11050055 CITY OF CUPERTINO BUILDING PERMNTRooF1NG PERMIT NO:11050055
CONTRACTOR.FOUR SE DATE ISSUED:05/10/2011
BUILDING ADDRESS: 10982 NORTHSEAL SQ PO BOX 1668
PHONE NO:(408)278-0330
OWNER'S NAME: JOHN HSE" SAN JOSE,CA 95109
Ota,NEWS PHONE: 4089738557
ELECT
LICENSED CONTRACTOR'SRESIDENTIAL PLUMB�
DECLARATION BUILDING PERMIT INFO: BLDG COMMERCIAL
Lic.# MUCH REMOVE EXISTING CEMWOOD ROOF,INSTA
LLG
3
License Class
Date JOB DESCRIPTION:RE-ROOF
t
Contractor provisions of Chapter 9 30LB
I hereby rrm that I am licensed under the p FELT UNDERLAYMENT&GAF GRAND CANYON ASPHALT
Section-7000)of Division 3 of the Business&Professions
commen once and effect. SHINGLES OVER EXISTING SUBSTRATE.COLOR STONEWOO
Code and that my license is in full f
I hereby affirm under penalty of perjury one of the following two declarations:
self-insure for
consent to
I have and will maintain a certificatSeeo�on 3700 of the Labor Code,for
Compensation,as provided for by
performance of the work for which this peation Insurance,as Prrmit is issued. ovided for by Valuation:$4400
I have and will maintain Worker's Comp performance of the work for which this Sq.Ft Floor Area:
Section 3700 of the Labor Code,for the p Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
ation is APN Number:31640034.00
that I have read this application and state tordinaneat the s anve d state laws relating
certify with all city and county
correct.I agree to comply purposes- (We)agree to save PENT EXPIRES IF WORK IS NOT STARTE
authorize representatives of this city to enter
to building construction,and opetyfor inspection purp judgments, IT ISSUANCE OR
upon the above mentioned property of Cupertino against liabilities, 180 DAYS OF PERM
N.
indemnify and keep harmless the City WITHIN
accrue against said City in consequence of the y5 FROM AST CALLED INSPECTIO
costs,and expenses which may y )-cant understands and will comply 180 D )
granting of this permit. Additionally,the app /O •� /
with all non-point source regulations_Cupertino Municipal Code,Section - Date:
9.18. -� ��t7`�� Issued by
/- Date
Signature <
--BUILDER DECLARATION RE-ROOFS:
ER_ b
C inspected prior to any roofing material berg installed.If a roof is
All roofs shall be insp an inspection,I agree to remove all new materials for
affirm that I am exempt from the Contractor's License Law for one of
1 hereby nsation, installed without first obtaining
the following two reasons: employees with wages as their sole compe inspection.
1,as owner of the property,or my Date:
will do the work,and the structure is not intended or offered for sale(Sec.7044, Si n ure of Applies✓ -- _/
Business&Professions Codam exclusively contracting with licensed contractors to __ "A"OR BETTER
1,as owner of the property, &Professions Code)
ALL ROOF COVERINGS TO BE CLASS
construct the project(Sec.7044,Business .
of perjury one o
I hereby affirm under penalty y f the following three P J HAZARDOUS MATERIALS DISCLOSURQ 6.95 of the
declarations:
Section 3700 of the Labor Code,for the Code,Sections 25505,25533,and 25534. I will maintain
I have read the hazardous materials requirements under Chap
I have and will maintain a Certificate of Consent to self-insure for Worker's ter 9.12 and the Health&
Compensation,as provided for by it is issued. California Health&Safety
Chap
provided for by compliance with the Cupertino Municipal Code,
performance of the work for which this pensation Insurance,as p comp should I store or handle hazardous material.
Safety Code,Section 25532(a)
I have and will maintain Worker's Comp erformance of the work for which this equipment or devices which Maag Management District
i trict I will
Additionally,should I use eq he Bay Area Air Quality Chapter 9.12 and the
Section 3700 of the Labor Code,for the p defined by Cupertino Municipal Code,
permit is issued. permit is issued,I shall contaminants ai'a ice with the Cup
erformance of the work for which this p maintain comp 25505,25533,and 25534.
I certify that in the p I Health&Saf�y-
erson in any manner so as to become subject to the Worker's
not employ any P this certificate of exemption,r Code,I must �' � <
Compensation laws of California. If,after making
of the Labor caner or authorized agent: Date.
become subject to the Worker's Compensation provision
1 with such provisions or this permit shall be deemed revoked.
forthwith comply __—_--
CONSTRUCTION LENDING AGENCYe ffo�ance of work's
APPLICANT CERTIFICATION I hereby
affirm that there is a construction lending agency for the p
that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
I certify 1 with all city arrd county ordinances and state laws relating
correct.I agree to comp Y authorize representatives of this city to enter Lender's Name
to building construction,and herebyfor inspection purposes.(We)agree to save
of Cupertino against liabilities,judgments,
upon the above mentioned propertyuence of the Lender's Address
indemnify and keep harmless the Cityin conseq TION
co qnd expenses which may accrue against said City
y )-cant undersands and will comply ARCHITECT'S DECLARA
g ;of this permit.Additionally,t er the Cupertino Municipal Code,Section Tans shall be used as public records.
win..,.d non-point source regulations P I understand my p
9.18.
Date_ Licensed Professional
Signature
REROOF PERMIT APPLICATION
L2 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)777-3228 • FAX(408)777-3333 • building(Dcupertino.ong
CUPERTINO
PROJECT ADDRESS O C) HOAPN# C)
.
OWNER NAME ` J PHONE E-MAIL V
� 7 3- ss7
STREET.ADDRESS y CITY, STATE,ZIP FAX
APPLICANT NAME PHONE E-MAIL� �z�.t�
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STREET.ADDRESS f I ` CITY,STATE �JL ' C...!/ FA
SD Z pkv
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ONTRACTOR 11CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBERLICENSE TYPE BUS.LIC #
dn Cj�.Z cre 7 1 O
COMPANY NAME ^ E-MAIL Fp G —7 Q-0
cw r Se.;-. r�OcD O O
STREET ADDRESSCI ,STATE ZIP PHONE
Sb Z �aT ru n T. L C `l // 2 (_ o6).27 .356
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET.ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Dup1eXMulti Family ROOF AREA VALUATION:
STR CTUR-E ❑ Commercial IYAXGo
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES �,'<TI'[-!ER(SPECIFY) 0762/45)V
REMOVE/REPLACE > YtS IF NO, PLYWOOD ❑ '/" ❑ PLYWD ❑ OSB !
7��
C ^C ROOF
13 NO #LAYERS THICKNESS: ❑ 5/8" TYPE: ❑ DX CLASS: A
ICC-ES REPORT#
PROPOSED ROOF TYPE ❑BUILT-UP ROOF HALT SHINGLES ❑WOOD SHAKES 11WOOD SHINGLES ❑OTHER
DESCRIPTION OF WORK.
S for: S +z- ^eL. In4 ,-<1 l �-
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 b ding nstruc ion. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanvAgent-. Date:
SUPPLEMENTAL INFORMATION REQUIRED
�s'n'` OFFICE IJSExONLY` y '
_ If building is associated with a Home Owner's Association,provide letter PLAN CxEGIc TYPE ROUTING SLIP
of approval from HOA. ❑` OVERTHE-COUNTF ❑ BUILDINGPLANREVIEW
_Provide Planning approval t0 verify if there any restrictions. ❑ EXPRESS ❑" PLANNING PLAN REVIEW
Provide copy of,vianufacturer's Installation Specifications. ❑ STANIDARD ❑'FIRE nE>rI
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroofApp_2011.doc revised 03/02%11
r 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 • building(a7cupertino.org
PROJECT ADDRESS ( h C �� J e� a APN#
OWNER NAME ,w 2, ��t - jt PHONE 73
J ST� _
EMAIL
STREET ADDRESS 1"` 1` 1h CITY, STATE,ZIP FAX
CONTRACTOR NAME LICENSE NUMBER (/� 03
O p LICENS TYPE BUS.LIC.#
7 ` O
COMPANY NAME h
E-MAIL
\ ��J /,?'d_Z33
STREET ADDRESS CITY,STATE,ZIP �. PHONE
41& -�`� e,K 279
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-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 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 detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code. ��t'�
Signature of Applicant/Agent: Date:
RerooJPolicy_2011.doc revised 02/16/11
ye�
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: "VALUATION: 1$4,400
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex 2nd Unit? 0 Yes ' No PENTAMATION 1 R3SFDREM
USE: I OTC. 0 Yes GNo PERMIT TYPE:
WORK remove existing cemwood roof, install 30 Ib. felt underla ment and GAF Grand Canyon Asphalt
SCOPE shingles over existing substrate. Color Stonewood
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
R-3(Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00
i — I -
TOTALS: 0 $0.00 $0.00
MECH,HOURLY C) Yes (F) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY 0 Yes Q No
Lj
NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept-for addn'l info.
FEE ITEMS (free Resolution 09-05I F;ff. ? .-"10) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1,400 s.£ Re-roof
Suppl.PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 $182.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee-0 Reg. 0 OT 0.0 hs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Acoustical Fee: 0 Yes (F) No $0.00 0
Work Without Permit? 0 Yes (D No $0.00 0
Planning Fee: $0.00 Select a Non-Residential E)
Building or Structure 0
Strong, Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $1.50 $182.00 TOTAL FEE: $183.50
Revised: 04/29/2011