12080012 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11441 S STELLING RD CON-fRACfOR:QUALITY ROOFING CO PERMIT NO: 12080012
OWNER'S NAME: SNIPES HENRY AND SALINA 10415 NEW AVE DATE ISSUED:08/032012
OWNER'S PIIO,\Ii: 4087611185 GILROY,CA 95020 PI IONE NO:(408)461-0484
.. LICENSPD CONTRACI'OR'S DECLARATION .TOB OF:SCIt II''1'ION: RESlll li\PIAL COAT\IERCLU.
License Class `L Lie.q q.2 RE-ROOF 30 SQ-TEAR OFF EXISTING ROOF INSTALL 7/8
` p OSB INSTALL 30LB FELT AND 30 YR ASPHALT SHINGLES
Contractor Date f1 �� CLASS
hereby affirm that I am licensed under the provisions of Chapter')
(commencing with Section 7000)of Dk i.sion 3 of the Business S Professions
Code and that lily license is in full force and effect.
1 hereby affirm under penalty of perjuy 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:$11000
I have and will maintain Worker's Compensation Insurance,its provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
APN Number:3622303400 Occupancy Type:
permit is issued.
APPLICANT CER'1'IFICA'I'ION
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 withall city and county ordimmcesand state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives ofthis city'to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY FOM LAST CALLED INSPET ON.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of oil.
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
pj 3— c7 RD:ROOFS:
Signatu Date CJ f All reals shall be inspected prior to airy roofing material being installed. If a roof is
installed without first obtaining ml inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of ApplicanC Dae:
1 hereby affirm that I am exempt from the Conlr:wrhr's LicenseI-:lir far one of
the following two reasons: ALL ROOFCOVERINGS'f0 BE CLASS"A"OR BETITR
I,as owner of the property,or illy employees with wages as their sole compensation,
will do the work,and the stricture is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to IIA--/-ARDO11S NIArI'ERIAIS DISCLOSURE
construct the project(Sce.7044,Business 8•Professions Code). 1 have read the hazardous materials requirements under Chapter fi 95 of the
California Ilealth S Safety Code,Sections 25505,25533,and 25534. I wiff
1 hereby aflinn under penalty of perjun•line of the following Ihrre maintain compliance with the Cupertino Al unicipal Code,Cha pier 9.12 and the
declarations: Ilealth S 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 nue 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 Ray Area Air Quality Management District I
perfommnce of the work for which this 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 Ilealth&Safety Code.Sections 25505,'_5533,Isand 25534.
Section 3700 of the Labor Code,Ibr the performance of the work for which this �•NYi O �C : (9 `
permit is issued. Oil or authorized agenuc,�e.i�-+� Date
I certify that in the perfommnce of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I 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. w'ork'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 aid state that the above informtion is
correct.I agree to comply with all city and county ordinances and slate laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned properly lot inspection purposes.(We)agree to save ,\I2C11I'I'GCf'S DECLARATION
and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand lily plans shall be used as.public records.
granting of this permit.Additionally,lire applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 11441 S. Stelling Road DATE: 08/03/2012 REVIEWED BY: Sean
APN: 13P#: 'VALUA'T'ION: $11,000
*PERMrr TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAhIATION
USE: SFD Or Duplex PERMITTYPE: 1SFDWLR00
WORK Remove existing asphalt roofing and install OSB and 30 Ib felt and new 30 year asphalt roofing.
SCOPE:
FEE II) ROOFAREA
(s.r.)
1REROOFFRES 3,000
,47ech, Plan Check Plumb. Plan Check Flee. Plan Check
hlech, Permit Fee: Plumb. Permit Fee: F.lec•.Permit Fee:
Odmr Afech. IasP. Wee Plumb Insp. Other rice.Insp. L1 I
Mech.Insp.Fee: Plumb. htsp.Fee: Flee./asp. Fee:
NOTE: This estimate does not include fees clue to other Departments(i.e. Planning, Public Narks, Fire,Sanitan•Saner District,School
District, etc.). These feav are based nn the prelintinan information mailable and are onh•ntt esdinate. Contact the Dept for aurin'/into,
FEE ITEMS (Fee eso/radon 11-053 Elf. 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Plumb.11fech.lElec
Permit Fee: $450.00
Suppl, lisp Fee
Plunrh./11ech./Elea
1'1tmvh./A,lech.1E1ec Permit Fee:
Consftwelion Tar:
Administrative Fee:
Work Without Permit? O Yes (j) No $0.00
Ad am-ed Planning Fees:
Travet Documentation Fees:
Suone Motion Fee IBSFISAIICR $1.10 Select an Administrative Item
131(Ie Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: $452.101 $0.001 TOTAL FEE: 1 $452.10
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)77///7111-3333•buildina(ftupertino.org
PROJECT ADDRESS y/ / APNs
� . CU 1K
OWNER NAME S
P NE / ` r es E-MAIL
STRE1 1ARRES -�� 1i � , f 1 CIT'.STAT ZLTIP b FAX
CONTMCfORNAME LICENSF.N MBER LIC SE TYPE BUS.LIC.0
COMPANYNAQ1 F� E-MAIL FAX
4 . Nk
STREET ADD R CITYST TE.ZIP PHONE
'S� 2
1 UNDERSTAND AND AGREE TO THE FOLLOWING:
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 oft" 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 ofS126.00. 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
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residenti I Code.
Signature of Applicant/Agent: Date:
RerooJPoliev_20//.doe reviser/02116111
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228 •FAX(408)777-3333•buildina(a)cupertino.org
PRCjj A DRESS
OWNERN M t PHONE EMAIL
STREET ADDRESS S� CITY, STATE,ZIP FAX lt,_ e:✓ rv.= Cs,
CONTACT NAM1IE i P ONE \QLC E-MAIL
SfREEr�AppRFS'15�+ �� C Y,S Aw ZIP y Zjti FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENr COMA.{CrOR ❑COZ n CrOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CO CTO N h1E , - LICENSE NM1D LICENSE ME BUS.LIC.A
_Ola r` o
COMPANY NAME E-0IAIL ^ FAX c,
sT D.{D KESS -6� CIT =T'.`` 1` C-� C`
� a g 6 —6 7
ARCHITECI'IENGINEERNAME LICENSEHUhm ER BUS,LICA
COMPANY NAME E-MAIL FAX
STREET ADDRESS Cm•,STATE ZIP PHONE
USE OF SFD or Duplex C3 Multi-Farnily. ROOF AREA: VALUATION:
STRUCTURE. ❑ Conunercid b QtS�
EXISTING ROOF TYPE. ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD���S///ttrHINGLES C3OTHER(SPECIFY)
REh10VE(REPLACE �YFS IF NO. PLYWOOD ❑ K" 11PLYWD pos
B PITCH: ROOF
❑ NO M VERS K cS si3" TYPE /❑ C —•l' CLASS A
PROPOSED ROOF ME: ❑BUILT-UP ROOF {SPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES 11 OTHER ICC-ES REPORT M
DESCRIP'r1UN OF WORK:
L bLb p. hs� vt,sL(s
By my signature below,1 certity to each of the following: I am the property oTnrer or authorized agent to act on the property behalf. 1 have read This
application and We information I have provided is correct. [have read the Description or Work and verify it is accurate. 1 agree w comply With all applicable local
ordinances and stare laws relating to building construe. n. I uthonze resentnuves of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicantlAgenr. Date: f
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home Owners Association,provide letter PLAN CHECK TYPE` ROUTING SLIP
of approval front HOA. OVER-THE-COUbTER %BUILDING PLAN REVIEW'
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS - ❑ PI:ANRiHG PLAN REVIEW
_Provide copy of MaHufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT'
Provide signed copy of Cuperninos Tear-Off Policy. - ❑ OTTTER:, _
Reroofdpp_2011.doc revised 03/16%11