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12050052CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22437 ST ANDREWS AVE OWNER'SNAME: ERIC ENG OWNER'S PIIONF-: 4084808838 ❑ LICENSED CONTRACTOR'S DECLARATION License Class 03,9 .it. iv So/p S Z Contractor _�%7.ir�i1�-cam Date 1 hereby affirm that l am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 orthe Business & Professions Code and that my license is in full force and effect. 1 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 Workers 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 indemnifyand 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. �j� �'�-r Signature- �"��- � Date `S' ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am 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 (See 7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sea7044, 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 (his 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 Cali lomia. 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. APPI-ICANTCERTIFICATION 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 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. Date CONTRACTOR: TNT ROOFING CO PERMIT NO: 12050052 1610 BLOSSOM HILI- RDSTE 6C DATE ISSUED: 05/03/2012 SAN JOSE. CA 95124 PHONE NO: (408(277-0800 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MEC" r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: RE -ROOT 25 SQPT REMOVE SI IAKE ROOF, INSTALL CDX PLYWOOD 30LB FELT PAPER, CLASS A Sq. Ft Floor Area: I Valualiun: $9036 APN Number: 35604018.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b Date: --F— RE-ROOFS: RE -ROOFS: All rools shall be inspected prior to any tooling material beYtg installed If roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date. ALI, ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Ilealth & Safely Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code. Chapter 9.12 and the Ilealth & Safety 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 Coda Chapter 9.12 and the Ilealth & Safely Code, Sech s 25505, 25533, and 25534, Owr.a Ih eil- t- C Dale• I hereby affirm that there is a conslmction lending agency for the perfomrance of cork's for which this permit is issued (See 3097, Civ C.) Lender's Name Lender's ARCIIIT'F,CT"S DECLARATION I understand my plans shall he used as public records, Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35604018.00 DATE ISSUED.......: 05/03/2012 RECEIPT #.........: BS000016704 REFERENCE ID # ...: 12050052 SITE ADDRESS 22437 ST ANDREWS AVE SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ........ OPERATOR: patg COPY # : 1 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 351.90 --------------- 351.90 VOICE ID DESCRIPTION ----- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- -------- ----- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF OWNER ............: ERIC ENG ADDRESS ..........: 22437 ST ANDREWS AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: MICHAEL D WILLIAMS CONTRACTOR .......: WILLIAM TYLER LIC # 22988 COMPANY ..........: TNT ROOFING CO ADDRESS ..........: 1610 BLOSSOM HILL RD STE 6C CITY/STATE/ZIP ...: SAN JOSE, CA 95124 TELEPHONE ... :.... : (408)277-0800 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ------ NEW BAL --- ---------- 1BCBSC ----------------------- VALUATION 9,036.00 --- ------ 1.00 0.00 1.00 0.00 1BSEISMICR VALUATION 9,036.00 0.90 0.00 0.90 0.00 1REROOFRES SQ FEET 25.00 350.00 0.00 350.00 0.00 ----- TOTAL PERMIT ---------- ---------- 351.90 0.00 ------- 351.90 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 351.90 --------------- 351.90 VOICE ID DESCRIPTION ----- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- -------- ----- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF CUPERTINO 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 (408) 777-3228 - FAX (408) 777-3333 • buildinona cupertino.oro PROJF:CTADDRESS �li APN0 OWNER NAME -� PHONE./) W� N )Qt EMAIL STREETADDRESS �L Y. L U CITY. STAT�bZIP �'�/ FAX CONTRACTOR NAME LICENSE NUMBER` 5y G(- LICENSETYPE BUS LIC. u COMPANY NAME�-J Vu i`LoU, /�2C� I STREET ADDT 1 / CItTYY,,STATE, IP �jD� PH -10y � 10 }fOoJ 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. 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/4" 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 authorized 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 8314 and R315 of the 2010 California Residentiaj Resident'Code. Signature of Applicaru/A enc Date: l C CUPERTINO l ZUj �U�Z REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 0014 -MM (408) 7773728 • FAX (408) 777-3333 • buildinoftwoertino.oro PROJECT ADDRESS rf Z / N� APNq to - Ur J OWNER NA,\9:LCi PHONE �l` 3 E\WI- STREET ADDRF.S? 2 L13 A. CFFY /vlw c, FAX IL(1 I J '/J/I'•-•` CA 4 CONTACT NAMECC PHONE�`�f V v� r✓ l: STRFIT ADDRESS - ,�/ _ CRY. ATSzIP F.l\J Z ,�/ ❑ OWNER ❑ OWETA-BUILDER ❑ OWNRRAOFM CONTRACTOR ❑CONiRACTORAGENT ❑ ARCHMCr ❑ ENGNTER ❑ DEVT OPRR ❑ TE- ANT CONTRACTOR NAME IJCFTSE NUNMER 56 s � �/ LICE\SET E �, NUS Mr.. e COMPANY NAME (Zb E-MAIL e FAC_ gS- )87 � r,ll<e-�f-ISL, 44,v -<w( STREET ADDRESS i Z3q Wee cruGrfY,ST ZIP ny be &iq 25713 7'ps ARCIMTCf NGPJEFR NA1W IACI . NUMBFR BLS. I.IC, 0 COMPANY NAME E-MAIL FAX STRF}T ADDRFSS CITY, STATF. 71P PHONE USE OF FD or Duplex ❑ Multi -Family ROOFAARFA VALUATION: STRU=RE: ❑ Commercial 0 (30 -60 F_CISTING ROOF TYPE: ❑BUILT-UPROOF 13 ASPHALT SHINGLES ,,....,,��ZSQo71 IAWOODSHAKF.S ❑WOODSHINGLFS ❑ OITIER(SPECIFY) REMOVEIREPLACE YES I TF NO.PLYWOOD X" ❑ PI.YWD 13OSB PRCH: ROOF AYERS 712 A PROPOSEDROOFTYPE- ❑BUILT-UPROOF ltfASPHALTSHINGLPS ❑WOODSHAKES 11 WOOD SI UNOLFS ❑OTT U -M ICC -FS RFT'ORTH DESCRIPTION OF WORE: y (2��a�c � rtuu / �NJYw4 C.D�_ 30 �/ cotton �S By my signature below, I certify to each of the following: Ism the property owner or authorized agent to act on the property owner's behalf. I havv raced this application and the information 1 have provided is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and stale laws relating to building construction. I authorize nprescnatives of CupLnjno to enter the above -identified property for inspection purposes. Signature of ApplicanUAgent: Date: Z. L / SUPPLEMENTAL INFORMATION REQUIRED �'F-� ' ; omcls USE om.Y r_ r/ PIANCHWKTYPE' rh 'wm NOV17Nr46LP.... I ,r .+ of approval from HOA. ®y-. O\BR-=-TT3I%-('OIwrfYTCR z IYC -{-xW-..i HL7IDPLIN R6VI6\\ Provide Planning approval to verify if there any, restrictions. .` ❑ �� t .. � ❑ nwN�LNc 'nAni rrr�R Provide copy of ManufachJrv's Installation Specifications.❑ 9M1k' R0 �' Rev'sw ❑ �7RR ide signed copy of Cupertino's Tear -Off Policy. j a �`� of ❑ o1ffiR.' k I 1 r + u. 1 c _ ReroojApp_2011.doc revised 03116/11