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12070256 CITY OF CUPERTINO BUILDING PERMIT RUILDING ADDRESS: 7530 LEEDS AVE CONTRACTOR:M&S ROOFING CO. PERMIT NO: 12070256 OWNER'S NAME: FIAFEZI MOSTAFA AND RASTEGAR BA 208 COPCO LN DA'Z'E ISSUED:07(312012 OWNER'S PHONE: 4082534801 SAN.IOSF-,CA 95123 PIIONF.NO:(4o8P[4-0370 ❑ LICENSED CON T'RACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUDIB r License Class C•���_ Lic.# © I /lam s7 r r r blECll RESIDENTIAL COMMERCIALCommctor `i Date hereby afprni that 1 am lice tsedmuder the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF 24 SQFT REMOVE SIIAKE,ROOF INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions DOUBLE Code and that my Ilarnse is in full force and effect. #30 FELT AND LIGHTWEIGHT TILE CLASS A 1 hereby,Minn under penalty of perjury one of the following two declarations: I have and will maintain a certificate ofconsent 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'dic work for which this Sq.Ft Fluor Area: Valuation:$17500 permit is issued. Alli'LIG\\I'CIiR'1'IFICA'1'ION APN Number:36616071.00 Occupancy Type: 1 cenifY that 1 have read this application and state that the above info-oration is correct.I agree to comply with all city and county ordinances and state Imus relating to building construction,and hereby authorize representatives of this cin'to enter upon meabovementioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indenmity and keep harmless the City of Cupertino against liabilities,judgnicnts, costs,and expenses which may accrue against said City in consequence of the WITHIN 1 0 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAY OM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. t ^ /r� Issued by: Date: Signator Date ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law Formic of All roofs shall be inspected prior to any roofing material beiig installed.If a roof is the fullowing two reasons: installed without first obtaining an inspection,1 agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,laid the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: ` Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business& Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BF: ITR herebyaffirm under penally of perjury nue of the following three declarations: I have and will maintain a Cenificate of Consent to self-insure for Worker's IIAZARD011S M,%IE?RIAI S DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the perlDrmance of the work for which this permit is issued. California Ilealth&Safety Code,Sections 25505.25533,and 25534. 1 will maintain 1 have and will maintain Worker's Compensation Insurance,as provided far by compliance with the Cupertinu Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,lot the performance of the work for which this Safety 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 performance of die work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the not employ any person in any manner so as to become subject to the worker's Health&Safety Code,Sections 25505.25533,and 25534. Compensation laws ol'Califimia. If,after making this certificate of exemption,1 become subject to the Worker's Compensation provisions of the Labor Code,I aril Owner t`I\r authorized agent: forthwith comply with such provisions or this permit still]]be deemed revoked. � `,N`fib— I , Doer A I'll LICANI'CIsRTI FICATION CONSTRUCTION LIiNDING AGENCY I certify that I have read this application and state that the above info nation is I hereby affirm that there is a construction lending agency for the perfa n ince of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this pennit 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 sive indenmify:md keep harmless the City of Cupertino against liabilities,judgments. Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply A RCIIITECt"S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Dade Licensed Professional By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the rimnenv owner's hehalf. 1 understand and aeree to comoly with the re-roof policy stated above. I also understand [ha[ CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 7530 LEEDS AVE DATE: 07/31/2012 REVIEN'EU Bl': Sylvia APN; RPti: 'VALUATION: $17,500 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARYPENTAIIIATION 1SFDWLROOF USE: SFD or Duplex PERMITTYPE: A WORK Re-Roof 24 sq- remove shake roof install double #30 felt and lightweight tile class a SCOI'E FEE 11) ROOF AREA • s.fJ 1REROOFFRES 2,400 Mech. flan Cheek Phnnb. Plan Cheek Ehq% Plan Check Mech.Permit Fee: Plumb. Permit Fee: Elec. Permit Fee: Other Mech. lnsp. Other Plumb Insp. Other F.1ee.Insp. Ll Mach. insp.Fee: Phunb, btrp. Fee: Elec.insp.Fee: NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public /forks, Fire.Sanitary Serer District,School District,etc. . These feev are baser/on the prelintinarl information available and are only as estimate. Contact Ute Dept for ade t'1 info. FEE ITEMS (Fee Resolution lI-053 F_lC 7/1/11) FEE QTY/FEE MISC ITEMS Rhin Check Fee: Srtppl. PC Fee Plumb.Alfech./Flec Permit Fee: $360.00 Suppl. /nsp Fee Plumb./Adec:h./Flee Plumb./11ech./1-lec Permit Fee: Construction Tax: Administrative Fee: Work Without Permit? O Yes tD No $0.00 Advanced Planting Fees: Travel Documentation Fees: i Snonc Motion Fee: IBSEISMICB $1.75 Select an Administrative Item 131de Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $362.75 $0.001 TOTAL FEE: 1 $362.75 Revised: 07/01/2012 REROOF TEAR-OFF POLICY 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-buildinaCdcupertino.oro PROJEL ADDRFSS T APN a OWNER NAME `.� ) A PHONE -1 _ D t E-MAIL STREET ADDRESS `C CITY.STATE.ZIP FAX CON—MCfORNAMELICENSENUMBER LICENSE TYPE BUS.LIC.0 l� COMPANY NAME , ,N` 1 E.,MAIL FAX �/1�-j A6 a-4 +, I f n. STREET ADDRFSS _ CID „ ♦ CITY.STATE ZIP r7 ^{ PHONE ` 4 �A0�/1 W I UNDERSTAND AND AGREE T'O,,i THE OFOLLOWING: V tl I. 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: 1 am the property owner or authorized agent to act on the property owner's behalf. 1 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 Code Signature of Applicant/Agent: _ "•• r .lam. t Dale: ReroofPoliCX 201 Ldoc revised 02116/11 -... iac>-I Dot REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•building cupertino.oro CUPERTINO PROTECT ADOBE'S 7 1� J �J�\ rS APN b _o- 0 ka_ OWNER NAME _ i PHONE r3 ` 01 E-MAIL STREET ADDRESS 7 �j ♦ I\� CITV, STATE.ZIP,( a FAX CONTACT NAME •f _' (/ PHONE Q E-0UIL ` O STREET ADDRESS CRY,STATE, ZIP FAX 14 OVVNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONIRACIORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEvaLopER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER V D ' (j LICENSE TYPIC ; BUS.LIC.a zoo COMPANY NAMEE-MAIL Q CJ FAX J• � STREET ADDRESS C (—(�_ . CITY.STATE,ZIP • PHONE yt1P8 DQp ARCHITEGMEN01NEER NAME LICENSE NUMBER BUS.LIC.0 COMPANY NAME E-MAIL FAX STREET ADDRESS CRY,STATE,ZIP PHONE USE OF ,❑-SFD Or Duplex ❑ NIUIh-Fa^Ily, ROOFAREA: /� VALUATION: STRUCTURE. ❑ Commercial I V •Q (/� �- EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES IWWOOD SHAKES 11 WOOD SHING LES ❑OTHER(SPECIFY) REMOVE 41EPLACE o. T I-NO, PLYw00D ❑ X" ❑ PLYWD ❑ OSB PRCH: AC—:12-- ROOF ❑ NO 9 AYERS. THti K C.. ❑ I'.' TYPE ❑ I.X L A PROPOSED ROOP TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT M DESCRIPTION OF WORK T ` L!"(-!I By my signtauic Wow,(certify to each of the following: I am the property owner or audmrized agent to act on the properry owner's behalf. I have read This application and die information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree w comply with all applicable local ordinances and state laws relating to buildin construction. 1 authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: —� SUPPLEMENTAL INFORNIAT NREQUIRED OFFICE USE ONLY _ If building is associated wilt a Home Owners Association,provide letter PLAN CHECK TYPE �, Eowrmc SLIP of approval from HOP,. "6�RTH- Etoun-reR _-BuaDLi— TING PLAN REVIEW Provide Planning approval to verifv if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _Provide copy of Ma ufacturer's Installation Specifications. ❑,STANDARD ❑. FIRE DEPT e ,fined copy of Cupertino's Tear-Off Policy. ❑. oTHER: Reroofdpp_201 Ldoc revised 03//6/11