14040186 i
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10742 CARVER DR CONTRACTOR:R E ROOFING& PERMIT NO: 14040186
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
f GMAIN HOUSE:(13 SQ'S)TEAR OFF(E)T& G,INSTALL
+ Licen lass l 1 �1� Lic.# -7 11�c (N)3-PLY,HOT MOP"COOL ROOF" SYSTEM
l �
ContraEto; ��F' Date
I hereby afiirmAhab3 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:$8000
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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter LED INSPECTION.
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS a
indemnify and keep harmless the City of Cupertino against liabilities,judgments, hy
costs,and expenses which may accrue against said City in consequence of the Date:
granting of this permit. Additionally,the applicant understands and will comply ssue
with all non-point source regulations-per upertino Municipal Code,Section
9 18. _
( RE-ROOFS:
Signatur8 f Date�_I All roofs all be inspected prior to any roofing material being installed.If a roof is
installed withourfi tainin an inspectio , agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signage of Applicari Date:
I hereby affirm that I am exempt from the Contractor's License Law for one ofthe following two reasons: ALL ROOF COVERINGS TO BE CL A "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 , ailf am co Bance with the Cupertino Municipal Code,Chapter 9.12 and
the'Health&Safety ode,Sections 25505;_and 25534.
I have and will maintain Worker's Compensation Insurance,as provided for by / r I
Section 3700 of the Labor Code,for the performance of the work for which this ` Date:
Owner or authorized ge
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
9 18.
Signature Date
REROOF PERMIT APPLICATION 1
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•building a__cupertino.org
CUPERTIINO
PROJECT ADDRESS APN# i 009
OWNERNAME PHONE E-MAIL
STREET ADDRESS 0 /1 (�� CITY, STATE,ZIP 'l� v FAX
CONTACT NAME 17 Jl PHONEq o k - �/I EMAIL
STREET ADDRESS. p .� .1 I{ry C/( J 1�VVI r CITY,STATE,ZIPFAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENTONTRACTOR ❑CONTRACTOR AGENT 11 ARCHITECT ❑ENGINEER 11 DEVELOPER ❑TENANT
CONTRACTOR NAME i LICENSE NUMBER Z� LIC ETYPE BUS.LIC.#� I t
COMPANY NAMEE-MAILi w u E-MA ` - FAX
1 I
STREET ADDRESS i - ,F CITY,STATE,ZIP Cn (Z PHONE 0 —61N(gin(
kRCHrrECT/ENGINEER NAME LICENSE NUMBER / BUS.LIC.# �J(�0
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE n
USE of SFDrDuplex ❑ M -Family ROOF ARE /y / VALUATION:
STRUCTURE: ❑ Coom�mercial
EXISTING ROOF'TYPE: . 4UILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE�/BYES` IFNO, PLYWOOD ❑ %:" ❑ PLYWD ❑ OSB PITCH: ROOF
❑NO #LAYERS: THICKNESS: ❑5/8" TYPE: ❑COX 12 CLASS: `�
PROPOSED ROOF TYPE: BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK _
IIJJ 1 (1�1 v y�'
T
r �� L?
i
By my signature below each of the following: I am the erty owner or authorized agent to act on the property owner's behalf I have read this
application and the ififormati.1 ha 'rovided is co sect. IWI ive read the escription of Work and verify it is accurate. I agree comply with all applicable local
ordinances ands a laws relating t g I ut z e ntatives of Cupertino to enter the above-i en;ifi rope for inspection purposes.
Signature of App'cant/Agent: Date:
SUP INFO REQUIRED 011
If building is associated with a Home Owner's Association,provide letter
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupertino's Tear-Off Policy.
ReroofApp_2011.doe revised 03/16111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10742 CARVER DR DATE: 04/28/2014 REVIEWED BY: MELISSA
APN: 375 32 009 BP#: "VALUATION: 1$8,000
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLR00
WORK 13 SQ'S TEAR OFF E T & G INSTALL N 3-PLY HOT MOP "COOL ROOF" SYSTEM
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 1,300
L9�c,'t ,r'iar(=szrX Numb. Now('hec A L k>c:. Ilia r
t_c/r. 1'erm:lFee: Plumb. Flo-mil Fee:
Otlher Wccr/r.Insp. Otlwr Piumb Insp. Otltcr E'lec.fav),
I r-.ch. Itzsu.1`' !'/zrrub. tisp. 'cet: Eslec.I»fx,f s:e:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These ees are based on the relimina in ormation available and are onl an estimate. Contact the Det or addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 711/13) FEE QTY/FEE MISC ITEMS
SllpoL PC P "o
Permit Fee: $208.00
F�'z}rral�.: i lvf�:lr.iLslec
Pcrn7it Fee:
&hninistrafive Fee:
Work Without Permit? ® Yes (E) No $0.00
,1dvunc ed Planning Fees:
D"i vei l)(>t'79Tneraaiion /'e(' S:
Strong Motion Fee: IBSEISMICR $0.80 Select an Administrative Item
Bldg Stds Commission.Fee: IBCBSC $1.00
1OI W4A-l $209.80 I $0.00 TOTAL FEE: $209.80
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
(408)777-3228-FAX(408)777-3333-buildin4CcDcupertino.org
PROJECT ADDRESS �J `r� �1)- APN# (►-' �D O
OWNERNAME 0AWO
PHONE `l ` �f,� E-MAILSTREET ADDRESS 0 CITY,STATE,ZIP �M ,� FAX
CONTRACTOR NAME / LICENSE NUMBER ::ZE LIC S T PE BUS.LIC.# 2 t
COMPANY NAME E-MAIL FAX
STREET ADDRESS (J , Q
CTrY,STATE,ZIP PHONE ` 62
I UNDERSTAND AND AGREE TO THE FOLLOWING: 2
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 underst d agree to c 1 with the re-roof policy stated above. I also understand that
smoke detectors and carbon oxide d ectors,46f•e require `_Ui ns ed in accordance withSec ons R314 and R315 of
the 2013 California Resident' 1 Code.
Signature of Applicant/Agent: Date:
ReroofPolicy_2014.doc revised 01115/14