11110058 CITY OE CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 6370 COTTONWOOD CT CONTRACTOR:CUPERTINO ROOF,INC PERMIT NO: 11110058
OWNER'S NAME: BARBARA NUNES 1052 KELLY DR DATE ISSUED: 11/10/2011
ER'S PHONE: 4082570625 SAN JOSE,CA 95129 PHONE NO:(408)973-9427
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL
License ClassL 3 99 Lic.q RE-ROOF 14 SQ,TEAR OFF COMP INSTALL TIMBERLINE
SHINGLES CLASS A
Contractor C U�-oQ�'I^�a�G� Date � 1 —�o"-��
1 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 whichthis permit is issued. Sq.Ft Floor Area: Valuation:$9000
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:36918013.00 Occupancy Type:
permit is issued. _ a,
APPLICANT CERTIFICATION 1�J`
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 WITHIN 180 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 DA ' ' OM 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
granting of this permit, Additionally,the applicant understands and will comply Issued by: '� Date: j 0
with all nAtizacunt source regulations per the Cupertino Municipal Code,Section
9.18.
yt, RE-ROOFS:
Signature 1 rrr�Date �^'� O~I All roofs shall be inspected prior to any roofing material beng installed.If a roof is
installed withoutung an inspection,I agree to remove all new materials for
inspection.
OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of Signature of Applicant: Date: �C
the following two reasons: ALL ROOF COVERINGS TO 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(Sce.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), 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. twill
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 1
performance of the work for whichthis permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,-Sectio s 25505,25533,and 25534.
Section 3700 of the Labor Code,for Bate 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 many manner so as to become subject to the Worker's
Compensation laws of Cal ifomia, If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,1 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
1 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
mnify,and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
Y ,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
..ting of this permit.Additionally,the applicant understands and will comply
with all nom-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
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-buildinaCdcuoertino.ora
PROJECT ADDRESS �"l 0 4�Or\ `J_ l-1 APNO
OWNER NAMEY /'�y7� Q PHONE b/ l�_ -MAIL
STREETADDRESS o cdtfa NWOo.9 CIN STATE,ZIP FAX
CONTRACTORNAME LICENSE NUMBER LICENSE TYPE BUS.LIC.#
IDgv,e S r..
COMPANYNAME ru R� E-MAIL FAX
STREET ADDRESSI O y Z .z 1 I T) CITY,STATE,ZIP C PHONE
d I`UNDEAR1STAND AND AGREETOTHE FOLLOWING: / T
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 Y<" 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
Is smoke detectors and carbon mopoxidedetectors are required to be installed in accordance with Sections R314 and 8315 of
the 2010 California Residential Co e.
Signature of Applicant/Agent: Date:
RerooJPolicv_201 Lr1oc revised O2ll&l I
.. G
• CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36918013 . 00
DATE ISSUED. . . . . . . : 11/10/2011
RECEIPT #. . . . . . . . . : BS000015287
REFERENCE ID # . . . : 11110058
SITE ADDRESS . . . . . : 6370 COTTONWOOD CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BARBARA NUNES
ADDRESS . . . . . . . . . . : 6370 COTTONWOOD CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : DAVE SMITH
CONTRACTOR . . . . . . . : DAVE SMITH LIC # 25701
COMPANY . . . . . . . . . . : CUPERTINO ROOF, INC
ADDRESS . . . . . . . . . . : 1052 KELLY DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95129
TELEPHONE . . . . . . . . : (408) 973-9427
•
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
1REROOFRESSQ FEET 14 .00 196 . 00 0 . 00 196 .00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 197. 90 0.00 197.90 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT
------------------
CREDIT CARD 197. 90 me
---------------
TOTAL RECEIPT 197. 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
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
• 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228 • FAX(408)777-3333 - buildinglEDcupertino.om ` l I
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PRO]ECr ADDRESS AFN M I�
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APPLICANT NAME �< ( PHONE Z4 _t I f llMAB,
STREETADDRESS r�-Z CITY.STATE,78 Y
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❑OWNER ❑ 0WNBR-Bt11L0E0. ❑ OWNER AOZVT 1lk10NTRA=R ❑CONTRACTOR AGENT ❑ ARCHTIPIT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME )M� LICENSE NUMBER C�/^ +, LICENSE TYPF�.�j BUS.LIC M
COMPANY NAME G U PQ AI�U 9 MAIL FAX
STREET ADDRESS ` J f 1 CTIY.STATE,W ` PHONE
ARCHTTECTMNOPNEERNAtr� G� \ LICENSE NUMBER J BUS.LIC W 7 a
COMPANY NAME E-MAIL FAX
STREET ADDRESS( CITY.STATE,ZP PHONE
USE OF Tal SFD or Duplex ❑ Multi-Family ROOF AREA':/ VALUATION; (�
STRUCTURE: 1❑`Commercial 1 `f"&O -( O
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES Q WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPEam
REMOVE/REPLACE YES IF NO. PLYW000 ❑ K" ❑ PLYWD ❑ OBB Pli'CFL ROOF
❑ M ❑ _ ❑ Lmx :12CLASS
A
PROPOSED BOOP TYPE: ❑BUP,T-UP ROOF L ASPHALT SHINGLES Q WOOD SHAKES Cl WOOD SHINGLES ❑OTHER ICC-ES REPORT a
DESORPTION OF WOR): (I A
'C R, 04 C o v— D Ivl S '-4 )
By my slgnamne below,I certify to each of the following: I am the property owner or authorized agent to=an the property owner's behalf. I have reed this
application and the infom m.p agree to s correct I have read the Description of Work and verify it is accurate. I agto comply with all applicable local
ordinances and state laws relating to uild n nstuction. I au orize.representatives of Cupertino Lr,enter the above-identified property for inspection purposes.
Signature afApplicsnt/Agent Date:
SUPPLEMENTAL ORMATION REQUMD
m
_If building is associated with a Home Owner's Association provide letter
of approval from HOA.
Provide Planning approval to verify if there any restrictions. ,a _
Provide copy of Manufacnuzr's Installation Specifications. - r
Provide signed copy of Cupertino's Tear-Off Policy. R
QE
ReroojApp_201 Ldoc revised 03/02111