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13040041 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7625 ERIN WAY CONTRACTOR:KEITH ROOFING CO INC PERMIT NO: 13040041 OWNER'S NAME: JOSEPH LEE 920 LINCOLN AVE DATE ISSUED:04/04/2013 OWNER'S PHONE: 4082552636 SAN JOSE,CA 95126 PHONE NO:(408)295-8616 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class (� — Lic.# f— F MECH RESIDENTIAL COMMERCIAL Contract Date I hereb irm that I am licensed under:the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF,REMOVE SHAKES INSTALL 7/16 OSB 30 LB (commencing with Section 7000)of Division 3 of the Business&Professions FELT,PRESIDENTIAL COMP ROOF 30 SQRS 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. I have and will maintain Worker's Compensation Insurance;as provided for by Sq.Ft Floor Area: Valuation:$16500 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:35920019.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino,against liabilities,judgments; WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against.said City in consequence of the 180 DA S FROM LAS ALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-poin source regulations per the Cupertino Municipal Code, ection 9.18. Issued by: )–late: Signa re ate ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtainin inspection,I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant Date: Business&Professions Code) I,as owner of the property,am exclusively contracting,with licensed contractors to construct the project(See.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one-of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance;as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I O or authorize t: [�/� become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or thispermit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino,against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-poi ource regulations per the Cupertino Municipal` 'de,S ction I understand my plans shall be used as public records. 9.18. Licensed Professional Sign re Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10.300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building _cupertino.org CUPERTINO' 7 . �� j PROJECT ADDRESS: APN# � /C l OWNERNAME j+gCJi P �/�JJ &MAIL STREET ADDRESS V CTI Y, TATE,ZIP r—y/ FAX CONTACT.NAME n PHO E-MAII STREET ADDRESS C� CITY T TE,ZIP a 1:1 OWNER El OWNER BUILDER ❑ OWNER AGENT NTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME gWUMBER LI SE E BUS.LIC.# �� 0 COMPANY N E-MAIL F AX STREET ADDRESS CITY,STA P O n ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or DllPlex' ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: . CI Commercial ?� EXISTING ROOF TYPE: .:❑BUILT-UP ROOF: ' ❑ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE, ES IF NO, PLYWOOD ❑ ''/s" PLYWD QSB PITCH: ROOF ❑NO #LAYERS: THICKNESS: ❑5/8" / TYPE: ❑CDX 12 CLASS: A ICC-ES REPORT# PROPOSED ROOF TYPE: ❑BUILT-UP ROOF JLwIALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER DESCRIPTION OF WO I I -:36 � onola By my signature below,I certify to a 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 information I e rovided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relaf g o wilding co cti I authorize representatives of Cupertino to enter the above id' tifie roperty for inspection purposes.., Signature ofApplicant/A t: Date: SUPPL&AE<fj6 INFO TION REQUIRED _If building is associated with a Home Owner's Association,provide letter r of approval from HOA. Provide Planning approval to verify if there any restrictions. ' Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/16/11 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 CUPERTIM0. (408)777-3228•FAX(408)777-3333•building a0cugertino.org PROJECT ADDRESS APN# OWNER_NAME PHO c C E-MAIL <rA e.<D, STREET ADDRESS CITY ST E,ZIP FAX CONTRACTOR NAME l' 4 LICENSEB,VIir� !LJILENSEU/ E BUS.LIC.# 7 tAl COMPANY NAME E-MAIL 5 OV's/�S FAX. By <144J STREET ADDRESS ' S &CI7 STATE,Z F PHONE J 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 illrequire 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'/4"per foot of slope and demonstrate there is no ponding. b. Listings ftom.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 944ree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon mono ' det tors are required t installed' ccordance with Section R314 d R315 of the 2010 California Residential de. Signature of Applicant/Agent: Date: ReroofPo1icy_2012.doc revised 10/7/12 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 7625 erin way DATE: 04/04/2013 REVIEWED BY: larrys APN: BP#: *VALUATION: 1$16,500 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION SFD or Duplex 1 SFDWLROOF USE: I PERMIT TYPE: � WORK remove shakes install 7/16 obs 30 Ib felt residential comp SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 3,000 to gn 2NW::. ,Wch. Flan Check Plrutib. Plzen Cheek FT Elec.Plan(.;heck Mech. Peni-it Fee: Plumb.Permit Fee: Elec. Permit Fee: Lk tt ech.Insp. Other Plumb Insp. Other Elec.Imp.Insl)..h'ee. Plumb. hull).Fee: Elec.Insp. Fere: NOTE:This estimate does not include fees due to other Departments(Le,Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). Theseees are based on the preffinWdna information available and are only an estimates Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/12) FEE QTY/FEE MISC ITEMS Plan (:'heck Fee: S'uppl. PC Fee 1'luinb./Mech./Is'lec Permit Fee: $450.00 .Sulrp/_117srp Fee Plum b.%Nlech./flee Plumb./.Wec.h./Is'lec Permit Fee:, Construction :Tax: fl dlninistr"ative.Fee: Work Without Permit? 0 Yes (j) No $0.00 dvanced Planizing FC'csS: Travel Documentation Feet: � Stro:njz Motion Fee: 1BSEISMICR $1.65 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $452.65 $0.00 $452.65 Revised: 04/01/2013