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12090204CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10379 LANSDALF AVE OWNER'S NAM F.: MAO KEVIN AND KOO HELEN TRUSTEE OWNER'S PHONE: 6504526816 ❑ LICENSED CONFRACfOR'S DECLARATION License Class Lie. # Contractor Date hereby affirm that I am licensed under the provisions of Chapter 9 (Coll] with Section 7000) of Division 3 of the Business S Professions Code and that nn• license is in full force and effect. 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 die work for which this permit is issued. APPLICANT CERTI FIC.ATION I certify that I have read this application and state that the above infommtion is correct. I 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 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 applicaa understands and will comply with all non -point source regulation; per the Cupertino Municipal Code, Section 9.18, Date ❑ OWNER- RIIILDER DECLARATION hereby affirm that I 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 (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 of firm 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 perfommnce of the work for which this permit is issued, I cenify,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 ofCalifamia. If, after making this cerificate 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. U'PLICANF CERTIFICATION I certify that 1 have read this application and state that the above infommtion 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. CONTRACTOR: MAO KEVIN AND KOO PIiRMIT NO: 12090204 1IELEN TRUSTEE 2841 0AKM0N`f DR DATE ISSUED:, 09242012 SAN BRUNO, CA 94066 PRONE NO: BUILDING PERMIT INFO: BLDG (- ELECT (_ PLUMB J DIECII r RESIDENTIAL r COMMERCIAL I— ,JOB DESCRIPTION: RHBfOVE WOOD SIIAKES INSTALL COMP 2070 SQ CLASS A Sq. Ft Floor,Area: I Valuation: $12119 APN Number: 36911003.00 1 Occuryiq•Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. I pr Issued by: . WYa' Date: q•2'i.� RE- ROOM'S: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF CONTRINGS TO [IF. CLASS "A" OR BED—IT R HAZARDOUS MATERIALS DISCLOSURE have read the hazardous materials requirements under Chapter 6.95 of the California Ilealth S Safety Code, Sections 25505. 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code. Section 25532(x) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants its defied by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Ilealth A Safety Code, Sections 25505, 25533, and 25534..��//�� Owner or at borax g Date.�y-' CONSTRUCTION LENDING AGENCY I hereby affum that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCIII'1'ECf'S DECLARA'T'ION 1 understand my plans shall be used as public records. _7V/1 I Licensed REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUPERTINO (408) 777 -3228 • FAX (408) 777 -3333 • buildinc(a)cupertino.ora �s r PROJECT ADDRESS 03 q J �•,�� Qr l /r1 Ow74ER NAME / ew- n/ ,,"Q"'o Mao /Ij PHONE &' A 1C1 6r4/ /V! / YCl l O�'O E -MAIL �oheV0 nt` l ^ -_ _, 5. j� Ll.t / STREET ADDRESS / V 3 7 •J f...6�VK ///��4 V{ CITY, STATE ZIP I N v FAX CONTACT NAME PHONE rte., ^� /V L E -hLUL O2.7s wlr.T STREET ADDRESS CITY. STATE, ZIP FAX �,-,// ❑ OwvER ❑ OWNER- BUROEA ❑ OWNERAGENT 9/ CONiR1CrOR ❑CONIRA`CCrORAGEtIT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME j;_ - (� LICENSE NUMBERQ ^ d LICENSETYPE � BUS. LIC.0 COMPANY NAME Y'- E -MAIL FAX STREET ADDRESS - - — - r -- CITY', ST.AIE, ZI rte. use - _ /2 _ PHONE A SZ -Z - ARCHITECTIENGINEER NAME LICENSE NUMBER BUS. LIC. 0 COMPANY NAME E -MAIL FAX STREET ADDRESS CRY, STATE, ZIP PHONE USE OF ;<SFD or Duplex ❑ hlulh-Family, STRUCTURE: ❑ Conlrtlercial ROOF AREA: % VALUATION: EXISTING ROOF TYPE: ❑ BUILT -UP ROOF Cl ASPHALT SHINGLES A WOOD SHAI:ES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE YES ❑ N IF N0. qRC PLYWOOD ❑ :5' ❑ THI c - ❑ alt" PLYWD OSB ❑• PITCH: -'1' ROOF CLASS' PROPOSED ROOF TYPE: ❑ BUILT -UP ROOF XSPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC "ES REPORT d DESCRIPTION OF WORE: ✓>° Sff� C By my signature below. 1 certify to each of the followine: I am the property o%vner or authorized agent to act on the property owner's behalf. 1 have read this application and die information [have provided is correct. I have read the Description of Wort: and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin^ nst - n. I a ho a representatives of Cupertino to enter the above -idcni ed ro Try• for inspection purposes. Signature of ApplicandAgent: '' Date: 9 a �1y SUPPLEMENTAL INFORMATION REQUIRED _ If building is associated with a Home Owners Association, provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions. _ Provide copy of Manufacturers Installation Specifications. Provide signed copy ofCupertino's Tear-Off Policy. - oFFI('EUSEONLV - PLAN CHCCKTYPE:_ _ ROMNG sue _ '0 UY'CR- TI {E- CUUKrEHM ❑' EXPRESS ❑ TANDARU•. , - 13 BUILDING PLAN REVIEW • ❑ PLANHIN6. PLAN Nec{ew' ❑ 1`1 RE DErr ❑: OTHER: ReroojApp_201 I.doc revised 03116111 .r1, Can CITY OF CUPERTINO Imo/ /I FEE ESTIMATOR - BUILDING DIVISION JAFADDRESS: 10379 Lansdale Ave. DATE: 09/24/2012 REVIEWED BI': jsg blech. Permit Fee: APN: BP #: 'VALUATION: $12,119 *PERNIITTI'PE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY USE: SFD or Duplex Eire. Insp. ree: PENTADLITION PERMITTI'PE: 1SFDWLROOF WORK Remove wood shakes install con SCOPE FEE ID ROOFAREA s. f. 1REROOFFRES 2,070 NOTE: This estimate docv not includejees Flue to other Departments (i.e. Planning, Public II'orks, Fire, Sanitary Sewer District, School District. etc.). These feet are based on die mreliminary information asmilable and are only an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11 -053 F_/L 711111) Alech. Plan Check Phonb. Plan Check Elec. Plat Check blech. Permit Fee: Plumb. Permit Fee: F.lec. Permit Fee: Other APech. Imp. Other Plumb Insp. Other Elce. Insp. Alech. Insp. Fee: Phonb. to j). ree: Eire. Insp. ree: NOTE: This estimate docv not includejees Flue to other Departments (i.e. Planning, Public II'orks, Fire, Sanitary Sewer District, School District. etc.). These feet are based on die mreliminary information asmilable and are only an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11 -053 F_/L 711111) FEE QTY /FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee Plamb.lHech./Elec Permit Fee: $315.00 SuppL Insp Fee Plumb.1blech.1&e c. Plumb. /A,lecb.Aaec Permit ree: Construction Tax: Administrative Fec: Work Without Permit? O Yes 0 No $0.00 Advanced Planting Fees: Travel Docnnentation Fees: Strong Motion Fee: IBSEISAHCR $1.21 Select an Administrative Item Bldg Sids Commission Fee: IBCBSC $1.00 SUBTOTALS: $317.21 $0.00 TOTAL FEE: 1 $317.21 Revised: 07/01/2012 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 - building(aDcuoertino.oro PROIECFADDRFSS /C,?3 i //1��5 �, ` / APNN OWNER NAME ` PHONE /� A �� /1O/ / !7 tiCJ (7 1 / ✓ �W y-J STREET ADDRESS 162 17 i _ /_ �/ ��yGl (,u((f jCe CITY, STATE ZIP -�-nD `LICENSE FAX CONTRACTOR NAME L LICENSE NUMBER TYPE BUS. LIC. a COMPANYNAME Ir. �( E -MAIL lD itr l STREET ADDRESS CITY. STATE M PHONE v r� 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. 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 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 R314 and R315 of the 2010 California Residential Code. 9 Signature of Applicant/Agent: ReroofPolicv_ 201 Ldoc reviser/ 02116111