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13080056 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20111 STEVENS CREEK BLVD CONTRACTOR:ALL SEASONS ROOFING PERMIT NO: 13080056 &SOLAR OWNER'S NAME: SAN JOSE,CA 95112 PHONE NO:(408)971-4455 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11COMMERCIAL0 License Class C' Lica# © RE-ROOF 72 SQ-REMOVE WOOD SHAKE AND INSTLL NEW Contractor,4/!/p S .-i2 Date � ROOF COMP INSTALL NEW FLASHING AND 30LB FELT I hereby affirm that I am licensed under"f4eprovisions of Chapter 9 CLASS (commencing with Section 7000)of Division 3 of the Business&Professions A 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:$38719 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:31623026.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the aboveinformation 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 DAY M LAST CALLED INSPE TI N. 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 Issued by: granting of this permit. Additionally,the applicant understands and will comply Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature ��`t/ Date l 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. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: 4Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS 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 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is;issued: will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,255 3,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: lJP/lS 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 {408)777-3228•FAX(408)777-3333•building(cDcupertino.org O� c PEkrtt46 PROJECT ADDRESS p C OWNERNAME r STREET ADDRESS / CITY, STATE,ZT FAX CONTACT NAME - PHI �-Mp STREET.ADDRESS 4��.. w C ATE,ZIP FAX L �7 3 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT V CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECr/ENGINEERNRME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex El Multi-Family ROOF AREAA:] VALUATION: -717 STRUCTURE: 117/Commercial EXISTING ROOF TYPE: ❑BUILT-UP ROOF rJ ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE, OYES IF NO, PLYWOOD ❑ %" ❑ PLYWD ❑ OSB PITCH: ROOF Lr IVO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑C :12 CLASS: ` (�(Y�� ICC-ES REPORT# . PROPOSED ROOF TYPE: 13BUILT-UPROOF . .13ASPHALT SHINGLES 11 WOOD SHAKES 11 WOOD SHINGLES ❑OTHER- DESCRIPTION OF WORK O / �✓ t2 F Ccj D aa �ta Ceibr NhAm By:my signature below,I certify to 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 the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to ilding co tion. I authorize represen es of Cupertino to enter the above-id nntified roperty for inspection purposes. Signature of Applicant/ Dater 7�%� SUPPLEMENTAL INFORMATION REQUIRED © a- - 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. s Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. p s � ReroofApp_M1.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 20111 SCB DATE: 08/13/2013 REVIEWED BY: MENDEZ APN: BP#: *VALUATION: 1$38,719 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1 COMMLROO i WORK RE-ROOF 72 SQ- REMOVE WOOD SHAKE AND INSTLL NEW ROOF COMP INSTALL NEW SCOPE FLASHING AND 30LB FELT CLASS A FEE ID ROOF AREA s.f. 1REROOFCOM 7,200 Mesh. Plan Check Plumb.Plan Check Elec.Plan Check F,—t,,, .Permit Fee: Plumb.Permit Fee: Elec.Permit Fee: Other llech.Insp. Other Plumb Insp. Other Etec.Insp. Lj .11ech.Insp. Fee: Plumb. Insp.Fee., Eke.Insh,Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are based on the prelindna information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS(Fee Resolution 11-053 E . 711112) FEE QTY/FEE MISC ITEMS Plan Cheek Fee: SuPpL PC Fee Plumb.11 Tech./Elec Permit Fee: $557.00 Suppl. Insp Fee F 77 Plunnh./1 tech./E lec P1urnh,/11eeh.1Islec Permit Fee: Construction .Tax: Arlinini,s trative Fee: Work Without Permit? ® Yes (j) No $0.00 Advanced Planning Ilees: Travel Doettnnentation Fees: Strong Motion Fee: IBSEISMICO $8.13 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $2.00 N sf $567.13 $0.00 - EE „ $567.13 Revised: 07/01/2013 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•building 5cupertino.org PROJECT ADDRESS AFN N OWNERNAME PHONE STREET ADDRESS CITY,STATE,ZIP FAX CO CTOR�NA s� LICENSE NUMBER/6, LICENSE TYPE BUS.I Jr if 22 2 ^; COMPANY NAME E-MAIL FAX (� STREETi DRESS CITY,STATE,ZIP PHONr a 77,2 D A Le- 4 e l I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. 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 require the 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 I/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 callfor a.tear-off or plywood nailing inspection and the work is not complete,you will be charged.a re-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 understand and agree to comply with the re-roof policy stated above. I also understand that smoke.detectors and carbon.monoxide detectors are required to be installed in accordance with Sections R314 and 8315 of the 2010 California Residential Code. / / Signature of Applicant/Agent: LC• Dat • 7( ReroofPolicy_2012.doc revised 10/7/12