12080312 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7688 RAINBOW DR CONTRACPOR:T D ROOFING PERMIT NO: 12080312
OWNER'S NAME: ktZ� V(V[ `l:;f 0LLSJ/YII 675TULL\'RD DATE ISSUED:08(302012
OWNISR'S PIIONE: 4083555881 SAN JOSE.CA 95111 PHONE NO:(408)692-8872
LICENSED CON'TRACTOR'S DECCLLACRATION BUILDING PERMIT INFO: BLDG [ ELECT r PLUMB r,
,License Class L Lie.9 q 5 � —1
Q MECIi (_ (✓RESIDENTIAL COMMERCIAL r
Contractorr r Date U 3
hereby ulftr al ani licensed m r the provisions of Chapter 9 JOB DESCRIPTION: REMOVE EXISTING WOOD SHARE ROOFING AND
(commencing with Section 7000)of 1), ision 3 of the Business& Professions INSTALL
Code and that my license is in full force and effect. RADIANT BARRIER,UNDERLAYMENT AND NEW COMPOSITION
ROOFING 25SQIT CLASS A
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 the work for which this
permit is issued. Sq.FI Floor Area: Valuation:$9000
APPLICANT CERTIFICATION
I certify that I have read this application mid state that the above information is APN Number:36611029.00 Occupancy Type
correct. I agree to comply with all city and county ordinances mid 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
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 of the
granting of thispemiit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point s ar&rulatiorts per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. / G
Signature Date 3� Issued by: �EfN ��GfT Date:
❑ OWNER-BUIM;R DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of RP:ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material beiig installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed withou first obtaining ins a ion,I agree to remove fill new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. /
Business&Professions Code) Q J
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicuit: Dale: U
construct the project(Sec.7044,Business& Professions Code). (/
I hereby affirm under penally of perjury one of the following three ALL ROOF COVERINGS TO E CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent m self-insure for Worker's IIA-1,ARDOUS JLy'1'F-RI.US DISCLOSURE
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 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 Health&Safety Code,Sections 25505,25533,and 25.534. I will maintain
Section 3700 of the Labor Code,for theerformance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ilealth&
p Safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
1 cenify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain cont Iianee with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of Cali fomia. If.after making this certificate of exemption,I Ilealth&Saf y CodKCOTR:1JCI'I0N
,25533.and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must /
forthwith comply with such provisions or(his permit shall he deemed revoked. Owner or au ze ^� l
Date: - �..J
r
APPLICANT CER'T'IFICATION LF:\UING AGENCY
I certify that I have read this application and state that the above information is
cored.I agree to comply with all city and county ordinances and state laws relating I hereby affirm that there is a construction lending agency for the perfornance of work'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 all non-point source regulations per the Cupertino Municipal Code,Section ARCIIITFCI"S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
IZog � 3 � Z
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 rx
CUPERTINO (408)777-3228• FAX(408)777-3333•buildino(dcupertino.00rro�-' l� /�
PROJECT ADO CLC V7 0 1 I J �Np f-�' / 2
71
OW'NE N 4E ` w PHON S� Y✓l� E-MALL
-CITY. STAv Ul Q FAX
CONTACT NAME PHONE, E-ALUL
STREET ADDRESS CITY.STATE,ZIP FAX
❑ Ow'NER ❑ OWNER-BURDFR ❑ OWNERAGENT ACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CON;'CTOR 1,0E O r LICENSE /fin LICENSFI?P ; BUS.LIC.0
CONU ANY NAME E-01111. p FAX (�
�S Ll Tl',STATE.ZIP O -` 9, Pql( C V
ARCHITECTIENGINEER AhIE LICENSENII.®ER BUS.LIC.k
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF S D or Duplex ❑ Multi-Family. ROOF.AREA: VALUATION:
STRUCTURE: ❑ Commercial
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPPo T SHINGLES XWOOD SHAKES 0w'DOD SHINGLES ❑OTHER(SPECIFYI
REAIOF'E IREPLACE IFNO. PL\1\'pOD ❑ :5' PLY D % ZE) PITCH: ROOF
❑ O k LAYER THICK c . ❑ 'n- 7 ( T\TE' ❑ �')2CLASS 'a
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT M
DESCRIPTION OF\t'ORF::
1lwOocl 1
By my signature below.'271'h
certin•m each o'the f Ino 'ine: I am the prop".,owner or authorized agent to act on Ute proper owner's behyi. I lave read this
application and dte informs[ion I have pr 'ide a ones[. t hale read the Description of Wort:and verify it is accurate. agree To comp G Wid[ell applicable local
ordinances and state laws relating to bui - o coon. I authorize representatives of Cupertino to enter the abOCi IIte8rope r ion ins�xetioIt purposes.
Signature ol'Applican/Agene Date:
SUPPLEMENTAL[NFOPMAT U[RED '.-OFFICEUSEONIN
_If building is associated With a home Owners Association,provide Izuer PI_sN cxecK'n•PE, ROUTING SLIP
of approval from HOA. ottiR=THCCgoN'i'eli nuaulnt-PI;wk REVIcw
_Provide Planning approval to veriN if there any.restrictions. FX PR r PWYNING PUt N REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ sTANUARu+ _'r - ❑ `naL ncrrl
Provide signed copy of Cupertino's Tear-.Off Policy • '❑ OTHER-
Reroofdpp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
:121 ADDRESS: 7688 Rainbow Dr DATE: 0913012012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: 1$9,000
*PERMIT TYPE: Minor Building Permit PLAN CHECK TN'PE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK Remove existing wood shake roofing and install'radiant barrier, underla ment and new composition
SCOPE roofing.
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,500
bleeh. Plan Check Plumb. Plan Cheek Elec.Plon Check
Mech.Permit Fee: Phonh.Permit Fee: Flee•.Permir Fee:
orber,llech. lisp. 0iher Plumb Insp. Li I Other Elco Guy. Li I
,Hach.Insp.Fee: Plumb. lisp. Fra: Flee.bup.roc:
NOTE: This estimate does not include jeer due to other Departments(i.e. Planning Public Works, Fire,Sanitary Seu,er District,School
District,etc. . These feev are based on the prelitninat3 in onnation availahle and are ono'an estinirte. Contact the De t or addn'I info.
FEE ITEMS(Fee Resolution 11-053 Ell 711111) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
SuppL PC Fee
Phimb./11ech./Elec
Permit Fee: $375.00
Suppl, Insp Fee
Plumb.1A1ech./Flee
Ph nih.1A•Iech.1Elec Pei-nut Fee:
Constriction Tac:
Adminisuntive Fee:
Work Without Permit? O Yes (j) No $0.00
Advanced Plinning Fees:
Travel Doctnnentation Fees:
A
Soong Motion Fee: IBSE/S ICB $0.90 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $376.90 $0.00 TOTAL FEE: $376.90
Revised: 07/01/2012
2 REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
GUPERTINO 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333• buildino(ta.cupertino.org
PaaecrA �`C7 99 VI >V DVAPN0
O1WNER�\�1M /� r o L PHONE E-MAIL
STREET' D h-- ' CITY.STA ZIP s FAX
D _j
CON OR NA n LIC 6 R ' LICErETY BUS.LIC.p
COMPANY NAME E-MAIL FAX
S E 1`�SS r CI .ST P / q�' P
r) l v
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. 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 1/<" 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, 1 certify each oft e follow. g is true: I am the property owner or authorized agent to act on the
property owner's behalf. 1 understaMeter
d e t o is
with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxire required to be installed in accordance with Sectio s R314 a R31 of
the 2010 California Residential CodG 3�
Signature of Applicant/Agent: Date: O
ReroofPolicv_201 Lrloc revised 02116/11