12090020 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 VALLEY GREEN DR CONTRACTOR:NEMMER ROOFING PERMIT NO: 12090020
OWNER'S NADIE: 20800 VALLEY GREEN DR 5348 AUDUBON PARK CT DATE ISSUED:09/042012
OWNER'S PHONE: 6505923960 FREMONT,CA 94538 PHONE NO:(510)919-2930
'P LICENSED CON'TRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG C ELECT CJ PLUMB Fj
License Class — Lic.q / .3
/1Ozti7,w�� MECFI r RESIDENTIAL r COMMERCIAL (-
Contractor 9�' ie
hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:UNITS 472479 RE-ROOF 52 SQ-TEAR OFF SHAKES,
(commencing with Section 7000)of Division 3 of the Business&Professions INSTALL UNDERLAYMENT&GAF CLASS A
Code and that my license is in full force and effect
1 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(his permit is issued.
1 have and will maintain Worker's Compensation Insurance,as provided for by Sq.F1 Floor Area: Valuation:$15578
Section 3700 of the Labor Code,for the performance of die work for which this
permit is issued.
,\I'N Numbrr:32609040.00 Occupancy Type:
APPLICAN I'CERTIFICATION
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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply i
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. .f Is a bj•• v* C . Date:
Signature - to
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the Contrnelor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applic nt� Dale: 9
Business&Professions Code)
I,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 BETTER
1 hereby affirm under penalty of perjury one of the following three
declarations: IIAZARDOUS JLATERLUS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's 1 have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Ilealth&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ilealth&
1 have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will
P maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Ilealth&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of Cali fomia. If,after making this certificate of exemption,I Owner�d t.� /z
become subject to the Worker's Compensation provisions of the Labor Code,I must _� Datr.
forthwith comply with such provisions or this pennit shall be deemed revoked.
CONST'RUCT'ION LENDING AGENCY
APPLICANTCF,RTI FICATION I hereby offirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct.T agree to comply with all city and county ordinances and slate laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply .ARCII I'I'F:CI"S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
09/14/2012 19:52 4004367002 BUIS CONSTRUCTION PAGE 02
REROOF PERMIT APPLICATION td
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION r,]J�
RRE AVENUE•CUPERTINO,CA 95014-3255 \
CUPER 0 (408)777
2 -3228• FAX(408)777-3333•tWilding0.gj0eftino om
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PROTECT ADDRESS 2060d VaGk� Green Dr APNP 32-bO 0 6 , 00
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US5 OF ❑ SFA or Dupla Multi-Family ROOT AREA; VALITATION:
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Bp my slgnaTwe below,I comfy M caeb of The following: Tanta the pmpem owner or cnnhotizhd agent to act on The pnpprny mmer's behalf. f have raid this
application and the infolmna. I I have M vided is coned I have read the Description of Wodc and verify it is securete i agree W comply with all applicable local
ordinances and sine laws relating to g cnnSrrTc(' 1athorire representatives ofCn
pmio0 to rnln the aygsT>idcntifiM prope[ty for inapeednn pnrppses.
Signature ofApplicnnUAaeat Date: / z--/z _
SUPPLEMENTAL DNFORMATION REOUTRED .omcarl usti on-r.y _
_If budding is RSSOCiated with a Home OWmees Association,provide letter :PIAN Cr7•CK T'VIR aovrtuc SLIP
of approval from HOA. O OVTiR•TN&COUNP'aR ❑ pU6DINCPt.nNRavncW
Provide Planning approval To veHfv if there any mariction5, ❑ unansgSS ❑ RLANICENG RLANRRVIkW
Provide copy of\4artufactura's Dnstallotion Specifications, d srA.vDARn O Pray Dyrr
Provide signed copy of Cupertino'R Tear-Off Policy. ❑ onim
Rernn/1pp_2011.doc reviser!0311 h/11
09/14/2012 19: 52 4084367802 BUIS CONSTRUCTION PAGE 03
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR., P.E., C.B.O„BUILDING OFFICIAL
CUFERTINO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-31333• builoinq@lcenlno.org y 72_ y ,
PROJECT ADDRESS 20800 \1()1Je en
Ate: 32(o(�g0 u10 ,100
OWNER:IAME 'JPI 199N'F P.-MAn.
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1 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 (nylon-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. 'fear-Off Inspection is required Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless bew 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 there-roofing is
completed, To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of y/" per foot of slope and demonstrate there is no ponding.
h. 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 of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxid detectors are quired to be installed in accordanec with Sections R314 and R315 of
the 2010 California Residential C g
Signature of Ap licant/Agent: - Datc:
ReronlPoflcy_2011.dnr.revised 02/16/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20800 VALLEY GREEN DATE: 09/04/2012 REVIEWED Bl': MENDEZ
APN: BP#: 'VALUATION: $15,578
*PERMITTI'PE: Minor Building Permit PLAN CIIECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Buildina is PENTAhIATION 1R2R00F
USE: 3 Stories O Yes (DNo PERI%HTTYPE:
WORK UNITS 472-479 RE-ROOF 52SQ-TEAR OFF SHAKES INSTALL UNDER LAYMENT & GAF
SCOPE TIMBERLINE ULTRA COMPOSITION
FEE ID ROOFAREA
s.f.
1REROOFMRES 5,200
Mech. Plan Check Plumb.Plan Cheek F,lec. Plan Check
Mech. Permit Fee: Plumb.Permit Fee: F.lec•.Permit Fee:
Oder Mech. Insp. Other Plumb Insp. Odor Flee.hrtp.
Mech. hc+p. Fec: Plumb. h,sp.Fee: Clec.Imp. Fee:
,VOTE: This estimate does not include fees due to other Departments(i.e. Planning Public (Forks, Fire,Sanitary Sewer District,School
District, etc. . These fees are based on the prelindnai3 information available and are only an estimate Contact die Dept for addn'l in o.
FEE ITEMS (Fee Resolution 11-053 EA 771/1 U FEE QTY/FEE MISC ITEMS
Plun Cheep Fee:
SnppL PC Fee
Phimb.1,1/ech.7Elec
Permit Fee: $780.00
SuppL bup Fee
Plumb.7Adech.lElec
Plunrh.lblech.lF.lec Permit Fee:
Construction Tat:
Administrative Fee:
Work Without Permit? O Yes (j) No $0.00
Advanced Planning Fees:
Travel Doemnentation Fees:
Stione Motion Fee: IBSEISMICR $1.56 Select an Administrative Item
131de Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $782.56 $O.C)01 TOTAL FEE: $782.56
Revised: 07/01/2012