14040187 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10742 CARVER DR CONTRACTOR:R E ROOFING& PERMIT NO: 14040187
CONSTRUCTION INC
OWNER'S NAME: CHRIS CAMPO 15230 CLYDELLE AVE DATE ISSUED:04/28/2014
OWNER'S PHONE: 4088651340 SAN JOSE,CA 95124 PHONE NO:(408)626-9320
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑
CARPORT(5 SQ'S)TEAR OFF(E)T&G,INSTALL(N)
SContra
ass Lic.# r� 3-PLY,HOT MOP"COOL ROOF" SYSTEM
Date` that ya►n 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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$2000
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:37532009.00 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 WITIIIN 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 FROM ::ftl��KD 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 `l �i�
pr of this permit. Additionally,the applicant understands and will comply Date:
with all n -point source regulati er the Cupertino Municipal Code, on
918.
RE-ROOFS:
Signatur Date ( 11 be inspected prior to any roofing material being installed.If a roof is
installed with t first obtaining anjnspectio , agree to remove all new materials for
-----
inspection. tr
❑ OWNER-BUILDER DECLARATION
Signature of ppl c,' Date: Ld
I hereby affirm that I am exempt from the Contractor's License Law for one o -
the following two reasons: ��' �— OOF COVERINGS TO BE CLASS' "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)
1,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 . Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contam ants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain om�i����ce wr C rtino icipa1 Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for b the Health&4hri7*p
d Sectio 550 25533,,nd 25534. ��
Section 3700 of the Labor Code,for the performance of the work for which this Owner or and a Dater I 1
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 O
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildinga_cupertino.org "V
GUPVRTINO
PROJECT ADDRESS (}/� ��/�` 1\tel] , APN# S4_5-
4_� 2 2— 0013
OWNERNAME PHO E-MAIL
CAAVo
STREET ADDRESS CITY,STATE,ZIP Jv FAX
CONTACT NAME �. PHONE �J G Z�I E-MAIL
STREETADDRES$ f7 '\ (n_ ,�r CITY,STATE,ZIP a FAX
11 OWNER ❑ OWNER-BUILDER ❑ Or/WNERRA (GENT/ CONTRACTOR ❑CONTRACTOR AGENT ❑(, ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME (�L/.`� / LICENSE NUMBER LICE E BUs.LIC.# r
COMPANY NAME U 1 I N E-MAIL FAX l
STREET ADDRESS1 CITY,STATE,ZIP ��- PHONE
ARCHITECT/ENGINEER NAME 1 LICENSE NUMBER BUS.LIC.
i
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF I I,XSFPOyzuplex ❑ Multi-Family ROOF ARE • f VALUATION: V
STRUCTURE:
COmmercial
EXISTING ROOF TYPE:, ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMO PLACEAYES I IFNO, PLYWOOD ❑ '/: ❑ PLYWD ❑OSB PITCH: ROOF
❑NO #LAYERS: THICKNESS, 115/8" TYPE: ❑CDX 12 CLASS: A
PROPOSED ROOF TYPE: BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ST^ICC-ES REPORT#
DESCRIPTION OF WORK U 1 j I/iq ] X�
E
By my signature below,Lcertify'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 inform
ati0 a provided is correct. I have,read the Description of Work erify it is accurate. I agree to comply with all applicable local
ordinances and state law dating to b 'L construction. I au ize re ese Ives of C ino to enter the above-i ntified roT for inspection purposes.
KAI
Signature of Applicant/Agent: Date:
SUPPLIL vI�IE.I,.J.TA�INFO N REQUIRED Ju
If building is associated with a Home Owner's Association,provide letter - fl
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
_Provide copy of Manufacturer's Installation Specifications. 3
Provide signed copy of Cupeitino's Tear-Off Policy.
ReroofApp_2011.doe revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10742 CARVER DR 1 ]DATE: 04/28/2014 REVIEWED BY: MELISSA
APN: 375 32 009 BP#: *VALUATION: 1$2,000
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLR00
WORK CARPORT 5 SQ'S TEAR OFF E T& G INSTALL N 3-PLY HOT MOP "COOL ROOF" SYSTEM
SCOPE
FEE H) ROOF AREA
s.f.
1REROOFFRES 500
ON
MM
ivy
a= — 01
.
,Meeh. Plart t hcrk 11hw7b. lyhm(°hu,k 1_%('c. /"an Chact
'Fill" P refit Fee., Phtmb. Per mit hear.
C�tlrcr SIE'`-h.1rt�.r= t)tIM,Pian,Ira p, Other t`lec. �t?-s,.
Liecr Int. t':a' Plumb. Txsp. hire. l>lec.Itzi, I':e
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These _f
fiees are based on the relimina information available and are onlyan estimate. Contact the Detor addn'l info.
FEE ITEMS (Fee Resolution 11-053 E f 7/1/131 FEE QTY/FEE MISC ITEMS
Suppl. PC FCC
Permit Fee: $80.00
Supp/. Irr. 1 Fee
PlurrPh,`,A,1<c ir,il ler., Permit Fee:
(.`oj iswtrcrrclrt
i(,brfinj,wrafiVc Foe:
Work Without Permit? ® Yes No $0.00
12 cavollce� 11PcIli tting Fee—s:
lir�,c�J Doctrtmeniolion Fees: �
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
$81.50 $0.00 TOTAL FEE: $81.50
Revised: 04/01/2014
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
t(4/0�8)777-3228•FAX(408)777-3333•building0)-cupertino.org
PROJECT ADDRESS O I 1 1 '/ �J, /, (APN# '{ T 1 - 6 O S
OWNER NAME , ^ PHONE /1 x I 2�-132J E-MAIL
STREET ADDRESS l/` 7 /� CITY, STATE,ZIP SIU FAX
CONTRACTOR NAM LICENSE NUMBER
LICENT ' BUS.LC.#7 �J il
COMPANY NAME E-MAIL FAX i .!
� r �
STREET ADDRESS i(� `� \ CITY,STATE,ZIP PHONEr
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/"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 b I certify each of the following is true: I am the property owner or authorized agent to act on the
property o ner's behalffderstand and agree to comply with the re-roof policy stated above. I also understand that
smoke d tectors and carbon m oxi ectors e r uire be installed in accordance with Sections 314 and R315 of
the 2013'California Residential o
Signature of A�pjicant/Agent: Date:
ReroofPolicy_2014.doc revised 01/15/14