11050096 . CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10659 MAPLEWOOD RD CONTRACTOR:GORMAN ROOFING PERMIT NO: 11050096
SERVICES,INC
OWNER'S NAME: ESSEX PROPERTY TRUST 2229 E UNIVERSITY DR DATE ISSUED:05/23/2011
ER'S PHONE: PHOENIX,AZ 85034 PHONE NO:(602)262-2423
❑ LICENSED CONTRACTOR'S DECLARATIONF
2 Q �-7 BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class C 7 ( Pco,m4
# C
MECH F RESIDENTIAL r COMMERCIAL F
Contractorc-F-O �N Date 3
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APT A-D- RE-ROOF OVERLAY EXISTING ROOF WITH
(commencing with Section 7000)of Division 3 of the Business&Professions POLYURETHANE FOAM CLASS A 24SQFT
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 Sq.Ft Floor Area: Valuation:$8232
permit is issued.
APPLICANT CERTIFICATION APN Number:31643003.10659 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-po' sou regulations per the Cupertino Municipal Code,Section
9.18.
Signature Date
a 3 Issued by: Date:
L 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' spection,I agree to remove all new materials for
1,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 o Appli ant: Date:
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(x)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 Owner ozed agent:
r t o '
forthwith comply with such provisions or this permit shall be deemed revoked. Date:Ilivrf
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 Wrk'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
i- inify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with 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
3 ITEMS OF 51 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 31643003 . 10659
DATE ISSUED. . . . . . . : 05/23/2011
RECEIPT #. . . . . . . . . BS000013531
REFERENCE ID # . . . : 11050096
SITE ADDRESS . . . . . : 10659 MAPLEWOOD RD
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER ESSEX. PROPERTY TRUST
ADDRESS 925 EAST MEADOW DR
CITY/STATE/ZIP . . . : PALO ALTO, CA 94303
RECEIVED FROM . . . . : GORMAN ROOFING
CONTRACTOR DANIEL J GORMAN LIC # 32440
COMPANY GORMAN ROOFING SERVICES, INC
ADDRESS 2229 E UNIVERSITY DR
CITY/STATE/ZIP . . . : PHOENIX, AZ 85034
TELEPHONE (602) 262-2423
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 8, 232 .00 1. 00 0 . 00 1.00 0. 00
1BSEISMICR VALUATION 8,232 .00 0. 82 0. 00 0 .82 0 . 00
1REROOFRES SQ FEET 24 . 00 312 . 00 0 . 00 312 .00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 313 . 82 0. 00 313 .82 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
309 EXTERIOR LATH 311 SCRATCH COAT
600 PRE-INSPECTION 601 ROOF TEAR OFF
602 ROOF PLYWOOD NAIL 603 ROOF BATTENS
604 ROOF IN-PROGRESS 605 FINAL REROOF
REROOF PERMIT APPLICATION �2�
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION /-6D
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 \�
(408)777-3228• FAX(408)777-3333•buildin cu ertino.or \
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PROTECT ADDRESS APN#9971=1-I
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❑ OWNER ❑OWNER-BUILDER ❑ OWNERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAM LICENSE NUMBER N LICENSETYP BUS.LIC.#
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COMPANY INAME E-MAIL ^ FAX10
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STREET ADDRESS 4 D Je ' C r #/e CITY, .TE ZIP PHONE
ARCHITECrTNGINEERNANIE, LIC ENSENUMB (ER �( 7 ifV BUS.LIC.# !'
COMPANY NAME E-MAIL FAX
STREET-ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or DuplexEqLllti-Family ROOF AREA: VALUATiO • ^�
STRUCTURE: ❑ Commercial
EXISTrNG ROOF TYPE: u' BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE 1�.1.,YES IF N0, 11 PLYWOOD -w ❑ PLYWD ❑ OSB PITCH: ROOF
11d'IQO #LAYERS: l THICKNESS: ❑ 5/8" TYPE: ❑ CDX . / 12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ;-1!5THER 159 AAA, ICC-ES REPORT#
DESCRIPTION OF WORK: J
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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 o comply with all applicable local
ordinances and state laws relating to builon tru tion. I authorize representatives of Cupertino tc enter the above- entified property for inspection purposes.
Signature of Applicant/Agent: Date: a
SUPPLEMENTAL ORMATION REQUIRED
_Ifbuilding is associated with a Home Owner's Association,provide letter PLArrcl�cxPE •: #�ouTZlysrtP
of approval from HOA. Q IVERLHE ❑ Bus>Duy PLALYREVII R
Provide Planning approval to verify if there any restrictions. Q T XPREss = ❑ pLpNZ(pI�pLANREVIEW
Provide copy of Manufacturer's Installation Specifications. TT
s�alvDAxD _4 f s CQ i�LRri nET �, y
_Provide signed copy of Cupertino's Tear-Off Policy.
ReroofApp_2011.doc 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.
CUPERTINO
(408)777-3228 FAX(408)777-3333•buildinq@cupertino.org
APN#
PROJECTADDRESS Or
OVINER NAME '}- PHONE V 50- .015.015
CITY, ST r. / FAX
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COMPANY NAME t
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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 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.
4. 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.
5. A final inspection and approval shall be obtained from the building inspector when the re-roofmag is
completed. To receive a final sign-off,the following items will be verified:
a. Flat roofs shall have a minimum of 1/4"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.
6. 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 d t ors are required to be installed in accordance with 7S7-L
nd 8315 of
the 2010 California Residential Code.Signature of Applicant/Agent: Date:
ReroofPoli 2011.doc revised 0.2/16/11
�J
01 (,0
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
MDDRESS: rosewood/maplewood Dave_;—.;, DATE: 05/11/2011 REVIEWED BY: bobs.
PN: BP#: "VALUATION: 1$8,232
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Building is PENTAMATION 1 R2ROOF
USE: 1 >3 Stories 0 Yes E) No PERMIT TYPE:
WORK overlay existing roof with polyurethane foam.
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFMRES 2,352
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 09-051 E -1.-10) FEE QTY/FEE MISC ITEMS
Permit Fee: $312.00
Fee
Work Without Permit? 0 Yes E) No $0.00
F�
Strong-Motion Fee: 1BSEISMICR $0.82 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS': 1 $313.82 $0.00 TOTAL FEE: $313.82
Revised: 04/29/2011