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12090022 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20668 GARDENSIDE CIR CONTRACTOR:BRADSHAW ROOFING INC PERMIT N0: 12090022 OWNER'S NAME: YIN VICTOR HAO-EN AND KUEI CHUN 1821 S BASCOM AVE PdIB 160 DATE ISSUED:09/102012 OWNER'S PHONE: 4082469930 CAMPBELL.CA 95008 PHONE NO:(409)2449930 GY LIC�7ENSED CONTRAC`TOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB License Class .0 _n, Lic.9 / 3 RG r r I_w MECH RESIDENTIAL COMMERCIAL Contractor asdd Date I ho I a hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REMOVE EXISTING WOOD SHAKE ROOFING.INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions 1200 Code and that my license is in full force and effect. SQFT NEW CLASS A COMPOSITION SHINGLES(AGED BARK) hereby affirm under penalty of perjury nne 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 Sq.Ft Floor Area: Valuation:$6000 permit is issued. APPLICANT CERTIFICATION APN Number:36232014.00 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 mid 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify mid keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence ofthe WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting ofthis permit. Additionally,the applicant understands andwill comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point sourc regulatirns per the Cupertino Municipal Code,Section I.—f p—12 9.18. //D Z Issued by: Date: SignatureDate ❑ OWNER-BUILDER DECLARATION RE-ROOFS: hereby affirm that I am exempt from the Contractor's License Law for nne of All roofs shall be.inspected prior to any roofing material beitg installed.If a roof is the following two reasons: installed without first obtaining an i s ection,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, _ Sign Business&Professions Code) of Appli©nt: Date: //�Q I,as owner of properly,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE.CLASS"A"OR BETTER 1 hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 1 have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Cade,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work forwhich this permit is issued. California Health&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 Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code.Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Jtanagcment District 1 will I certify that in the performance of the work for which this pemtit is issued,I shall maintain compliance x'ith 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 Ilealth&Safety Code.Sections 25505,25533,and 25534. Compensation laws of Califomia. If,after making this certificate ofexemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must Ow err orva riz gent �D /2 forthwith comply with such provisions or this permit shall be deemed revoked. Date: CONSTRUCTION LENDING AGENCI' APPLICANT CERTIFICATION I cenify that I 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 Imus relating for which this permit is issued(Sec.3197,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 ARCHITFCI"S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9,18. I understand my plans shall be used as public records. Signature Date Licensed Professional Revised: 07/01/2012 REIROOF PERMIT APPLICATION ". COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION -" 10300 TORP,E AVENUE•CUPERTINO.CA 95014-3255 s CUPERTlNO (408)777-3228 •FAX(408)777-3333 •buildina(ccuoertino.org PROIECTADDRESS OOO IJ C r en lC C 1 r — OWNER NAAM PHONE ^ �^ �O E-MAIL STREET ADDRESS CY, STATE,ZI rK �-( FAX ac-1n)LACONTACT NMIE PHONE - E-NIAIL STREET ADDRESS CITY,STATE. ZIP , FAX ❑OWNER ❑ OWNER-0U ZER ❑ Ott'NERAGEUT M CON ICIOR ❑CONTRACTORAGENT ❑ ARCIBTECT ❑FIGHTER ❑ DEVELOPER ❑TERkW CONTRACT RNAME LICENSENUAda ER LICENSE TYPE BUS.LICA W! COMPANYNAME STREET ADDRESS C(Tl',STA [P r PHONE rr n ARCHITECL'ENOIEER NAME UCENSE NUMBER BUS.UC.d CObTANY NAME E.IAM FAX 1 STREET ADDRESS CT',STATE,ZIP PHONE USE OF ❑ SFD or Duplex Nfuld-Family, ROOF AREA: C VALUATION:// o' STRUCTURE. ❑ COnunercial PM s%. F4 1O EXISTINGROOFTYPE ❑BUILT{PROOF ❑ASPHALTSHINGLES G7'WOODSHAKES ( ❑WOoOSHn<GLES ❑OTHER(SPECIFY, REMOVE REPLACE I"'tT5 IF NO, /,I� PLY`.VoOD ;}' ❑ PLYWD ❑ OSB PITCH: (2 ROOF ❑ O al Rc j� c ❑ :3' ❑ fX PROPOSED ROOF TYPE: ❑BUILT-uP ROOFASPHALT SHR.OLES ❑WOOD SHARES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT a OESCmPTIUNOFN'ORR: ` 1f. By ray signature below,I cervi y to each oC the follo%ing: I am the property miner or authorized agent to act on the property owner's behalf. I have=d this applimdon and the information 1 ha.e provided is correct. I hm'e read tin Description of Work and verify it is accurate. 1 agree m comply with all applicable laml ordinances and suac laps relating to budldinn ons/�-e�q�on. I au nz epresentatives of Cupertino m enter the above-identif property Cor inspection purposes. Signature ofApplimnU.Aeene (.�. ` rs~ Date: 7(ara��c�)2 SUPPLEMENT.AL INFOn-LATION REQUIRED . OFFICE USE ONLY _If building is associated with a Home Owners,Association,provide letter Mkv CHECKT'PE ROU LNGSLIP - of approval tram HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _Provide Planning approval to eed iv if there any restrictions. ❑ 6YPItFSS ❑ PLANNING PLAN RErTER' Provide copy of ManufacnHer s Installation Specificadons. ❑ sTANDARo ❑ ETRE DEPT Provide signed copy of Cupertino'S Tem-Off Policy. ❑ OTHER: Reroof.lop_?011.docrevised 03R271 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20668 Gardenside Cir DATE: 09/04/2012 REVIEWED BY: Sean AN: BP#: 'VALUATION: $6,000 *PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Multi-FamilBuildino is PENTAMATION USE: y Dwelling >3 Stories O Yes E) No PERMITTYPE: 1R2R00F WORK Remove existing wood shake roofing. Install new Class A composition shingles A ed Bark). SCOPE FEE ID ROOFAREA s.f. 1REROOFMRES 1,200 Mech. Plan Check Phumb. Plein Chock Flec.Plan Check Mech.Permit Fee: Funk Permit Fee: Flec.Permit Gee: Other Mech.Inep. Other Plumb Insp. Other Elee.Insp. ,1•/cch.Insp. Fac: P/nmh. hup.Fee: Elec./"SP.Fee: NOTE: This ewinrate doer not include fees clue to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the preffininanv information available and are only an estimate Contact the De t or atldn'l info, FEE ITEMS (Fee Resohuion I1-053 Elf 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PCP ee Plumb.A%,1ech.1E1ec Permit Fee: $180.00 Supp/. Insp Fee Pluut h.1,ldech.1Elec Plunih.lXlech./Flec Permit Fee: Cntsmnction Tax: Adininisu•ntive Fee: Work Without Permit? O Yes G) No $0.00 Advancer/Planting Fees: Travel Documentation Fees: Strong Motion Fee: IBSEtSM1CR $0.60 Select an Administrative Item Bldg Sids Commission Fee: IBCBSC $1.00 SUBTOTALS: $181.60 $0.001 TOTAL FEE: 1 $181.60 Revised: 07101/2012 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION ALBERT SALVADOR. P.E., C.B.O.. BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildino(a)cupertino.orD PROJECT ADDRESS APNa , 1 Ll - OWNERNAME \j Tr I PHONE ��30 E-MAIL STREET CITY.STATE.2 FAX C, c .ns, Gr no QfA 9SQN CTO NA. E LICENSE NUMBE LICENSE TYP BUS.LIC.M. Ci, 1L % t� Q COMPANY NAME EMAI 'Ile "28-1 AX `II-2 - - OIS3 STREETAD Ee1S ` ' ` , ; C� CITY.STATE,LP l HONE V 246 S930 I UNDERSTAND AND AGREE TO THE FOLLOWING: I. 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 5126.00. 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: l 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. 1 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: Re,wgJPo1icv_201 Ldoc revised 02/16111