12080020CITY OF CU13ERTINO BUILDING PERMIT
1 UILDENG ADDRESS: 20875 VALLEY GREEN DR CONTRACTOR: NEMMER ROOTING PERMITNO: 12080020
OWNEMS NAME: KORET FOUNDATION 5348 AIJIMBON PARK Cl' DATE ISSIJIiD: 08/062012
OWNIIR'S PIIONE: 6505923960 FREMONT. CA 94538 I'IIONF,NO:(510) 919-2930
LICENSED C0NI'RAC`f0R'S DECLARA'T'ION
License Classes Lic. 4
Contractor�Csr'rA'tG�te
hereby affirm that I am licensed under th provisions of Chupter 9
(commencing with Section 7000) of Division 3 of the Business S Professions
Code and that nn• license is in full force and effect.
I hereby affirm under penally of perjury one uPthc following two declarations:
I have and will maintain a certificate of consent 10 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 Ibr by
Section 3700 of the Labor Code, for the performance of the stork for which this
pennit'is issued.
.\PI'1:1 C.\N'I' f:P:R'I'IPIGVI'ION
I certify that I have read this application .rad state that the above information 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 city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against Iiabilities,judgments,
costs, and expenses which may acerae against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with till non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature A Dateee
❑ OWNER-IMILDER DECLARA'T'ION
I hereby affirm that I am wennpt from the Contractor's License Law for one of
the following tau reasons:
I, as ocner of the property, or my employees with wages as their sole compensation,
will dothe work, and the structure is not intended or offered for sale (Sec. 7044,
Business F Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business S Professions Code).
hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided 1'or by Section 3700 of the Labor Code, for the
perfomnance 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 stork for which this
permit is issued.
I certify that in the performance 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 Imus of California. If, after making this cenilicate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
A PPLICANTCERTIFICATION
I certify that I have read this application mid stale that the above information is
correct. I agree to comply with all cit' and count 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
indemnity and keep harmless the Cit of Cupenino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting ol'lhis permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code. Section
9.18.
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
PIECII r RESIDENTIAL r COMM ERCIA I. 1—
.JOB DESCRIPTION: 416431 -TEAR OFF SHAKES REPLACE WITH GAF WITH
TIGER PAW UNDERLAYMENT CLASS A 7600 SQFr
Sq. Ft Floor Area: I Valuation: $17380
AI.N Number: 32609064.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 D YS FROM T CALLED INSPECTION.
Issued bp: - b ' / Date:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. Ira roof is
installed without first obtaining an inspection, 1 agree to remove all new materials for
inspection. //
Signature of Applicu Date
ALL 1200E COVERINGSTO BE CLASS "A" OR IiE'1-FER
HAZARDOUS MATERIALS DISCLOSURE:
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Ileallh S Safety Code. Sections 25505. 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code. Chapter 9.12 and the Health S
Safety Code. Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined hp the Iia Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Ileallh \ Safety Code, Sections 25505. 25533,and 25534.
Oat rtiutbor' gens: - y�
Date:
CONSTRIX--PION LENDING AGENCY
I hereby afrrn that there is a construction lending agency for the performance of wurk's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's None
Lender's
ARCIIITECI"S DF-CLARATION
I understand my plans shall be used as public records.
Date I Licensed
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
(408) 777-3228 • FAX (408) 777-3333 • buildingCcDcui)ertino.org
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1 UNDERSTAND AND AGREE TO THE FOLLOWING:
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.
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 S 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: 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 11314 and R315 of
the 2010 California Residential C
Signature of Applicant/Agent: Date:
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
J&DI)RESS:
20875 valley green drive 416-431
DATE: 08/06/2012
REVIEWED BY: larry s
btech. Permit Fee:
PN:
BP#:
'VALUATION:
$17,380
*PERMIT "TYPE: Minor Building Permit
PLAN CIIECK TYPE: Re -roof
PRIMARY Multi -Family Dwelling
USE:
Building is
3 Stories O Yes E) No
PENTAMATION' 1R2RO0F
PERMITTYPE: A
WORK
tear off shakes replace with gaf with tiger paw underla ment
SCOPE
FEE II) ROOF AREA
(S.f.
1REROOFMRES 7,600
NOTE: This estintate does not include fees due to outer Department' (i.e. Planning, Public Works, Fire, Sanimp' Sewer District, School
District etc. ). These fees are based on the arelin» nary information available and are onh' an estimate. Contact the Dept for athin'I into.
FEE ITEMS (Fee Resolution 11-053 L•fL 7/1/11)
,Nech. I'Ion Chcck
Plunrh. Plan Check
Flee. Plan Cheek
btech. Permit Fee:
Plumb. Permit Fee:
Flee. Permit Fee:
other'Vech. Imp,
Other Plumb Insp.
Other Elec. /nap,
d -loch. hap. Fee:
Plumb. lisp. Fee:
Flec. Insp. Fec:
NOTE: This estintate does not include fees due to outer Department' (i.e. Planning, Public Works, Fire, Sanimp' Sewer District, School
District etc. ). These fees are based on the arelin» nary information available and are onh' an estimate. Contact the Dept for athin'I into.
FEE ITEMS (Fee Resolution 11-053 L•fL 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
Strppl. PC Fee
PLrmh.Pdlech./Fle c
Permit Fee:
$1,140.00
Supp(. Insp Fee
Plumb./14ech./Flee.
Plunrh./t4/ech./Flee Perini! Fee:
Construction Tax:
Administrative Fee:
Work Without Permit? O Yes (2) No
$0.00
Advanced Planning Fees:
Travel Documentation Fees.-
ees.Strong
StrongMotion Fee: IBSEISHICR
$1.74
Select an Administrative Item
131da Stds Commission Fee: IBCBSC
$1.00
SURTOTALS:
$1,142.74
$0.00
TOTAL FEE:
$1,142.74
Revised: 07/01/2012
C
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777777-3 sea eFiiaea
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❑ OWNER ❑OWNER-HUIIDER ❑ OWNERAGFM ACOM1TRACrOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ tNGA'E`M. ❑ OEVfl.OPER ❑ TENANT
CONTRA OR NAME
LICENSE NUNSM
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AACHITECT/F]NGINEE R NAME LICENSE NUtABER
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COMPAW NAME E -MAI.
FAX
STREET ADDRESS CTI -Y. STATE, ZIP
PHONE
USE OF ❑ SFD Or Duplex VMuld-Family ROOF AREA:
STRUCTURE: ❑ Commercial % /p
VALUATION:
Z 3 '
EXISIVNG ROOF TYPE: ❑Bun T-UPROOF ❑ ASPHALT SHINGLES WOODSHAKES
❑WOODSHINGLES ❑ OTHER(SPECIFY)
REMOVE/REPLACE YDS
❑ NO
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Y /r
PLYWOOD ❑ w, ❑
THI n
PLYWD ❑ OSB-
TYP : ❑ X
PITCH: Y.1Z
OF
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PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT sm Nm Fc ❑ WOOD SHADS
❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT Y
DFSCRLffiION OF WORK J i
i Q
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act an the property owner's behalf. I have read this
application and the informatian I have ovided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
onlinances and state laws relating to udingco Ihorize representatives of Cupertino to enter the above-idenrified property for inspection purposes.
re
SignaruofApplira t/Agenc Date: O
SUPPLEMENTAL INTFORMATION REQUIRED
_ If building is associated with a Home Owner's Association, provide letter
ofroval from HOA.
aPP
_ Provide Planning approval to verify if there any restrictions.
_ Provide copy of Manufacturer's Installation Specifications.-n'e-
_ Provide signed copy of Cupetino's Tear -Off Policy.`.
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ReroofApp_201 1. do c revised 03/02111
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