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R-4662 (2) PERMIT R_ 4 6 6 2 . APPLICATION FOR CITY OF CUPERTINO NUMBER INSPECTION DIVISION PERMIT EXPIRATION REROOF PERMIT (408)777-3228 PERMIT EXPIRES IF WORK IS NOT STARTED • WITHIN 180 DAYS OF PERMIT ISSUANCE OR BUILDING ADDRESS 180 DAYS FROM LAST CALLED INSPECTION. I 6 ,- RESIDENTIAL--X �/ COMMERCIAL OTHER OWNER'S HAZARDOUS FIRE AREA n �-�/�/ h VES It yes s I understand that. Class A NAME `�, , I 6�/ v root assembly is required. !,� ^ �/ NO ❑ Initial I.C.B.O.kL� ADDRESS �2 L/� `I EXISTING ROOF COVERING PHONE NUMBER OF EXISTING COVERINGS CONTRACTOR'S / � live i i/:l TO BE REMOVED 70 BE RETAINED NAME�`�� �V' /� ADDRESS y �� ,�, A� j „/� � ��� TYPE OF ROOF COVERING CITY azlP_ i 2/, � JjG��jC EXISTING PHONE �yy / // e�Q 6 BUILT-UP ROOF ❑ LICENSE NUMBER O ASPHALT SHINGLES ❑ LICENSED CONTRACTORS DECLARATION I hereby affirm that I em licensed under provisions of Chapter 9(commencing with Section WOOD SHAKES 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect. WOOD SHINGLES License Ctte�a� U Number D ❑ Date Contractor L��/1�/ ��f+ OTHER(SPECIFY) ❑ OWNER-BUILDER DECLARATION PROPOSED I hereby affirm that I am exempt from the Contractors License Lew for the following reason. (Sec.7031.5,Business and Professions Coda: Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to Its Issuance,also requires the BUILT-UP ROOF ❑ applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions • of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the. Suet rose and Professions Code)or that he Is exempt therefrom and the basis for the alleged ASPHALT SHINGLES ❑ exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to e civil penalty of not more than five hundred dollars($500).): WOOD SHAKES El[:]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 and Profes. II--II dons Code:The Connectors License Lew does not apply to an owner of property who builds or WOOD SHINGLES L� Improves thereon,and who does such work himself or through his own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or Improvement ` Is sold within one year of completion,the owner-bullder will have the burden of proving that he did OTHER(SPECIFY) , not build or improve for purpose of sale.). ❑I,as owner of the property,em exclusively contracting with licensed contractors to construct Q the project(Sec.7044,Business and Professions Code:The Contractors License Law does not PROVIDE I.C.B.O. REPORT NO.` "/ apply to an owner of property who builds or Improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. PROVIDE MFGR.INSTALLATION SPECS. ❑1 em exempt under Sec. ,B 8 P.C.for this reason Owner Date APPLICATION DATE VALUATION PERMIT FEE WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declaration: 1 have and will maintain a Certificate of Consent to self-Insure for Workers Compensation, Building as provided for by Section 3700 of the Labor Code,for the performance of the work for which this r�1,ff permit is Issued. I �.0 " k' Seismic I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of as the Labor Code,for the performance of the work for which this permit Is Issued.My Worker's (� 1 Total Compenee n neu nc7e car rand Pollc number are: +� ` / V Cerner �pf/ / �G�/L�D policy on yNo.1, 0 19p PERMIT+AUTHORIZAT(ON DATE CERTIFICATE OF EXEMPTION FROM WORKERS' 11 COMPENSATION INSURANCE 0)9 uT UY (This section need not be completed If the permit Is for one hundred dollars lir lase.) t.�-1 I certify that In the performance of the work for which this permit Is Issued,I shell not employ any person In any manner so as to become subject to the Workers'ComPensedon Lawe of Ceu- All roofs shall be inspected prior to any roofing material being forma/. installed. If a roof is installed without first obtaining an Data/( ��` 7 5 Applicant inspection,I agree to remove all new materials for inspection. NOTICE TO APPLICANT: If,after making this Certificate of Exemption,you should become Applicant understands and will comply with all non point subject to the Workers'Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked, source regulations. 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 bulltling const ruction,and A roof coverings to be class"C"Or better. hereby authorl7o representatives of this city to enter upon the above-mentioned property for In- spection We)agrpoeea. (We)agree to Deva.Indemnify and keep harmless the City of Cupertino against Ilebllence • lud,meMe,costs and expenses which may In any way accrue against said Ciry,In consequence SIGNATURE OF APPLICANT DATE of the granting of this permit. PRE-INSPECTION: PLYWOOD: IN-PROGRESS: INSP. DATE INSP. DATE INSP. DATE TEAR OFF INSPECTION: BATTENS: FINAL: INSP. DATE INSP. DATE INSP. DATE NOTE: OSHA APPROVED ACCESSTO ROOF SHALL BE PROVIDED FOR INSPECTION OFFICE COPY SUBJECT: REROOFING POLICY FOR THE CITY OF CUPERTINO BUILDING DEPARTMENT PRIOR TO ISSUANCE OF PERMIT AND INSPECTION PHASE. 1. Prior to permit issuance, you must agree to comply with U.B.C. standards and manufacturers spec's on reroofing. 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 reroofing is completed. 3. All types of roof shall be inspected prior to any roof being installed. 4. In order to receive a final,you must complete steps 1,2,and 3. 1,) Preinspection or tear off approval. 2.) In progress inspection approval. 3.) Final inspection approval. a.) Operable smoke detector verification • b.) Spark arrestor installation 5. If plywood is installed,a plywood nail inspection is required. 6. If any roof is applied without first obtaining an inspection, you will be required to remove all ryw material down to the sheathing and a building inspector will inspect all sheathing at that time. WE UNDERSTAND THE ABOVE POLICY ON REROOFING AND WILL COMPLY WITH THE POLICY HOMEOWNERS NAME: ADDRESS: REROOFING COMPANY NAME: L 1 z APPLICANT'S SIGNATURE: �� " r / i�✓'y/ "►� CITY OF CUPERTINO BUILDING DEPARTMENT • Reroof(winword 14503 BERCAW LANE RLL STRUCTURRL 5ANJOSE. CA 95124 PHONE: (408)559-0340 EONSULTING ENGINEERS FAX, (408)559-2015 December 8, 1995 Western Region Roofing 231 N. 12th. Street San Jose, CA 95112 ATTN: Mr. Robert Sagor SUBJECT: 20396 Town Center Lane Cupertino, California Dear Mr. Sagor: At your request I have inspected the roofing and the roof structure of the subject building in order to establish the adequacy of a new roofing as specified further. At this time the roofing is constituted by 3-ply and gravel on the flat part and by flat ceramic tiles on the sloped portion. The roof structure is built with manufactured roof trusses. The trusses chords are 2x6's. The proposed new roofing system will keep in place the existing tar papers but will have the • gravel removed. The new roofing consists of the following elements: - 1/2" "Weatherwood" asphalt coated 1 side (0.75 psf), - MB base sheet (0.27 psf), - and APP180 asphaltic waterproofing layer (1.15 psf). The added new roofing weighs 2.17 psf and the removed gravel weighs 2.5 to 3 psf. The whole new roofing system will lighter than the previous one and consequently the roof structure is able to resist the new dead loads and the prescribed live loads. There is not another roof covering under the existing one. The existing roof covering is securely attached to the plywood. The roof plywood and the trusses below are structurally sound. There is not any insulation between the existing roof covering and the plywood. The insulation is located on the ceiling joists and is not water soaked. Should you have any questions or require supplemental information; please.call. Sincerely, RECE � p`D ALL STRUCTURAL L� V CONSULTING EN RS a DEC 08 1995 . No.3003 BLDG. INSPECTION DEPARTMENT p.3/31/97 * CITY OF CUPERTINO Ge ge Dic , E, S' *s STRUCI SRPy��Q Structural.Engineer �qlf OF CA��F��