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10090033CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20791 GREENLEAF DR OWNER'S NAME: PETER PARK NER'S PHONE: 4087715113 ❑ LICENSED CONTRACTOR'S DECLARATION License Class C - l Lie. # $ 003 7� Contractor Date 7 r' 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 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 all non -point source re lations per the Cupertino Municipal Code, Section 9.18. Signature Date (ONTRACTOR: KEVIN SULLIVAN F OOFING PERMIT NO: 10090033 1696 VALLEY OAKS DR DATE ISSUED: 09/07/2010 (:ILROY, CA 95020 PHONE NO: (408)842-1057 BUILDING PERMIT INFO: BLDG r ELECT PLUMB MECH i RESIDENTIAL r COMMERCIAL IOB DESCRIPTION: RE -ROOF 28 SQUARES REMOVE EXISTING SHAKE ROOF, ,EPLACE WITH 7/16 OSB 330 FELT AND LIFETIME COMP LASS Sq. Ft Floor Area: Valuation: $9000 APN Number: 32609003.00 Occupancy Type: 3 OWNER -BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Law for one of he following two reasons: , as owner of the property, or my employees with wages as their sole compensation, vill do the work, and the stricture is not intended or offered for sale (Sec.7044, lusiness & Professions Code) , as owner of the property, am exclusively contracting with licensed contractors to =strict 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 mu :t 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 ^nn the above mentioned property for inspection purposes. (We) agree to save unify and keep harmless the City of Cupertino against liabilities, judgments, . .,s, 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 regulations per the Cupertino Municipal Code, Section 9.18. Signature Date PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 1801 AYS FRO AST CALLED INSPECTION. [ssued b ! +� r/ D Date: 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 Applicant: 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, Sections 25505, 25533, and 25534. Owne t d a iU ate: 4' 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 2' 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: r�QGtqBUSINESS MIT # b = 5 3 ® NE # OWNER'S NAME: I a��C �v LICENSI�E__# C� �� GENERAL CONTRACTOR: �ZD Y/ZIPCODE: C ADDRESS: G �i � ici al code requires all businesses working in the city to have a City of Cuper�HEDULEDlicense THE Our municipal WILL BE S NO BUILDING FINAL OR FINAL OCCUPAONNT �C PERS IHAVE OBTAINED A CITY OF CUPERTINO GENERAL CONTRACTOR AND A / BUSINESS LICENSE. -'" ate I am not using any subcontractors: Signature r-nlx&7;na information: Please check applicable subcontractors and compl �L $VSUBCONTRACTORBUSINE nets & Millwork ent Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating lnsulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date Owner / Contractor Signature REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPAFTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BU LDING OFFICIAL CUPERTINO 10300 TORRE AVENUE • CUPERTINC, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building) Dcupertino.org PROJECT ADDRESS a MQ f/�� / J� ` APN # OWNER NAME C.r / I // PHOJE 7 / �7 I ^ C %/ 2 ( E-MAIL STREET ADDRESS / l t/�w CITY,_S( ATE, ZIP' / O �J� �/'�� r / I FAX CONTRACTO ME f �� LICENSE N B: R��C/�� LICENSE gt C_._ J BUS. LIG # COMPANY E //n"V, h w/ / �� E-MAIL FAX STREET ADDRESS(`(L� I 011l� / S / J CITY, ST 'TE, ZIP (_! ` //' Cj CVO PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applica )le 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. ?5% 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 dow i to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtainec from the building inspector when the re -roofing is complete. To receive a final sign -off, the follow ng items will be verified: a. Flat roofs shall have a minimum of/4" per f )ot of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for ill pre -manufactured products used shall be available on-site to review at the time of the inspectio i. c. Proper spark arrestor installation. 8. NOTE: If you call for a tear -off or plywood nai ing inspection and the work is not complete, you will be charged a re -inspection fee of $126.00. The r, --inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify eac f the following is true: I am the property owner or authorized agent to act on the property owner's behal . der ;p_ce} ly with the re -roof policy sttaated bov . Signature of Applicant/Agent: Date: -/ ReroofPolicy_2010.doc revised 05/17/10 7 CITY OF CUPERTINO FEE ESTIMATOR-13UILDING DIVISION ;ADDR7ES7S:20791 Greenleaf Drive DATE: 09107/2010 REVIEWED BY: Larry S BP#: *VALUATION: $9,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair �� tl JPENTFA�MATION 1SFDWLROOF PRIMARY SFD or Duplex RMT TYPE: USE: t�1,C)t}� .�ilt �_ �: WORK 28 s .reroof. remove shakes re lac�with 7/16 osb #30 Ib felt, lifetime comp 50 Year. SCOPE NOTE: These fees are based on the preliminary in FEE ITEMS (Fee Resolution 09-05I Eff 7i1/101 Plan Check Fee: Suppl. PC Fee: (F)Reg. 0 OT 0.0 hrs PME Plan Check: Permit Fee: Suppl. Insp. Feer Reg. 0 OT 0.0 hrs PME Unit Fee: PME Permit Fee: C. c)ltS177IC`L7�)i7 /'ax Acoustical Fee: 0 Yes 0 No Work Without Permit? 0 Yes E) No Planning Fee: TrcrWl i?o(?r,r,1crzfFr1c,rt `cc's_ tion available and are on1v an estimate. Contact the Dept -for addn'l FEE QTY/FEE MISC ITEMS $().0o 2,800 s.f. Re -roof so.0o $364.00 1REROOFRES $1).00 $1).00 $,).00 $ ).00 $ ).00 $ 0.00 Q 10.00 g 0.00 Select a Non -Residential Building or Structure Q Strong Motion Fee: 1BSEISMICR :i0.90 Bldv- Stds Commission Fee: 1BCBSC :61.00 SUBTOTALS: ; 51.90 Select an Administrative Item $364.00T - TOTAL FEE: I $365.90 Revised: 9/01/2010 CITY OF LQ CUPERTINO CITY OF C UPERTINO RER OOF PERMIT APPLICATION f APN # Date: 7 /p Building Addre��q / Owner's Name: "j 7�) fejetz dcHOA: Phone #: Yes ❑ No ❑ If yes, provide letter from HOA Phone #: �FU,Y_5 y2- �G s Contractor: � 007 Fax #: Cupertino Business License #: Contract�r�L�icense #: Type of Roof Covering: Existing: ❑ Built -Up Roof Proposed: ❑ 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: S �a e �30 14 /1/',s shake �emvvC e.XoSl,.�a i Ck00t Residential Commercial Green Building: Please complete relevant portion of the Confirmed 3A ith Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: applicable, include in plan set & the sheet ind.-.x. Valuation: A t C�oc) �— I Have Re , U derstand and Will Comply with Cupertino's Tear -Off Policy: Signature Revised 02/05/09