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11050082CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20875 VALLEY GREEN DR I CONTRACTOR: NEMMER ROOFING I PERMIT NO: 11050082 OWNER'S NAME: KORET FOUNDATION 15348 AUDUBON PARK CT I DATE ISSUED: 05/12/2011 I OWNER'S PHONE: 6505923960 LICENSED CONTRACTOR'S DECLARATION License Classy _ Li�c. 4 2 79 Contractor / " y"'tl ��' -�I Date S —//—// I hereby affirm that I 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 m ormation 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 re,ulqlions per the Cupertino Municipal Code, Section 9.18. SignaturX� OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ;, and expenses which may accrue against said City in consequence of the .ting 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 FREMONT, CA 94538 PHONE NO: (510) 919-2930 r— f— F_ BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH RESIDENTIAL COMMERCIAL JOB DESCRIPTION: BLDG 400-415 CARPORTS 1,2,3,4 RE -ROOF TEAR OFF EXISTING T+9 ROOF, FIX AND DRYROT Sq. Ft Floor Area: Valuation: $17000 APN Number: 32609064.CARPRTS Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued 4p, ". `..' _. . Date: f--ez--/ / RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applican s`!Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sectio* 25505, 25,5A$�%nd 25534. Owner or authorized agent/— Date 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 CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.00rnrg a/ PROJECT ADDRESS -2 0 APN # C� v/ v ( r �%[ OWNER NAME v ,^C- �C�iG °Yom► ! 6 �l .59 — 3,)6 " EMAIL STREET ADDRESS/ CITY�/ST� , IF FAX MTZ �zr %a 5Zi ctl ' APPLI E-MAIL STREET ADDRESS TATE, ZIP FAX s� ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR 4 LICENSE TYPE BUS. LIC. # rLICENSE, / 1 s COMPANY NAME E-MAIL FAX STREET ADDRESS/ cy-� • � 4' CI Iy,,STATE, ZIP �� �� y 6 P ) 9 1'9 f9 --2,2S6(vb 7 ARCI-=CT/ENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplex ulti-Family ROOF AREA: e VALUATION: S5 STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: ABUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE RLYES IF N0, PLYWOOD ❑ 'f,"❑ PLYWD ❑ OSB PITCH: :12 ROOF A ❑ NO # LAYERS: THICKNESS El is., TYPE: ❑ CDX CLASS: PROPOSED ROOF TYPE: �. un T -UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WO �J -` SCJ u` 4%t—� c 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 ha rovided is orr . 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 ilding c " tion. I authorize representatives of Cupertino tc enter the above -identified pro/pe t, for inspection purposes. Date: Signature of Applicant/Agent: SUPPLEMENTAL INFORMATION REQUIRED If building is associated with a Home Owner's Association, provide letter PSN 0MIWTYPE z �0UTI1NG SLTP ' 'B--L>vFiir cpa;t Svc PirANxEw _ of approval from HOA. .�� Ufa - - _ Provide Planning approval to verify if there any restrictions. ❑Ssy ❑ p� P�, _ Provide copy of Manufacturer's Installation Specifications. s VL'� i.. ms's£ , 0TnlvDn t t +—¢-- - - - ❑ FIATDI±ET = rovide 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 (408) 777-3228 - FAX (408) 777-3333 - building�Scupertino.org PROJECT ADDRESS / �-� N . >—oV7 S 7- L, lvJ - AFN # OWNER NAME BSC/ &MAIL' STREET ADDRESS STA ZIP QZ ' ©� FAX CO R4TOR NAME LdCEUS�ERLlff E TSP BUS. LIC. # COMPANY NAME E-MAIL. FAX /� 5 ADDRESS J C'T C�TATE. ZIP LZ 9yS3s- PHONE 3 s j a 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 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. 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 e required to be installed in accordance with Sections R314 and R315 of the 2010 California Residenti ode. / G Signature of Applicant/Agent: !G — Date c0 �/ — `% lter00J1'011cy_ZU11.aOC reviser! Ul/16/11 W-W CITY OF CUPERTINO ZRi`5_FEE ESTIMATOR - ]BUILDING DIVISION FEE ID ROOF AREA s.f. 1REROOFMRES 5,500 Ivul E: ( hese fees are based on the preliminary in ormation available and are only an estimate. Contact the Dept for addn 7 info. FEE ITEMS L�'ee Resolution 09-051 l f: 1.,%10) FEE QTY/FEE MISC ITEMS Permit Fee: $715.00 Work Without Permit? 0 Yes E) No $0.00 i Strom Motion Fee: IBSEISMICR $1.70 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $717.70 $0.00 TOTAL FEET $717.70 Revised: 04/29/2011 ADDRESS. -29f52 -Val ley green dr. bldg 400 DATE: 05/12/2011 APN: BP#: REVIEWED BY: bobs. "VALUATION: 1$17,000 y PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY Multi -Family Dwelling USE: Building is TENTAMATION >3 Stories Q Yes Q NoERMIT 1R2ROOF TYPE: WORK tear off t & q roof replace with 3 ply built up roofs stem carport 1,2,3/4 onl . SCOPE FEE ID ROOF AREA s.f. 1REROOFMRES 5,500 Ivul E: ( hese fees are based on the preliminary in ormation available and are only an estimate. Contact the Dept for addn 7 info. FEE ITEMS L�'ee Resolution 09-051 l f: 1.,%10) FEE QTY/FEE MISC ITEMS Permit Fee: $715.00 Work Without Permit? 0 Yes E) No $0.00 i Strom Motion Fee: IBSEISMICR $1.70 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $717.70 $0.00 TOTAL FEET $717.70 Revised: 04/29/2011 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 32609064.CARPRTS DATE ISSUED.......: 05/12/2011 RECEIPT #.........: BS000013436 REFERENCE ID # ...: 11050082 SITE ADDRESS .....: 20875 VALLEY GREEN DR SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER*'*''****'** KORET FOUNDATION ADDRESS 20875 VALLEY GREEN DR CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: NEMMER ROOFING CONTRACTOR .......: RONALD F. NEMMER LIC # 31890 COMPANY ..........: NEMMER ROOFING ADDRESS ..........: 5348 AUDUBON PARK CT CITY/STATE/ZIP ...: FREMONT, CA 94538 TELEPHONE ........: (510) 919-2930 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC -------------------- NEW BAL ----------------------- 1BCBSC VALUATION ---------- 17,000.00 ---------- 1.00 ---------- 0.00 1.00 0.00 1BSEISMICR VALUATION 17,000.00 1.70 0.00 1.70 0.00 1REROOFRES SQ FEET 55.00 715.00 0.00 715.00 0.00 ---------- TOTAL PERMIT ---------- 717.70 ---------- 0.00 ---------- 717.70 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 717.70 --------------- 717.70 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 600 PRE -INSPECTION 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS REFERENCE NUMBER -------------------- 2539 VOICE ID DESCRIPTION -------- ---------------------------- 311 SCRATCH COAT 601 ROOF TEAR OFF 603 ROOF BATTENS 605 FINAL REROOF CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 2_ a 2 �� , ,1 !` PERMIT # r7 So e� OWNER'S NAME: 4."r _7��w-n PHONE #-,5., j - 3 D GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS:5`3 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 SUBCONT CTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: 5--11 -1 Date Owner / Contractor Signature Date 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 Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date