13010089 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7598 KIRWIN LN CONTRACTOR:R E ROOFING& PERMIT NO:13010089,.
CONSTRUCTION INC
OWNER'S NAME: KNIPE RUTH C AND GARRY D 15230 CLYDELLE AVE DATE ISSUED:01/172013
OWNER'S PHONE: 4082536148 SAN JOSE,CA 95124 PHONE NO:(408)626-9320
LLIpCENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
ass�% ` N? Lic.# —7ZI!511 TEAR OFF(E)WOOD SHAKE,INSTALL NEW 1/2" CDX,30#
I I FELT LIFETIME COMP(29 SQ'S)
Contractor Date I -
there y icensedum er be provisions of Chapter 9
(commencing with.Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I 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. Sq.Ft Floor Area: Valuation:$14500
1 have and will maintain Worker's Compensation Insmance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35922021.00 Occupancy Type:
permit is,issued.
_APPLICANT CERTIFICATION -
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 DAYS OF 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 DAYS FRO LED SPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Iss Date:
granting of this permit. Additionally,the applicant understands and will comply
al -poin oorce regul er the Cupertino Municipal Code,Section M
9.1M.
8.
RE-ROOFS:
ignat a Date I 1 All roofs shall be' rior to any roofing material being installed.if a roof is
installed wi ut firs obmim inspe a to remove all new materials for. .
inspection
❑ OWNER-BUILDER DECLARATION
atureo pp' Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROO^ ERINGS 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 HAZARDOUS MATERIALS DISCLOSURE
concoct the 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. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code;Chapter 9.12 and the-
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's itionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air con tamiman as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain co lienee with the Cup nicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation insurance,as provided for by the Health&Safe a 'ons 2 5 2553 ad 25534.
Section 3700 of the Labor Code,for the perfdrnance of the work for which this Owner or author' d n • Date:
permit is issued. : - I I _
I certify that to 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 CONSTRUCTION LENDING AGENCY -
Compensation laws ofCalifornia. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work'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 county ordinances and state laws relating
to building construction;and hereby authorize representatives of this city to enter -
upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION -
indemnify and keep harmless the City:pf Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City inconsequence 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
A
REROOF PERMIT APPLICATION et�
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION V
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 1
CUPERTINO (408)777-3228• FAX(408)777-3333•
OWNER NAME buildingOcuoerlino.ora' `47
PROJECT ADDRESS 1/1 �1 V X 1 R W I. I W �I 3, T Z Z _ 0
Z
ITT IJ PHONE t`�-'1��I ` ISI E-MAIL
STREET ADDRESS J1`�l\(/ N 1 O W I. I CITY, STATE,ZIP ( 'L� 71^,� � IYQ FAX
CONTACT NAME 1 J Iw ND,wry,f,/ PHONE y Y/1U�v_' 'Itl2_,) E-MAIL
STREET ADDRESS CITY,STATE,ZIP [ j— i/�jLf FAX
❑OWNER 13OWNER-BuJUnER ❑ oo1•`�,WNERA VA
GEmr CONTRncrOR ❑CONTRAcmRJAGENr ❑ A&1CIBIECT ❑ENGINEER ❑ DEVELOPER 11 TENANT
CONTRACTORNAME �mN/�� /� LICENSENUNIBER LICENSE'PYP BUS.LIC.N
COMPANY NAME FMAE. FAX
STREET ADDRESS _ CITY,STAT ,ZIP
PHOE -
�bJ��1�7I
ARCHITECT/ENGINEER NAME I LICENSE NUMBER BUS.LIC.k
CONIFANY NAh1E E-MAD. FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE of SF r Duplex ❑ Multi-Family ROOF AREA:
�) C T777.77STRUCTURE: ❑ Commercial1
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SNB rLE OOD SHARES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE PLACE YES IFNO. I PLYWOOD W. ❑ PL ❑ PITCH: ROOF
❑ p ❑ TYPE: DX :12 A A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF 13 ASPHALT SHINGLES 11 WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT N
DESCRIPTION OF WORK:,IT eX� �' 1 Kj V`
h l6 II,�✓
y IL
By my signature w,I certify t ch 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 a information I hav disco . I av scription of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and tate laws relating to ildi onslmcti I ntatives of Cupertino to enter the above- ndfied property for inspection purpose.
SignaNre of Ap 'cant/Agent: Date:
S U P P CE_MM_N T A L I N F-0-RI R T I OR REQUIRED sa aim at,`.-`'i OFF7CETISEONL
Ya tat S 4'A"n'n y+ Lj21V':"illR
_If building is associated with a Home Owner's Association,provide letter .P't ' caEci2 T,Yr4'^ f� ° '� 'Q'-:�Rouig3cse t � .
of approval from HOA.
PP
_ paxk RCRyTRTFE
Provide Planning approval to verify ifthere an restrictions.
�>k" ti
Provide copy ofManufacturers Installation Specifications. SIc i❑❑❑c 3rBrF:"�tIm'�.ItA6EkN,�DDr'7`Imi�E?N vtcrLTt A,�A5�"`p i��6E'Pv`InE:W'w°:�'
i
-
_Provide signed copy of Cupertino s Tear-Off Policy.
ReroojApp_2011.doe revised 03116111
(pA�N>
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 7598 KIRWIN LN DATE: 01117/2013 REVIEWED BY: MELISSA
APN: 35922 021 BP#: VALUATION: $14,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair
PRIMARYSFD or Duplex PENTAMATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK TEAR OFF E WOOD SHAKE INSTALL NEW 1/2" CDX 30#FELT LIFETIME COMP 29 SO'S
SCOPE
la I�a r,gq
,tfo:h. Pini;Ch,rk Plwnb. Pian Check Lice.Plan Cb"'x
;buten.Perlwz Fec: P[und'.Perntit/"ee; Fir;:. Permit['�e:
tltirer aledi.fray. O/Ger Plu"th hup. Oihe,, Elca hasp.
Voch:In.cp_Fire: . . P/uutb. Drip.I<,,,: !uu Inen. Pee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer D1strlet,School
District.etc). These ees are based on the prell n information available and are only an estimate. Contact the Dept for addn'l info,
FEE ITEMS (Fee Resolution 11-053E .. 711112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 2,900 s.f. Re-roof
Suppl.PC Fee: Q Reg. O OT 0.0 hrs $0.00 $435.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl.Insp.Fee:Q Reg. OOT F0.0 I hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
C ouslowliun Tax: -
- Administraiii,e Fee.. 0
Work Without Permit? O Yes (E) No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential
`7ruvet lhicutne�nlutiorr l=ees:- Building or Structure O
Strone Motion Fee: 1BSEISMICR $1.45 Select an Administrative Item
B1dp.Stds Commission Feer IBCBSC $1.00
Ra
$2.45 $435.00 TOTAL FEE: $437.45
Revised: 10/01/2012- -
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(4''��,�'08)777-3228• FAX(408)777-3333-buildinafa�cuoertino.org
`
PROJECT ADDRESS - /N 1�..(l� APNq//
OWNER NAME l.�L�,{ �'1JW�� PHONE U _`2,( /_ I I E-MAIL
STREET ADDRESS Vj I Ij �� crrY,STATE,zip CX(7(/ )LY'/l J FAX /
CONIRACIOR NAI.O;BIZ ,ti,/I, / LICENSE NUI+IDERy�,Z-75�� '1ILIIC(E�NSE TYPIEjO/3(�' ,O BUS.LIC.N
COMPANY NAhe I_\ EMAa. r()�, I✓rl I4L�, L,ad.. IUI'n FAX
STREET ADDRESS CnY.STATE,ZIP �.s fit�I�1 PHONE
I UNDERSTAND� AND AGREE TO THE FOLILOLWING:
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 one business day before the requested inspection date.
Please call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pm (Friday) to schedule
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.
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. 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/d' 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.
7. 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. 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: I am the property owner or authorized agent to act on the
property owner's behalf. I un tand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and car monoxi detectors are required t I Iled in accordance with Sectio s R3 4 and R315 of
the 2010 Califomia Re dential Code.
Signature of ApplicanUA nt: Date:
RerogfPo1icy_2012.doc revised 1017/12