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12060020 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21622 REONART RD CONTRACTOF D PERMIT NO: 12060020 OWNER'S NAME: MCCARTY AR,riIUR RJR ANDCAMILL C (t�(S DATE ISSUED:06/05/2012 OWNER'SPHONE: 4082526337 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class C �� Lic.N V <6-7 *5-7 MECH r RESIDENTIAL r COMMERCIAL r Contractor 14 A57 P-P—FAACf- Dale S- G — LZ- 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF ITIAR OFF SHAKES AND INSTALL 1/2"OSB 30p (commencing with Section 7000)of Division 3 of the Business&Professions FELT AND INSTALL 50YR COMPOSE JOIN WI Fit RIDGE VIiNTS Cute and that my license is in full force and effect. CLASS A 37 SQ I hereby affirm under penally of perjury one of the following two declarations: 1 have and will maintain a ceniticale 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. 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 Sq.FI Floor Area: Valualion:$14000 permit is issued. APPLICANT CERTIFICATION APN Number:35623002.00 Occupancy Type: 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(his city to enter upon the above mentioned properly for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep hard the City of Cupertino against liabilities,judgments, costs,and expenses win h ay accme against said City in consequence of he WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this Perini A diurnally the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point so r• re I I er the Cupertino Municipal Code,Section 9.18. Signature Date Issued by: /�� TGd Date: 6• fj �la ❑ OWNER-RUILDF-R DECLARATION RF.-ROOFS: hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to my roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the propen}'.or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant Date: L as owner(if the properly,am exclusively contracting with licensed contmclors to construct the project(Sec.7044.Business&Professions Code). ALI,ROOF COVERINGS TO BE CLASS"A"OR FIETIER I hereby affirm under penally of perjury one of the following three Ideclarations: have and i HAZARDOUS MATERIALS DISCLOSURE: 1 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 1 have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which[his permit is issued. California Ilea11h&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Cute,Chapter 9.12 and the I Iealth& Section 3700 of the Labor Code,for the performance of the work for which this Safely Code.Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air Permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will I certify that in the perl'omhance of the work for which this permit is issued,I shall maintain c Iiance with the Cupertino Municipal Cade,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's health"et) ections 25505,25533,and 25537. Compensation laws of Cali forma. If,after making this certificate of exemption,I t611-2 become subject to the Worker's Compensation provisions of the Labor Code,I must Ownent: �7 forthwith comply with such provisions or this permit shall be deemed revoked. Date: _C G APPLICANT CERTIFICATION CONSTRUCTION LENDING.AGENCY I certily Ihm I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating Ibr which this permit is issued(Sec.3097,Civ C-) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmlCSS the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which nray accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply with all non-paint source regulations per the Cupertino Municipal Code,Section ,\RCIIITE:C7"S DECLARATION 9.18. 1 understand Or, plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 21622 Regnart Rd DATE: 06/05/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: $14,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F USE: PERMIT TYPE: WORK Tear off shakes and install 1/2" OSB/30#felt and install 50 yr composition with ridge vents. SCOPE FEEID ROOFAREA s.f. 1REROOFFRES 3,700 11,r:.r. I'hm C'h.vi. l'hmrh. Tlon ChrrF li lrr. 17rn(:h,:r;; 1/rclr I'•nuir l'r•,•r Ph..nh. A.,mil l4,,: P:lec ltvvrrir I'l•.': ib6rr Vu,h. levy_ Orhe, /'lurch/nyLi 1 0/17rr IiG•r. Irlgr. .Nair. Lop. l.'r" Vlumh. hop. Fe". /ihe. Imp. 1.t' NOTE: This estimate does not includejees due to other Departments(i.e. Planning,Public Works, Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De ! or aeldn7 info. FEE ITEMS (FL•e Resolution /1-053 E1Z 711.//1) FEE QTY/FEE MISC ITEMS Plan ( lrrk uppl_ l'C F •r. 1'(runl.:�:I Irr:Ir.'Zi(cc Permit Fee: $518.00 l'lranit:51 dcr Jr.i7i(cc l'hmrlr.i':Ilrrlr.;lslec 1'r:rmil (tic: Curn'n Anion Tin. tidmini.antnirr hrr: Work Without Permit? O Yes (j) No $0.00 ,Irlr,nrrrul l'lurruin� hrtr.r. Stron ,Motion Fee: IBSEISMICR $1.40 Select an Administrative Item Bide Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $520.40 $0.001 TOTAL FEE: F $520.40 Revised: 05/01/2012 CITY OF CUPERTINO 3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35623002 .00 DATE ISSUED. . . . . . . : 06/05/2012 RECEIPT #. . . . . . . . . : BS000016994 REFERENCE ID # . . . : 12060020 SITE ADDRESS . . . . 21622 REGNART RD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : MCCARTY ARTHUR R JR AND CAMILL ADDRESS . . . . . . . . . . : 21622 REGNART RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4821 RECEIVED FROM . . . . : MASTERPEACE ROOFING CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 14, 000 .00 1 .00 0 .00 1 . 00 0 .00 1BSEISMICR VALUATION 14, 000 .00 1 .40 0 .00 1.40 0.00 1REROOFRES SQ FEET 37 .00 518 .00 0 .00 518 .00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 520 .40 0 . 00 520 .40 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CASH 639.40 --------------- TOTAL RECEIPT - 639.40 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 TEAR-OFF POLICY 2 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(Dcugertino.org PROJECTADDRESS D., p 1� APN u OWNERNAME �� '��C VkiZZ" PHONE EMAIL STREET ADDRESS CITY. STATE.ZIP FAX CONTRACTORNAME \ AAr•1G A [7C LICENSE NUMBEI�5c?,<z LICENSE Ta BUS-LIC.0 COMPANY NAME Iv•r+"H�fr E-MAIL "\ ! FAX STREETADDRESS 3�I`$ ZI'�tPN W CIT.STATE.ZIP �.S f Gj_tIt o250VJ-�\ PHQ`.�� sIj Ql'C.t� T 1 UNDERSTAND AND AGREE TO THE FOLLOWING: J 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/<" 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$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, 1 certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I understa an agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon mono d rare required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Signature of Applicant/Agent: Date: Reron/Ynlier 1111 Lrine rrris•rl I71/lG/ll F Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Building Ike artment JOB ADDRESS: PERMIT # OWNER'S NAME: ./y/ PHONE # z/UfJ b GENERAL CONTRACTOR: ir/ i94:E FAX # I am not using any subcontractors: ignature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper. Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date � Zv(o C O' REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CU PERTI N O (408)777-322288-FAX(408)777-3333•buildinaCdcuoertino.ora PRUIECT ADDRESS LI62Z Z�,NAR`t 1Wr1D t APNx <G1 ,P — Z3 / c ?— OWNERNAME AaT . w C'�A 2� PHO$D y --)SID D l�W - IL l/l� STREET.ADDRESS L r/_2r2\ r�Gl �.�"t CRY. STATE,ZIP (-o r P F FAX Z.-CONTACT NAME lFJ e!kotso E-MAIL � � A Go.✓r�� STREET ADDRESS CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-nUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONIIUCTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME 0AS-fG2 PeAC� LICENSE NUMBERSOIS-7-S LICENE7 BUS.LIC.x COMPANY NAME 1 ,rrA,C.4f /1 r)x+��.G Cborl-l< E-MAIL �_1I DD /� �� FAX STREET ADDRESS j,rJ ur VQ PH CRY,STATE.ZIP L_.S. F rj 40S PHS Ott �'`�_9'1 44_ ARCHITECTiENGINEER NAME r-L LICENSE NUMBER J 1 BUS LIIC..4 TY COMPANY NAME E-MAIL FAX STREET.ADDRESS CRY.STATE.ZIP PHONE USE OF 44 SFD or Duplex ❑ Multi-Family. ROOF AREA V.A[_UATIO STRUCTURE. E] Commercial 1 3 700 Sq FY I L't� 000 EXISTING ROOF TYPE..y❑BUILT-UP ROOF ❑ASPHALT SHINGLES %VOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY, REMOVE/REPLACE IPYES IF NO. PLYWOOD ❑ w. ❑ PLt}YD OSB PITCH. ROUF ❑ NO xLAYER THICKNESS 13in.. TVP: ❑Cox -4!L-- '(z LASS A PROPOSED ROOF TYPE. ❑BUILLTT-UP ROOF `MSPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC..ES REPORT x DESCRIPTION OF WORK:TETT R SFr SN q►G (ZapF SO %I co MPrx t-T 10 r t - (z1 bc, V F-+-'TS By my signature below,I certify to each oC Follo IDg- I am the properp•owner or authorized agent to act on the property owner's behalf I have read this application and the information 1 hate pro deA h orre 1 have read the Des riplion of Work and verify it is accurate. I agree in comply with all applicable local ordinances and slate laws relating m buil I tlonu representatives oCCupertino to enter the above-identified property for inspection purposes, Signature of..Applicam/Agenl: Date_ J A 1-2 SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY _If building is associated with a Home Owners Association,provide letter PLAN CHECK TYPE ROUTING SLIP of approval Cmm HOA. y�`�VER-THE-COUNTER ❑ BUILDING PLAN REVIEW Provide Planning ryrproval to verify if there any restrictions. LJ ExPRESS ❑ PLANNiXr,,PLAN REVIEW _Provide copy of Manufacturers Installation Specifications. ❑ STANDARD ❑ FIRE IIEPT Provide signed copy of Cuperdno's Tear-OR-Policy. ❑ OTHER: Reroojdpp_2011.doc revisec!03'16111