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13110174 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19680 AUBURN DR CONTRACTOR:R E ROOFING& PERMIT NO: 13110174 CONSTRUCTION INC OWNER'S NAME: WU WAYNE Y AND CHEUNG LINDA K 15230 CLYDELLE AVE DATE ISSUED:11/27/2013 OWNER'S PHONE: 4082539161 SAN JOSE,CA 95124 PHONE NO:(408)626-9320 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALLJ Class l_� Lic.# 2 � RE-ROOF 29 SQ-REMOVE EXISTING 1 LAYER OF COMP INSTALL NEW FELT CLASS A 7ontracf6 Date ` Z I hereby affirm that I am licensed under 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$12000 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 APN Number:31635022.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITIIIN DAYS 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 180 DAY LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the `/ 270 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: all non-point source regulations per the Cupertino Municip Code Section 9.18. l� RE-ROOFS: Signature Date n roo hall be inspected prior to any roofing material being installed.If a roof is installed w ho btaining an inspection,I agree to remove all new materials for inspection r I ❑ OWNER-BUILDER DECLARATION ` Signature p cant: �- Date: 444 Z I 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,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) I,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. 1 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 in Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contam. nts as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain om 'anc$ ith the Cu ertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health& 55 3,and 25534. t Section 3700 of the Labor Code,for the performance of the work for which this `l Z1 I ner or auth d agen : 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the'Labor Code,I must I hereby affirm that there is a construction 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 Lo COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION. 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 `���•i (408)777-3228• FAX(408)777-3333•building a(�.cupertino.orq CUPERTINO. `✓ PROJECT ADDRESS 6U I�1 1 APN# w 22� OVTNERNAME \�, ( / PHONE V /�j J (I E-MAIL STREETADDRESS 'Oi n f�I I CITY, STATE,ZIP ? (�IFAX _- CONTACT NAME j I C - �� PHONE U �� E , MAIL STREET ADDRESS C STATE,ZIP , L FAX ❑ OWNER ❑ OWNER-BUILDER ❑.OWNERAGENT ONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT 13 ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME U afJ[,_ ( � LICENSE NUMBER �7 �� LICENSE TYP BUS.LIC.# o COMPANY NAME l/ N E-MAIL ( FAX G 4Q STREET ADDRESS n yy�n �" CITY,STATE,ZIP ARCHITECT/ENGINEERNAMME LICENSENUMBER BUS.LIC�# 4 Gkj V COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF WSFD� rDuplex ❑ Multi-Family ROOF AREA t/�/ ) VALUATION: IfSTRUCTURE: ercial 1 l Z Q EXISTING ROOF TYPE: ❑BUILT-UP ROOFAS PHALT SHINGLES ❑WOOD SHAKES 11WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE YES IF NO, PLYWOOD 11 h" ❑ PLYWD 11OSB PITCH: ROOF ❑NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDXA-:12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF PHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property mAmer's behalf. I have read this application and the inf=ation 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 stat laws rel a' g I a f rete tatives of Cupertino to enter the above-i ntified p perty for inspection purposes. 113 Signature ofAp licanUAgent: Date: Z 7 SUPPLEMENTAL INFORMATION REQUIRED MA-r If building is associated with a Home Owner's Association,provide letter =? NWxovTlnGL� =' — of approval from HOA. oy>g-T co sR �ubvmGPLANIR LLOR _Provide Planning approval to verify if there any restrictions. OR �xPREs �y4y Provide copy of Manufacturer's Installation Specifications.. - �' _Provide signed copy of Cupertino's Tear-Off Policy. 60 a = • �I�R T' �- � ' Reroofilpp_2011.doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 19680 auburn dr DATE: 11/27/2013 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$12,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF USE: PERMIT TYPE: WORK re-roof 29 s SCOPE FEE H) ROOF AREA s.f. 1REROOFFRES 2,900 ._ .. _ Y€.s .5 u`-_ L1ec Plan Check Plumb.Plan Check Elec,Plan Check 1i>ch.Permit Fee: - Plumb.Permit Fee: I;lec•, Permit Flee: Q her :bletrh.Insp. Other Plumb Insl3, Other Elec_Inrp. A3ech. Li Imp.Fee. Plumb. lash.Fee: Elec,Insp. T ee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Theseees are based on the relimina information available and are onlyan estimate. Contact the Det or addn'1 info. FEE ITEMS(Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Sup1_)1. FC;`Fee Plumh.11fech./Elee Permit Fee: $464.00 Suppl. Inst)Fee Plum bJ1�lccli.IFl ec, PlumliJtvlech.l lee Perttait'Pee: Consowctivn :Tax: A.dininistrative Fera: Work Without Permit? ®Yes (E) No $0.00 (1vcanced 1'lun11irig 11ees: Travel Documentation F"e<es: � Strom Motion Fee: IBSEISMICR $1.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $466.20 $0.00 p ., _ $466.20 Revised: 10/01/2013 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 GUPERTING (408)777-3228• FAX(408)777-3333•building a(�cupertino.org PROJECT ADDRESS I qr 1 7 A I I\., APN n OVJNERNAblE I� I V JVV���1 f� f PHONTE E-MAIL STREET ADDRESS CnY, STATE,ZIP FAX CON7RACTORNAMELICENSENUMBER n J�ij LICENSE BUS.LIC. �J �� r G, COMPANY NAME 1 E-MAIL L I , ( FAX // ! J STREET ADDRESS I mo�u- CITY,STATE,ZIP L J �l 2 PHO 1/l I �p I UNDERSTAND AND AGREE TO THE FOLLOWING: ©7 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 one business day before the requested inspection date. Please call (408) 777-3228 from 7:30-3:30pm(Mon-Thurs) or 7:30-2:30pm (Friday)to schedule 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 ons hour. 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. 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 I/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. 7. 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. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below,nade he following is true: I am the property owner or authorized agent to act on the property owner's behand agree to comply with the re-roof policy stated above. I also understand that smoke detectors and c el equirei o be insta d in accordance with Sections R3 4 and R315 of the 2010 California R Signature of Applicant//A _\ —'� ~ Date: I21 + ReroofPolicy_2012.doc revised 10/7/12