09120014I CITY OF CUPERTIr 0 BUILDING PERMIT I
BUILDING ADDRESS: 1100 NOVEMBER DR CONTRACTOR: REROOFING & PERMIT NO: 09120014
CONSTRUCTION INC
(""'NER'S NAME: TUTTLE RALPH W AND GRACE C
O v iNER'S PHONE: 4082551140
❑ LICENSED CONTRACTOR'S DECLARATION
�,.cZens
asLic. # TO2- T91
Date l I o
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
1 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,
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 a i -point source regulations per the Cupertino Municipal Code, Section
9.1 c�--, .Z
S i - tore � _— Date
1 Z 2-�U
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1, 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.
C
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
I he above mentioned property for inspection purposes. (We) agree to save
t�,, nify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granti of this permit. Additionally, the applicant understands and will comply
wjtiu all no - 9i regu o_;s;the Cupertino Municipal �o� � Section
9118. f_� " r
Signe r -- ate
15230 CLYDELLE AVE
SAN JOSE, CA 95032
DATE ISSUED: 12/02/2009
PHONE NO: (408)626-9320
BUILDING PERMIT INFO: BLDG I— ELECT F_ PLUMB
MECH I— RESIDENTIAL I— COMMERCIAL f—
JOB DESCRIPTION: RE -ROOF REMOVE EXISTING 1 LAYER OF ROOK,
INSTALL
NEW 1/2"CDX, 30# FELT, & LIGHTWEIGHT TILE CLASS A
28SQ
Sq. Ft Floor Area:
APN Number: 36217022.00
Valuation: $15000
Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 D ;75 -
OM LAST CALLED INSPECTION.
Issued by: / 2'* z *Q � Date:
RE -ROOFS:
AllCtion.
be 'nspected prior to any roofing material being installed. If a roof is
insout tai � an to'
ins I agree to remove all new materials for
ins
Signature ofAppttdant: �- ._� / Date: I 2
lo
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, Sections 25505, 25533, and 25534.
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
011 2_0c�)tq
J CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION
APN # � 2.. 2Z. 6 v
Date: 12-12-101 2-1ZU
1
Building Address: 1 I UU , l (,,/
, /k, M R� `
Owner's Name: .-T -L T R u ��
Il
Phone #:
qoq
HOA: Yes E]No 2 If Yes, provide letter from HOA
Contractor:
Phone #:
vl
Fax #: ( �2(O
Cupertino Business License #: G (�
Contractor License #:
-759 7
Type of Roof Covering:
Existing: Proposed:
❑ Built -Up Roof ❑ Built -Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes L� 6� ,,
❑ Wood Shingles ❑ Wood Shingles i
❑ Other (Specify) X Other (Specify) LI�-
Number of existing coverings ❑ Provide I.C.C.E.S. Report #
J,\To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
Residential Commercial El
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the a pplication or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation: Y' G
15 (
I Have nderstand and Will Com wits. Cupertino's Tear -Off Policy:
Signature
Revised 02/05/09
CITY OF
CUPEkTINO
CITY OF C'UPERTINO
REF:OOF
FEE SCHEDULE
Number of
Squares
Fee ID
Fee Description
Fee
Group
Permit Type
1REROOFCOM
Re -roof Commercial
B
1COMMLROOF
1BCBSC
Cal Bldg Standards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICO
Seismic Commercial
B
1 REROOFRES
Re -roof Re 3idential
B
1SFDWLR00F
{
l
1BCBSC
Cal Bldg Si:andards
Commission Fee
B
ALL PERMIT TYPES
J
1BSEISMICRE
Seismic Residential
B
1 REROOFMRES
Re -roof Multi -Family
B
1MFDWLROOF
1BCBSC
Cal Bldg Si:andards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICRE
Seismic Residential
B
1BUSLIC
Business L:.cense
B
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
Subject: Re -roofing policy for the City of Cupertino
1. Prior to permit issuance, you must agree to comply with 2007 IBC Standards
and manufacturers specifications on re -roofing. All roofs are Class "A" per Cupertino
municipal code 16.04.080.
2. New roof coverings shall not be appL- ed without first obtaining all inspection
and written approval from the buildilg inspector. A final inspection and
approval shall be obtained from the t uilding inspector when the re -roofing
is completed.
3. All roofs shall be inspected prior to a1y roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre -inspection and/or tear off apF roval.
2) In -progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be pe rformed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re -inspection fee of $176.18. The re -inspection fee must
be paid before another inspection czm be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of IV, " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be o:1 the job site at the time on inspection.
I understand and will comply with the aborre stated policy on re -roofing.
Homeowner's Name: AL,�` ' t l' �
Job Site Address:
Roofing Company \ 0 LY_ t
Applicant's Signore: Date:
Greg Casteel
Building Official
Reviled 07/30/08