12080279 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 VALLL•Y GREEN DR CONI'RACI'OR:NEMMER ROOFING PF-RMITNO: 12080279
OWNER'S NAME: 20800 VALLEY GREEN DR 5348 AUDURON PARK CI' DATE, ISSUED:080/2012
OWNER'S PI IONF-: 6505923960 FREMONT,CA 94538 PI IONS NO:(510)919-2930
❑ LICENSED CON T'RACTOR'S DECLARA'T'ION r
,7 BUILDING PERMIT INFO: BLDG _ ELECT _ PLUMB--
License Class Lic,H 7y g 3 a r: r r
N � t_-,� J< M1IECH RESIDENTIAL COMMERCIALContmclor � Date e
hereby affirm that I am licensed under the provisions of Chu pier 9 JOB DESCRIPTION:UNITS 502 THRU 509-TEAR OFF EXISTING SRAKE ROOF
(commencing with Section 7000)of Division 3 of the Business&Professions AND INSTALL NEW UNDERLAYMENT AND 7900 SQFTCLASS A
Code and that my license is in full force and effect. GAF TIMBERLINE UL'T'RA COMPOSITION ROOF
Ihcrcbyaffirm under penalty of perjury one of the following Iwo 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 perfommnce of the work for which this Sq. Ft Floor Area: Valuation:525000
permit is issued,
APPLICANI'CERTIFICATION APNNumber:32609040.00 Occupaney'fype:
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 accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulatims per the Cupertino Municipal Code,Section
9.18. /� — / �,J/ q
Signature��/` `�F% Date �� Issued b}•: EA,'V / /�TG� Date: •O�' —1�
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
hereby affirm that I am exempt from the Contractor's License Law, for one of All roofs shall be inspected prior to any roofing material being installed.Ira roof is
the following two reasons: installed without first obtaining an inspection,1 agre to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,mid the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicml Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BF:fTER
I 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 I IAZARDOUS MATERIA S DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the 1 have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued California Ileallh&Safety Code,Sections 2550.5,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Dl unicipal Code,Chapter 9.12 and the I lealth&
Section 3700 of the Lobar Code,for the perlbor mnce of the work for which this Safety Code,Section 2.5532(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 Alanagement 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 tiny person in any manner so as to become subject to the Worker's Ileallh&Safely 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 or Ittoai nt:
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANTCF.R'TI FICATI ON CONSTRUCTION LENDING AGENCY
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 work's
correct.I agree to comply with ail 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 theCity of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may aceme against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCIIIT'E,CI'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
09/20/2012 21:14 4884367802 BUIS CONSTRUCTION i n ��E 02
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT.gUILDINO DIVISION
10300 TORRE AVENUE.CUPERTINO,CA OSD1432W
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_Provide Plamiag gTMve(to if them Ovta'r�eomrrta � O>f4.SAelvlty
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09/20/2012 21:14 4084367802 SUIS CONSTRUCTION . n � E 02
77
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014,U85
C OPERTINO (408)777,228'FAX(406)777,333•WagnaQaWALra=
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_Pmvide PiRtmiDZ approval to verify if there arty MSttietionL ovdaFt�eooxrRR �'prpn`mRa'rwvnsvltw
Provide m ❑ +LARkmunrwN A>PRW
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Provide signed copy of CapmtlDo'B TDs¢-Off Policy. STANDARD t nvzrr
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CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20800 Valley Green Dr DATE: 08/28/2012 REVIEWED BY: Sean
\ APN: BP#: 'VALUATION: $25,000
°PFRMITTVPF: Minor Building Permit PLAN CIIECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Buildina IS PENTAnIATION 1R2R00F
USE: 3 Stories O Yes (F) No I PERMITTYPE:
WORK Units 502 thru 509: Tear off existing shake roof and install new underla ment and GAF Timberline
SCOPE I Ultra composition roofing.
FEE ID ROOFAREA
s.f.
1REROOFMRES 7,900
b/ech, flan Check P/anrh.Plan Cheek Flee.Plan Check
Mech. Permit Fee: Plumb.Permit Fee: lilec•. Permit Fee:
Odrer,tlech.Imp. Plumb Insp. Other Elcc.Insp.
El
dle.ch.iso.Fee: !'hath. Insp.Fee: Elce. Insp. Fee:
NOTE.: This estimate does not include jeer clue to other Departments(i.e. Planning, Public Works, Fire,Sanitary Server District,School
District, etc.). These ees are baser/on the prelintinan•information available and are ash'an estimate. Contact the Dept for tuldn'I info.
FEE ITEMS (Fee Resolution 11-053 E1/ 71111 1) FEE QTY/FEE MISC ITEMS
Plum Check Fee:
Supp/. PC Fee
Plumb.1jllech.1Elec
Permit Fee: $1,185.00
Suppl. hisp Fee
Phimb./A-lech./Elec
Phtmh./dlech.Mlec Permit Fee:
Construction Tax:
Administrative Fee:
Work Without Permit? O Yes (F) No $0.00
I
Advanced Planning Fees:
Travel Documentation Fees: A
Strong, Motion Fee: IBSEISMICR $2.50 Select an Administrative Item
Bldg,Stds Commission Fee: IBCBSC $1.00
SUBTOTALS1 $1,188.50 $0.001 TOTAL FEE: $1,188.50
Revised: 07/01/2012
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 10M TORRE AVENUE-CUPERTINO,CA QW143255
(408)7773228-FAX(408)777-3333•p t r� .502 — 50 9
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F t emevter A60o , v — 736
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776 9t9-2930
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2010'Califomia 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-Thrus)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 Insneetion is ug"t 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 Nalli ng Insnecoon is required.
5. Rooting shall not be applied without fust 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. gess Inspection is reggired when approximately 50%of roof coveripg is installed.
7. A Final Inspection and approval shall be obtalned from the building inspector when the re-roofing is
completed. Td receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of per foot of slope and demonstrate there is no ponding.
b. Listings #in 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 rc-inspection fee shall be paid before another in p%-Ien
can be Ischeduleli,
By my signing below, 1 ccrtify each of the following is true: I am the property owner or authorized agent to act on the
Property owncr's behalf. I understand and agree to comply with there-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are requ' to installed in accordance with Sections 8314 and R315 of
the 2010 California Residential CO
Si tune of A IlranttA t: Date: $•— _
RcrooJPo4iry_d0l l.dx rriYazd 02116111