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14010077 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10349 LEOLA CT CONTRACTOR:DAN ELLIOTT'S PERMIT NO:14010077 ROOFING CO OWNER'S NAME: P O BOX 26878 DATE ISSUED:01/13/2014 OWNER'S PHONE: SAN JOSE,CA 95159 PHONE NO:(408)559-7327 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL y TEAR OFF(E)SHAKE&INSTALL 29 SQ'S CLASS A COMP License Class_ "/—�3� Lic.# ContractorT'G q f Date /• �� I hereby affirm that I am licensed unde4e 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-instire for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$10488 v� 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:37504022.00 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 D T 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 D OM 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 granting of this permit. Additionally,the applicant understands and will comply b Date: I with all non-point source regulations per the Cupertino Municipal Code,Section 918. RE-ROOFS: Signatu % Datgl—13— 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 Applic Date:J / .3 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,Sec' 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 918. Signature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION ' D 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 l h CUPERTINO (408)777-3228-FAX(408)777-3333-building0muaertino.ora \ V PROJECT ADDRESS t(C) 3 20 a C4APN 3 �- 5 - o cq o ZZ OWNER NAME `/ PRONE ��- FAX CONTACT NAME ,O NE - /y--TZ-7 E-MAIL STREET ADDRESS Z( joq /0l+ `t „ CITY,STATE,ZIP ✓� l FAX 13 OWNER 13OwNER-BuiLDER ❑owNERAoENT ❑ CONTRACTOR ❑CONTRACTOR AoENT ❑ ARcmmcr ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACfORNAME , {J LICENSENUMBEEL ��(� LICENSETYPE BUS.LIC.# I �(s D C - COMPANY o E-MAIL Q I ® lAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.4 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE of ❑ SFU or Duplex ji Multi-Family RO�eO-FF AREA:� VALUATION: STRUCTURE- ❑ Commercial C2.q (� , o 12� EXISTING ROOF TYPE: . ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ®WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE 10 YES IF NO PLYWOOD ❑ '/" ❑ PLYWD )�OSB PITCH: ROOF ❑I4o u ❑5/s- ❑ X :12 MASS, A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ®ASPHALT SHQ4GLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT n DESCRIPT 1 OF WORK: ` _ Ot 1 'PLOas IS13z,\ V CLS S ) c S 5 1 yn By my signature below,I certify to each of the following: I an 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 construction. I authorize representatives of Cupertino to enter the above-identified iproperty for inspection purposes. Signature of ApplicantlAgent: Date: J SUPPLEMENTAL WFORMATIbWREQUMD OFAM un oNLY _I€building is associated with a Home Owners Association,provide letter #LANCHWKTM ROUTING SUP of approval from HOA. VER-TMWC01WM ❑ BURRING PLnNREVI vs; Provide Planning approval to verify if there any restrictions. VIE3 EXPRzss ❑ Pl A lvlltG PLAN IREVIM Provide copy of Manufacturer's Installation Specifications. ❑ srnl DMD Q vm DEPT Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHM- ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 40349 LEOLA CT DATE: 01/13/2014 REVIEWED BY: MELISSA AN: 375 04 022 BP#: `VALUATION: $10,488 *PERMIT TYPE: Minor Building.Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex . PENTAMATION 1SFDWLROOF USE: PERMIT TYPE: WORK TEAR OFF E SHAKE INSTALL N OSB 30# FELT CLASS A COMP SHINGLE 29 S.F. SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 2,900 MEON A-g, . ro, e Akch.flan Check Plumb. Plan Cdreek Elee..Plan(,heck Lleclr.Permit Fee: Plumb.Permit Fee: Elec. Permit Fee Other.Wech.Insp. Other Plumb Insp. Other Elec.Insp. .Rech.Insp.lee: Plumb. Insp.Fee: Elec.Insp.lee: NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based o&the prelimina information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 Eff. 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: suppl. PC Fee Plumb.J.fech./Elec Permit Fee: $464.00 S"uhpl. .lnsp Fee Plumb.%�Iec;It./Flee Plumb.IiWech.iElec Permit Fee: Construction Tear: Administrative.f%ee: Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fees: Travel Documentation Fees: A Strong Motion Fee: IBSEISMICR $1.05 Select an Administrative Item Bldg;Stds Commission Fee: 1BCBSC $1.00 - � o s.� $466.051 $0.00 $466.051 Revised: 01/01/2014 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL CUPEFtT[C�tb 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildinaCa).cupertino.org - PROJECr ADDRESSZt TAPN 4 �-S r O ( U OV,gJERN STREET AIDRESS7 CITY,STATE,ZIP FAX C. *rRACTOR .,�IAIJF ' LI NSE E LI NSETYP) BUS.LIC 4 MAIL _ F - ` 7 ST ,STATE,ZIP 7 S �Z / sHO7 O� L �1 V 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. � oofmg 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 Reside ialCodg,, Signature of Applicant/Agent Date: /-1,3 RerooJPo1 icy_2012.doc revised 10/7/12