12080230 CITY OF CUPERTINO BUILDING PERMIT
BUILDING.ADDRESS: 20800 VALLEY GREEN DR CO,YI'RACI'OR:NEMML'R ROOFING PERMIT NO: 12080230
OWNER'S NAME: 20800 VALLEY GREEN DR 5318 AUDIRION PARK C1- HATE ISSUED:0821/2012
OAVNER'S Pl IONE: 6505923960 FRE.MON I'.CA 94538 PIIONF.NO:(510)919-2930
LICENSED CO\I'RAC`FOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
T '
License Class / Lic.4 / 7 Z67
�/ z \IEC14 r RESIDENTIAL r CODIiAtERC1AL r
Contractor Ns+�s�- Date rJ C} —/
hereby affi nn that 1:run licensed raider the prorisiuns of Chapter 9 .1013 DESCRIPTION:UNIT 461-471,RL'-ROOF 62 SQ REMOVE EXISTING
(con]inencing with Section 7000)of Dirision 3 of the Business& Professions SHARES
Code and that niv license is in full force and effect. AND INSTALL NEW UNDERLAYMrNT,TIMBERLINE ULTRA
COMPOSITION CLASS A
hereby affirm under penalty'of perjury line of the following 1110 declarations:
I have and will maintain a cetificatc 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 mid will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the perfonnawe of die work for which this
Permit is issued. Sq.Ft Fluor Area: Valuation:$20160
,u'r1.ICAN•r cbarrrrlccrloN
I certify that I have read this application and state that the above infommtion is APN Number:32609040.00 Occupancy Type:
correcl. I agree to comply with all city and county ordinances and state laws relating
to buildin_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 liabilities.judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs.and expenses which may accrue against said City in consequence ol'the
granting of this permit. Additionally,the applicant understands and will comply WITHIN180DAYS OF PERMIT ISSUANCE OR
with all non-point source regulalias per the Cupertino Municipal Code,Sectia, 180 DAYi1 ROM LAOT CALLED INSPECTION.
9.18. _ /�}
Signature- Date =�./ —,/ Issued by: v ?'� Date:
OAVNER-BUILDER DECLARATION
hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOF'S:
file following 1110 reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first oblation an inspection,I agree to remove all new materials for
will do the work,mid the structure is not intended or offered for sale(Sce.7044, inspection.'
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applign i Date:�—
construct the project(Sce.7044,Business&Professions Code).
1 hereby affirm under penalty of perjury line of the following three ALL ROOF COVERINGS TO 13E CLASS"A"OR BE'ITER
declarations:
I have mid will maintain a Certificate of Consent to self-insure for Worker's IIA%.ARDOUS M ATERIAIS DISCLOSURE
Compensation,as provided for by Section 3700 of the labor Code,for the
perRxmame ofthe work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Ilcalth&Safety Code.Sections 25505,25533,and 25534. 1 will maintain
Section 3700 of the Labor Code,for theerforni nce of the work for which this compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ilcalth S.
p Safely Code,Section 25532(a)should 1 store or handle hazardous material.
permit is issued Additionally.should I use equipment or devices which emit hazardous air
1 certify that in the performance of die work forwhich this permit is issued,I shall contaminants as defined by the Bay Area Air QualityManagement District I%rill
not employ any person in any rammer so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
Compensation laws of California. 11,after making this certificate ofexen,ption.I Ilcalth&Safety Code,Sections 25505.'_5533,and 25534.
become subject to the Worker's Compensation provisions of the labor Code,I must
nO , o� �tw �wu:
mruviurmmply with such provisions or this pcnnil sh;dl nc deened revoked.
��ate:
APPLICANT CERTIFIC ATION CONSTIOIC11ON LENDING AGENCY
I certify that 1 have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances mid state Imes relating I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and herebyauthorize 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 acerae against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARC1I ITECI"S DECLARATION
9.18.
I understand n]y plans shall be used as public records.
Signature Date
Licensed Professional
'19/1-1/2`012084':F.7;;fr
B I -XIH=•TRL ICT101.1 F—G
,E 9?
REROOF TEAR-OFF POLICY
COh41e1UNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISIUPJ
ALBERT SALVADOR. P.E.• C.C.0,• BUILDING OPFICUL
CUPFRTlr4O 10300 TORRE AVENUE • CUPERTINO. CA 95014-3255
(408)777-3228• FAX(:051 777.3333• buildinq(c. uDenlno ort pp
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2010California 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 (,\ton-Thugs) 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 ofthe inspection 01,13, 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 Ins ection is required. Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless pea'plywood roof sheathing is proposed throughout, all the uflils/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 perfo,mcd•
6. Progress Inspectf0n is re uired when approximately 50% of roof covering is installed.
7. A Final inspection and approval shall he obtained from the building;inspector when the re-roofing is
COmple ed. To receive a final sigh-off, the following items will he verified:
a. Flat roofs shall have a minimum of I/" per foot of slope and de monstrate 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: .Ifyou call fora tear-offor plywood nailing inspection and die Work is not complete, you will be
charged a re-inspection fee of 5120.00. The re-inspection fee shall be Paid before another ins ection
can bescheduled,
By my signing below, 1 certify each of he rollo"Ig " 'rue: 1 am the property owner or authn ped agent to set on the
progeny owner's hehalf, I understand and agree to comply with chs re-roof policy stated above. I also understand [hat
smoke detecto s and carbon monoxide detectors are required to be installed in acco grange with Sections R314 and R315 0f
the 2010 Califnmia Residaiti�l Code./) i
Signature of Ap 11ca0✓Agent: /`f.7y,
ri
Reron/Pollrl+ 20/l.dnr.revised 02114///
09/14/2012 19: 52 4084367802 BUIS CONSTRUCTION PAGE 02
12-C)4? oZ3
2 REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
CUPER 0 (408)777-3228• FAX(408)777-3333•h ildin rtino.ora
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(\INTaYI' •ff E-MM, PAX
STRRFi AODRBSS CFJ7.STAT$21P PHTTi
USE OF ❑ SFDorDuples zNfulti-Family Roar Alli : VAulArinN: I
Sm.'C - ❑ COtmnercial 6 ZO
VXIST'OROOPTITE: ❑nVILTdrPROOP ❑A.SPHALTRHiNOZY3 $a'WOODRHAVU ❑WOODSIILNGLO OOT ER(3PECIFY)
RES:a%T/R£PLACl! 1ql'ES VNO. I Pl.l'lt•OOD V'A ❑ PLl'WD ❑.Oin PITCTI: ROOF
❑N J r TTnr-y-N'DRS ED ,,. ❑
PP.OPOSCDROOPnTE: 12BLRLT•UPROOF -E AMALT SHLNGLBF ❑WOOD SIL%: ❑woor,STDNOLBs ❑otme]x IMES M. ORTI
DESrn Cel rwt)":
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COMPOS 1T-1 O� '
By my slgnmvro below,I ccltity to well of the rollowing: r a:n the Property ewnn er nutholizcd agent to act on the Pr1Pan:otlnei s bc)W l 1 have read this
npplicadon and the infur n Icon I]IM Prnvided is Coneet. I have ro.d the Dcscriptioa nr Work nod veri5•it is accurate, r agree W comply With all applicable local
nrdinnnces and xtam law.rola' to build ng-enncernetiCo. autL c reprec¢ntnlive5 orCo7mnine to enter the obo%vidcr if'ed mperty for inap=l.oil pllrpeles.
Siguatera of Applicant/Aacet: . 9 Doc; — z
SUPPLEIuf�NTAL I\TORNLATION RGOURtED 'OMCF.it9LONLY
If building is associated with a Home 011nefs Assxlciarion,provide letter AotrmG slm
Of approval firm HOA. OVAR•TnR.COONTRR ❑ DV6DING�I+I.AN AAtTDR'
Provide Planning approval w vcriry if there ally re.;trictions. ❑ El AA55 ❑ DUNNING 1'1..11'AEV Isw
Provide copy Or Manafaca='s Installation Specifications. ❑ SULN'aaa0 0 rmum
Provide signed copy of Cupertino's Tear-Off Policy. p onrm
Fernnf fpp_2011.doc revised 031161;1
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
!121 ADDRESS: 20800 Valley Green DATE: 08/21/2012 REVIEWED BY: Sylvia
\PN: BP#: 'VALUATION: $20,160
'PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMAR\ Multi-Family Dwelling Building is PENTAI\IATION 1R2ROOF
USE: 3 Stories O Yes Q No PERMIT YPE:
WORK UNIT 461471 RE-ROOF-62.SQ - REMOVE EXISTING SHAKES AND INSTALL NEW
SCOPE UNDERLAYMEN , TIMERLINEJULTRA COMPOSITION CLASS A
EF ID ROOFAREA
(s.f.)
1REROOFMRES 6,200
Meth. Plan Check Phmah.Plan Check Flee. Plan Check
blech.Permit Fee: Phamh.Permit Fee: MCC.Permit Fee:
Other,tlech.Insp. Other Plumb Insp. Other Flec.hup. Li
.Meth.Insp.Fee: Moab. /rep.Fre: Flee.Imp.Fee:
NOTF: This a tintate does not include jeer due to other Departments(i.e. Planning, Public IPnrk.s, Fire,Sanitary Setaer District,School
District,ere.). These ees are hosed on the preffininarl information available and are onh'an estimate. Contact the De t or addo'I in o.
FEE ITEMS (Fee Resolution 11-053 Ell: 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Phimb./11ech./Elec
Permit Fee: $930.00
Suppl. Insp Fee
Plumb.1A1ech.1Elec
Plumh.AWech./Elec Permit Fee:
Consovction TiL:'
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Advancecl Plarming Fees:
Travel Doctanemation Fees:
Strong Motion Fee: IBSF.ISMICR $2.02 Select an Administrative Item
Blde Stds Commission Fcc: IBCBSC $1.00
SUBTOTALS: $933.02 so.coj TOTAL FEE: $933.02
Revised: 07/01/2012