12080231 CITY OF CUPERTINO BUILDING PERMIT
I UILDINGADDRESS: 20800 VALLI-YGREL•N DR CONI'RACI'OR:NEMMER ROOFING PERMITNO: 12080231
OWNER'S NADIR: 20800 VALLEY GREEN DR 5348 AUDIIBON PARR Cl' DA'Z'E ISSUED:08212012
OWNER'S PIIONL: 6505923960 FRFNIONI',CA 94538 PI ZONE NO:1510)919-2930
LICFNS P:D CONI'KACI'OK'S UI?CLn K,\"1'ION BUILDING PERMIT INFO: BLDG r ELECT r PLWVIB r
License Class Lie.H l C� 7�-'
r
D1ECH (- RESIDENTIAL COMMERCIAL r
Contractor one
1 bcrcby affirm that I am licensed muter the provisions of Chapter 9 .JOB DESCRIPTION:UNII'490-501,RE-ROOF 103 SQ RIiMOVE EXISTING
(commencing with Section 7000)of Division 3 of the Business& Professions SI IAK1iS AND INSTALL NEW UNDERLAYMENT,TIMBERLINE
Code and That my license is in full force and effect. UTA RA COAIPOSPI'ION CLASS A
1 hereby affirm under penalty of perjury one of the folloe,ing uwo declarations:
I have and will maintain a certificate of consent to sell'-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which[his permit is issued.
1 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 Sq.Ft Fbmr Area: Valuation:$34650
permit is issued.
,\I'1'LIC\N'I'CIil2'I'I FIC,CI'ION MIN Number:32609040.00 Occupancy'l'ype:
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county 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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may macre against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understandsmnd will comply 180 DAY OM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18, nay
_ �C� �� Issued by: V Z�, Dale:
Signmur "� D:uc
❑ OWNFR-BUILDER DI?CLARATIO,N
RE-ROOFS:
hereby affirm that I am exempt from the Contractor's License Laeformic of All roofs shall be inspected prior m any roofing material being installed.If a roof is
[he following list)reasons: installed without firs[obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as[heir sole compensation, inspection.
will do the e'ork,and the structure is not intended or offered for sale(Sec.7044. �r
Business&Professions Code) Signature of Applicunt�/���� /� � Date:_;Y
I,as owner of the property,am exclusively contracting with licensed contractors to
construct[he project(Sec.7044,Business 8•Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR ISP:ITER
hereby affirm under penalty of perjury tine of the follnwing three
declarations: ILA%ARDO11S M ATFRIAI S DISCLOSURE
I have and will maintain a Certificate of Consent Io self-insure for Worker's
Compensation,as provided toothy Section 3700 of[he Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which[his permit is issued. California Ilenith\Safet•Cole,Sections 25505.25533,and 25534. 1 is ill maintain
I have and will maintain Workers Compensation Insurance,,%provided for by compliance with the Cupertino Dlunicipal Code,Chapter 9.12 and the Ileakh&
Section 3700 of Ilse Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)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 I will
I certify that in the performance of die work for which this permit is issued,I shall maintain compliance with the Cupertno Municipal Code,Chapter 9.12 and the
not employ any person in any manner so a to become subject to the Worker's I lealth&Safety Code,Sections 25505,25533.and 25534.
Compensation laws of California. If,after making this certificate of exemption,I // /�
become subject to the Worker's Compensation provisions of the Labor Code,I must Ow' �,r authnn' >f c
forthwith comply with such provisions or this penni[shall be deemed revoked. Date:
ate:
CONSI'RUCI'ION LENDING AGENCY
APPLIC\N I'CER'1'IPIC,\'PION
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of swrk's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit 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 save
indemnify and 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 ARCI ITECI"S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand ret•plans shall be used a public records.
Signature Dane Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20800 valley Green DATE: 08/21/2012 REVIEWED BY: Sylvia
N:
2:- s AP : BP#: 'VALUATION: $34,650
*PERMITTYPE: Minor Building Permit PLAN CIIECKTYPE: Re-roof
PRIMARY Multi-FamilyDwelling Buildina is PENTAbIATION 1R2R00F
USE: g >3 Stories O Yes (j) No PERMITTYPE:
YORK UNIT 490-501- RE-ROOF 103 SQ - REMOVE EXISTING SHAKES AND INSTALL NEW
SCOPE UNDERLAYMENT, TIMERLINE ULTRA COMPOSITION CLASS A
FEE 11) ROOF AREA
(s.f.)
1REROOFMRES 10,300
,Meeh.Plan Check Plumb. Plan Chock Elec, Plan Check
hlech. Permit Fee: Plmnh. Permit Fee: Elec.Permit Fee:
Other'Vech.Insp. Oiher Plumb Insp. Other Flee.Lap.
,blech.ht.,p.Fer.: Plumb. Insp.Fee: Elect.Insp.Fee:
,VOTE: 7bis estiauue rhes not includejees due to other Departments(i.e. Planning, Public Warks, Fire,Sanitary Server District,School
District,etc.). Thesefees are haled on the prefintinan information available and are onh,an estinutte. Contact the Dept for ad dit in n.
FEE ITEMS (Fee Resolution 11-053 L•l7 i/1/11) FEE QTY/FEE I111SC ITEMS
Plun Check Fee:
Suppl. PC Fee
Pluntb./A•lech./Flee
Permit Fee: $1,545.00
Suppl. Insp Fee
Plumb./A/ech./F1ec
Phrnh.111ech./0ee Permit Fee:
Construction Tax:
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Advanced Planning Fees:
Travel Documentation Fees:
Strong i'vtolion Fee: 1BSF.IS,VICR $3.47 Select an Administrative Item
Bide Stds Commission Fee: IBCBSC $2.00
SUBTOTALS: 1 $1,550.47 $0.001 TOTAL FEE: $1,550.47
Revised: 07/01/2012
49111a'12,fr12 19: 5_ E!II=. i;pi! TfirTl ild F cr_ 40
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTyiENT • BUILDING DIVISION
ALPERT SALVADOR. RE.. C.C.O.,BUILDING OFFICIAL
C U P ERT I tJ0 10300 TORRE AVENUE- • CUP ERTINO. CA 95014.3255
(406) 777-3228 • rA;((408)771-3333• buildirgfc�cuocnlno.or_
PRDIECr ADDRESS �pQ�U 4I nrNe
C/ r . 32cc.0gn LID -C-0
OWNERNAME I� PI leNF. I R-VAII,02�i E"oJc�tDATtp•,�l
STIUBT ADDRV$S CIN,STATE,ZIP PAX
050 k�.C' is >a. LCMDWr C.A, Qyoo2_
CO;;TRnrTert, +�F ucGNS11.MINRER
Kora rel.-b `-, NctAMcP` �jI�Ci C� 'S'1vrE els14 - .uc.e
COMPANYNAME
I V 1`411 rnc.,:AO. rnx
coFtNC tr�Y\nemmer �utA'neo ,wot l 1-5 4`7'30
STIUr' ADDRF,SS GrY.STATC.P.IP rnONE
3` F AvDu6oN l�cczr CT. F ,- Nr �l'-4.5'ov ro 949 - 2930
I UNDERSTAND AND AGREE TO THE FOLLOW NG:
1. The re-roofproject 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 Inspeetions, 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 t11is 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 renuired when approximately 50% ofroof covering is installed.
7. A Final Inspection and approval shall be obtained from the building inspector when the re-rooting is
Completed. To receive a Final sigh-oll the following items will he verified:
a. Flat roofs shall have a minimum of;." per foot of slope and demonstrate there is no ponding.
h. Listings from approved testing agencies for all pre-manufacnrred products used shall be
available on-site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter/down?pouts installed, debris removed.
S. 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 staid before another inspection before another inspection
can be scheduled.
By my signing below. I certify each of the following is IT= ] ,am the property own�:r or authorized agent it)act on the
property owner's behalf. I understand and agree to comply with the re-roof policy slated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R.314 and R313 of
the 2010 Califnmia Res"
`Coclp•
Signature of Ap IicandAgcnt: �` -T�- �L�r• %'_•>
RerpnfPo1fCY_2011.dnr.revised 0716111
09/14/2012 19: 52 4064367602 BUIS CONSTRUCTION PAGE 02
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REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•[lyildin0(O�cUpenino oro
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USE OT ❑ SFA or Duplex Nr Multi-Family ROOF APB : VALUATIAN:
srxucrtntD: ❑ COlnmercial / 03 C7 3 S�
L'XISTNOROOMTE: ❑MUILT-LTROOP ❑ASPHALT RH1HOrF< IaWOcicsR I, ❑WOODSKINXCLO ❑gTatER(3PEL'IFY)
RE ❑ , . F4 —JL ROOF
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c_By my algnatme below,l ecnily to inch of the following: tam Ilx prope cmna or nthodzd agem N act on the proPety oWner'a bchal[ I have rcid the
application and the infurmadon I have pmWed is ccmoca le,cad the peaeriptino of Work nod verify it G ucurate. I agroe to comply with all applicable local
ordinances and state laws MIntin, 0 ti mnctnlc' �I outharize r <
6 eprc rnlnlivcs ofCuprninD to carer the aMauidrntificd Drpperty for inspcainn mrrpotea.
Signature of App]icantlAgeet
Dat2I
e -
SUPPLEMENTAL INFORM.ATiON REQUIRED Ok'FICF.rise ONLY
_If building is associated with a Home Owners Associarion,provide Icurr :Pian crrF,CK n-re AolrmcsLm
of approval from HOA. \TR-THRLOUNTiR ❑ DU6DINCP(.AN RRaICP'
_Provide Planning approval to v_-rife if there any restrictions,
EXPRARR ❑ PtANXNGi'L.a.N ACVIBw
_Provide copy of%`FR ufactu er's rnstallatiort Specifications. O STL.N'DARD O
FTifG DCi'r
Pro\'ide signal copy of Cupertino',Tear-Off Policy. 0 'y'W.i:
RcrnnfAj)p_2011.doc r,,ited 03116111