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11070132CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 22724 MAJESTIC OAK WAY I CON TRACTOR : DRAEGER I PERMIT NO: 11070132 N INC I OWNER'S NAME: FURUSHO JOAN K 605 COMMERCIAL ST I DATE ISSUED: 07/20/2011 -R'S PHONE: SAN JOSE, CA 95112 PHONE NO: (408)536-0420 I ❑ LICENSED CONTRACTOR'S DECLARATION License Class ✓ Lie. # Contractor -P cmi Date 2 l I hereby affirm that I 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. 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 permit is issued. 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 upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regula ' per the Cupertino Municipal Code, Section 9.18. Signature Date L OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 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. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 upon the above mentioned property for inspection purposes. (We) agree to save i unify and keep harmless the City of Cupertino against liabilities, judgments, and expenses which may accrue against said City in consequence of the 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. BUILDING PERMIT INFO: BLDG r ELECT r PLUMB MECH I RESIDENTIAL COMMERCIAL F JOB DESCRIPTION: REROOF, 13.5 SQ, REMOVE WOOD SHAKE, INSTALL NEW SHEETING AND ASPHALT SHINGLES Sq. Ft Floor Area: I Valuation: $12882 APN Number: 34232124.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: RE -ROOFS: All roofs shall be inspected prior to any roofing in rial being installed. If a roof is installed without first obtaining an inspection, I glee to rem Il new materials for inspection. Signature of Applicant: Dater/// ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air 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 Health & Safety Code, Sections 25505, 25533, and 25534. OW n r or aptlorizgJ! ag�� 20 �//(�l �i > Date71 / CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of vork's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date I Licensed Professional CUPERTINO REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION (.rte Y -22-7gH -ZZ-7ZZ ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 2 ,Z-7,gZ — 227V' (408) 777-3228 • FAX (408) 777-3333 • building(&cupertino.org PROJECT ADDRESS 7 G L ! � + J �� APN # OWNER NAME PHONE E-MAIL <<4e,4- STREET ADDRESS CJTY, STATE, ZIP FAX CONTRACTOR NAME n /, LIC ENS MBER LIC SE TYPE BUS. LIC. # COMPANY NA E 1�C � E- Al rct%L 24 FAX STREET ADDRESS �� I— uloc_ CITY, STATE ZIP PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 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/" 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 monoxide detectors are required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Code. Signature of Applicant/Agent: Date: ReroofPo1icy_2011.doc revised 02/16/11 REROOF PERMIT APPLICATION V10" COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINa (408) 777-3228 • FAX (408) 777-3333 • building aacupertino.org PROJECT ADDRESS -2 / �r APN # ^ OWNERNAME / PHONE E-MAIL STREET ADDRESS r I CITY, STATE, ZIP FAX APPLICANT n PHONE E-MAIL STREET ADV W� J Crr X STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER OWNER AGENT ❑ CONTRACTOR _*O-NTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRA R NAME „ LICENSE NUMBER LIC�ISE TYPE BUS. LIC. # nL COMPANY NAME E- AIL ` FAX STREET ADD CITY, STATE, ZIPG PHONE O ke- ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplexulti-Family ROOF AREA: VALUATION: ❑ Commercial 3 � �.�y� �� (SCJ STRUCTURE: EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE S IF NO, PLYWOOD .&Lvw' ❑ L ❑ OSB PITCH: ROOF 13 NO # LAYERS: THICKNESS: 11YPE 5/8" T: ❑ CDX ' I Z CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK: Reroof4pp_2011.doc revised 03/02/11