14030090 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7325 FALLENLEAF LN CONTRACTOR:ABRIL ROOFING,INC PERMIT NO: 14030090
OWNER'S NAME: BRIAN BATES 3490 PACHECO BLVD DATE ISSUED:03/14/2014
OWNER'S PHONE: 4089961411 MARTINEZ,CA 94553 PHONE NO:(925)228-0160
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑
Q� f� (20 SQ'S)FOAM OVERLAY OVER TAR AND GRAVEL
License Class G �q Lie.# O v
Contractor
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
Compensation,as provided for by Section 3700 of the Labor Code,for the
4performance of the work for which this permit is issued. Sq.Ft F►oor Area: Valuation:$9250
ave and will maintain Worker's Compensation Insurance,as provided for by
ection 3700 of the Labor Code,for the performance of the work for which this APN Number:35927024 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 DAYS F LED INSPECTIO
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the l `
granting of this permit. .onally,the applicant understands and will comply by te:
with all non-point sour lations per the Cupertino Municipal Ce,Se tion
918.
RE-ROOFS:
Signature Date / �/(AAll roofs shall be inspected prior to any offing material being installed.If a roof is
installed without first obtaining ani tion,I agree to remove all new teria for
inspection.
❑ OWNER-BUILDER DECLARATION � 1 �G
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COV RINGS 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 Cup e o Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Section 0 2 33,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: 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
M
REROOF PERMIT APPLICATION O�
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 O�
P R, INO (408)777-3228•FAX(408)777-3333•buildingCa)cuoertino.org
CUI
PROJECT ADDRESS G/ FF E- APN# 3S_9 Q _ O
OWNER NAME � j� (J�t'OvNE J E-MAIL
STREET ADDRESS -7_32_.S-/[ C
CITY,STATE,ZIPi./(® �.A �y FAX
CON CT NAM�� ! � G E-MAIL
ST T D cb /O _ i/ CITY STATE, IP FAX
❑OWNER ❑ OwNER-BUHAER ❑ OWNERLAr, ❑ CONTRACTOR )a CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME ��r LICENSE NUMB / 9 LICENSE TYPEV/`-37 BUS.LIC.#
COMPANY NAME n' _ D s.�r��/.// _/�. E-MAIL 1 FAX
STREET ADDRESS 3,LtO6 CITY,STATE,Ay/� , A � �
/"70
ARCHITECT/ENGINEERNAME LICENSE NUMBER NE
/'�U (� BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATIO
STRUCTURE: Commercial P-0) N: g
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY)
REMOVE/REPLACE ❑YES IF NO, PLYWOOD ❑ w, ❑ PLYWD ❑ OSB PITCH: ROOF
19 NO
O #LAYERS: THICKNESS: 135/8" TYPE: ❑ CDX �:12 CLASS: `,
PROPOSED ROOF TYPE: 1�BUILT-UP ROOF ❑ASPHALT SHINGLES 11 WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK:® 77V-
or
By my signature below,I certify to each of the fo ing: I am the property owner or authorized agent to act on the property owner's behalf I have read this
application and the infonuation I have provided.,,
rovided' I have read the Description of Work and verify it is accurate. I agre to coI with all applicable local
ordinances and state laws relating to.build' c' n. I authorize representatives of Cupertino to enter the above-iden' d p_p ly for inspection purposes.
Signature of Applicant/Agent: Date: '
SUPPLEMENTAL INF TION REQUIRED ,; x ,, oF�zrcE uSE C N
_If building is associated with a Home Ownet's Association,provide letterNrr �� x�ot�INc sLlr :.
of approval from HOA.
PP OVER-THE=G TER ❑ BUILDING PLANREVJEW
Provide Planning approval to verify if there any restrictions. '`£'r
EXPRESS ❑ PLANrINc PLAN REVIEW /
Provide copy of Manufacturers Installation Specifications. SVx F "El 1FxIrE DEBT .
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER.
ReroofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 7325 FALLENLEAF LN DATE: 03/14/2014 REVIEWED BY: MELISSA
APN: 359 27 024 BP#: `VALUATION: 1$9,250
'PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLR00
WORK �20 SQ'S FOAM OVERLAY OVER TAR AND GRAVEL
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,000
llc`a. F' rs fr,ec't; t'lzurrh.I'!ura C`lrec icc_ 7 i< C�ya�xG
!"c.t_ Peo-rrr Fee: F/u nn. Pe mil Fee" F" P,1- ,-F�"t.�
Li ()(It?er•t'iurnl;Iris,>. 01 Cr,-t e'er. h7vl.
«ec . I,.Ed7. 1.e,e. irrrnb. tirs�r. Fi?e:
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . Theseees are based on the prelimina information available and are only an estimate Contact the De t or addn'1 info,
FEE ITEMS (Fee Resolution 11-053 E,f'. 7/1/13) FEE QTY/FEE MISC ITEMS
l r/)r`. PC t'CC
Permit Fee: $320.00
f'r`2:raizfr.:R,s��<.;It.iTslcc:
'ltrr�r}r.j i clr..%T set: Permit Pete:
�'�Liti2tJ7i.�"<r'L7TIL'c'p'c't':
Work Without Permit? 0 Yes No $0.00
.lta'i°tanc air PIannin-Fees:
;'i..e e}s s)0crrrm,ni ariorr Fees: /
Strong Motion Fee: 1BSEISMICR $0.93 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
01
- -U' 5�z $321.93 $0.00 TOTAL FEE: $321.93
Revised: 01/15/2014
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(d)cupertino.ong
PROJECT ADDRESS `77 /��L' _ /� APN#
S717
OWNER NAME / � P b� � / EMAIL
STREET ADDRESS -�/� �A f� / CITY, S TE, FAX
CONTRACTOR NAM L� LICENSE NUMBE O LICENSE TYP� BUS.LIC.#
COMPANY NAME J� E-MAIL FAX
. //
STREET ADDRESS � _911y5 I
CITY,STATE,ZIP /. Ii AI
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2013 California Codes.
2. An inspection request can be scheduled up to one business day before the requested inspection date.
Please schedule inspections online or 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. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs)
and 7:30-10:30am and 12:30-2:30 (Friday). 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/"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 a to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detec e required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code. 3
Signature of Applicant/Agent: Date:
V) 1
ReroofPolicy_2014.doc revised 01115114