12080280 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 VALLEY GREEN DR CONTRACI'OR:NEMMER ROOFING PERNIIT NO: 12080280
OWNER'S NADIE: 20800 VALLEY GREEN DR 5348 AUDUBON PARK CT DATE ISSUED:08/282012
OWN'ER'S PRONE: 6505923960 FREMIONI',C\ 94538 PHONE NO:(510)919-2930
❑ LICENSED CONfRACTOR'S DECLARATION
' 7 BUILDING PERMIT INFO: BLDG (_ ELECT r PLUMB ri
License Class Lie q 7 y`'1 30 '1 r r' rl
p J Li
p �G � -I 2 MECH RESIDENTIAL COi11D1ERCIAL
Contractor /y{lN++""�/� �'�ate
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: UNITS 480 THRU 489.TEAR OFF EXISTING SHAKE ROOF
(commencing with Section 7000)of Division 3 of the Business S Professions AND INSTALL A NEW UNDERLAYMENT AND 7900 SOFT CLASS
Code and that my license is in full force and effect. A GAF TIMBERLINE ULTRA COMPOSITION ROOFING
hereby affirm under penalty of perjury 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.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of die work for which this Sq.Ft Flom Area: Valuation:$25000
permit is issued.
APPL.ICAN'T CERTIFICA'T'ION APN Number:32609040.00 Occupancy Type:
I certify that I have read this application and state that the above information is
correct.I agree to compl-v 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 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 accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this pernit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-points urce regulatinms per t upertino Municipal Code,Section
G�rZ_
Signature Date tg7 ^�-2 — Issued by: /T ✓ �Ar�� Date: 5 afJ fa
❑ OWNER-BUILDER DECLARA'T'ION
RE-ROOFS:
I hereby affirm that I'am exempt from the Contractor's License lane formic of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtainin an inspection, ,gree to remove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business K Professions Code) Signature of ApplicanDate:
1,as owner of property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BE17TIiR
I hereby affirm under penalty of perjury one of the fallowing three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IIAZARDOUS MATERIAL S DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code.Sections 25505.25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Mlunicipal Code,Chapter 9.12 and the Health&
Section 3700 of the 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 us defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Ilealth Safety Cod S tions 25505,25533,and 25534.
Compensation laws of Cali fomia. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must 0 er
forthwith comply with such provisions or this permit shall be deemed revoked Date:
APPLICANT CERTIFICATION CONSTRUC110N LENDING AGENCY
I certify that I have read this application and state that the above information is I hereby affirn that there is a construction lending agency for the performance of work'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
with all non-point source regulations per the Cupertino Municipal Code,Section .ARCII I"I'IiCI"S DECLARATION
9.18. 1 understand my plans shall be used as public records.
Signature Dale Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20800 Valley Green Dr DATE: 0812812012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $25,000
*PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Buildina is PENTAM TION
USE: Multi-Family Dwelling >3 Stories O Yes Q No PERMITTYPE: 1R2ROOF
WORK Units 480 thru 489: Tear off existing shake roof and install new underla ment and GAF Timberline
SCOPE Ultra composition roofing.
FEE ID ROOF AREA
s.f.
1REROOFMRES 7,900
,ilech. flan Check Plumb. Plan Cheek F./ee. Plan Check
Mech. Permit Fee: Plnmh. Permit Fee: F.lec. Permit Fee:
Other dlech./nsp. Ocher Plumb In.sp. Other Elce.Insp. El
119ech.limp. Fee: Plumb. hrsp. Fee: Elec.Insp.Fee:
NOTE: This estimate does not include fees clue to other Departments(i.e. Planting, Public Works, Fire,Sanitary Sewer District,School
District,etc. . These feav are based on the prelitninan information available and are onh,an estinale. Contact lite De t or aildn't info,
FEE ITEMS (Fee Resolution 11-053 Ell' ZLI1 U FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC lee
!'l tan 6.111 ech.lEl e c
Permit Fee: $1,185.00
Supp/. lisp Fec
Pluntb./1lech.1Elec
Phinih.ldlech.lElec Permit Fee:
Construction Tay:
Administrative Fee:
Work Without Permit? O Yes 0 No $0.00
Advanced Planning Fces:
Travel Documentation Fees•: A
Strone Motion Fee: IBSEIS,WICB $2.50 Select an Administrative Item
13lde Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: $1,188.501 $0.001 TOTAL FEE: $1,188.50
Revised: 07101/2012
09/20/2012 21:14 4884367802- BUIS CONSTRUCTION PAGE 02
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT^BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 850143255
CUPERTINO (408)7773225•FAX(408)>77�i333•b4tildinDd�a era Nan mer
PRO=TADD&M �oeOd Jatt
Green br Awa 32roo
OwAT.RNAl® 'N o6 , 00
PTRMAD1b1839 PH 0 592-39491� •ILUAM
MY.STAMw E,L-M Nr CA rAR
OOR(TALT NANB
�� Rd1AR.
u,P=,ADDRM CTY,STATE,A! .
PAR
❑Owam ❑ owosammncm O owKmAama 0 aow"cron ❑CM-MACM.AaW 0 ARGMECf 0DMva 0 ogY Loew D, ,T
tRRfrAACIOR NA tjam)3 hM1Ilmmt
'"i2a Ls� F'. e 3� q p µ DIM uC� 3
00hIPANY NAME &MAIR,
IN erC` A�+oD-COYvI PAX
0 73-
RIaRP,TA006Hss t CAJY.STA IR
^' Li5 m�O 0 Igo
FEMPER
ARl>3ftDLTAAtOA'®lNAam LIMMaNOMM
811A t�p
OM&AYYNA&M
H NAD' FAX
MMM AMR= ITfP.RTArH,LB
PRONE
trap or 0 VD of Duplex wrmulti-Family ROOF AM: vALUATTON:
RMI) MR& ❑ commercial • / 9 5
EVS1A'O RDOP 7'YP& ❑BL'D,r-UY ROOp ❑ASPHALT R8M9Las jdwo009tiAR91 ❑wOop SHM(L,® ❑ortaAt 0Mcz't7
RttAn]Va Atart.A(A 0rgs D'ND, PLYWOOD Ptta:n;'f�k" ❑_ r[.YfVD ❑DEE
❑ �:12 A
PR0108®ROOP 7YfA; ❑8[DLT.IIP RDOP .�AafxAi.r..>�,,,"• ❑wDoDni joss UWOODSUMLO ❑Or®t HrMREPORTI
tmsnrrrtDNDrWouc;
A v� F i�AK�S t
— SevSrrau_ u bt=tZ L-P+ M ! + FTM EdwA
CO�MP04 tT1.DN - �A •
Hr oty aipNnve bdow,I eady to mcb of the Nliaw{ng Inn of PtopertS'oaoa or mhoraod
aWliration and Poe ikon I hew dfd if m c Dead the Desai qVM to as tm tho pmpnty ewnn'e behalf I haw tv0 thi7
axdmaooq fed Strtc IePf reladog ildmg mess . I'a madortze phoo of We*and vat ty it if nremna. I Agree to=Ply With aD aMl'afblc IoW
repmaavHv�e Orcupe tim m amr the 06opo-idoodited property for pmpo�
Sigoatme otAPPNmer/Agmc Date: 7— / Z
311LEMBNTAL INFORMATION REQUIRED -
_If bath °nanY
t>g is assoeiatod w1W a Aoma Owrcr'a AeaociatkD,provide I� .1%M Of EpptOVal f}om HOA.
pvfi'lHbCotaR@ El' .. .
provide Pl=Ing approval to vE w if ftm a'w reSMetlon0. Wit:30A wMt lto
t�cdaer'e inatallaonp
dSmlBationg. 13 �ss 0 +4tNYmtorswN
_Provide ropy of Metro ❑ ���
provide signed copy ofIj mRDarr
CupefSno'ATear-OffFolicy. 0 ori
A000ONJO /.doe fePGnd 03/16w
09/20/2012 21:14 4084367802 BUIS CONSTRUCTION PAGE 03
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR,P.E., C.B.O.,BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO.CA 85014-3255
(408)777.3228•FAX(408)777-3333•buildin in o �v U �! 9
PROIECr ADDRESS 20600 \ , C
v APNN 3yD:00
OP'ATiR NAME ��//
�02�i 1- p.INDATtoN Pa 54� -3960 s-MAIL
$7'k=ADDRM City ArE.m' FAX
O ak_s is, t�rnON r cal 44002 .
CONTRAcroa� LICVmNrwnx pcvimlyn- susuc,
t�out+.I_p 1'r NEMM� 1agD
CDMPANYNAMF, -T� E-MM
YN ernmer al,00 . Fido
SiREBT ADDRESS .7�C? l•W AU$0�•rp.(2.� t''T. Cr'.STAMZM
.7 Fc r G1 4510b "0 919-Z930
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. The ret-roof project shall comply with ail applicable provisions of the 2010'Califomia Codes.
2. An inspection request can be scheduled up to the day before the inspection date. Please call (409)777-
3228 from 7:30 -3:30pm (Mon-Thars) 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 anter 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 repaired 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 coverigg 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 1141, 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$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: lam the property owner or authori7ed agent to=on the
property owner's behalf. T understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors ired to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Co
SigDatvrD of A lirant/A nt Date: g•— 7 /3
AcrovJPnlicv_l0!l.do Ppv/s¢d 0211611_1