11070187 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1144 HUNTERSTON PL CONTRACTOR:CUPERTINO ROOF,INC PERMIT NO: 11070187
OWNER'S NAME: STARR ANNE M TRUSTEE 1052 KELLY DR DATE ISSUED:07/26/2011
O`11NER'S PHONE: 4082532657 SAN JOSE,CA 95129 PHONE NO:(408)973-9427
C� LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG ELECT PLUMB
`
License Class G `j Lic.# S 4 .� ) �
�., MECH RESIDENTIAL COMMERCIAL
Contractor 4:� -e2 In& Date
I hereby affirm that I am licensed under t provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF COMP SHINGLES&INSTALL FELT
(commencing with Section 7000)of Division 3 of the Business&Professions CLASS
Code and that my license is in full force and effect. CLASS A 16SQ
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
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$9000
permit is issued.
APPLICANT CERTIFICATION APN Number:36222025.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all source regulations per the Cupertino Municipal Code,Section
9.18. , /�
Signature Date
—Z� I Issued by; / Dater
OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection. '
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant:' Gti ;� Date: Z. I
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.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
declarations: HAZARDOUS MATERIALS DISCLOSURE
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 I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
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
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
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 mugt er or auth id agent: ) L
forthwith comply with such provisions or this permit shall be deemed revoked. Date:- 1
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
-+s,and expenses which may accrue against said City in consequence of the
ting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
.pith all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 1144 hunterston pl. DATE: 07/26/2011 REVIEWED BY: bob s.
APN: BP#: "VALUATION: 1$9,000
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: p PERMIT TYPE:
WORK tear off comp install comp shin les
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 1,600
El L
NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addh 7 info.
FEE ITEMS (Fee Resolution 11-053 I.ff. ';, FEE QTY/FEE MISC ITEMS
Permit Fee: $224.00
Work Without Permit? 0 Yes No $0.00
Strong Motion Fee: IBSEISMICR $0.90 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $225.90 $0.00 TOTAL FEE: $225.90
Revised: 07/04/2011
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
CUPERTINO
(4'08/)777-3228• FAX(408)777-3333•building
(gcupertino.org
PROJECT ADDRESS �j ^ l Q APN#
OWNER NAME �4�� :; ` �v-• �-- PHONE E-MAIL
TJ-/ / T
STREET ADDRESS ' \ / �I CITY, STATE,ZIP J R 1^ FAX
CONTRACTOR NAME V �� ACU �� LICENSE NUMBER C'/ ��f "� LICENSE TYPEBUS.LIC.#
COMPANY NAME q` Y� E-MAIL FAX
STREET ADDRESS i ` -�\ 1 CITY,STATE,ZIP !3t-4S PHONEZrr) A,42 'l
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 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.
7. 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/" 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$126.00. 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 xide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residentialo
Signature of Applicant/Agent: Date:
ReroofPolicv_2011.doc revised 02/16111
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: -PERMIT#
OWNER'S NAME: �� }-c�r �' PHONE # �` 1-7)
GENERAL CONTRACTOR: BUSINESS LIC NSE#
ADDRESS: 10 Z CITY/ZIPCODE:
*Our municipal code requires alf businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors: -
Signature Date
Please check applicable subcontractors and complete the following information:
V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/Carpeting
Linoleum /Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333 • buildingCE)cupertino.org
PROJECT ADDRESS j ,A V^ � ?\ ,q � APN# r C)
OWNER NAME ��. 571 q 1 `9PHONE 2 - .- -:2 Le_S 1 E-MAIL
STREET ADDRESS 1 l ( OL;n_r_ CITY. STATE,ZIPC milU Q - t f FAX
APPLICANT NAME � - ' y�T� c PHONE E-MAIL
STREET ADDRESS / 1 i n CITY,STATE,ZIP,–+q C� FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME O 11 (�G� LICENSE NUMBER S h^ LICENSE TYPE BUS.LIC.#
COMPANY NAME 1Y� E-MAIL FAX
STREET ADDRESS ` CITY,STATE,ZIP PHONE •� Z
ARCHITECT/ENGINEER NAME LICEATSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF A-51F�D or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial aa G C
EXISTING ROOF TYPE: ❑BUILT-L71sMOF"— 9 ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE YES IF NO. PLYWOOD ❑ yv, ❑ PLYWD ❑ OSB PITCH: ROO
' F
❑ NO #LTHI
AYERS: CKNESS: ❑ 5/8" TYPE: ❑ CDX 12 CLASS: A
ICC-ES REPORT#
PROPOSED ROOF TYPE:
El R�ASPHALT SHINGLES ❑WOOD SHAKES WOOD SHINGLES OTHER
DESCRIPTION OF WORK:
too
By
By my signature below,I certify to each 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 have provided 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 relatin ilding constru 'on. I authorize representatives of Cupertino tc.enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: —7
SUPPLEME INFORMATION REQUIRED
—If building is associated with a Home Owner's Association,provide letter
�iaTr� uri i sLxP ,
of a royal from HOA. r -
PP pR�ca 3c 3 its�� t xEw
Provide Planning approval to verify If there any restrictions. - tXE �ss �. 0
�r-b�n"�
raTlvlEw
Provide copy of Manufacturer's Installation Specifications.
Ovide signed copy of Cupertino's Tear-Off Policy.
ReroofApp_2011.doc revised 03/02/11