11110142 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10827 MINETTE DR CONTRACTOR:M C ROOFING PERMIT NO: 11110142
OWNER'S NAME: MARILYN WILLIAMS 14800 MCVAY AVE DATE ISSUED: 11123/2011
'NER'S PHONE: 4082170831 SAN JOSE,CA 95127. PHONE NO:(408)729-3436
LICENSED CONTRACTOR'S DECLARATION JOB DESCENPTION: RESIDENTIAL 0 COMMERCIAL
13
License Class (-- 3r/ Lic.# RE-ROOF 14 SQ-.TEAR OFF TAR AND GRAVEL,REPLACE
W/
Contractor / Date COMP SHINGLES
I hereby affirm thilf4in 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.
1 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:$6000
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,forthe performance of the work for which this APN Number:37532057.00 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.l 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 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accme against said City in consequence of the Issued by:
Date: / w
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the pertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature i Dete 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 remove all new materials for
inspection.
OWNER-BUILDER DECLARATION ?3
I hereby affirm that 1 am exempt from the Contractor's License Lew for one of Signature of Appli
-10
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(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. 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(x)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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
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,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for Ste performance of the work for which this
Owner or authorized agent: . Date:
permit is issued.
I certify that in the performance of the work forwhich this permit is issued,l shall
not employ any person inany manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,1 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
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
emnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
s,and expenses which may accme 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 non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
D U P E RT I N O Telephone: 408-777-3228
Fax: 408-777-3333
CONTRACTOR / SUBCON*ACTOR LIST
JOB ADDRESS: �r PERMIT#
OWNER'S NAME: PHONE#
GENERAL CONTRACTOR: BUSINESS LICENSE# C-3
ADDRESS: CITY/ZI PCO D E:
*Our municipal code requires all businesses working in Ke 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 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
Owner/Contractor Signature Date
'VI
REROOF TEAR-OFF POLICY
2 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-buildinc(cDc6 ertinc.ora
PROIECTADDRESS a C. APN0
OWNERNAMEo PHO E E-MAIL ork
STREETADDRESS CITY, STATE.ZIP FAX
CONTRACTO0.NAME tom ' LIC NS NUMBER LICENSETYPE BUS.LIC.a
COMPANY M NJ 1 E-MAIL FAX
ZOO
STREET DRESS CITY,ST IP - PHONE
7 G.-
S A AND AGREE TO THE FOLLFWmG:
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 Nallin¢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/o" 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: 1 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 Cod
Signature of Applicant/Agent: Date:
RerooJPo1icv_201 Ldoc revised 02116111
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
• CITY OF CUPERTINO
PERMIT INVOICE OPERATOR: SylviaM
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37532057. 00
. INVOICE DATE. . . . . . : 11/23/2011
REFERENCE ID # . . . : 11110142
SITE ADDRESS . . . . . : 10827 MINETTE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MARILYN WILLIAMS
ADDRESS . . . . . . . . . . : 10827 MINETTE DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
CONTRACTOR . . . . . . . : MIGUEL CASTILLO LIC # 24741
COMPANY . . . . . . . . . . : M C ROOFING
ADDRESS . . . . . . . . . . : 14800 MCVAY AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95127
TELEPHONE . . . . . . . . : (408) 729-3436
FEE DESCRIPTION DUE FOR AMOUNT DUE PAID BALANCE
CAL BLDG STAND COMMISSION F PRINTING PERMIT 1. 00 1. 00 0 .00
SEISMIC RESIDENTIAL PRINTING PERMIT 0.60 0.60 0.00
RE-ROOF: RESIDENTIAL PRINTING PERMIT 196. 00 196 . 00 0 .00
---------- ---------- ----------
197.60 197.60 0 .00
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
•
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
:LalADDRESS: 10827 minette dr. DATE: 1112312011 REVIEWED BY: bob s.
PN: BP#: "VALUATION: $6,000
*PERMIT TYPE: Minor Building Per PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION 1SFDWLROOF
USE: SFD or Duplex PERMIT TYPE:
WORK tear off tar and gravel, replace with comD shingles.
SCOPE
FEE ID ROOFAREA
s.f.
1REROOFFRES 1,400
,l fe,h. Nan Cheek ek PIInn11 Flan C"beck Llmr.1'Imr Chr;:k
,b(e(A f'r<ruri;Firm: f'lunrb. t'rcnar fcwF.lac. Pernsh F e:
il:her 1'f'41.hal" tuber Plunrh Insp. Miter Flvo. 111y,
81 J, Ince. Fee: Plumb. 1"r.Fia•: fikx.Inq>. Pea:
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 prelinin Information avrdlable and are on!y an estimate. Contact the Dept for addn'!info.
FEE ITEMS (Fee Resobaion 11-053 EH' 7//.'111 FEE QTY/FEE MISC ITEMS
Plan Cle,tck Pee: 177
Suppl. E'C.Fee
f'GrtnJt.%Adach.;Zlau
Permit Fee: $196.00
Supprl. Insp Fee
Pl r un b.:`.klech,/1;7ec:
Plnmh.i<b1e�7z:llec Permit Few
Construction 1h.S
Administf.'awe Fee:
Work Without Permit? O Yes (F) No $0.00
Adfi'arrct;d P1annin� Fres:
T-Livel Docnrnvniation Foes:
• Strom Motion Fee: IBSE/SM/CR $0.60 Select an Administrative Item
BId�Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $197.60 $0.001 TOTAL FEE:'j $197.60
. Revised: 10/01/2011
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO. CA 95014-3255
® CUPERTINO (408)777-3228• FAX(408)777.3333 • building(_ ,super no.
1 )0I��
PROTECT ADDRESS 1 1 APN 05 12. p5e
0 NAAffi � �((es121I W PHONE -0 . ' 8-MAII, v`�
SIREET DRESS , STATE ZIP s FAX
r
APPLICANT '
PH � - a /a E-MAILc
STREET ADDRESS CRY,SCATrE� Z@ `s/" 7 FAX .
6
❑OWNER ❑ OWNER-BUILOBR ❑ OWNER AGENT 71Y50NTRAC OR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NANI J" \ CEN
C r LIS LICE`77-- � BUR LIC.0
COMPANYN E-MAIL J4Js FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
ARC=CTXNC1 EERNAME LICENSE NUAIDER BUS.LIC.d
COSTANY NAME E-MAIL FAX
STREET ADDRESS CRY,STATE ZIP PHONE
USE OPSFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial A/17
=STtNO ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑W DOD STAKES ❑WOOD SHEJOLTS ❑OTHER(SFECFY)
REMOVEIREPLACEYES IFNO, PLYWOOD ❑ K- PLYWD ❑ OSB PITCH: ROOF
❑ B ❑ A. E :12 (A
)—
PROPOSED ROOF TYPE: ❑BUD.T-UP ROOF Qd ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑oTHER ICC-Es REPORT e
DFSCRTPTTON OF WORK
Les Ye
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 Ihave the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to buildin nstructi p 'ves of Cupertino w enter the above-i ntified p perry for inspection purposes.
Signature afApplicmUAgen�� Date:
_Zzza3 ZZ
SUPPLEMEN'TAL&FORMATION REQUIRED •q�.� - tsPPT¢russ.,wteLs a -t -
-Ifbuilding is associated with a Home Owner's Association,provide letter -t-' t011T9'0MR, T
of approval from HOA. et
—Provide Planning approval to verify if there my restrictions. ' Y"
Provide wI} ofManufaenzer's Installation Specifications. (
'G
'
B,DFIIR'i
�r-• -.;-' �� tri 3" '�
vide signed copy of Cupertino's Tear-Off Policy.
ReroofApp_2011.doc revised 03/02/11