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12090203 CITY OF CUPERTINO BUILDING PERMIT BIJILDING AIIDRI.SS 21557 RAIN13OW DR CONI'RACFOR:CAS'rll-LO'S ROOFING PERMIT NO: 12090203 OWNI,R'S NAMF,: KIMSFY ROY 13 AND SUIRIAill 1703 CATI L\1'1)R DA'Z'E ISSUED:09242012 O\\'NE.R'S 1'11ONE: 4082570843 SAN JOSE,C\ 95122 PHONE NO:008)251.3565 ❑ LICENSED CONTRACfOR'S Dir:47LARA-1"ION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r //�� G License Class a 3 � Lic.q� 111EC11 r RESIDENTIAL r COMM ERCLU.r Contracto D:nc hereby':Air[] rut lam licensed under the provisions of Chapter 9 JOB DESCRIPTION:"1'6\R OI'l°SIIAKI:S.INSTALL 19 SQRS-7/16"OSB. (commencing w h Section 7000)of Division 3 of the Business S Professions INSTALL 304 PIiLT,INSTAI.I.GAP GRAND CANYON COMP Code:tad that my license is in full force and effect. SHINGLE'S I herehy affirm under penally of perjuq'one of the following Boo declarations: I have and will maintain a cenificale of consent to self-insure for Worker's Compensation,is provided for by Section 3700 of the Labor Code,(or 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 Sq,Ft Floor Area: Valuation:$9800 permit is issued. ,\I'1'I.IC\N'I'CF.RI'IFICA'I'ION APNNumber.35623028.00 OccupancyTpe: 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 ordin:mces and state laws relating to building consrucliom,and hereby authorize representatives o(lhis 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 by 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 pemnit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code.Section 9.18. 1 (/ �� Issued bv:Q,D4 �N.hF . Date: Signalurc Dale .1� I ❑ OWNE.R-BUILDER DI•'CLAIIATION RE-ROOFS: hereby affirm that I am exempt from the Contractor's License 1,:nv for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following too rl`nxans: installed without first obtaining an inspection,I agree 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,and the structure is not intended or of fired for sale(Scc.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business-Professions Code). ALL ROOT:COVERINGS TO BE CLASS"A"OR 13b;FFER 1 hereby affirm under pen ity of perjury one of the following three declarations: 1 have and will maintain a Certificate of Consent to self-insure for Worker's IL\%AItUOIIS d1A'I'lilt h\LS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I Intoe 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 Municipal Code,Chapter 9.12 and the Health S Section 3700 of the Labor Code,for the per(onnance of the work for which this Safety Code,Section 25532(x)should I store or handle hazardous material. Additionally,should 1 use equipment or dcoices which emit hazardous air permit is issued, contaminants as defined by the Bay Area Air Quality Management District I e'ill I certify that in the performance of the work for which this permit is issued,I shall Immintain 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 I le:dth\Safety Code Sections 25505,'_5533.and 25534. Compensation laws of California. If,after staking this certificate of exemption,I become subject la the Worker's Compensation provisions of the Labor Code,I must - ly'ner a luvized a em: U:rtc: forthith comply such provisions or This permit shill be deemed revoked. / wY Z CONSTRUCTION LENDING AGENCY A PP L I C\N'T CERTI FI CATI ON 1 certify that I have read this application and state that the above information is I hereby of train that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances:tad slate lases 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 indenmify and keep harmless the City of Cupenino against liabilitics.judgmenls, Leader's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,lire applicant understands and will comply ,\ItCI l I'I'EC'I"S IIECI.,\RA'I'ION with all non-point source regulations per the Cupenino'Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date I Licensed Professional REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228 • FAX(408)777-3333•buildinaacuoertino.Dra CUPERTINO PROJECT ADDRESS 'r-/_ 'n 1 \Q r APN p :3s(19 d,3 as 9/ OWNER NAME 'h i r` k t rYl PHONE E-MAIL STRFEr ADDRESS CITY', ATE,ZIP51 FA% CONTACT NAME ♦ ` PH _ E-MIAILIJ/1�C� /•� M 1 ' STREET ADDRESS .` % C CITY.STA •� t�`� FAX ❑ OWNER •❑ OWHER.BUILDER ❑ OWNERAGENf CONTRACTOR ❑CONTRACTORAGFM ❑ ARCIRTECT ❑EN(aMER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME ! O` �7 LICENSE NIIM[BER 4�N��'] LICENSE TIPE/1 �J BUS.LIC.d '�✓erj COMPANY NAME p E-MWL ijll`�/ l.—`J FAX aC,_Ja V STREETADDRESS _ _ _ �.•_— CI TATE.ZIP � _ - -��I^(� PHONE �y�l �t_�J _(- _ ARCHITECrIENGiNEERNAME LICENSENUM®ER - (n C/� BUS.LIC.pL `J,(J`� COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF Z/SFD or Duplex ❑ Multi-Family ROOF.AREA: VALUATION: l//�� STRUCTURE: C] Commercial . 1 . . l EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES P411)SHAKES ❑WOOD,S..HHIINGLES ❑OTHER(SPECIFY) :12 CLASS A REMOVE/REPLACE YES IF N0. PLtl\FOOD ❑ :5- !7 I PLYILD .19 OSB PRCH: ROOF PROPOSED ROOF TYPE: ❑BUILT-UP ROOF yO.ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT M DESCRIPTION OF WORK: 1�M O J TeG r v w ooc( s 1 GA 1' By my signature below,I certify to each of the following: I am die property owner or audiorized agent to act on the propem•owner's behalf. I have read this application and the information 1 have provided is correct. 1 have read the Description of Work and verify it is accurate. I agree in comply with all applicable local ordinances and state laws relating to ihling- 'tion. I authorize representatives of Cupertino to enter the abpye-i entified ropeny for inspection purposes. Signature ofAp SUPPLENIENTALI I`IATION REQUIRED orFICEUSEONLY -_ _If building is associated with a Hon Owners Association.provide tetter PI-AS CHECK TYPE ' •.ROUTING SUP ofapproval from IiOA. ❑ OVER-THE-COUNTER. ❑ BUILDING PLAN.Revim _Provide Planning approval to veri R•if there any restrictions. ❑ EXPRESS ❑ .PLANNING PLAN REVIEW _ Provide copy'of Manufacturer's Installation Specifications. ❑ STANDARD - ❑ TIRE ocrr Provide signed copy of Cuperuno's Tenn-O IT Pol icy. - ❑ OLIIER: . . Reroojdpp_1011.doc revised 03/16/11 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228/- FAX(408)777-3333•building(a�cuoertino.org PROJECT ADDRESS I t_ l/tn �a� DP-/ APN a 3sly-a..3 00;2,9, OWNER NAME + `J PHONE c;25 /'�� E-MAIL q3 I STREETADDRESS C ,J n ' 1 CITY,STATE,ZIP u� FAX . C e, n CONTRACTOR NAME eo (,`- J t � ( ,Y LICENSENUMBER � LICEt! 2 BUS.LIC.a��/� COMPANYNAME E-MAIL '^ FAX a STREETADDRFSS I nM 1 / CITY,STATE,zIP Oar PHONE gS-+ 3 1 UNDERSTAND AND AGREE TO TA FOLLOWING: I. 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 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: 1 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 monoxide det tors are required to be installed in accordance with Se cti s R314 and R315 of the 2010 California Residential Co e. Signature of ApplicanVAgent: J Date: ReroofPoliry_2011.doc revised 02/16/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION :121 ADDRESS: 21557 Rainbow DATE: 09/24/2012 REVIEWED BY: jsg APN: BP#: 'VALUATION: $9,800 *PERMIT TITE: Minor Building Permit PLAN CIIECK'1'1'PE: Re-roof PRIMARY SFD or DupleX PF.NTAMATION 1SFDWLROOF USE: PERMIT Tl'PE: WORK Remove wood shakes install comp SCOPE FEE ID ROOFAREA s.f. 1REROOFFRES 1,900 Meet?. flan Check Phoub. Plan Check Flee. Platt Check r tech. Permit Fera Plumb. Permit Fee: Flec.Permit Fee: Other Alech.Insp. Other Plumb Ince. Other Elev.last). E37- Hach.Insp. Fee: Plumb. Lisp. Fee: Eler,Insp. Fee: NOTE: This estimate hoes not include fear due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District,ete). These feev are based on tire prelitninan information arailable and are only an estimate. Contact the De t or addn'I in o. FEE ITEMS (Fee Resolution 11-053 F_lL 71111/) FEE QTY/FEE MISC ITEMS Plan Crack ree: SuppL PC ree Plumb./A,1ech./F_lec Permit Fee: $285.00 Stipp/. Itrsp ree P1mnb./A-1ech.//;1 ec Plunih./AA,uh./Elea Permit Fee: Construction Tar: Administrative ree: Work Without Permit? O Yes Q) No $0.00 Advanced Planning Fear: Travel Documentation F•aea: Shone Motion Fee: 18SF.ISMICR $0.98 Select an Administrative Item 131de Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $286.98 $0.001 TOTAL FEE: $286.98 Revised: 07/01/2012