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11050157 - CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7640 ERIN WAY CONTRACTOR:FALCON ROOFING PERMIT NO: 11050157 OWNER'S NAME: WYLLIE WILLIAM J AND MARILYN C 13088 POTTS DR DATE ISSUED:05/19/2011 O"'JER'S PHONE: SAN JOSE,CA 95111 PHONE NO:(408)225-1705 CJ LICENSED CONTRACTOR'S DECLARATIONF BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class C_ .3 Lic.# 26 �(p " MECH RESIDENTIAL COMMERCIAL Contractor G ate I hereby affirm that I am licensed under t e provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE OLD WOOD SHAKE&INSTALL 1/2 (commencing with Section 7000)of Division 3 of the Business&Professions OSB Code and that my license is in full force and effect. INSTALL SOYAS COMP CLASS A 28SQ I hereby affirm under penalty of perjury one of the following two declarati6�: 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:$10600 permit is issued. APPLICANT CERTIFICATION APN Number:35921016.00 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 non-point source regulations per the Cupertino Municipal Code,Section 9.18. SignatureDate 1s lC.�,rG �2 QriLz��c� C- �� / Issued by: r 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 Ap Iicant:. C�(,l�if�ci/Z� �ate: 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 1 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 must OwnorrAor authorized agent: — forthwith comply with such provisions or this permit shall be deemed revoked. e,. tw,Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 r I and expenses which may accrue against said City in consequence of the ng of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION ,,,,t all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35921016 . 00 DATE ISSUED. . . . . . . : 05/19/2011 RECEIPT #. . . . . . . . . : BS000013504 REFERENCE ID # . . . : 11050157 SITE ADDRESS . . . . . : 7640 ERIN WAY SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : WYLLIE WILLIAM J AND MARILYN C ADDRESS . . . . . . . . . . : 7640 ERIN WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4343 RECEIVED FROM . . . . : FALCON ROOFING CONTRACTOR . . . . . . . : MARIO RENTERIA LIC # 22569 COMPANY . . . . . . . . . . : FALCON ROOFING ADDRESS . . . . . . . . . . : 13088 POTTS DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95111 TELEPHONE . . . . . . . . : (408) 225-1705 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 10, 600 . 00 1. 00 0 . 00 1 .00 0. 00 1BSEISMICR VALUATION 10, 600. 00 1. 06 0. 00 1.06 0. 00 1REROOFRES SQ FEET 28 .00 364 . 00 0. 00 364 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 366. 06 0. 00 366 . 06 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 366 . 06 #5720 --------------- TOTAL RECEIPT 366. 06 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF 0&5 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildincl acupertino.orG .LINA PROJECT ADDRESS APN OWNER NAMEP O / 7E-MAIL I 1A STREET ADDRESS CITY, STATE,ZIP FAX ek APPLICANT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE_ BUS.LIC.#z2 61 COMPANY NAME r E-MAIL C F STREET ADDRESS CITY,STATE,ZIP PH , O �• ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAn FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: n .TUBE: ❑ Commercial EX[STWG ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES X WOODS ❑WOOD SHINGLES ❑OTHER(SPECIFY) L' REMOVE/REPLACE AYES IF N0, J PLYWOOD K" ❑ PLYWD K OSB PITCH: ROOF ❑N #LAYERS: / THI 135 8" TYP 11 :12 A A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF .ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: rem_/00 t) �02 •� a Ag U <: 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 relating to building construction. I authorize r of Cupertino to enter the above-idegoad pro rty for inspection purposes. Signature of Applicant/Agent Date: SUPPLE ME AL INFORMATION REQUIRED _ If building is associated with a Home Owner's Association,provide letter of approval from HOA. - f�AI`t _Provide Planning approval to verify if there any restrictions. F � I� I— Provide-copy of Manufacturer's Installation Specifications. ,` i —Provide signed copy of Cupertino's Tear-Off Policy. r ReroofApp_201I do revised 03/02/11 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 'ERT1NO (408)777-3228 • FAX(408)777-3333•building0kupartino.ora PROJECT ADDRESS ApN OWNERNAME6�1 -MAIL r ' S7 RE6?ADDRESS CITY, STATE,ZIP FAX CONTRACTOR NAME / LICENSE NUMBER `�� LICENSE TYPE BUS.LIC.# COMPANY NAME J E-MAIL FAX STREET ADDRESS CTIY,STA ,ZIP �- 3 PHONE LY H I UNDERSTAND AND AGREE TO THE FOLLOWING: r r 1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request shall be scheduled 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. -On the day of the inspection, a building inspector will be available within one hour for either a Tear-Off Inspection or Nailing Inspection if you call again on that day between the hours specified. 3. The following inspections are required: a. 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. b. If plywood is installed, a plywood Nailing Inspection is required, c. Progress Inspection is required when approximately 50% of roof covering is installed. 1. New roof coverings shall not be applied without first obtaining all 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. >. 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 dombns`ixate there is no ponding. b. Listings from approved testing agencies for all pre-manufactured products used shakl be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. i. 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 shallbe paid before another inspection can be scheduled.. 3y my signing below,I certify each of the following is true: I am the.property owner or authorized'agent to act on the Iroperty owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that ,mol ietectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of he�. .i California Residential Code. , signature of Applicant/Agent: Date: - ReroofPolicy_2011.doc revised 02/16/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 7640 evin way DATE: 05/19/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$10,600 "PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F USE: PERMIT TYPE: WORK replace exisitnq wood shake with comp shingle. SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 2,$00 77 LLJ Li NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn 7 info, FEE ITEMS (Fee Resolution 09-051 FEE QTY/FEE MISC ITEMS Permit Fee: $364.00 Work Without Permit? 0 Yes E) No $0.00 Strom Motion Fee: 1BSEISMICR $1.06 Select an Administrative Item Bldg>4,Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $366.06 $0.00 TOTAL FEE: $366.06 Revised: 04/29/2011 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: - t&) t,1V PERMIT# OWNER'S NAME: f ,� PHONE# y C i- z c C� GENERAL CONTRACTOR: CGS /v" BUSINESS LICENSE# 'L' S ADDRESS: y (j' CITY/ZIPCODE: *Our municipal code requires all 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: 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 7' 3 2 Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date