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13090135 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7984 FOLKESTONE DR CONTRACTOR:QUALITY ROOFING CO PERMIT NO:13090135 OWNER'S NAME: BONNIE LIBBY 10415 NEW AVE DATE ISSUED:09/18/2013 OWNER'S PHONE: 4084999475 GILROY,CA 95020 PHONE NO:(408)461-0484 M LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class C `3 `� Lic.# 'AX"6 F1 (35 SQ'S)-TEAR OFF(E)WOOD SHAKE,INSTALL(N) 1/2"OSB,30 LBS FELT&LIFETIME COMP Contractor `� toO��Date Q`�8�`3 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 foilowing 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:$15500 JC 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:36211002.00 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 ED INSPECTION. li upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS indemnify and keep harmless the City of Cupertino against abilities,judgments, q costs,and expenses which may accrue against said City in consequence of the Date: / 3 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. �� �� t RE-ROOFS: Signature \ r m,- Date 9— [— All roofs shall be inspected prior to any roofing material being installed.If a roof is NJ installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applican+• �wa�.�_ ll� ate: 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 1,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 25 255005',25533,and ,25534. 1�ems+. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: (; 14d� 1�'`` -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 CONSTRUCTION LENDING AGENCY 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 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 inconsequence 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 ` ELI COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 'CA 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 v (408)'777-3228•FAX(408)777-3333•building a.cupertino.org CUPERTINO. \, PROJECT ADDRESS APN# 162, I I O Z OWNERNAME \ PHONE _ E-MAIL V STREET ADDRESS r CITY, STATE,ZI FAX 72, WA CONTACT NAME PHO E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT 13 CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CO CT R AME LICENSE NUMBER LICENSE TYPE BUS.LIC.# COMPANY NAME &MAIL FAX STREET ADDRESS V CITY,STATE,ZIP S S6 q / PHO E 6 IN ARCHITECT/ENGEER NAME LICENSE NUMBER b BUS.LIG# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial b b EXISTING ROOF TYPE: ❑BUILT-UP ROOF PHALT SHINGLES WOOD HAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE KYES IF NO, PLYWOOD ffl%" ❑ PLYWD OSB PITCH: ROOF C1 NO #LAYERS: I THICKNESS: 115/8" TYPE: ❑CDX '12 CLASS: L1 PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: \ t - O SLko 5e}F � Y66 1 ws � 8 S 6 tl. 4 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 relatigto building co c' n. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of ApplicanUAgen vim— �\ Date: ` U MI SUPPLEMENTAL INFORMATION REQUIRED ousEovr _If building is associated with a Home Owner's Association,provide letter AA of approval from HOA. a`} vER ��Buunnvc r> r� _Provide Planning approval to verify if there any restrictions. - LAIvw Provide copy of Manufacturer's Installation Specifications. _Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_201 1.doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 7984 FOLKESTONE DR DATE: 09/18/2013 REVIEWED BY: MELISSA APN: 36211002 BP#: *VALUATION: 1$15,500 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Du lex PENTAMATION 1SFDWLR00F USE: P PERMIT TYPE: i WORK 35 SQ'S -TEAR OFF E WOOD SHAKE INSTALL N 1/2" OSB 30 LBS FELT& LIFETIME COMP SCOPE FEE H) ROOF AREA s.f. 1REROOFFRES 3,500 t1" ' P �G55t'tl�. -'.� _ - I i •i�m��n F� V:r�i ..,,,'a Llech. Plan Check Phimb.Plan Cheek Elec..Plan Check FTPermit Feet: Plumb.Permit Fee: Elec. Permit Fee: Flheh Akc.h.Insp. Other Plumb Insp. L1 Other Elec.Insp. ED-L-- I Insp. Fzze: Plumb. Insp.Fee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments('tie.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These ees are based on the relimina information available and are onlyan estimate. Contact the Dept or addn'1 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: .Stppl. PCFee Plumb.ijtlech./Flee Permit Fee: $560.00 Supp/, Insp Fee Plumh.ilhech./Flee Plumb.111ech.,'Flee Permit Fee: C:onstrzaction Ta:v: F71 Administrative Fee: Work Without Permit? ® Yes (j) No $0.00 Advanced Planning Fees: "Travel Uoctimentation Fees: Strom Motion Fee: IBSEISMICR $1.55 Select an Administrative Item Bldy,Stds Commission Fee: 1BCBSC $1.00 w� = 00 m 25 5 A► Revised: 08/01/2013 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 CUPER`I'IN0 (408)777-3228 FAX(408)777-3333•buildinaCa.cuoertino.ora PROJECT ADDRESS 7APN# (o Z - r - 00'L p, C, v-,S 7 . O NAME y ` PHONE 8 \1 EMAIL bt,V\� Q. b STREET ADDRESSCTrY,STATE, P FAX �� Qr� ��: CO CTOR NA LICENSE NUMBER LICENSE T E BUS.LIC.# _ t�- COMP NA C E-MAIL FAX t STREET ADDRESS C STATE,ZIP2LL k C0.' H " / 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 call for 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 R315 of the 2010 California Residential Code. (�' A : 1 Signature of Applicant/Agent: �3�-�'� �" ��`" Date: ReroofPolicy_2012.doc revised 10/7/12