03100128 BUILDING DIVISION PERMIT CONTRA&tOR INFORMATION
BUP.DINGADDRESS: FLORENTINO SERVICES INC. PERMIT NO.03100128
\ OWNER'S NAME: 31241 FREDI ST. PERMIT LSBUE DATE '
\`
E: (877) 374-4897 SANITARY NO. CONTROL NO.
ARCI II]TCr/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
o o LICENSED CONTRACTOR'S DECLARATION
F I hereby affirm that I am licensed under provision:of chapter 9(commencing Job Description
iiw with Scnian]fkM))af Division3ofthc Businus rJdpy, ade. emylmoneis
;t2� in full arae and effeaC G M
License ela,,_j II if Lia. fir RER, LOF [RNALED
;�W Das es/a. Contractor -
ARCHITECTS DECLARATION
w U I undcrsund my plans shall he used as public records
o Licensed Professional MAR G 2 2004
f S OWNER-BUILDER DECLARATION
<Y 1 hereby affirm that I am exempt from the Contractor's Urania Law for the rofl II�p ra��ra situ
-o O fallowing reason.(Section]1131.5,Business and Professions Code:Any city or county 1`IYIJI IL11111SYN IYI�`pI1511iN
m E which requires a permit to construct,alto,improve,demolish,or repair any atrumum
nnn
rvi prior tons iturraw,alsi,m,im,lheapplicam forsuch permit o rile a signed statement
< that he isliecnsadpursuant nthe provisions it[the Contractor's License,Law(Chapter 9 Sq. Ft. Floor Area Valuation
2H$ (command ng with Section 7")of Division 3 of the Business and Professions Code)Or
_
that he is exempt therefrom and the basis for the alleged exemption.Any violation of 36936035 . 00
Section 7831.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more man five hundred dollars(S500). P Y YP
0 I,as owner of the property,or my employcu with wages as their sole compensation,
will do the work,end Ute swans i....intended or offered rot are(Sec.7014,Business
and Professions Code:The Contractor's Licerve Taw dots not apply to an owner of Required Inspections
progeny who builds of improves thereon,and who does such work himself or through his
awn employers,provided that such improvements arc not intended arrested for sale.If,
however.the building or improvement is said within ane year of camplelion,the owner-
builder will have me burden of proving that he did not build or improve for purpose or
sale.).
❑1,as owner of she property,am exclusively contracting with licensed convenors m
construct the prejecl(Sec.70,14,Business and professions CndeJ The Contractor's Li
cense Law does not apply to an owner of property who Wilds or improves distant.and ,
who contracts for such projects with a crntri ctor(s)licensed pursuant to the Contractor's
License Law.
[31 am exempt under Sec. .B A,P C for this mason
Owner Data
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penally of perjury arc of(be following declarations:
I has and will maintain a Cerlificzs of Consent to self-insurt for Worker'sCompen-
sation.as provided for by Section 3700 of the Labor Code.for the performance of the
ik for which this pmmil is issued.
have and will maintain Worker's Compensation Insurance,as required by Section
PT of the lather Chile,for the performance of the work for which this remain is issued.
My Walkers Contpen anion Insurappnce carter end Policy nu�9W art:
Cartier. � ��^^0.
CERTIFICATE OF EKEMI'ITON FROM WORKERS'
COMPENSATION INSURANCE
(Thissection need not he completed if the permit is for enc hundred dollars($100)
Is,,,)
1 certify Nal in me Performance of the work for which this permit is issued.1 shall nut
employ any person in any manner sat as to hecume subject to the Workers Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should
become subject to the Wmkers Compensation provisions of the tabor Code,you must
z roMwith comply with such provisions or this permit shall be deemed mvrkcd.
L O CONSTRUCTION LENDING AGENCY
1 hereby amrm On,there is a emosuuelinn lending agency Rothe perfufmance of
yx ,1 the work for which this permit is issued(Sec.3097.Civ.C.)
[7 Q Larder's Name
Lender's Address
� z
;)0 1 certify mat 1 have read this application and tune that the above information is
y F coral.I agree to comply with all city and county ordinances and state laws relating to
DU building construction.and hereby authoriae mparentativcaaf this city to enter upon the
shove-mentimod properly for iupectio t purposes.
(We)agree an save,indemnify and keep harmless the City of Cupertino against
liabilities.judgments,costs and expenses which may in any way mane against said City
j Z in eonm9uenec of the granting of this permit.
APPLICANT UNDE ANDS AW OMPLY LTH ALL NON-POINT Issued by: Date
SOURCE RE UL NS. /
Re-roofs
Signature ofApp scam/Cmur.amf Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or BOOM Wilding oe'eupant store or handle ha'rarmus material
az derined by the Cupertino Municipal Code,Chapter 9.12.and the Health and Safety
Code.Senior 25532(a)'!
❑tics --4
!U No All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building accupant use equipment fir dcviccs which If a roof is installed without first obtaining an inspection, I agree to remove
hazardous air contaminants m defined by the Bay Area Al
r Quality Management all new materials for inspection.
District?
❑Yea �Nu
I
I have mad thelia,Samo materialsre33 a rd 55umk:fChapur6.95iftheWildin-
miaHca enoxi f,th.n,Sccduu 25505.25533 and 25534.1 unxrsrand thaifdr Willing l�+E/ l6l/L/V
Jou not curtcntly hate a¢n l Na it is my rex ihilaty m nvdfy IK azupant of the
requirements which must et poor w' u CeNfic flkcu ancy
����� Signature ofApplicant Date
Owner authori¢JagcAll roof coverings to be Class "B" or better
Community Development Department
Building Division
Y City of Cupertino
10300 Torre Avenue
tPCITY OF Telephone: (408)777-3228
UPEkTINO Fax: (408) 777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: QLt ,
Job Site Address: ;70.3 7�3 r �•�' Q d
Roofing Company Name: �r/t /
A plicant's Signature: �. Date:,`r 26103
\�l/�61NpCX1
® Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO 03
100 / 20
REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# �7 �3 , Date:
Building Address: 0,3 Z3 � �
� d
Owner's Napwte: Phone#:
C/La � a 4f / :3 2Z�
Contractor Pho #: License #:
1. 7�/ 3
O 2b53gS$ '7y89
Contac • Phone #: S' Cupertino Business License #:
t712 a�.�� � �—
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles\_
❑ Other(Specify) * Other(Specify) " L-L
_ Number of existing coverings ❑ Provide I.C.B.O.Report# E2 S 2Jl f(
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: J � /
01_ a,4 warn s // PSF
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
/(o VOV
Qty. if
Ap2licable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
2 3s�'
Uc 6
-� LEGACY REPORT ER-5627
, ;, Reissued November 1, 2003
j� 3
ti
ICC Evaluation Service, Inc. Busirms'Reglonal Office•5360 Workman Mill Road,Whittier,Calrfomia 90601 •(562)699-0549
V
l.Regional Office•900 Montclair Road,Suite A,Birmingham,Alabama 35213 •(205)599-9800
www.icc-es.org1,44"',Regional Office•4051waist FlossmoorRead,Country Club Hills,Illinois 60478•(708)799-2305
Legacy report on the 1997 Uniform Building Code""', the 2000 International Building Codes and the 2000
International Residential Code®
DIVISION: 07—THERMAL AND MOISTURE PROTECTION caps,to hold the underlayment in place until the roof covering
Section: 07305—Shingle Underlayment is applied.
Two layers of the underlayment,solidly cemented together
ELK VERSASHIELDT'" UNDERLAYMENT with asphalt roofing cement complying with ASTM D 4586,
comply with the requirements of Chapter 15 of the UBC for
ELK PERFORMANCE NONWOVEN FABRICS, INC. underlayment in severe climate areas, and comply with
14911 QUORUM DRIVE requirements of Chapter 15 of the IBC and Chapter 9 of the
DALLAS,TEXAS 75254 IRC for ice dam protection.Application must be in accordance
:,with the applicable code.
1.0 SUBJECT t,.r The underlayment may be bent to a minimum 1/z-inch(25.4
Elk VersaShieldTM Underlayment. t, mm) radius, but must not be creased. At junctions between
2.0 DESCRIPTION �c°.Y ti,-u , �.., the roof deck and vertical surfaces, the underlayment is
installed a minimum of 3 inches (76 mm) up the vertical
2.1 General: ; ,,;�jy •1� ' surface.
c
Elk VersaShield Underlayment is an altemative to Type 15 or 2.4 Reroofing:
Type 30 roofing underlayment complying with UL-Standard p q 1 General: The existing roof must be inspected in
55-A, as required in Chapter 15 of the 1997;Unifonn Building accordance with Appendix Chapter 15 of the UBC, Section
Code (UBC); to Type I or Type II underlayment complying 1510 of the IBC or Section R907 of the IRC. The new roof
with ASTM D 226-97a,as required in Chapter 15 of the 2000 .covering must be installed over the VersaShield
International Building Code® (IBC); and to Type I or Type II Underlayment in accordance with the roofing manufacturer's
underlayment complying with ASTM D.226-97,as required in instructions.The new roof covering must be recognized in a
Chapter 9 of the 2000 International Residential Code®(IRC). current ICC-ES evaluation report, and, when applicable, the
When installed in accordance with Section 2.4.2 of this evaluation report must address installation over wood shake,
report, VersaShield Underlayment can also be used over wood shingle or asphalt shingle roofs.
existing wood shakes or shingles as an alternative to the 2.4.2 Existing Wood Shakes or Shingles: Where the
covering materials specified in Section 1516.3 of the application of a new roof covering overwoed shingle or shake
Appendix to the UBC, Section 1510.4 of the IBC, or Section roofs creates a combustible concealed space, VersaShield
R907.4 of the IRC. ,- Underlayment can be used as an alternative to the covering
2.2 Materials: "is;" +' 'materials specified in Section 1516.3 of the UBC Appendix,
VersaShield Underlayment is aresin-bound'chopped-glass- Section 1510.4 of the IBC or Section R907.4 of the IRC.The
underlayment must cover the entire existing wood roof.
fiber substrate, coated on both sides4kwith a mineral-filled
aqueous coating.The underlayment hada minimum finished '•Battens used for the roof covering system must be installed
weight of 15 pounds per 100 square feet'(0.73•kg/m2),and is over the underlayment. The underlayment may be placed
supplied in rolls 42 inches (1067 mm)'wide byA00'feet (30 - under or over counterbattens, spaced a maximum of 24
480 mm) long. inches(610 mm)on center.The underlayment is fastened to
the counterbattens with asufficient numberof nails,having tin
2.3 Installation: •Y.-;"' -' caps or 1-inch-diameter(25.4 mm) plastic caps, to hold the
underlayment in place until the horizontal battens and roof
VersaShield Underlayment is limited to use over spaced or covering are applied.When counterbattens are installed over
solid sheathing, or over existing asphalt-shingles, wood the underlayment or when counterbattens are not used, the
shakes or wood shingles installed .ori spaced or solid underlayment is fastened directly to the existing roof covering
sheathing. The sheathing must comply,with the applicable in the same manner.
code.The underlayment is applied at right angles to the slope
of the roof, beginning at the low point of the roof; is laid with 2.4.3 Existing Asphalt Shingles: The underlayment is
minimum 2-inch (51 mm) horizontal and 6-inch (152 mm) applied over the existing roof covering and fastened through
vertical lapped joints;and is attached with a sufficient number the shingles to the sheathing with a sufficient number of nails,
of nails,having tin caps or 1-inch-diameter(25.4'mm)plastic having tin caps or 1-inch-diameter(25.4 mm)plastic caps,to
]CC-GS legacyreportr are not to he cnnamred as representing acstheras or any other eaributes not specilirafiy addreeaed,nor are they ro be rnn.ernrcAns
on rrulursemrm of rhe suhjmr q/7hc report am rrew,m,endminn far ih me.There i,no warranty by iCCCvmaatlon Service,hm.,express or implied, sit
any finding or other matter in this report,or astir any prdburr,covered by the report
Copyright 02003 "^ Page 1 of 4
Try
Ji,
Page 2 of 4 y'1.�. ,';'�, ER-5627
hold the underlayment in place until. the 'roof covering :3:0 EVIDENCE SUBMITTED
assembly is applied. 3
1. ", Data, reports of tests, and a quality control manual in
• 2.5 Roof Classificationr };_•-y 'accordance with the ICC-ES Interim Criteria for Nonasphaltic
....,,,, .•.Y,tFiberglass-based Roof Underlayment(AC160),dated January
When installed in accordance with this report,,,VersaShield 2000.
Underlayment can be used as an alternative to'Type 15 or 40. FINDINGS
Type 30 underlayment with any noncom&u"ilible roof covering
complying with Section 1504.2 of the UBC;the exceptions to That the Elk VersaShieldTM Underlayment described in
Sections 1505.2 and 1505.3 of the IBCand Section R902.1 this report complies with the 1997 Uniform Building
of the IRC;or any roofing assembly having a Class A, B or C CodeTm, the 2000 International Building Code®and the
roof classification, without reducing'tfie-roof classification. 2000 International Residential Code', subject to the
When installed in accordance with Section 2.3'and Table 1 of following conditions:
this report, roofing assemblies incorporating.the VersaShield
Underlayment have the roof classification specified in Table 4.1 The underlayment is manufactured, identified and
1.The roof coverings must be recognizedwin a current ICC-ES installed in accordance with this report and the
evaluation report. manufacturer's instructions.
2.6 Identification: - 4.2 The underlayment is manufactured in Ennis,Texas,
under a quality control program with inspections by
Each roll of underlayment bears a label.indicating the Elk Underwriters Laboratories Inc. (AA-668).
Corporation name and address, the product name, the roll -..4 3 Insulation used in roofing systems must comply
number, the name of the inspection agency (Underwriters with the applicable code.
Laboratories Inc.)and the evaluation re ..
ER-5627). This report is subject to re-examination in two years.
TABLE 1—ROOF CLASSIFICATION OF ASSEMBLIES INCORPORATING VERSASHIELD UNDERLAYMENT
ROOF COVERING' SUBSTRATE:• UNDERLAYMENT' ROOF MAXIMUM
CLASSIFICATION SLOPE
Class A asphalt glass fiber "/,z inch plywood One layer VersaShield A Unlimited
shingle •'�'";,;,,,;,, ;,;;� ..
• Stone coated,steel,direct to 15/ inch plywood or One layer VersaShield A Unlimited
deck,0.013 inch thickness(0.330 spaced sheathing
mm),shingles or panels 5" •+, ;iir
Steel direct to deck,0.013 inch 's/,z inch plywood or One layer VersaShield,and one layer A Unlimited
thickness(0.330 mm),shingles or spaced sheathing Type 30 asphalt saturated organic felt
panels'
"/,-inch plywood or One layer VersaShield B Unlimited
spaced sheathing
's/,z inch plywood or One layer VersaShield A Unlimited
spaced sheathing._
Steel over battens,0.013 inch Existing wood shakes or Two layers VersaShield A Unlimited
thickness(0.330 mm),shingles or spaced'shingles installed over
panels' iir solid sheathing ` .?
Existing wood shakes or One layer VersaShield B Unlimited
shingles installed over
spaced or solid sheathing
Steel,0.016 inch thickness(0.406 "/,i inchplywood'or One layer VersaShield A Unlimited
mm),panels or standing seam spaoed;sheathing
system'
'%,46h plywbc;a or One layer VersaShield,and one layer A Unlimited
spaced sheathing Type 30 asphalt saturated organic felt
Existing wood shakes or Unlimited
shingles installer over Twolayersof VersaShield A
Copper,0.016 inch thickness p s aced or solid sheathing
(0.406 mm),shingles or panels' 1$ -
/,,-inch plywood or One layer VersaShield B Unlimited
spaced sheathing
Existing wood shakes or One layer of VersaShield B Unlimited
shingles installed over
spaced or solid sheathing
"/u inch plywood or -Two layers VersaShield A Unlimited
spaced sheathing
"/,-inch plywood or -One Iayer,VersaShield B Unlimited
Aluminum, files, inch s,or spaced sheathing
mm),shingles,panels,or
standing seam system 5,e Existing'wood shakes or One layer VersaShield B Unlimited
shingles installed over
spaced'or solid sheathing
Page 3 of 4 ER-5627
TABLE 1—ROOF CLASSIFICATION OF AS INCORPORATING VERSASHIELD UNDERLAYMENT—(Continued)
ROOF COVERING SUBSTRATE �UNDERLAYMENT' ROOF MAXIMUM
CLASSIFICATION SLOPE
"/�yinch plywood Two layers VersaShield A 1'/2:12
TPO,CSM,CPA, EPDM,cap Iz/23 inch plywood, Two layers VersaShield A 1'/2:12
sheet,or modified bitumen single- „t insulation
ply membranes"
'5/,,-inch plywood One layer VersaShield B 11/2:12
1%2'inch plywood Two layers VersaShield A 2:12
PVC single-ply membrane 3,° "/,-inch plywood, Two layers VersaShield A 1'/2:12
insulation
'54,-inch plywood One layer VersaShield B 1'/2:12
Duro-Last PVC,0.040-inch "/,,-Inch plywood One layer VersaShield B 2:12
(ER-5694)
'Underlayment must be installed in accordance with Section 2.3 of this report.
2Roof coverings must be recognized in a cu"r"rent ICC-ES evaluation report.The roof covering must comply with the Class A and B flame-spread
requirements of UBC Standard 15-2(ASTM E 108),as applicable to the systems defined in this table.See Table 2 for approved roof coverings.
3The evaluation report on the single-ply membrane must include the same classification on the same assembly described in this report.Actual roof
slope is determined bythe maximum existing membrane classification incline in the ICC-ES evaluation report,butcannot exceed 1'/2:12,except Class
A uninsulated PVC single-ply roof membrane assemblies may be installed on slopes not exceeding 2:12.The membrane must also be UL classified.
°For insulated systems,the ICC-ES evaluation report for the single-ply membrane must include a Class A roof classification over the insulation used.
Actual roof slope is determined by the maximum slope allowed in the ICC-ES evaluation report for the insulated system,but cannot exceed 11/2:12.
The membrane must also be UL classified over the insulation used. .
'Thickness for metal roof coverings is the minimum allowable thickness.Panels are defined as having a minimum installed exposure of 3 square feet,
and shingles as having an installed exposure of less than 3 square feet, as specified in Section 1.3 of the ICC-ES Interim Criteria for Metal Roof
Coverings(AC166),Section 1502.1 of the IBC;,end Section R202 of the IRC.Standing seam systems are recognized under the definition of panels.
'When installed over the underlayment in jurisdictions.enforcing the IBC or.IRC,aluminum shingles and panels must have a minimum thickness of
0.019 inch(0.483 mm)and 0.024 inch(0.610,,mm),respectively.
7Stone coated steel shingles or panels are defined as�steel shingles or panels having a coating of stone granules or chips, bonded to the exposed
surfaces with an acrylic resin or polymer basecoat,and must be described in this manner in a current ICC-ES evaluation report.
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