13100052 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10209 BONNY DR CONTRACTOR:MARCO ROOFING PERMIT NO:13100052
OWNER'S NAME: CHANG WANG-YANG AND CHIANG JANET S P O BOX 1691 DATE ISSUED: 10/07/2013
OWNER'S PHONE: 4083910604, FREMONT,CA 94538 PHONE NO:(510)656-6400
l LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class C 3 Lie.# '40 2, (4 RE-ROOF 31 SQ-RE-ROOF TEAR OFF,RESHEET W/1/2
/13 OSB CLASS A
Contractor /-'1Z-C,0 �t^fS Date t0 7
I hereby affirm that I am licensed and r the provisions of Chapter 9
(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
p ormance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$22290
--rand
will maintain Worker's Compensation Insurance,as provided for by
ection 3700 of the Labor Code,for the performance of the work for which this APN Number:35912032.00 Occupancy Type:
ermit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT XPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WIT 8 AYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 18V,1�§AOM LAST CALLED INSPE T N.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of thegranting of this permit. Additionally,the,applicant understandsand will comply Issued byDate:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date 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 ove all new materials for
inspection.
❑ OWW90ILDER DECLARATION J
Signature of Applicant: Date: �d 7
I hereby affirml at I am exempt from the Contractor's License Law for one of
the following two reasons: AL OOF C RING BE CLASS"A"OR BETTER
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 HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Cha r 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 2553
Section 3700 of the Labor Code,for:the performance of the work for which this
Owner or authorized agent: Date:
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 California. If,after making this certificate of exemption,I CONS N LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that the, onstrnction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•building(@cupertino.org 0
PROJECT ADDRESS to-7 o pD 1)A)
/ APN# A -, 0,52-
-6
OWNER NAME CL� G A /` PH 1 ' I'G/o 1 E-MAIL
il
S DRE �1 CITY,STATE,ZIP L' G� FAX
DO O AJIJ I 2 c-U E 71A)d CA /501`1
CONTACT NAME PHONE E-MAII
i 1�C 1,JG 5io -656-6400
STREET ADDRESS O� 1` � , CTfY,STATE,Z% C A 'F� 9 FAX
❑OWNER lDJ ❑ OWNER-BUILDER ❑ OWNER AGENT WCONTRA.CTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NUMBERoeD I
'MPANY NAME LI�SE E BUS.LIC.
�� #
CO ,)6 E-MAIL `7 J FIo -656 -6 302-/
STREET^A�� q CIT ,STA 1 F A� �� 4 ` PHONE39 D
ARCHITECT/ENGINEER NAME LICENSE NUMBER 5 BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD or Duplex ❑ Multi-Family ROOF� W AREA: VALUATION:VALUATION: 1
STRUCTURE: ❑ Commercial 2 ,70
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE %,YES IF NO, PLYWOOD %z" ❑ PLYWD 19OSB PITCH: ROOF
❑NO #LAVE THICKNESS: ❑ SB" TYPE: 13 Cox J—:12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF 9(ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK: )
1 " ?
I� 2 �9 • cif-// � �/ME
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 represenoto enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: �� 7
SUPPLEMENTAL INF TION OFFICE USE ONLY
_If building is associated ' a wner s Association,provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HO . OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FM DEPT
Provide signed copy of Cupertino's Tear-Off Policy. / ❑ OTHER:
L�
ReroofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: *VALUATION: 1$22,290
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF
USE: P PERMIT TYPE:
WORK
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 3,100
77.77
Llech.Plan Check P1.wnb.Plun Check Elec.Plan Check
Xlech.Perini[Fee: Plumb.Permit I ee: 1>lec•. Permit T'ee:
F
Alec�h.Insp. Other Plumb Insp. Other flee.Insp.
. Insp.Fee: Plumb. Insp.Fete: Elec.Insp.Fee:
NOTE:This estimate does not include fees due to other Departments(Ga Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta). These fees are based on the prefindna information available and are only an estimate. Contact the Dept-for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC'T'ee
Plum b.l'illtech./Flee
Permit Fee: $496.00
Sulopl. Insp fere
Plumb.i1v1ech./Flee
Plumb./;Ylech./Flee Permit Fee:
Construction Tax:
Administrative Fee:
Work Without Permit? ®Yes No $0.00
,Advanced Planning 1+'ees:
Travel Documentation.Fees: i
Strong Motion Fee: IBSEISMICR $2.23 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
=Y0:� 499.23
,- $499.23 $0.00 - $
Revised: 10/01/2013
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-buildinQCWcupertino.oro
PROJECT ADDRESS IO zO cl �N' APN#
OWNERNAMEJA G.� T[77�
PHONE f O
STREET ADDRESS CITY,STATE,ZIP (�q FAX
AJ %Z Gu 271 O G / SOl'`F
CONTRACTOR NAME LICENSE NUMBER j O,_q/ 7 I LICENSE TYPE n BUS.LIC.#
COMPANY NAME 1 A E-MAIL � F 316 , 6 s6 - 302-1
STREET ADa I / CITY.-STATE,ZIP -7e-� �,//��/ PHONE
J2' b I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code.
2. You must schedule all needed inspections a minimum of one day before the requested inspection date.
Please schedule inspections online or call(408)777-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be available within one hour.
There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm(Mon—Thurs);
7:30 — 10:30am and 1:00—2:30pm (Friday).
4. If plywood is installed,a plywood nailing inspection is required.
5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is
weather tight after installation of approximately 25%of the roofing material.
6. New roof coverings shall not be applied without first obtaining all inspections 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.
7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is
complete. 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 must 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.
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 under n agree o coin - oo policy s abov ./
Signature of Applicant/Agent: Date: /(5)/-7 /
ReroofPoliq M adoc revised 05/17/10