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10080117 CITY OF CUPERTINO BUILDING PERMIT WILDING ADDRESS: 10422 JUDY AVE CONTRACTOR:MCAULIFFE CONST PERMIT NO: 10080117 )WNER'S NAME: BRAD&PEGGY MEYER 886 TALLMAN CT DATE ISSUED:08/17/2010 'NER'S PHONE: 4082031227 SAN JOSE,CA 95123 PHONE NO:(408)227-0343 LICENSED CONTRACTOR'S DECLARATION BUILDI vG PERMIT INFO: BLDG F ELECT r— PLUMB r ,icense Class 8 Lic.# 4R9.9 MECH I— RESIDENTIAL r COMMERCIAL � r C� �-07� Date 9,I f contractor � JOB DESCRIPTION:RE-ROOF TEAR OFF EXISTING WOOD SHAKE TO SOLID f hereby affirm that I am licensed under the provisions of Chapter 9 1 XSHEA1 HING INSTALL 40YR COMP SHINGLE.RESHEATH ;commencing with Section 7000)of Division 3 of the Business&Professions 1/2"OSB F NEEDED CLASS A APPROX 24SQ 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 Sq.Ft FI�►or Area: Valuation:$16000 permit is issued. cvok_ APPLICANT CERTIFICATION APN Number:37510001.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of . ermit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non oin source regulations per t upertino Municipal Code,Section 9.18. Issued IrDate: Signature Date ' OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtai an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspecti(n. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signator of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to — wor — construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have r ead the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. Califorida Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by complis nce with the Cupertino Municipal Code,Chapter 9.12 and the Health& Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 mustO� r o aut ize a t : DateV forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereb:,affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for whish this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save i"'�mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address and expenses which may accrue against said City in consequence of the _.Ling of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section I under>tand my plans shall be used as public records. 9.18. Signature Date Licens!d Professional CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 3 ITEMS OF 4 COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37510001 . 00 DATE ISSUED. : . . . . . : 08/17/20:.0 RECEIPT #. . . . . . . . • : BS000011::03 REFERENCE ID # . . . : 10080117 SITE ADDRESS 10422 JUDY AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER BRAD & PEGGY MEYER ADDRESS : 10422 JUDY AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM • " ; MCAULIFFE,CDANTEUCT CONTRACTOR . . . . . . LIC # 20524 COMPANY . . . . . . . . . . : MCAULIFFE CONST ADDRESS . . . . . . . . . . : 886 TALIMAN CT CITY/STATE/ZIP . . . : SAN JOSE., CA 95123 TELEPHONE . . . . . . . . : (408) 22' -0343 FEE ID UNIT QUANTITY AMOUNT' PD-TO-DT THIS REC- --NEW-BAL ---- - - ---------- --------- --- ---------- ------ ------ :_. 00 0 .00 00 1. 00 0 .00 1BCBSC VALUATION 16, 000 . 00 60 0 .00 1BSEISMICR VALUATION 16, 000 . 00 60 0 .00 0 . 00 1.312 .60 0 .00 1REROOFRES SQ FEET 24 . 00 31:_ .00 TOTAL PERMIT 311 .60 0. 00 314 .60 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ____ -- ---------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CITY OF CUPERTINO isREROOT, CUPERTINO PERMIT APPLICATION Date: APN # , -- - ,� l Building Address: 1 :� Q ?' Z Phone #: u6 -,2-v'3 Owner's N e: 4,� HOA: Yes ❑ No If es, rovide letter frons HO Phone#: '7D•��5� Contractor: Fax#: 3"?D (� 3 Cupertino Business License #: Contractor License #:AV?& Type of Roof Covering: EPro posed: Existing: ❑ Built-Up Roof �� Built-Up roof ❑ Asphalt Shingles �� Asphalt Shingles Wood Shakes 13 Wood Shakes Wood Shingles j Wood Shingles ❑ Other (Specify) :i Other (Specify) N � Provide I.C.C.E.S. Report# Number of existing coverings 13 Provide Mfgr. Installation Specs. To be Removed Job Description: �� ,� SKA� C Residential Commercial El Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green BuildingChecklist & attach it to the application or if there are any restrictions: El a licable, include in plan set & the sheet index. Valu on: C-P I Ha a ead, Und stand d Will Comply Cupertino's Tear-Off Policy: s -1�-- ID Signature Revised 02/05/09 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: I DA7 E: REVIEWED BY: APN: BP#: *VALUATION: $16,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARYSFD or Du lex 1�1/ t1 APPLICATION 1SFDWLR00F USE: P I�C�tJI;.11�L:,1. TYPE: WORK SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 2,400 At a . 71,. y z 44F r'Lririb 17_x:; 1', b ma 1'c' F/11117b, I'errr,ill'a'e.: ET-1- :1 fns p. 6c /r75�� F-1 I 011m.1'lan�nb Ir1s'[� Ulirr ., c'r .1' '' h��. l.�r•. l'!rnuh. I�uy, 1:r.a: Ek'[. 1ns�+. 1'r'i1: NOTE: These ees are based on the prelindna in ormation available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS(ree Resolution 09-051 E(1.' 7/1;70) FEE QTY/FEE MISC ITEMS .S11hV%1. PC Fee F771 L f'itrrllh.'";1Ic'r.h.'l lei: Pkm Check. Permit Fee: $312.00 Phonk i'lr.�rnh..'Afcch. /,I T Permit C �r11.�lrlrc'lrun T�1.� N ey!Oyh''ul 1�"vic11'f'-OC. Work Without Permit? O Yes No $0.00 11 al c'I Ooc mricnlalinr; Strong Motion Fee: IBSEISMICR $1.60 Select an Administrative Item Bldf4 Stds Commission Fee: IBCBSC $1.00 r z {EJB TS.. $314.601 $0.00 �. �Tb�y '�A y $314.60 Revised: 8/12/2010 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING DFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•building a7.cupertino.org PROJECT ADDRESS APN# OWNER NAME PHONE i _ E-MAIL STREET A{]�RES ('� /� CITY, STATE,ZIP �`/a � FAX � CONTRACTOR NCM r „„ — LICENSE NUMBERLICENSEE BUS.LIC# CO PANY ME �_ E-MAIL 1`� F r ikl 0- STR- T ADDRI.S CITY,STATE,ZIP 0 G4 P � • 3 std I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. 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)777-322 3 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 d-y-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-Prouess 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 oblaining 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 tI e 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/4"per foot of sl ape and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pre-rianufactured 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 insp ection 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 c rti each the following is true: he property owner or authorized agent to act on the property owner's e If e t a a e to plfwith the re-roof policy stated above. Signature of Applicant/Agent: Date: 1 -1 1"tp ReroofPolicy_2010.doc revised 05/17/10 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: _ PERMIT# 1 V OWNER'S NAME: PHONE ' 3'?D GENERAL CONTRACTOR: - BUSINESS LICENSE# ADDRESS: (o &vN (j CITY/ZIPCODE: e '' L *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass /Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal S Rock Ti e Owner/Contractor Signature Date