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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!