12090216 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7557 NEWCASTLE DR CONTRACTOR:CUPERTINO ROOF,INC PF.RINIIT-NO: 12090216
OWNER'S NAME: JOHNSON JUDY M AND LARS E TRUSTEE 1052 KELLY DR DATE ISSUED:09252012
OWNER'S PRONE: 4082529047 SAN JOSE.CA 95129 PHONE NO:(408)973-9427
❑ LICENSED CONIRAC'MR'S DECLARATION BUILDING PERMIT INFO: BLDG (__ ELECT r PLPLUMBLicense ClassesLI� CLie.9 \ �.7 � r r
(� NIECII RESIDENTIALCOMMERCIAL -'
Contractor ^ 1� f> C Dane
hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHARE ROOFING AND
(commencing with Section 7000)of Division 3 of the Business S Professions INSTALL
Code and that ore license is in full force and effect. NEW OSB WITH COMPOSITION ROOFING(2500 SOFT)
hereby affirm under penalty of perjury anc 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. Ft Floor Aren: Valuation:$14000
APPLICANT CERTIFICATION
1 certify that I have read this application and slate that the above information is APS Number:36617073.00 Occupancy T pe:
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 propertyfor 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 this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non- oml source regulatims per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature I Date �� ' -issued by: /�elZ2/W Date:
❑ O\VNER-RUILDER DECLARA'T'ION ,
hereby affirm that I am exempt from the Contractor's License La" for one of RE-ROOFS:
the folluaingg two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining, inspection,I agree to remove all 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 Applictutt: Date:
construct the project(Sec.7044,Business g Professions Code).
hereby affirm under penalty of perj try one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's
TLV'.,\RDOl15 JL\TTRhU ti DISCLOSURECompensation,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 Ilealth S Safety Code.Sections 25505,25533,and 25534. 1 will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ilealth S
Safety Code,Section_553_(a)should I store or handle hazardous material.
permil 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,l shall contaminants as defined by the Ray Area Air Quality Management District I will
not employ any person in my manner so as to become subject to the Worker's maintain cum plia nee aith the Cupertino Municipal Code.Chapter 9.12 and the
Compensation laws of California. If,after making this certificate ofexemption,I Ilealth S Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must
i ed agent: ?
forthwith comply with such provisions or this permit shall he deemed revoked. er or auth Date. ��Z
APPLICANTCERTIFICATION CONSTRUCI-ION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and herebyauthorize 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,judgmcnts,
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 ARCIIIT'ECVS DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
co
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
GUPERTINO
(408)777-3228• FAX(408)777-3333•buildino(rilcuoertino.om
�"1 —1 I
PROJECTADDRESS S S I ` w C Sal APN I / _ ( _ O 7
OWNER NAA¢ LK TUl G_ ) PHONE,?
Z� E-AU♦IL
STREET.MDRFSS (r�.•�� 5r N`��J i` ,\^ �(C�e..1CITY, STATE,ZIP FAX
CONTACT NAME J J'T PHONE E-AIAIL
STREET ADDRESS CITY,STATE.ZIP FAX
❑ OwNER ❑ OWNFR-BURD6t ❑ OWNERAG[ ONIRACrOR ❑COMRACTORA//GENT ❑ ARCHITECT ❑ENGIN�t ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NIR. \/ LICE 'C7_F� BUS.LIC.M
COMPANY'NAME I (�D E-MAIL I SS FAX
STREET ADD S�--z CITY.STATE.ZIP P ONE q/
!�
ARCHITECDENGINEER NAME.( / LICENSENUMBER �• BUS.LIC.Y V
COWANY NAME E-MAB. FAX
STREET ADDRESS CITY.
CITY'.STATE,ZIP PHONE
USE OF r�SFD Or Duplex ❑ A'IUIti-Family, ROOF AREA: VALUATION:
STRUCnme: ❑ Commercial
EXISTWGROO�FTYPE.J
:.., ❑BUILT-UPROOF ❑.ASPHALT SHINGLES 'OOD SHAKES ❑ ❑
WOODSHINGLES OMER(SPECIFY)
REAIO\ REPLACE—LYES IF N0, PLYWOOD 13 'A' ❑ PLY WD I
OSB PITCH: ROOF
❑ N d LAYERS ICK c ' 11 Sm' TYEl ❑% :12CLASS
PROPOSED ROOF TYPE: 11 BUILT-UP ROOF ASPHALT SHMGLES ❑WOOD SHAKES C1 WOOD SHINGLES ❑OTHER ICC-ES REPORT tl
DESCRIPTION OF WORK:
S 4-C\.� O S S J J
By my sigimture below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the informaton rovided is correct. I have read the Description of Work,and verify it is accurate. I agree to comply with all applicable local
ordinance and state laws relating w uil g construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature ofAppliumt/Agrnr. Date:
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a[ionic Owners Associadon,provide letter ,,!{ Pt-An'cHEcx TYPE - ' ROUTING SLIP
of approval from HOA. Ip.oycni-1 NE-COUNTER /quaDING PLAN REVIEW
Provide Planning approval to verify if there ally restrictions. /❑ EXPRESS L Fu�Y LD-INGc PLAN Rn1Ew
- 6 f'I'carel- 6.S• Q
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ElriR E --
Provide signed copy of Cupertino's Tear-Off Policy. O. OTHER: -
RerwfApp_1011.doc reY-ised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 7557 Newcastle DATE: 09/25/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $14,000
*PERMIT TYPE: Minor Building Permit PLAN CIIECK TYPE: Re-roof
PRIMARY PEi'TAMATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLROOF
WORKTear off existing wood shake roofing and install new OSB with composition roofing 2500 s ft .
SCOPE
FEEID ROOFAREA
s.f.
1REROOFFRES 2,500
I
Mech. Plan Check Plumb. Plan C/ae•A Flee. Plan Check
Xlech. Permit Fee: Plumb.Permit Fee: Flec. Permit Fee:
Other,lfech.Insp. Odin Plumb Insp, Other Elce.Insp. El
,blech. lnaP.Fee: Plumb. lrnp. Fee: Elee.Insp.Fee:
NOTF: This estimate does not include jeev due to other Departments(i.e. Planning, Public(Parks, Fire,Sanitary Seaver District,School
District,etc. . Theve fees are based on the preliminan information available and are only an estinmte Contact the Dept for mitln 7 info.
FEE ITEMS (Fee ltevolution ll-053 IiD' 7/l/I U FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Phtmb.611ech./13Pec
Permit Fee: $375.00
Supp/. Insp Fee
Plumb./,14ech./1--_lec
Plumh.hblech./Elec Permit Fee:
Consntiction Tax:
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Adveincecl Planning Fees:
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICR $1.40 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $377.401 $0.001 TOTAL FEE: $377.40
Revised: 07/01/2012
REROOF TEAR-OFF POLICY
2 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(dcuoerlino.org
PROJECT ADDRESS! SS �, �-+- S+I1
APN n
OWNERNAME PHONE �) E-MAIL
STREET ADDRESS S� I CITY.STATE.ZIP 1 FAX
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.#
COMPANYNAME / ) I , G EMAIL FAX
STREETADDRESS U�Z �/ I CITY.STATE.ZIP r^ ^ 1 2 �1 PHONE
I UNDERSTAND AND AGREE TO THE FOLLOWING: / 1
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/4" 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 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 carbo *de detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential 11- p
Signature of Applicant/Agent: / Date: 1 Z- r
ReroofPolicv_201 Leloc revised 02116111