13080157CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22590 VOSS AVE
CONTRACTOR: ALLIED CONSTRUCTION
PERMIT NO: 13080157
SERVICES
OWNER'S NAME: EXCELL DONALD L AND DARLENE TR •
7602 NATIONAL DR
DATE ISSUED: 08/22/2013
OWNER'S PHONE: 2087611513
LIVERMORE, CA 94551
PHONE NO: (925)724-2324
CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
22LICENSED
/
License Class V Lie. # �0 27 /
(543 SQ'S) TEAR OFF (E) SHINGLE (NO RE -SHEET) &
22
INSTALL (N) 40 YR COMP, CLASS A
Contractor Date
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
ompensation, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $217000
rfonnance of the work for which this permit is issued.
I ave and will maintain Worker's Compensation Insurance, as provided for by
S tion 3700 of the Labor Code, for the performance of the work for which this
APN Number: 34229044.00
Occupancy Type:
p it 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
DAYS FROM LED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
;180
Issue Date:
granting of this permit. Additionally, the applicant understands and will comply
�tff
with all non -point source regulations per the Cupertino Munici al Code, Section
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
9.18.
�/
Signature Date p 32 �)
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ R -BUILDER DECLARATION
Signature of Applicant: Date: �j 13
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVE O 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 Managem�istrict I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Co al apter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25505, 25533, 34.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date: � I2Z1 �3
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
CO TRUCTION 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
�IT
REROOF PERMIT APPLICATION C�,p�
is COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 /L,O
CU'IT1NCi (408) 771-3228 • FAX (408) 777-3333 • build ing(Qcupertino.orq
PROJECT ADDRESS `7 Z }� 0�; /� ' c
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STATE, ZIP
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FAX
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT Ia CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CO TRACTOR NAME /��n,�� ��� •
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LICENSE NUMBER I_�/ z_*7'
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ARCHITECTIENGINEER NAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi -Family
STRUCTURE: COmmerClal
ROOF AREA: ^-�
5 4 3 C�
VALUAT ON: 7 /
Z! / r
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF 9ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE/REPLACE AYES
❑ NO
IF NO,PLYWOOD
I # LAYERS:
❑ %,, ❑
THICKNESS: ❑ 5/8"
PLYWD ❑ OSB
TYPE: ❑ CDX
PITCH:
' 12
ROOF
CLASS: A
PROPOSED ROOF TYPE: 11BUILT-UPROOF KASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC- S REPORT #
150
DESCRIPTION OF WORK: C 41 . r 1E. f y/y-T— 7
bJ Via-! 1 AFDiZ 5 sS 's
By my signature below, I certify to each of the following: I am the property owner or authorized ado 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 aetclt nd verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize repre vea[1" s of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: a/
QUIRED
SUPP NTALINFORMA�SA
_ If building is associated with a Ho ciation, provide letter
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupertino's Tear -Off Policy.
gYFICEUWONLY
PLANK f[ECKTYPE
ROUTING SLIP
VER -THE -COUNTER
, ❑., EXPRESS
❑ STANDARD
❑ -BUILDING PLAN REVIEW
❑ PLANNING PLAN REVIEW
❑ FIRE DEPT
❑ OTHER:
ReroofApp_2011.doc revised 03116111
— CITY OF CUPERTINO
FORM
1PUU IPQ9rY tiATnP—RITTT.nING DIVISION
NOTE: This estimate does not include fees due to other Departments (ie. rlanntng, ruouc rrorKs, rtre, aurtttury newer unarm t, JG""Ut
_ •n,_ __ _ tom__ .. t.....,.,t ,... s6Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 7if /1/12)
ADDRESS: 22590 VOSS AVE
DATE: 08/22/2013
REVIEWED BY: MELISSA$01 .
APN: 342 29 044
BP#:
*VALUATION: $217,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY Commercial BuildingPENTAMATION
PERMIT TYPE: 1COMMLROOF
USE:
$0.00
PME Plan Check:
WORK
TEAR OFF E SHINGLE NO RE -SHEET & INSTALL N 40 YR COMP CLASS A
SCOPE
Permit Fee:
NOTE: This estimate does not include fees due to other Departments (ie. rlanntng, ruouc rrorKs, rtre, aurtttury newer unarm t, JG""Ut
_ •n,_ __ _ tom__ .. t.....,.,t ,... s6Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 7if /1/12)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
54,300 s.f.
$3,863.00
Re -roof
IREROOFCOM
Suppl. PC Fee: (F) Reg. ® OT
0.0 1
hr's
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feer Reg. Q OT0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction :Tax:
dininistrative .Fee:
0
Work Without Permit? O Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
-ravel Documentation /+Fes.
Strong Motion Fee: 1BSEISMICO
$45.57
Select an Administrative Item
Bldp- Stds Commission Fee:
$9.00
a
$54.57
$3,863.00
m . v _ , . e
$3,017.57
Revised: 07/01/2013
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building .cuoertino.org
PROJECT ADDRESS �i /7
APN # 2- — Z, 7 p ' Q
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OWNER NAME .� II+`-YI f!`
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STREET ADDRESS
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FAX
CONTRACTOR NAM
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LICENSE NUM-��RC7
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BUS. LIC. #
COMPANY NAME
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STREET AD RESS
ACL r font A I 1 2 .
CITY, STATE, ZIP'74
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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)777-3228 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.
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 f is true: I am the pro ner or authorized agent to act
on the property owner's behalf. I u stand an gree to c ith the re -roof policy stateP above.
Signature of Applicant/Agent: Date: q t Z
ReroofPolicy_2010.doc revised 05/17/10