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11010080CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20875 VALLEY GREEN DR CONTRACTOR: NEMMER ROOFING OWNER'S NAME: KORET FOUNDATION V"NER'S PHONE: 4082530200 D LICENSED CONTRACTOR'S DECLARATION y License Class ( Lic. # 7 / q 3 f Contractors ate �'3 —! 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 w'c this permit is issued. 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 ffl 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, applicant understands and will comply with all non -poi source regul i the Cupertino Municipal Code, Section 9.18. Signature OWNER -BUILDER DECLARATION 5348 AUDUBON PARK CT FREMONT, CA 94538 PERMIT NO: 11010080 DATE ISSUED: 01/13/2011 PHONE NO: (510) 919-2930 BUILDING PERMIT INFO: BLDG [_ ELECT r PLUMB r MECH [_ RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: BLDG 706 -CARPORT 1,2,5 & 6 - RE -ROOF TEAR OFF TAR & GRAVEL & INSTALL SAME REPLACE ANY DRYROT. INSTALL RED ROSIN, BASESHEET & 2 PLYS AND GRAVEL [ hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: [, 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, +.s, and expenses which may accrue against said City in consequence of the .rating 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_ Sq. Ft Floor Area: Valuation: $44840 APN Number: 32609064.CARPRTS I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b Date_ 1-3'Itl 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. `r -,/3 l� Signature of Applicant:4�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, Se 5505, 25533, and 25534. Ow r author' f �% 3 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Date I Licensed Professional REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building(�i_)cupertino.org PROJECT ADDRESS ifv ,jo,„ ree►� J T(-,,qe �i APN# OWNER NAME PHONE - ..- ^„ E-MAIL STREET ADDRESS c..7�.� ` I la`� V� 11, STATE ZIP �2 FAX CONTRACTOR NAME�On .� `-e1 mro Q r LICENSE N�JAjB J_qT LICE^ SEXY `� Z-7 BUS. LIC. # COMPANY NAME e� �• Ike ,m E-MAIL ,-, rnmer 0 ahao�ca FAQ �)0 5�3--1-fG73�+1�o $,. 1 STREET ADDRES ✓ �V I(I G1ii l CITY re`rY` IP CA 1 ��� PHONE - /G% - ; / 3 o I UNDERSTAND AND AGREE TO THE FOLLOWING: The re -roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon -Fri). 3. Tear -off roof inspection is required. Please call for tear -off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry -rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00 — 3:30pm (Mon — Thurs); 7:30 — 10:30am and 1:00 — 2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In -Progress roof inspection is required. Call for an in -progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained from the building inspector when the re -roofing is complete. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of per foot of slope and must 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. 8. 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 be I unders agree to comply with the re -roof policy stated above. Signature of Applicant/Agen Date: ReroofPolicy_201 0. doc revised 05/17/10 CITY OF CUPERTINO -viv>c >cCT7M A TFnI] — RTTTT ,n"INC nIVIRInN FEE ID ROOF AREA s.f. 1REROOFMRES 14,300 ADDRESS: 20875 valley green dr #706 DATE: 01/13/2011 REVIEWED BY: bobs. APN: I BP#: "VALUATION: $44,840 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY USE: Multi -Family Dwelling __T>3 Buildina is Stories ® Yes (F) No PENTAMATION 1 R2ROOF PERMIT TYPE: WORK 4car ort roof tear offs only, tar and gravel, class A 143 squares SCOPE Phold). Iil"h. FEE ID ROOF AREA s.f. 1REROOFMRES 14,300 a ii ..,i _ —i., _ n.4-nia /'nntaM /ho Dont far addn'l info. Nui,E: mese fees are ouseu un tree reurrur•u• v 6•• �• FEE ITEMS (Fee Resolution 09-05I E '. 7i1%701 ;I'l,"lt. Plan Chcrk Phnttl�>. 1'lun ('iret'!, � Eie,'. l'iart C`h,( L1c'cr`t. P'r't tit I't'i': ;'1?;ntb. Perin t F 'c : L;lec. Powlii t";, Other. Akch. Insp, P- Uth , 1>icc Irish. Lj a1�rc{t. Imp. Fcc Phold). Iil"h. Mv� , I` "C. a ii ..,i _ —i., _ n.4-nia /'nntaM /ho Dont far addn'l info. Nui,E: mese fees are ouseu un tree reurrur•u• v 6•• �• FEE ITEMS (Fee Resolution 09-05I E '. 7i1%701 •••�••��•• .. FEE - -- QTY/FEE -- MISC ITEMS Plan Check Fee: Sllppl. PC.' Fee PlTllt117.;.1:Ict'It.;'I:'Ic'c; Plan (711c'c:k: Permit Fee: $1,859.00 Snpp/. hisp Fee Plrnnl�. %_11et 1i.'I:lec: t %nit Fee: hltaTil�. ,"��TkCl!✓1�IPC 1"cri71itFcc: (construction 7,ax ri t;O LLSI'lCf t I llt' 1'JE'11` �` F'(': Work Without Permit? ® Yes 0 No $0.00 Plannin), Fees: 7 i-cavel l )ocitlne'ntatitm 1' e'.C.S: Strong Motion Fee: IBSEISMICR $4.48 Select an Administrative Item Bldg, Stds Commission Fee: 1BCBSC $2.00 SUBTOTALS: $1,865.48 $0.00"TOTAL FEE: $1,865.48 Kevisea: uitustzu-i-i CITY OF CUPERTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION /l cel 00�-o APN # 0q - If residential, is house an Eichler? Yes ❑ No N If yes, needs planning approval. Building Address: Z� 9-s_�� ( ���� V r� ��e e,r` � r � v ,5 - � C 1 Owner's Name: nc ,o -V k Phone #: HOA: Yes ❑ No [E If yes, provide letter from HOA Contractor: Phone #: 510 — C) Fax#: Cupertino Business License #: Contractor License #: � y C) Type of Roof Covering: Existing: Proposed: ,s Built -Up Roof --�k Built -Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: f, d 7` � R � Av�� Reside tial ,gym �` S �n l� Commercial ❑ c i, Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: i Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: i 00 f