11010081CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20875 VALLEY GREEN DR CONTRACTOR: NEMMER ROOFING
OWNER'S NAME: KORET FOUNDATION
C - -'ER'S PHONE: 4082530200
LICENSED CONTRACTOR'S DECLARATION
,icense Class Lic. # !
Date
'.ontractor
hereby affirm that I am licensed under t e provisions of Chapter 9
commencing with Section 7000) of Division 3 of the Business & Professions
"ode and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
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
merformance of the work for which this permit is issued.
[ 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 abovAn/foZtion 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 alAnon-* source re 1 .per the Cupertino Municipal Code, Section
9.18. SignatDate
OWNER -BUILDER DECLARATION
5348 AUDUBON PARK CT
PERMIT NO: 11010081
DATE ISSUED: 01/13/2011
FREMONT, CA 94538 I PHONE NO: (510) 919-2930
BUILDING PERMIT INFO: BLDG F ELECT i PLUMB r
MECH r— RESIDENTIAL F COMMERCIAL r
JOB DESCRIPTION: BLDG 692 -CARPORTS 3,4,7 & 8 -ROOF TEAR OFF TAR &
GRAVEL & INSTALL SAME REPAIR ANY DRYROT INSTALL
RED ROSIN, BASE & 2 -PLY TOP WITH GRAVEL CARPORTS
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.
Sq. Ft Floor Area:
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,
ts, and expenses which may accrue against said City in consequence of the
sting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
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:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspec ion, I agree to remove all new materials for
inspection.
Signature of ApplixtDate:
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 255059 25533, and 25534.
Own authorize te
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.
4Z; n hi P Date I Licensed Professional
CITY OF CUPERTINO
1VU V IV QTIX4 A TnR — RI IIT .DING DIVISION
FEE ID ROOF AREA
(S.L)
1REROOFMRES 13,400
JL' _z.:j JUJ JL
ADDRESS: 20875 valley green dr #692
DATE: 01/13/2011
REVIEWED BY: bobs.
1j
APN:
BP#:
*VALUATION:
[$44,840
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY
USE: Multi -Family Dwelling
Buildina is
>3 Stories 0 Yes E) No
PENTAMATION 1R2R00F
I PERMIT TYPE:
WORK
4 arport roof tear offs onlV, tar and gravel, class A, 143 squares
SCOPE
I
FEE ID ROOF AREA
(S.L)
1REROOFMRES 13,400
Ala and are onh, an estimate. Contact the Dept for addnl into.
NOTE: These /ees are based on the pretirrurtaryto orma
FEE ITEMS (Fee Resoltition 09-051 Eff. 7111101
Wcdi. Plan 'ha, k
QTY/FEE
- — -
MISC ITEMS
Pcrmif
Ph"t?"t). Pconit Fcc
Po mi[ VA:'
olhur'lfcvk,
Pfuinlj frup.
Mcch, My, F"'C"
Plan ( `heck:
Ala and are onh, an estimate. Contact the Dept for addnl into.
NOTE: These /ees are based on the pretirrurtaryto orma
FEE ITEMS (Fee Resoltition 09-051 Eff. 7111101
ton -vat
FEE
QTY/FEE
- — -
MISC ITEMS
Plun Che,,.,, Fe'
T A
supp/. PC 11-cle
Plan ( `heck:
Permit Fee:
$1,742.00
S11pp/' Insp Fee
I
ph fild), it FCC:
Pcrinit Fcc:
_/ '
Con.,�Iructioii Tcn
77
Work Without Permit? 0 Yes E) No
$0.00
71-ovel
Strong Motion Fee: IBSEISMCR
$4.48
Select an Administrative Item
Bldy, Stds Commission Fee: IBCBSC
$2.00
SUBTOTALS:FEE:
$1,748.481
$0.00TOTALEE:
1
$1,748.48
Revised: 01/03/2011
CITY OF CUPERTINO
3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 32609064.CARPRTS
DATE ISSUED.......: 01/13/2011
RECEIPT #......... BS000012480
REFERENCE ID # ...: 11010081
SITE ADDRESS 20875 VALLEY GREEN DR
SUBDIVISION ......
CITY CUPERTINO
IMPACT AREA ......
OWNER KORET FOUNDATION
ADDRESS ..........: 20875 VALLEY GREEN DR
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
RECEIVED FROM ....: LINDA M NEMMER
CONTRACTOR .......: RONALD F. NEMMER LIC # 31890
COMPANY ..........: NEMMER ROOFING
ADDRESS ..........: 5348 AUDUBON PARK CT
CITY/STATE/ZIP ...: FREMONT, CA 94538
TELEPHONE ........: (510) 919-2930
FEE ID UNIT QUANTITY
AMOUNT PD -TO
------
-DT THIS REC NEW
BAL
-------------------------------------------
1BCBSC VALUATION 44,840.00
2.00
0.00 2.00
0.00
1BSEISMICR VALUATION 44,840.00
4.48
0.00 4.48
0.00
1REROOFRES SQ FEET 134.00
1742.00
----------
0.00 1742.00 ------0_00
----------
TOTAL PERMIT
----------
1748.48
0.00 1748.48
0.00
METHOD OF PAYMENT AMOUNT
REFERENCE
-------------
NUMBER
----------------- ---------------
CREDIT CARD 3,613.96
MC
---------------
TOTAL RECEIPT 3,613.96
VOICE ID DESCRIPTION
VOICE ID
-------
DESCRIPTION
-------- ----------------------------
309 EXTERIOR LATH
311
SCRATCH COAT
600 PRE -INSPECTION
601
ROOF TEAR OFF
602 ROOF PLYWOOD NAIL
603
ROOF BATTENS
604 ROOF IN -PROGRESS
605
FINAL REROOF
CUPERTINO
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - building
laDcugertino.org
PROJECT ADDRESS
�v
APN #T
OWNER NAME � >re � � J O
PHO
� 0
E -M AIL
STREET ADDRESS O �o \ r �v�
CI Y, STATE, ZIP
elt -r%piNy 6A
CONTR OR NAME
o n lie rn
LICENSE 14 3
LICENS T
BUS. LIC. #
COMPANY NAME
E-MAIL
r 0(D YY rAtor C� ahcv,�o�►,f5io
FAX
-573-14-736
STREETADj1RF$S, t� Iv/ D� DR
�vv
CITY, STATE
o4
PHONE/l/O -3'9- Xi30
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I . 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 1/4" 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 beh I under d agree to comply with the re -roof policy stated above.
Signature of Applicant/Agent: Date:
ReroofPolicy_2010.doc revised 05/17/10
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION
!j c>/ U vs /
! , /� r Date:
APN # � � cJ
If residential, is house KanEic:hLler? Yes No [� If yes, needs planning approval
Building Address:
Owner's Name:
HOA: Yes
Contractor:
Ore
No rl
Phone '
V0J r, to (--- -
If ves, provide letter from HOA
N` -e C-7 \ �
Cupertino Business License #:
Existing:
W- Built -Up Roof
❑ Asphalt Shingles
❑ Wood Shakes
❑ Wood Shingles
❑ Other (Specify)
Number of existing coverings
❑ To be Removed
Type of Roof Covering:
Phone #: Jr/o — 9/ 9- a9�3C)
Fax#: 510 — 5 7.3_ 14736
Contractor License #:
Proposed:
Built -Up roof
❑ Asphalt Shingles
❑ Wood Shakes
❑ Wood Shingles
❑ Other (Specify)
❑ Provide I.C.C.E.S. Report #
❑ Provide Mfgr. Installation Specs.
Job Description: a r c-�,"d c; ncK-4-e at c�
Residential
Green Building: Please complete relevant portion of the
Green Building Checklist & attach it to the application or if
applicable, include in plan set & the sheet index.
Valuation:�--
;ial ❑ % :j L1
Confirmed with Planning Dept. if
there are any restrictions: ❑
i Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: