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11100068 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10553 CEDAR TREE CT CONTRACTOR :ERMIT NO: 11100068 OWNER'S NAME: CHEN CHUNG-CHIEH AND HSU CHIA-LING DATE ISSUED: 10/11/2011 PHONE NO: WI—JER'S PHONE: 4082505208 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG� ELECT� PLUMB License Class / Lic.# 8K/0 MECH T_ RESIDENTIAL r COMMERCIAL Contractor 6(-,f Cy), 1'�V Date JOB DESCRIPTION:RE-ROOF 30SQ REMOVE WOOD SHAKE,INSTALL OSB I hereby affirm that I am licensed under the provisions of Chapter 9 SHEETING&50YR COMP CLASS A (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 Sq.Ft Floor Area: Valuation:$9000 permit is issued. ��f APPLICANT CERTIFICATION IIIf��P� APN Number:31634020.00 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 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 and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply 180 DAYS F LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section - 9.18. Issued by: f/ Date: Signature Date/6, OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing 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 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, /�/�/ Date: Business&Professions Code) Signature of Applicant: 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I 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& Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with 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 Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized agent: ��— Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify 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 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 and expenses which may accrue against said City in consequence of the ng of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION wun all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31634020. 00 DATE ISSUED. . . . . . . : 10/11/2011 RECEIPT #. . . . . . . . . : BS000015002 REFERENCE ID # . . . : 11100068 SITE ADDRESS . . . . . : 10553 CEDAR TREE CT SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CHEN CHUNG-CHIEH AND HSU CHIA- ADDRESS . . . . . . . . . . : 10553 CEDAR TREE CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : BRIAN CLINTON MILLE 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 9, 000 .00 1. 00 0. 00 1.00 0 . 00 1BSEISMICR VALUATION 9, 000 .00 0. 90 0. 00 0 .90 0 . 00 1REROOFRES SQ FEET 30 .00 420. 00 0. 00 420 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 421. 90 0 . 00 421. 90 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 421. 90 VISA --------------- TOTAL RECEIPT 421. 90 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF REROOF PERMIT APPLICATION Ell COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228 • FAX(40,8)777-3333 • building aacupertino.org CUPERTINO PROJECT ADDRESS p S53 r al . 4PN# OWNER NAME , ✓ PHONE _�J q E-MAIL i /_ STREET ADDRESSCITY, STATE ZIP_ FAX Iasi CA d. APPLICANT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ;R CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHMCT ❑ENGNEEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME6 LICENSE NUMBER _f LICENSE TYPE q BUS.LIC.# A, COMPANY NAME I j I,^ E-MAIL FAX STREET ADDRESS s ' i CITY,STATE,ZIP ( PHONE � 1 C� J p� ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: C STRUCTURE: ❑ Commercial Aa EXISTING ROOF TYPE: 13BUILT-UPROOF 13 ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE YES IF NO, PLYWOOD E] 'he ❑ PLY VD NOSB P1TCI� ROOF [] No #LAYERS: THICKNESS: 135/8, TYPE: ElCDX 'L 12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORY-- cmt io By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino Lc,enter the above-identified /property For inspection purposes. Signature ofApplicant/Agent Date: (0 SUPPLEMENTAL INFORMATION REQUIRED If building is associated with a Home Owner's Association,provide letter of approval from HOA. =i �_ �- Provide Planning approval to verify if there any restrictions. h TM 'S - Ss�==� Provide copy of Manufacturer's Installation Specifications. E a _ Provide signed copy of Cupertino's Tear-Off Policy. F. � �.� — � ,- ReroofApp_2011.doc revised 03/02/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION JJADDRESS: 10553 Cedartree ct DATE: 10/11/2011 REVIEWED BY: Sylvia PN: BP#: "VALUATION: $9,000 "PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION 1SFDWLR00F USE: SFD or Duplex PERMIT TYPE: WORK Re-roof 30 sq, remove wood shake install OSB sheeting and 50 yr comp, Class A SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 3,000 El NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These fees are based on the prelindina information available and are onl an estimate. Contact the De t or addn'l info, FEE ITEMS (1 ee Resolution 11-053 Eff' '1.-11) FEE QTY/FEE MISC ITEMS Permit Fee: $420.00 Work Without Permit? 0 Yes No $0.00 i Strom?lylotion Fee: 1BSEISMICR $0.90 Select an Administrative Item Bldiz Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $421.90 $0.00 TOTAL FEE: $421.90 Revised: 10/01/2011 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•building(a)cupertino.org PROJECT ADDRESS ( APN# U.) ,;3 cc�mAry-L1 OWNER NAME PHONE 510 �) O E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX CONTRACTOR NAME AA LICENSE NUMBER O/ Q LICENSE TYPEC,3 BUS.LIC.# COMPANY NAME /�i /' © 1^ E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP G PHONE 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 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. Signature of Applicant/Agent: Dater I� t ReroofPolicv 2011.doc revised 02/16/11 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 .0 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: SV, PERMIT# I ( 10, OWNER'S NAME: V/ PHONE# 3,S GENERAL CONTRACTOR: bf/ MOW BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1� 14) . 1 � ' 1 am not using any subcontractors: ��� � Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile / Date Owner/Contractor Signature