13020128 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10427 VISTA KNOLL BLVD CONTRACTOR:O.D.R.ROOFING PERMIT NO: 13020128.
OWNER'S NAME: DEFRANCO THOMAS J AND DORIS A 5334 KNIGHTS ESTATES DATE ISSUED:02/222013
OWNER'S PHONE: 4087390974 SAN JOSE,CA 95135 PHONE NO:(408)590.5512
❑ .LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL
License Clas c.#
4!71490 REMOVE(E)TILE.CLEAN AREA&INSTALL 2 LAYERS
Con —a a 30#
Contract Date FELT&RE-INSTALL(E)TILE
I hereby affirm t _ t I am licensed under the 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:$20000
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 APN Number:32613034.00 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 tosave 180 DAYS F CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Z2i )
Date:
granting of this permit. Additionally,the applicant understands and will comply a
with all non-poi lat the Cupertino Municipal Code,Section
9.18.
Signature A Date RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
installedwithout first obi n an ins ec o ,I agree to remove all new materials for
inspection.
13 ^'7 �
OWNER-BUILDER DECLARATION Signature of Applican Date: �`Q2J
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF CO RINGS TO BE CLASS"A"OR BETTER
1,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)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct 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 material. Additionally,should I 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 complia ce wu he Cupertino Munici al Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety s e,Secti a 55 d 4. -
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent.
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 laws of California. It after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
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 of Cupertino against liabilities,judgments,
costs,and expenses which may accme 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
REROOF PERMIT APPLICATION �\
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION /v
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 n
CUPERTINO (408)777-3228•FAX(408)777-3333•building(Mcuoertino.org \M
PROJECT ADDRESS/041,9,_ r APNq
_ST
OWNERNAt. (ate P O 3 9 0 (i10 E-MAn7 V
STREET ADDRESD U/S� � CITY, STATE,ZIP FAX
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CONTACT NAME PHONE E-MAR,
STREET ADDRESS CITY,STATE,ZIP FAX
OWNER ❑ OWNER.Brmjum ❑ OWNERAGENr ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTORNAME LICENSE NUMB LICENSE TYPED BUS.LIC.#
0 I 0
COMPANYNAA¢ 1, 1 MAB-�� O 1 YI A`bO• FAX
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STREET ADDRESS �' / �� CITY,STATE,Z OS / PHONED D ,
ARCHITECT/ENGINEER NAME - �a LICENSENUMBER BUS.LIC.q
COMPANY NAME &MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family. ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial �r./' or;),!:�w
EMSTMG ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY) e_
REMOVE/REPLACE ❑YES IFNO, PLYWOOD ❑ -N, ❑ PLYWD ❑OSB PITCH: ` ROOF
11k ❑ ❑ D :12 L A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-Es REPORT k
DESCRIPTION OF WORK: 0 • /_� �-
r2k1,57 10
t/�/((/��/yI
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By my signature below,I certify to each of the following: n the property owner or authorized agent to act on the property owner's behalf I have read this
application and the information I have provided is correc ave read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws rel i thorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature ofApplicanNA Date:
SUPPLEMENTAL INFORMATION REQUIRED 0MCEUSi ONLY_
_If building is associated with a Home Owner's Association,provide letter �,/� PLAN CHECK TYPE.' ROUTING SLIP
of approval from HOA. APER-TRF uriuR ❑ BUILDING PLAN REVIEW
_Provide Planning approval to verify if there any restrictions. !❑ ExPRFSS, ❑ PLANNING PLAN REVIEW
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD' ❑. FERE DEPT
Provide signed copy of Cupertino's Tear-Ott'Policy. ❑ OTHER.
ReroofApp_2011.doc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10427 VISTA KNOLL BLVD DATE: 02/2212013 REVIEWED BY: MELISSA
APN: 326 13 034 BP#: `VALUATION: 1$20,000
*PERMIT TYPE: Building.Permit PLAN CHECK TYPE: Alteration/Repair
PRIMARY SFD Or Duplex PENTAMATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK REMOVE E TILE. CLEAN AREA& INSTALL 2 LAYERS 30#FELT& RE-INSTALL E TILE
SCOPE
6
Mech.Plan Check Plumb.Plan Check Dec.Plan Check -
bfech. Permit Fee: Plumb. Permit Fee" (flee. Permit Fee:
Other bfech.Insp. Other Plumb Insp. Lj Ocher Elec.Insp. ED
:Rech.Insp.Fee: Plumb. hie'p.Fee: Elec.Insp.Fee:
NOTE:This estimate does not includejees due to other Deparanents(Le.Planning,Public Works,Fire,Sanitary Sewer Distric4 School
Districtetc). These fees are based on the predundn information available and are only an estimate. Contact the Dept for addn'1 info,
FEE ITEMS(Fee Resolution 11-053 E . 711112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 E80fl s.f. Re-roof
Suppl. PC Fee: Q Reg. Q OT 0.0 hts $0.00 $570.00 iREROOFREs
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee:Q Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Consfl -action Tax:
Administrative Fee: o
Work Without Permit? O Yes O No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential
Building or Structure 0
Travel Documentation Fees: . g �
Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item
Bldg Stds Commission Fee: iBCBSC $1.00
$3.001 $570.001& �X exr3Y $573.00
�t\ . Revised: 01/01/2013
�J2- 6 Z �
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
(408)777-3228• FAX(408)777-3333•buildina(a),cuoertino.ora
PROJECT ADDRESS APN 1 7"/3 ( 3 03
OWNERN PHONE 7 (, � E-MAIL
0l0 1 2 0
STREETADDRESS CITY,STATE,ZIP FAX -
CONTRACTORNAME LICENSE NUN9E /bQ LICENSE TYPE(f BUS.LIC.9
COMPANY NAME E-MAB. C� FAX
�� 7� o "� a o in ah00 •�
STREET ADDRESST- LL CITY,STATE,ZIP PHONE
? r c ?¢ 1M L o e L` /3 o O SS`
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 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 1/4"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.
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 understand and agree to complyvVith the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide ec or tur o e 1 d in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: & Date:
RerooJPolicy_2012.doc revised/0/7/12