12090246CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CALIFORNIA OAK WAY & MAJESTIC OAK WAY
CONT'RACT'OR: KING'S ROOFING
PERNIFTNO: 12090246
OWNER'S NAME: PACIFIC GAS AND ELECTRIC CO
PO BOX 1542
DATE ISSUED: 09272012
O\VNER'S PHONE: 4089211670
PATTERSON, CA 95363
PHONE NO: (209)892 -3386
❑ ' LICENSE[) CONTRACTOR'S DECLARA'T'ION
JOB DESCRIPTION: RESIDENI7AI, COMMERCIAL
License ClnssL 3 V !S Lie. k S' G % S f%
COMM. RE -ROOF 17 SQ TEAR OFF INSTALL 2"
INSULATIONS SINGLE PLY ROOF MEMBRANE CLASS A
Contactor p.� %q9�f Kr�o Y: �s Date i- 2 > — /_)
1 hereby affirm that 1 am licensed under the provisions of Chapter 9
(commencing with Seetion 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
I have and will mainmin a certificate of consent to self - insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $22000
performance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the perfomnmce of the work for which this
,\PN Number: 34212030.00
Occupanry'I'ype:
permit is issued.
AI'1'I,ICAN'1' CER'1'IFIC, \TION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 D F PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 7 LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
Q �'y
costs, and expenses which may accrue against said City in consequence of the
�
granting of this permit. Additionally, the applicant understands and will comply
Issued by: Date: /
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
c�
Signature Date
RE ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
...
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OIVNER- BUILDER DECLARATION
Signature of Applicant: �/ 1�
^ — Date: 9 —.2 i
hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALI, ROOF COVERINGS TO BE CLASS "A" OR BETTER
I, 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,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
11AZARDOIIS MATERIALS DISCLOSURE
construct die project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
1 hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Dlunicipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's
material. Additionally, should 1 use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code. Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Ilealth & Safety Code. Sections 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of die work for which this
On ner or authorized agent: 1;10— Date: 9-2 '7 a1
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation Imes of California. If, after making this certificate ofexemption, I
CONSTRUCTION LENDING AGF,NCI'
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby of inn that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
w'ork's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and comity ordinances mid state laws relining
to building construction, mid hereby authorize representatives ol'this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
, \RCI119'I :CI °S DECLARATION
and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
-Iw
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
0 ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • building a( )cupertino.ora
PROTECT ADDRESS3 //��
)0110 -Q7: f-n /f+,,a 04 5 �c.y
APNN
OWNER NAME ` i
CT
PHONE
,?e 221 1670
E -MAIL
STREET ADDRESS
STAE ZP � /
y SO
FAX
CON ROR NAME/� /�
S ,ems:,
LICE NUMBF.
SSG /Af
LICENSE TYPE
L3 - 6
BUS. LTC.
S X27
COAL NYNAMt i
E111, I b AA %09
FAX /.ir 3CJ IJ
STREET AOORESS
E G 3 o�,c/ �hn �l�i
C .STATE. ZIP
y�323
PHONE
y' /6
I UNDERSTAND AND AGREE TO THE FOLLOWING:
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.
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 S 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: 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 detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential /Code.
Signature of Applicant/Agent: Date:
ReroofPo1icv_2011.doc revised 02116111