......: 05/21,'2010 RECEIPT #.........: BS000010458 REFERENCE ID # ...: 10050:_66 SITE ADDRESS .....: 10338 COLD HARBOR AVE SUBDIVISION ...... CITY .............. CUPER-INO IMPACT AREA ...... OPERATOR: patg COPY # : 1 OWNER ............: WOO W::LLIAM K HO AND YAN Y ADDRESS ..........: 10338 COLD HARBOR AVE CITY/STATE/ZIP ...: CUPER"INO CA, CA 95014-4972 RECEIVED FROM ....: JOYCE YI PAK CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: , TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 14,000.00 ----------- 1.00 ---------- 0.00 ---------- 1.00 ---------- 0.00 1BSEISMICR VALUATION 14,000.00 1.40 0.00 1.40 0.00 1REROOFRES SQ FEET 35.00 455.00 ----------- 0.00 ---------- 455.00 ---------- 0.00 ---------- TOTAL PERMIT 457.40 0.00 457.40 0.00 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF CITY OF CITY OF CUPERTINO REROOF CUPERTINO PERMIT APPLICATION APN #Date: y n L.% Building Address: Owner's Name: XaA Phone #: HOA: Yes ❑ No ❑ If Yes, provide letter i'rom HOA Contractor: Phone #:, - j. --Z.'7 7,9– Fax #: Cupertino Business License #: Contractor License #: Q3 -7c` 35_ Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof Asphalt Shingles Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles -� `�i Other (Specify) ❑ Wood Shingles ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: � A yp1 y one Jager of- � :) cb h+_ze- tlypitj pio Je of 7L— uihim t-6 (TA�''' 't Residential 0 -3 5 5k Commercial Green Building: Please complete relevant portion of the Confirmed with -Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: 14, 000 - I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: Signature Revised 02/05/09 CITY OF CITY OF CUP_ERTINO REROOF CUPERTINO FEE SCHEDULE Number of Squares Fee ID Fee Descriptioa Fee Group Permit Type 1REROOFCOM Re -roof Commeicial B 1COMMLROOF 1BCBSC Cal Bldg Standards Commission Fee: B ALL PERMIT TYPES 1BSEISMIC0 Seismic Commercial B 1RER00FRES Re -roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards Commission Fec, B ALL PERMIT TYPES 1BSEISMICRE Seismic Resider..tial B 1REROOFMRES Re -roof Multi -Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards Commission Fe(, B ALL PERMIT TYPES 1BSEISMICRE Seismic Resideritial B 1BUSLIC Business License B CUPERTINO REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 55014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildirq(@cupertino.org PROJECT ADDRESS i^, �3Q /r, I (� /, L� ALJ �j / APN # OWNER NAME C? " PHONE 4` . ji � 666-8s E-MAIL STREET ADDRESS /r , ]yg ` 1CI H(tr o CITY, STATE, ZI} / 1,� / , 4- I� � FAX CONTRACTOR NAME G1 +, nC� �� /, Tn l// LICENSE NUMBER �j`�-7�� LICENSE TYPE BUS. BUS. LIC. # COMPANY NAME PeIKi� R©_ f � n� j� lr E-MAIL FAX ST ET ADD CrrY, ST TE, ZI PHONE Y' I UNDERSTAND AND AGREE TO THE FOLLOWING: The re -roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimurr. of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon -Fri). 3. Tear -off roof inspection is required. Please call for tear -off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and al. dry -rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:_,Oam and 1:00 — 3:30pm (Mon— Thurs); 7:30 — 10:-,0am and 1:00 — 2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection. is required. 5. In -Progress roof inspection is required. Call for ar in -progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained frorl the building inspector when the re -roofing is complete. To receive a final sign -off, the following it ems will be verified: a. Flat roofs shall have a minimum of }/4" per foot of slope and must 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. 8. NOTE: If you call for a tear -off or plywood nailing I nspection 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 a agree t coTply with the re -roof policy stated above. Signature of Applicant/Agent: ""��� Date: 0 ReroofPolicy_2010.doc revised 05/17/10