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13050209 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7676 WEST HILI,LN CONTRACTOR:R E ROOFING& PERMIT NO: 13050209 CONSTRUCTION INC OWNER'S NAME: MURPHY DANIEL C AND JANET R 15230 CLYDELLE AVE DATE ISSUED:05/30/201.3 OWNER'S PHONE: 4082571933 SAN JOSE,CA 95124 PHONE NO:(408)626-9320 LICENSED CONTRACTOR 'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALE] License Class ` C1 Li..it ( Z 1' ! RE-ROOF 21 SQ-REMOVE EXISTING 1 LAYER OF WOOD L�tl SHAKE,INSTALL NEW 1/2 CDX,30#FELT CLASS A Contractor Date ereb rr �Iie �der 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. Sq.Ft Floor Area: Valuation:$10000 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 APN Number:36227019.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DA F M LAST CALLED INS CTION. 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 Issued by: Dat wi no - int source regulations per the Cupertino Municipal Code Section 9 8. I I + RE-ROOFS: Sriature Date_ o0Ps s be ins ected prior to any roofing material being installed.If a roof is installed withou st obtaim jon,1 agree to remove all new terials for inspection. ❑ OWNER-BUILDER DECLARATION ; Signature o A `cat t: Date: / I hereby affirm that I am exempt froptahe Contractor's License Law for one the following two reasons: -AL3•RbOF CO_VERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9J12 and the declarations: afety Code,Section 25532(a)should I store or handle haiardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Al 'tionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code;for the air contaminan as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain co lance wi he Cuper. Municipal Code,Chapter 9.12 n I have and will maintain Worker's Compensation Insurance,as provided fo by the Health,& of ecti 505255 and 25534. Section 3700 of the Labor Code,for the performance of the work for which .s Owner or autt r ed ag t Date: '� 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT.CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. .granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18.' Signature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO. (408).727-3228•FAX(408)777-3333•buildingC�cupertino.org PRO JECT.ADDRESS. ..V� (b' \n`GL �q 1 L,� APN# �� 0 G ' OWNER NAME `V V Y V V�1 l PHONE Q E-MAIL 1 I� leuKIP STREET ADDRESS. . :'^� Wj (_. ,i 1�L� CITY, STATE,ZIP ; i� r F CONTACT NAME ` l ` I V n 1 PHONE (,` i1 E-MAII STREET.ADDRESS �/ �/ GVW �` CITY,STATE,ZIPC� FAX ❑,OWNER. ❑ OwNERR-BUILDER 11 OWNER AGENT - CONTRACTOR ❑CONTRACT//OR AGENT _❑``7ARCffiTECT ❑ENGINEER ❑ DEVELOPER v❑TENANT CONTRACTOR NAME - LICENSE NUMBER LICENSE fPTy BUS.LIC.# ILI COMPANY NAME. � E-MAIL `j/,/'� FAX V (0 STREET ADDRESS CITY,STATE,ZIP PHONE ARCHrrECT/ENGINEER NAME. LICENSE NUMBER BUS.LIC.# COMPANYNAME E-MAIL FAX . STREET ADDRES CITY,STATE,ZIP PHONE USE OFSFD 01 Duplex ❑ Multi-Family ROOF AREA: (5 VALUATION: ��e STRUCTURE: OmmerClll �+/ YVJ EXISTING ROOF TYPE: 11 BUILT-UP ROOF ❑ASPHALT SHINGLES AWOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) __[ REMOVEIREPLACEtOo ES IF NO, PLYWOOD ,/ ❑ PLY" ❑OSB PITCH: ROOF it LAYERS: THICKNESS: -❑ 5/8" TYPE: DX 12 CLASS: L1 ICC-ES REPORT# PROPOSED ROOF TYPE: ❑BUILT-UP ROOF XASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER DESCRIPTION OF WORK: ��'l �n! N r, fy(,�,N ,A / !"{ � Vv � ,, UM e �° LA -< 1 By my signature below,I each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and he.i nnation I ha: rovided is correct. *readhe Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances'and sta' laws relatingtob 'ldin c s on. I aurepre Ives of C4Npertino to enter the above identifie property for inspection purposes. Signature ofApplic t/Agent: ----Date: SUPPLEMIN`P ORMATION REQUIRED If building is associated with a Home Owner s Association,provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturers Installation Specifications. Provide signed copy of Cupertino''Tear-Off Policy. ReroofApp_2011.doe revised 03116111 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 CUPERTINO (408)777-3228-FAX(408)777-3333•buildinga-cupertino.org PROJECT ADDRESS 1 2 (' I A !n IL OWNER NAME yy PHONE E-MA � �� V ( t l!! STREET ADDRESS CITY,STATE,ZIP OAP 1 FAX n O V CONTRACTOR NAME LICENSE NUMBER LICEN T BUS.LIC.# COMPANY NAME. _ ' `ll V E-MAIL FAX !w N STREET ADDRESS �I �\ j h� �ITY,STATE,ZIP PHONE qo ` L V. I UNDEuRSTAND AND AGREE TO THE FOLLOWING: I. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. Please.call (408)777-3228 from 7:30-3:30pm(Mon-Thurs)or 7:30-2:30pm(Friday)to schedule inspection. For Tear-Off and Nailing Inspections,you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. Final Inspections will be given a two hour window. 3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either completely knocked-down or removed prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required: 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the building inspector.`Any roofing which is applied without first obtaining an approved inspection will requirethe removal of all new material down to the sheathing so a proper inspection can be performed. 6. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is completed. To receive:a final sign-off,the following items will be verified: a. Flat roofs shall have a minimum of'/4"per foot of slope and 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,vents painted, gutter/downspouts installed, debris removed. 7. NOTE: If you call for atear-off or plywood nailing inspection and the work isnot complete,you will be charged are-inspection.fee. 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 behalf :I un rstand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carb mono.' e detectors are re uired to e ' gtal e n cordance with Sections 14, d R3 I S of: the 2010 California.Rest ntial Code. C �f Sig nawre.ofAPP licant/Agen Dater �� RerooJPo1iey_2012.doe revised 10/7/12 h Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST_` JOB ADDRESS: `Z L\-/ PERMIT# ' OWNER'S NAME: DoJ Pt LkR-P PHONE#. GENERAL CONTRACTOR: BUSINESS.:LICENSE# ; ADDRESS: Z (rye;LU tZ , CITY/ZIPCO-DE: 2 *Our municipal code requires all businesses working in the city to have a City of CupeTtin0.4business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR TRA C HAVE OBTAINED-A=CITY OF PERTINO BUSINESS LICENSE. I am not using any subcontracto s� 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 Sheet Rock Tile Owner/Contractor Signature z:;: Date k ,