13120201CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10360 LEOLA CT
CONTRACTOR: -64 -5 t \
PERMIT NO: 13120201
OWNER'S NAME: TERRY LANCASTER ET AL
DATE ISSUED: 12/23/2013
OWNE PHONE: 6509960289
PHONE NO: -
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
TEAR OFF (E) WOOD SHAKE, INSTALL (N) 1/2 OSB,
License Class y Lic. #
30LBS FELT, 30 YR CLASS A COMP •ZS SQ'S
Contractor i Date ! 221 l �
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
performance of the work for which this permit is issued.
Sq. Ft Floor Area:
Valuation: $9750
n
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 37504025 01 l/0
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
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
WIZ. T ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
OD M LAS INSPECTION.
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Issued by: Z-3
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations r the Cupertino Municipal Code, Section
918.
Signature Date l 2
RE -ROOFS:
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- sM Date:
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, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
�255�533,
Owner or authorized agent: /� Str Date: / 23
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 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
CUPERTINO.
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildinga-cupertino.org
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PROJECT ADDRESSAPN
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❑ OWNER ❑ OWNER -BUILDER ❑ .OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
C CT N LI S NUMBER
LICENSE TYPE
BUS. LIC. # �i✓q
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COMP NAME I `�U
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ARCIETECT/ENG,TELER NAME LICENSE NUMBER
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COMPANY NAME
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USE OF ❑ SFD or Duplex ❑ Multi -Family
ROOF AREA: ggrra�
VALUATION:
STRUCTURE: ❑ Commercial
a s • ! Y
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EXISTING ROOF TYPE: ❑ BUILT-UP ROOF 4 ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE ❑ YES
IF NO,
1
PLYWOOD ❑ vp ❑
PLYWD O OSB
PITCH:
:12
ROOF
A
❑ NO
# LAYERS:
THICKNESS: ❑ 5/8"
TYPE: ❑ CDX
CLASS:
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT #
DESCRIPTION OF WORK G_
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By my signature below, I certify to each of the following: I am the pr rty 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 r t Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laves relating to build' nstruction. I authori epresentatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: 2-3
SUPPLEMENTAL INFORMATION REQUIRE
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If building is associated with a Home Owner's Association, provide letter
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of approval from HOA.
Planning approval to verify if there any restrictions.
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_Provide
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_Provide copy of Manufacturer's Installation Specifications.
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_ Provide signed copy of Cupertino's Tear -Off Policy.
Reroof4pp_2011.doc revised 03/16111
CITY OF CUPERTINO
-.. FF.F. F.CTIMATOR — RITII.DING DIVISION
LEADDRESS:
1.0360 LEOLA CT
DATE: 12/23/2013
REVIEWED BY: MELISSA
Plan Check Fee:
APN: 375 04 025
BP#:
*VALUATION: $9,750
*PERMIT TYPE: Minor Building Permit .
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
PENTAMATION 1SFDWLR00F
PERMIT TYPE:
USE:
Permit Fee:
Elec. Plan Check
WORK
TEAR OFF E WOOD SHAKE INSTALL N 1/2" OSB 30LBS FELT 30 YR CLASS A COMP
Ilec. Per -mit Fee:
Other :Wee . Inst.
SCOPE
.Plumb./Mech./Flee -
NOTE: This estimate does not include fees due to other Departments i.e. Piammng, rubuc works, f ere, aunitury acwct "tau my u ,.w
TL ., R .. _1 ,.w .1.e .—H—on, infartaniinn availahlo and are only an estimate. Contact the Dept for addn 7 info.
"gatt Me, C. - Z. e.i— eeu w.e .iwuan. v.. ...v V.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13)
==ROOF
AREA
I — (s.f.)
a c b �>
Plan Check Fee:
Suppl. PC Fee
Plurmb.11feeh./Flee
Mech. flan Check
Phimb. Plan Che
Permit Fee:
Elec. Plan Check
;L1c>ch. 11ernaitFee:
Plumb. Permit Fee:
Ilec. Per -mit Fee:
Other :Wee . Inst.
CJther Plumb Insp.
.Plumb./Mech./Flee -
Other Elec. Insp.
1R1ech. Insp. Fee:
Pluraab. Insp. Fee:
Elec. Insp. Fee:
Administrative Fee:
Work Without Permit? ® Yes No
$0.00
Advunced Planning Fees:
�
Trut,,el Documentation Fees:
Strong Motion Fee: 1BSEISMICR
NOTE: This estimate does not include fees due to other Departments i.e. Piammng, rubuc works, f ere, aunitury acwct "tau my u ,.w
TL ., R .. _1 ,.w .1.e .—H—on, infartaniinn availahlo and are only an estimate. Contact the Dept for addn 7 info.
"gatt Me, C. - Z. e.i— eeu w.e .iwuan. v.. ...v V.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13)
..--------- --------
FEE
- - -- ---
QTY/FEE
a c b �>
Plan Check Fee:
Suppl. PC Fee
Plurmb.11feeh./Flee
Mech. flan Check
Phimb. Plan Che
Permit Fee:
Elec. Plan Check
;L1c>ch. 11ernaitFee:
Plumb. Permit Fee:
Ilec. Per -mit Fee:
Other :Wee . Inst.
CJther Plumb Insp.
.Plumb./Mech./Flee -
Other Elec. Insp.
1R1ech. Insp. Fee:
Pluraab. Insp. Fee:
Elec. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments i.e. Piammng, rubuc works, f ere, aunitury acwct "tau my u ,.w
TL ., R .. _1 ,.w .1.e .—H—on, infartaniinn availahlo and are only an estimate. Contact the Dept for addn 7 info.
"gatt Me, C. - Z. e.i— eeu w.e .iwuan. v.. ...v V.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13)
..--------- --------
FEE
- - -- ---
QTY/FEE
MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Plurmb.11feeh./Flee
Permit Fee:
$400.00
S'uppl. Insp Fee 7
FA
.Plumb./Mech./Flee -
E'lurnb.111eeh.iElec. Permit Fee:
Conorfiction Tar:
Administrative Fee:
Work Without Permit? ® Yes No
$0.00
Advunced Planning Fees:
�
Trut,,el Documentation Fees:
Strong Motion Fee: 1BSEISMICR
$0.98
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
$401.98
$0.00 FES
$401.98
Revised: 10/01/2013
2
CUPIE RTINO
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
(408) 777-3228 • FAX (408) 777-3333 • building aacupertino.org
PROJECT ADDRESS
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16,-766
OWNERNANM E-MAII
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STREET ADDRESSCITY
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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 inspedtion.
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.
S_ 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-roofnig 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 deters are requir to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent:��_k Date: a
ReroojPolicy_2012.doc revised 10/7/12