13030092CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20810 PEPPER TREE LN
CONTRACTOR: SOLIS ROOF REPAIR
PERMIT NO: 13030092
OWNER'S NAME: MICHELE LUM
2789 GUM DROP DR
DATE ISSUED: 03/19/2013
OWNER'S PHONE: 4083152960
SAN JOSE, CA 95148
PHONE NO: (408) 238 -9233
13 LICENSED'CONTRACTOR'S bECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class C Lic. # �,3ftp �E
TEAR OFF (E) WOOD SHAKE, INSTALL PRESIDENTIAL
n Q
--P-r y b a0`1 Z- Date. t
COMP, CLASS A
Contract ort `� 1
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 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: $13700
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 35911041.00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
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 FROM T CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
e
costs, and expenses which may accrue against said City in consequence of the
Is Date: 7
granting of this permit. Additionally, the - applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
.9.18.
RE- ROOFS:
Signature Date 3
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.
❑ OWN - BUILDER DECLARATION
ate:
Signature of Applic
I hereby affirm that I am exempt from.the Contractor's License Law for one of
the following two reasons:
ALL ROOF CO E GS TO ASS "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
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: s
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
of the work for which this permit'is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
performance
1 have and will maintain Worker's Compensation Insurance, as provided for by
the Health &Safety Code, Sections 25505, 25533 nod 25534.
Section 3700 of the Labor Code, for the-performance of the work for which this
Owner or authorized 9g Date3
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
CONSTRUCTION LENDING AGENCY
Compensation laws of California. 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 theabove information is
t
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
ARCHTI ECT'S DECLARATION
indemnify 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
CITY OF CUPERTINO
Fig—ROM iviv V Ti A WnlD — 11111 T111 -n11T%Tr_'n1V1.qI0N
hoADDRESS:
20810 PEPPER TREE LN
'E: 03/19/2013
REVIEWED BY: MELISSA
QTY/FEE
APN: 359 11041
BP#:
*VALUATION:
1$13,700
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
hrs
PENTAMATION 1SFDWLR00F
PERMIT TYPE:
USE:
PME Plan Check:
14
woRy,
TEAR OFF (E) WOOD SHAKE, INSTALL PRESIDENTIAL COMP, CLASS A
$0.00
SCOPEJ
1-0—.0
Adech. Plan Check I I
IXlech. Permit Fee:
Ofher.Wech. Imp; F
N.fech. Insp. Fee:
Plumb. Plan Check I I
Plumb. Permit Fee:
Other Plumb Insp. Li
Plumb. Insp. Fee:
Elec. Plan Check I I
Elec. Permit ree:
Other Elee. Insp. EIF-1-
Elec. Insp. Fee:
NOTE., This estimate does not includejees due to owermepanments (i.e. running, ruvac; rrufAa, A,91v,
District, etc). These ftes are based on the prellmin information available and are only an estimate. Contact the Dept for addn 7 info.
FEE ITEMS (Fee Resolution 11-053 Fff. 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$o-oo
F2,_36_6 s-f. Re-roof
$345.001 IREROOFRES L
Suppl. PC Fee: G) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feel D Reg. 0 OT
1-0—.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Conswuction Tax:
F-1
Adtninistrative.Fee: 0
Work Without Permit? OYes 0 No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential
Travel Docu7n . en . tation T Building 0
or Structure
Fees:
Strong Motion Fee: IBSEISMCR $1.37 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.001 1 - ------
$2.371 $345.00 $347.37
IBM='
Revised: 01/0112013
f
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • buildinga- cupertino.org
PROJECT ADDRESS 'j/� q r Y•a�.� • — y�
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E-MAIL
STREET ADDRESS
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CITY, TATE, ZIP
FAX
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LICENSENUMBER,:;� `
LICENSE 6
BUS. LIC. #
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CITY�TE',i�„
.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 I /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 comply with the re -roof policy stated above. I also understand that
smoke detectors and,carbon monoxide detectors are re ired to be installed in accordance with Sections 8314 and 8315 of
the ,2010 California Residential Cod Q.
Sienature of Applicant/Agen Date: j 3
ReroofPolicy_2012.doe revised 1017112