11030114 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10137 SANTA CLARA AVE CO
NT
��RA
CT
--OR / __ PERMIT NO: 11030114
OWNER'S NAME: KEVIN HUBBARD&ELIZABETH KNIGHT C � �( C5 DATE ISSUED:03/28/2011
OWNER'S PHONE: 4088356966
PHONE NO:
G LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class li� ,.�
Lie.# C 3 L'/ _( C
MECH RESIDENTIAL COMMERCIAL�
Contractor�-lf=�J 0_4AD Date J L2
JOB DESCRIPTION:RE-ROOF REMOVE EXISTING BUILT UP ROOFING,
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions INSTALL
COMPOSITION OVER DOUBLE 30LB FELT.HD COMP.,ALSO
Code and that my license is in full force and effect. INSTALL TORCH DOWN AT FRONT LOWER AREA CLASS A
I hereby affirm under penalty of perjury one of the following two declarations:
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
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:$8600
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:32624021.00 Occupancy Type:
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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulati Per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. f
Si atu'e Date ^—" —1 l Issued by: Date:
Sn
I OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspecti I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code) �
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant;, Date `
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
1 have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
[have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
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.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
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. Own r r,@{U o ze ent: �-
I/Y Date• � � `
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
cr•-' and expenses which may accrue against said City in consequence of the Lender's Address
g of this permit.Additionally,the applicant understands and will comply
wi...dil non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10137 santa Clara ave DATE: 03/28/2011 REVIEWED BY: larry s
APN: BP#: 'EVALUATION: 1$8,600
Y PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex 2nd Unit? Yes • No PENTAMATION 1 R3SFDREM
USE: OTC? 0 Yes (D No PERMIT TYPE:
WORK remove existing built up roofing, install composition over double 30 Ib felt. hd comp. also install torch
SCOPE down at front lower area.
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
TOTALS: 0 $0.00 $0.00
MECH,HOURLY 0 Yes G No PLUMB,HOURLY 0 Yes Q No ELEC,HOURLY Q Yes Q No
77 7177111;;
L4, -----------F", Ll L
NOTE: These ees are based on the preliminary information available and are only an estimate. Contact the De t or addh 7 info.
FEE ITEMS (hf.'ee Resolution O3-OSI E ?/. /O) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 E37fl s.f. Re-roof
Suppl.PC Fee: E) Reg. 0 OT0.0 hrs $0.00 $312.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl.Insp. Fee.e Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Acoustical Fee: 0 Yes (D No $0.00 0
Work Without Permit? 0 Yes G No $0.00 G
Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
Strong Motion Fee: IBSEISMICR $0.86 Select an Administrative Item
BldgStds Commission Fee: IBCBSC $1.00
SUBTOTALS: $1.86 $312.00 TOTAL FEE: $313.86
Revised: 03/01/2011
I ► ' y
REROOF PERMIT APPLICATION
[[—Ed COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
CUP RTINO (408)777-3228- FAX(408)777-3333- building a�cupertino.org
PROJECT ADDRESS �4 �ITT i ,/� APN# '914
C a l
OWNER NAME Hd-6hf e-b PHONE g 35 b R 6 b E77
STREET ADDRESSWC O CITY,ST FAX
aA Vd
CONTACT NAME D ,` ^ PHONE _ E-MAIL-7
-7 STREET ADDRESS u f� CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME �/�`J p y� /�) LICENSE LICE" BUS.LIC.#
COMPANY NAME O d.eA / Cf� --e S �l v �! weFAX Z-b 2- 1,340
STREET ADDRESS�/\/� J� CITY,STATE ZIP A ' 9L503S PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-NPUL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
'SE OF SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
MUCTURE: ❑ Commercial 9 � (�'
EXISTING ROOF TYPE: ABUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE S IF NO. PLYWOOD ❑ 'w, ❑ PLYWD ❑ OSB PITCH: -b� ROOF
# RS: SS: 05/8', ❑ ,•12 CLASS: An
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER IQLW
ICC-ES RE6T#
DESCRIPTION OF WORK: E y j 6 fj) (� �' L,4
4 Cflr1,, r
j� A-
M fro w- We '01 10-eft
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 d the Description of Work and verify it is accurate. I agree to comply With all applicable local
ordinances and state laws relatirig ilding coon�stgntgction. I utho` e representa' es of Cupertino to enter the above-identified roperty for inspection purposes.
Signature of Applicant/Agent: /t/1 U� Date: v
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
_Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32624021. 00
DATE ISSUED. . . . . . . : 03/28/2011
RECEIPT #. . . . . . . . . BS000012998
REFERENCE ID # . . . : 11030114
SITE ADDRESS . . . . . : 10137 SANTA CLARA AVE
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : KEVIN HUBBARD & ELIZABETH KNIG
ADDRESS . . . . . . . . . . : 10135 SANTA CLARA AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : CROSS ROOFING CO
CONTRACTOR TBD - TO BE DETERMINED LIC # 00096
COMPANY TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 8, 600 .00 1. 00 0. 00 1.00 0. 00
1BSEISMICR VALUATION 8, 600 . 00 0 .86 0. 00 0 .86 0.00
1REROOFRES SQ FEET 24 . 00 312 . 00 0.00 312 .00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 313 . 86 0. 00 313 .86 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 313 . 86 #4158
---------------
TOTAL RECEIPT 313 .86
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
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- buildingL'c�cupertino.org
PROTECT ADDRESS C I APN#
OWNER NAME +�t t .\ PHONE �s ` U E-MAIL
STREET ADDRESS V U /A CITY, STATE,ZIP (�` FAX
CONTRACTOR NAME C Q � �� LICENSE NUMBER43 2 /T`, I Cr
LICEII TYKE BUS.LIC.#
COMPANY NAME Fj�� ✓ r1 s E-MAIL (J O + (�` FAX
STREET ADDRESS` G (�G ,I(� CITY,ST TE ZIPJ A,—S / PHONEolt/
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.
F
y signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
rty owner's behalf. I understand and agree to gomply with the re-roof policy stated above. I also understand that
smoke detectors and carbou_monoxide detectors a regi l ed to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential... e. V
Signature of Applicant/Agen': Date: —
RerogJPolicy_2011.doc revised 02/16/11