12090190 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19856 BEEEMAN PL CON rRACI'OR:ARMSTRONG PERMIT NO: 12090190
INSTALLATION
OWNER'SNAMF,: SCHWALBE JOAN 4575 SAN PABLO AVE DATE ISSUED:09212012
O\VNER'SPBONE: 4082526139 EMERYVILLE,CA 94608 PHONE NO:(510)777-1234
❑ LICENSED CONfI'RACFOR'S DECLARATION 1" Ci
7 , BUILUINC PERMIT INFO: BLDG ELECT PLUMB
License Class 55-3 ;q Lic.N ifV
Z/ /L DIEC11 r RESIDENTIAL Cl COMMERCIAL r
Contractor Date
I hereby affirm that I not licensed m er the pro%isinns of Chapter 9 JOB DESCRIPTION: REMOVE AND REPLACE BUILT-UP ROOF AND INSTALL
(commencing with Section 7000)of Division 3 of the Business&Professions FOAM
OVERLAY CLASS A 20 SQ
Code and that my license is in fall force and effect.
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 One work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$17000
AI'1'I,ICANf CER'I'IFICA'1'ION
I certify that I have read this application mid state that the above information is AM Number:31630123.00 Occupaney'rype:
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction,:md 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 C)•in consequence of the
granting of this permit. Additionally,lire applicant nderstands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source re ulatio s er IheCupe 'no Municipal C e,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. � `
Signature L — Dal �� Issued by: ✓�� / //7 i Gam/ Dale: y`c7/ gL
❑ OWNER-BUILDI.R DECLARATION
herchy affirm that 1 am exempt from the Contractor's License Law for one of RE-ROOFS:
the rollmving boo reasons: All roofs shall be inspected prior to any roofing material beiig in Iled.If a roof is
I,as owner of the property,or my employees with wages as(heir sole compensation, installed without Gro obtaining an inspe ion•I agree to r mo - new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Appl is ra: Date:
construct the project(Sec.7044,Business&Professions Code).
hereby affirm under penalty of,perjury one of the following three AL1,ROOF COVERINGS I'D BE CLASS"A"OR BE'I`fER
declarations:
I have and will maintain a Cenificate of Consent to self-insure for Worker's IIA'/,ARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
perl'omnance 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 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino 5lunicipal Code,Chapter 9.12 and the I lealth&
Safety Code,Section S53_(T)should I store or handle hazardous material.
permit is issued Additionally,should I use equipment or devices which emit hazardous air
I certify 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 compliance with the Cupertino\ unieipal Code,Chapte 9.12 and the
Compensation laws ofCalifomia. If,after making this cenilicate of exemption,I Health&Safely Co .Sections 25505.25 33,and 255 4.
become subject to the Worker's Compensation provisions of the Labor Code,I must ���
forthwith comply with such provisions or this permit shall be deemed revoked Own nnlhn zeJ a y
ate:
APPI,IGxNt'CER'1'I17ICA'I'ION CONS'IRUC ION LENDINGACF.NCY
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 slate laws relating I hereby of nn that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives oflhis city to enter for which[his 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 ARCI I ITECI"S I)FCLA RATE ON
9.18.
1 understand my plans shall beused as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
tw°�p FEE ESTIMATOR — BUILDING DIVISION
2 ADDRESS: ijlz Beekman Place DATE: 0 9121/2 01 2 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $17,000
*PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD Or DUIBX PENTAMATION 1SFDWLR00
USE: pPERMITTYPE: i
WORK Remove and replace built-up roof and install foam overlay.
SCOPE
FEEID ROOFAREA
s.f.
1REROOFFRES 2,000
,tfech. Plan Check Phonh. Plan Check Flee.. Plan Check
Mech. Permit Fe. Phnnh. Permit Pec: rice.Permit Fee:
other Mech. Imp. Order Plumb Insp. Other Flee.Insp.
,Neth.dup. Fee: Plurnh. losp.Fee: Elce.Insp.Fec:
NOTE: This estimate docs not indutle fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District, etc. . These ees are based on the prelintinan information available and are mth,an estinutta Contact the Det for addn'I info.
FEE ITEMS (Fee Resohuion 11-053 F_l1' 7/1/1/) FEE QTY/FEE 1%11SC ITEMS
Plan Check Pee:
SuppL PC Fce
Plumh./,blech./Elec
Permit Fee: $300.00
Supp/. Insp Fee
Phimb.1,44ech./F.l ec
Plumh./ddech.Xlec Permit Fee:
Construction Tax:
Administrative Fee:
Work Without Permit? O Yes (F) No $0.00
Advanced Planning Fecs:
Travel Documentation Fees:
Strong Nlotion Fee: IBSEIS,NICR $1.70 Select an Administrative Item
Bldg Stds Commission Pee: IBCBSC $1.00
SUBTOTALS: $302.70 $0.001 TOTAL FEE: $302.70
Revised: 07/01/2012
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA195014-3255
CUPERTINO
(408))777-3228• FAX(408)777-3333•building(DDcupertino.orcl
PROJECTADDRFSS /lee /� /47/ I APNM
L
OWNER NAME -^ /Wa//G PH _z — / 9 E-MAIL
STREET ADDRESS/Ol)/ l)•{� e G ///'Y✓�h CITE`ST TE,ZIP ; /E J O/� FAX
CONTRACTOR NAME//IJ�)M( /( hS�/ LIC2SE `Z�Ij �
LICENSE v(JTY/PE/} BUS.LIC.0
COMPANY NAME rGJ �) YYY" / (/ L E AY FAX
yrs �'�,. 1.nSt�✓/r.. err 'P ,� �.«{ Z 35'cow>
STREET7A�R SoH /� C CI],l',STATE-ZIJP /l� PHONE
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/<" perfoot of slope and demonstrate there is no ponding.
i
b. Listings from approved testing agencies for all pre-manufactured products used shall be
available on-site to review at the time of thI e 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-inspiection fee shall be paid before another inspection
can be scheduled.
i
By my signing below, I 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. 1 also understand that
smoke detectors and carbon monoxide detectors are required to be installed in a rdance with Sections R and R 15 of
the 2010 California Residential Code
Signature
Signature of Applicant/Agent: Date:
ReroofPolicv_30/1.rloc revised 02/16/Il
of c
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO.CA 95014-3255
Ell (408)777-3228• FAX(408)777-3333•bul1d1nO(a),CUDertin0.Or0
CUPERTINO /J
E
FROIEPROJECTADDRESS �e AFN b I /• 2 �)
OWNER NAM1 Q - IC PHONE E-MALL ,/
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STREET.ADDRESS /��Q^ Cll]� A Ufl irD G SU�-] FAX 1
CONTACT NAME r( [/PHONE 'eel /--'L®Arr9t 71. 112)ej
ow
STREET "Ess
FS 97
575 ,.� h cMd
❑ OwTER ❑ OW,,,-Bor DFR ❑ OWNERAGENr � CrOR .Z-
❑CONTRACIDRAGENT ❑ ARCHITECT ❑ENGINDE.R ❑ DEVELOPER- ❑ TENANT
CONTRACTORNAMEAr, )ro f //rnA/e - L EN ID� LICEN�F�C� BUS.LIC.b /J7)
C/1, E-MAIL f FAX G //L
u j/G— Sf
STREET ADO s CR STATE.ZIP PHONE
`f7s fw� />�6l AA
ARCHITECTlENGINEER NAME LICENSE NUMBER BUS.LIC.b
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY•STATE,ZIP PHONE
USE OF SFD or Duplex ❑ Multi-Famil-v, ROOF AREA: � VALUATION:
STRUCTURE: ❑ Commercial c,
EXISTING ROOF TYPE: BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE(REPLACE ❑YES IF NO. /11 PLYWOOD ❑ !1' ❑ PLY'wT) ❑OSB PITCH: /„ •(,) ROOF
:560a LAYERS' 1 .'NES ❑ vN" E ❑ CD
I
I C-E REPORT
PROPOSED ROOF TYPE: BUILT-UP ROOF 13 ASPHALT SHINGLES ❑WOOD SHAKES 11 WOOD SHINGLES OTHER O(t �z 1)L
DESCRIPTION OF WORK: /• r
By my signature below,I certify to each O the following: I am the property owner or authorized agent to act on dm property owner's behalf. 1 have read this
e read the Description of Wort:and verify it is accurate. I ree to c mply with all applicable local
application and the information I have provided is correct. I •
ordinances and state laws relating to building eanstruttno uthorize re sentati• OCCU to to enter the abo Rife p pe y ror inspection purposes.
Signature of ApplievtVAgent:/� Date:
SUPPLEMENTAL INFOR1,1AT10N REQUIRED OFFICE Use ONLY
_If building is associated with a Home Ownees Association,provide letter PIAN CHECK TYPE Z _ .ROUTING SLIP
of approval from HOA. Lp1 OAT -THE-COUNTER BUILDING PLAN REVIEW
_Provide Planning approval to verifv if there any restrictions. b EXPRESS PLANNING PLAN REvim
Provide copy of Manufacturer's Installation Specifications. ❑:i PAN�ABn . '❑ naE nc,
L"
_Provide signed copy of Cupelvno's Tear-Off Policy. ❑ !dTDrR -
RerwfApp_2011.doc revised 03/16/11