11070127. CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22772 MAJESTIC OAK WAY I CONSTRUCTOR : DRAEGER I PERMIT NO: 11070127 N INC I
OWNER'S NAME: TRITTELVITZ RENATE TRUSTEE
605 COMMERCIAL ST
DATE ISSUED: 07/20/2011
:R'S PHONE: I SAN JOSE, CA 95112 1 PHONE NO: (408)536-0420 1
❑ LICENSED CONTRACTOR'S DECLARAy,TION
License Class l Lie. # caC/
Contractor Date
I hereby affirm that 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.
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 ace a against said City in consequence of the
granting of this permit. Additio y, the applicant understands and will comply
with all non -point source reg ions per.the pertino Municipal Code, Section
9.18.
Signature Date _7Xa/91
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)
I, 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- inify 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.
Signature Date.
BUILDING PERMIT INFO: BLDG f— ELECT F PLUMB r—
MECH I— RESIDENTIAL r COMMERCIAL
JOB DESCRIPTION: REROOF, 13.33 SQ, REMOVE WOOD SHAKE, INSTALL
NEW
SHEETING AND ASPHALT SHINGLES
Sq. Ft Floor Area: I Valuation: $12882
APN Number: 34232116.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued In Date:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspe . n, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
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.
e/i1 e�I.agT V Date:
�—� J
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
3 ITEMS OF 37
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 34232116.00
DATE ISSUED.......: 07/20/2011
RECEIPT #......... BS000014110
REFERENCE ID # ...: 11070127
SITE ADDRESS .....: 22772 MAJESTIC OAK WAY
SUBDIVISION .......
CITY CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ............: TRITTELVITZ RENATE TRUSTEE
ADDRESS 22772 MAJESTIC OAK WAY
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
RECEIVED FROM ....: DRAEGER CONSTRUCTIO
CONTRACTOR .......: DRAEGER, JOHN EDWARD LIC # 21895
COMPANY DRAEGER CONSTRUCTION INC
ADDRESS 605 COMMERCIAL ST
CITY/STATE/ZIP ...: SAN JOSE, CA 95112
TELEPHONE (408)536-0420
FEE ID UNIT
QUANTITY
AMOUNT
PD -TO -DT
THIS REC
----------
NEW BAL
----------
-----------------------
1BCBSC VALUATION
----------
12,882.00
----------
1.00
----------
0.00
1.00
0.00
1BSEISMICR VALUATION
12,882.00
1.29
0.00
1.29
0.00
1REROOFRES SQ FEET
13.00
182.00
0.00
182.00
----------
0.00
----------
TOTAL PERMIT
----------
184.29
----------
0.00
184.29
0.00
VOICE ID DESCRIPTION
-------- ----------------------------
309 EXTERIOR LATH
601 ROOF TEAR OFF
VOICE ID DESCRIPTION
-------- ----------------------------
311 SCRATCH COAT
602 ROOF PLYWOOD NAIL
604 ROOF IN -PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
WME FEE ESTIMATOR—BUILDING DIVISION
FEE ID ROOF AREA
(S.E)
1REROOFFRES 1,300
ADDRESS:im
QTY/FEE
DATE:
REVIEWED BY:
A
APN: 9 L BP#: 110 10 1 —7�
_,� I a, I Lo,-
*VALUATION:
F$12,882
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE:
Re -roof
PRIMARY SFD or Duplex
USE:
PENTAMATION
PERMIT TYPE:
1SFDWLR00F
WORK
SCOPE
FEE ID ROOF AREA
(S.E)
1REROOFFRES 1,300
WITP- Th- Enna ora hnwad A" tho nrolimi"any i"iarmafin" avoilahlo and are only an estimate. Contact the Dent for addnl info.
FEE ITEMS (Fee Resohnion 1-053 Eff 1)
FEE
QTY/FEE
MISC ITEMS
A
L1 I
Permit Fee:
$182.00
F7
WITP- Th- Enna ora hnwad A" tho nrolimi"any i"iarmafin" avoilahlo and are only an estimate. Contact the Dent for addnl info.
FEE ITEMS (Fee Resohnion 1-053 Eff 1)
FEE
QTY/FEE
MISC ITEMS
A
Permit Fee:
$182.00
F7
Work Without Permit? 0 Yes No
$0.00
Strong Motion Fee: IBSEISMICR
$1.29
Select an Administrative Item
Bldg_) Stds Commission Fee: IBCBSC
$1.00
I SUBTOTALS:
$184.29
$04
1 .00 TOTAL FEET
$184.291
Revised: 07/04/2011
CUPERTINO
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 - building(&cupertino.org
&- 22--7LfH-Z72�72-2-
b — 2-2-752 — 2Z7.Vi
PROJECT ADDRESS �( %
/ +
/ 7
APN #
OWNER NAMEe
v
PHONE
E-MAIL
STREET ADDRESS
C)TY, STATE, ZIP n
FAX
CONTRACTOR NAME
LIC ENS MBER
vG17- 60'ZO
LICENSE TYPE
BUS. LIC. #
COMPANY NA E (
E- AI
FAX
STREET ADDRESS��
CITY, STATE ZIP
PHONE ' y/O_
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. Pro;_ress 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:
ReroofPolicy_2011.doc revised 02/16/11
Z77 z
CUPERTINO
- Z2'► 5�
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building aacupertino.org
PROJECT ADDRESS "]/) n 7 O �
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APN
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OWNER NAME PHO
E-MAIL
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STREET ADDRESS CITY, STATE, ZIP
FAX
APPLICANT NAME
PHONF�6
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STREET ADDRESS
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CITY, STATE, ZIP
60
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❑ OWNER AGENT 4<ONTRACTOR 11 CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
13 OWNER 1:1W
OWNER -BUILDER
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CONTRAC� N , A
LIC E NUMBER
LIC NS TYPE
BUS. LIC. #
COMPANY NAME
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STRVT_�DRESS
CITY, STATEZ n � �
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ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex lllti-Family
ROOF AREA:
VALUA ION:�%
( l
(
(L/ U-3 OD
STRUCTURE: ❑ Commercial
,
,
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES 5kWOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE FYES
IF NO,PLYWOOD
A %,, El<E
11OSB
PITCH:
:12
ROOF
A
❑ NO
# LAYERS:
THICKNESS: El 5/8,,
TYPE: ❑ CDX
CLASS:
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF JF 5PHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT #
DESCRIPTION OF WORK:
�
�f 1,71 �r
By my signature below, I certify to each of the following: I am prop owner or thorize agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I e real a Descripti of Work d verify it is accurate. I agree to co ply with all applicable local
ordinances and state laws relating to building construction au ze repres t es of Cupe no tc enter the above-iden ed pro elty for inspection purposes.
Signature of Applicant/Agent: Date: r ,f7
SUPPLEMENTAL INFORMATION REQUIRED
:` NOincl
iisE o�x'
If building is associated with a Home Owner's Association, provide letter
g24
�' `�ROU7ctrtc
'SLIP r"
PvER T coz�ri R��
❑ BUII nrnc PLAN tEvrEw` _
_
of approval from HOA.
— Provide Planning approval to verify if there any restrictions.
Q Ea"o?Rss
❑_ PLANNFNGrrAlvtEvlEw`.71.
Provide copy of Manufacturer's Installation Specifications.
[l �zaimtn - =
❑ �IRDEirr
_
❑oTaElt -
Provide signed copy of Cupertino's Tear -Off Policy.
.
.� ••� ,_ <-
._ .-..._._ :.�.. �. _ems _
ReroofApp_2011.doc revised 03/02/11