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12080122
CITY OF CUPERTINO BUILDING PERMIT RUILDINCADDRESS: SSTELLING RD CON'T'RAC'T'OR:CITYOF CUPERTINO PERMITNO: 12080122 O\VNER'S NAME: CITY OF CUPERTINO 10555 NARY AVE, DATE ISSIJED:08/132012 OWNER'S PHONE: 4083094246 CUPERTINO.CA 95014 PITONS NO: ❑ LICENSED M rRACl'OR'S DISCLARATION BUILDING PERDIIT INFO: BLDG r ELECT r PLUMB r License Class Lie.q DIECII (- RESIDENT,AL r COMMERCIAL Contractor Date hereby affirin that I ant licensed under the provisions of Chapter 9 1013 DESCRIPTION: REMOVE(E)NiUAL SEAM ROOF AND(4)SEYLIGI ITS; (commencing with Section 711011)of Di%ision 3 of the Business S Professions INN SRYIKY'LIGI4T OPGNINGSAND INSTALL(2)LAYERS OF Codc and that my license is infull force and effect. UNDERLAYMENT WITII NEW COMPOSITION ROOFING hereby affirm under penalty of perjury one of the fullnN'ing mo 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. 1 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 permit is issued. Sy.FI Floor Arne Valuation:54200 .\I'I'I-IC.\\I'CISR'I'IPICA"PION I certify(hat 1 have read this application and state that the above information is AI;N Number.35925049.00 Occupancy Type: correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby antborize representatives of this city to enter upon the above mentioned property for inspection purposes. (\\'e)agree to save indemnify and keep harmless tire CityofCupertinoagainst liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against solid City in consequence of the granting ofthls permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. ^/ • , �i 2 Signature Dane Issued by: Date: ❑� OWNER-BUILDER DECLARATION hereby affirm that I am exempt front the.Contractor's License Lan%for one of RE-ROOFS: the f lllom'ing two reasons: All roofs shall be inspected prior to any rooting material being installed.Ira roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business fi Professions Code) p awl I,as owner ofthe property,am exclusively contracting with licensed contractors to Signature ol'Appli©nl: construct the project(Sec.7044,Business F Professions Code). hereby affirm under penally of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BE 17ER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's 11A7.ARDOUS MATERIA1 S DISCLOSURE' Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which[his permit is issued. I hnye read the hazardous materials requirements under Chapter 6.95 of the ]have and will maintain Worker's Compensation Insurance,as provided for by California Ilcalth S Safety Code.Sections 25505,25533,and 25534. 1 will maintain earn[,fit ace m'f Ill the Cupertino Municipal Code,Chapter 9.12 and the IIcallh S Section 3700 of the Tabor Code,for the performance of the work far which this Safely Code.Section 25532(x)should [.store or handle hazardous material. permit is issued Addilionally,should I tae equipment or devices which emit hazardous air I certify that in the performance of die work for which this permit is issued I shall contaminants as defined by the liar Area Air Quality Monagement District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the Compensation lays of Cali forma. If,after making this certificate of exemption,I Ileallh S Safety Code.Sections 25505.25533.mad 25534. 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. at 'or a oboe ized agent: �- Do le: I APPLIC,\N'I'CISIt'1'I PIC,V1'1O,N CONSTRUCr1ON LENDING AGENCY I certify that I have read this application and state that the above infuriation is correct.I agree to comply with all city and county ordbta ces tad state lass relating I hereby affirm that there is a construction lending agency for the performance of ssork's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for,inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with till non-point source regulations per the Cupertino Municipal Code,Section ARCIIITECI"S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Licensed Professional 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-building(akwertino.orq PROJECT ADDRESS APN p OWNER NAME /- PHONE E-MAIL STREET ADORFSS/l _ CITY.STATE.ZIP .� C /f FAX CONTRACTOR NAMEvCEYSENUMBER /T LICENSE TYPE �j BUS.LIC.0 COMPANY NAME E-MAIL FAX STREET ADDRFSS CITY.STATE.ZIP PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 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 S 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 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 Signature of Applicant/Agent: J� �— Date: /12 _ RerooJPolicv_201 Ldoc reviser/02116/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 7623 Dumas Road DATE: 0811312012 REVIEWED BY: Sean APN: BP#: "VALUATION: 1$4,200 *PER,IIIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Commercial Building PENTAMATION 1COMMLROOF USE: PERMIT TYPE: WORK Remove a metal seam roof and 4 skylights; frame in skylight openings and install 2 layers of SCOPE underlayment with new composition roofing. FEE ID ROOFAREA (s.t.) 1REROOFCOM 875 Mech.Plan Check Pluurb.Plan Check Flec.Plan Check Hari.Peranit Fee: Plo,nh. Permit Fre: Ele.c.Pe.min Fee: Otte,.Meeh.Imp. Other Phtmh 1,u'p. Other,Elft.Imp. Li I Mach.Insp. f ea: Phnnb.Insp.Fee: Eler.Lisp. Fee: NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Puhlic Harks. Fire,Sanitary Server District.School District, etc.). These rees are based on the preliminarl in orntation available and are onli,an estimate. Contact the De t or addn7 info. FEE ITEMS(Fee Resolution 11-053 E8 711111) FEE QTY/FEE I4IISC ITEil'IS Plun Check Foe Supp!. PC Fee Plunth.LHech.!Elee Pennit Fee: $367.00 SuppL Insp Fee Plunrh.'Hech.Xlec. Plurnb.itlech.!Elec Permit Fee: Conswuclion Tia: Administrative Fee: Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fees: Travel Docuntentalion Fees: Strone Motion Fee: IBSEISHICO $0.88 Select an Administrative Item Bide Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $368.88 $0.001 TOTAL FEE-.T $368.88 Revised: 0 7101/2 01 2 2v O1 Zz REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228 • FAX(408)777-3333•buildino(acuoertinD.Gm /J \l PROJECT ADDRESS /,(� I / '/ ✓1_ f fl \ ) 1 O OWNER NAME y PHONE E-MAIL STREET.ADDRESS CITY. STATE, FAX / of 2:z /i�— NG G CONTACT NAME PHON -L E-MAIL STREET ADDRESS CITY,STATE.ZIP FA% 77 ❑ OWNER OwNFR-BUrLDER ❑ OWNERAGENT ❑ CON ACTOR ❑CONiRACTORAGENT ❑ ARCHHECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.4 f ANY NAME G E-PLAIL FAX 5 E DRE_ CITI',STATE, P PHONE Aili� c v ARCHITECTIENGNE&INAME ^ //n LICENSENUAIBER BUS.LIC.0 CONVANY NAME / E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE of ❑ SFD or Duplex ❑ Multi-Farnity, ROOF.4RE4: VAL TION: ^�/' STRUCTURE: Kr Commercial KI-5715!2 4 . L // -, ExISTINGROOFTYPE: ❑BUILT-UPROOF ❑ASPHALT SHINGLES ❑WOOD SHARES 13 WOOD SHINGLES `90THER(SPECIFY) REMOVE/REPLACE xYES I IF NO. ^ ' ❑❑ ROOF 11 0 KL RS SCO.: •(? CLASS `a PROPOSED ROOF TYPE: ❑BUILT-UP ROOF XISPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT N DESCRIPTION OF WORK: - Q • By my signature below,I certify to each ofthe following: I Into the property owner or authorized agent m act on die property owner's behalf. I have read this application and die information 1 have provided is correct. 1 have read the Description of WorA and verify it is accurate. 1 agree ID comply with all applicable local ordinances and state laws relatim,to building construction. 1 authorize representatives of Cupertino to enter the above fled property for i pection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INF&mATi6N RE UIRED OF'FIC USEONLY. _ - _If building is associated with a Home Owners Association,provide letter _ PLAN CHECX TYPE._ ROUTING SLIP of approval from HOA. f ovER-THE{OU\TER BUILDING PLAN REVIEW Provide Planning approval to verify if there any restrictions. '❑ ExPHFss, ❑"rugrvmr.TERN xcV•Iew _Provide copy of Manufacturer's Installation Specifications. ❑ Srarvuexii �❑ miDnE-rr: Provide signed copy of Cupertino's Tear-Off Policy. - O. OTHER: - Reroojdpp_201!aloe revised 03/16/11