14070075CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 874 SEPTEMBER DR
CONTRACTOR: R A CONSTRUCTION
PERMIT NO: 14070075
OWNER'S NAME: WU RONG Y AND SUE Y
3851 R CHARTER PARK DR
DATE ISSUED: 07/17/2014
OWNER'S PHONE: 4087506596
SAN JOSE, CA 95136
PHONE NO: (408)559-1877
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
RE -ROOF 28 SQ- REMOVE SHAKES, INSTALL 1/2 30 #
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License Class 3 Lic. # � b
FELTK, CLASS A
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Date / ��'
Contractor
I hereby affirm at I am lice a under the provisions of Chapter 9
(commencing ith Section 7 of Division 3 of the Business & Professions
Code and th my license is 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: $10800
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 36214015 00
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
WITHIN 180OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
180 DAYS(FROM AST CALLED INSPECTION.
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
17/7 „� /J
costs, and expenses which may accrue against said City in consequence of the
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Issued by: Date:
granting of this permit. Additionally, the applicant understands and will comply
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with all non -point source regulations per the Cupertino Municipal Code, Section
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RE -ROOFS:
9 18. %
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Signature Date/
All roofs shall be inspected prior to any roofing material being installed. If a roof is
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installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
WNER-BUILDER DECLARATION
❑ /irm
Date:
Signature of Applicant:
I hereby ofhat I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF VERING TO E 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, Sectio 5505, 2 3, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date:/ 7� /l
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
C STRUCTI N 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
CUPMi 140
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
'(408) 77773228 • FAX (408) 777-3333 • buildinga(�cuperlino.or9 u
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11 OWNER' ❑' OWI-MRR--B AGENT, ❑ CONTRACTORAGENTi�❑ ARCHITECT ❑ ENGAIEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME f A
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ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. #
COMPANY NAME
E-MAIL
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STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF __12F SFD or Duplex ❑ Multi -Family
STRUCTURE: ❑ Commercial
ROOF AREA t7
VALUATION. - p
EXISTING ROOF'TYPE:. ❑ BUILT -UP ROOF ❑ ASPHALT SHINGLES 18WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE/REPLACE YES
❑ NO
IFNO,
# LAYERS:
PLYWOOD �9 w ❑ �)
THICKNESS: 135/8”
PLYWD UOSB
TYPE: ❑ CDX
PITCH:
12
ROOF
CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT #
DESCRIPTION OF WORK 1 Z V-41 �l J ✓ / G U
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Pre-, -S,' L aVF /-u- 4 b re
By my signature below, I certify 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 information I have -provided is :correct. I have;read the De 'ption of Work.and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating ta building coris I authorize r sen ives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: /7 ✓ et /
SUPPLEMENTAL RTF.QFd.ATION REQUIRED
Ifbuilding is associated with a Home Owner's Association, provide letter
ofapproval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturers Installation Specifications.
Provide signed copy of Cupertino's Tear -Off Policy.
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ReroofApp 2011.doc revised 03116/11
CITY OF CUPERTINO
FF.F. FCTTMATOR — RIIIT,DING DIVISION
61' ADDRESS: 874 september dr
DATE: 07/17/2014
REVIEWED BY: Mendez
APN:
BP#:
*VALUATION: 1$10,800
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
USE:
PENTAMATION 1 SFDWLROOF
PERMIT TYPE:
WORK��28
sq- remove shakes install 1/2 30 # feltk class a
SCOPE
Permit Fee:
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Fee:
FEE ID ROOF AREA
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1REROOFFRES 2,800
1'Ittt;;h. Plan C. hccAi
T lJ rnh. Perm "I Ne'e
Other P"wnh Trsn.
/'hull;. iras. Fez':
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t`cc. Imp', 1,1re:
NOTE: This estimate does not include fees due to other Departments (i.e. rianning, rumic works, rare, aanuarynewer utstrict, .3caaot
L,. ,..7 „ sL .. ../:..... ...t f--4— • _a"Ato -I - ."h, aN octimntorantart tho vont for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13)
FEE
QTY/FEE
MISC ITEMS
zF lOn Check 7`� fV
Permit Fee:
$476.00
t=lifilaf;').
i'%?rrT}).: ;1<e't'rf.-'"CC f'efi•fatit Fee:
C= n,>il t. cfion
rI ljnifn,4ut`mi,,'e? Fec,:
Work Without Permit? ® Yes No
$0.00
Fees:
Strong Motion Fee: IBSEISMICR
$1.40
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
o r
$478.40
$0.00. TOTAL FEE:
$478.40
Revised: 07/10/2014
CUPERTINO
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(a.cupertino.org
PROJECT ADDRESS X -7 Lf
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APN#
OWNER NAME p �' w)
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E-MAIL
STREET ADDRESS
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CITY, STATE, ZIP
FAX
CONTRACTOR NAMEy
LIC EN E � MBER-3 3
LICA js TYPE
BUS. LIC. #
COMPANY NAME f� _1\ �n g3
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E-hMAIL
FAXLi
STREET ADDRESS F� G+ h ,A (-1 4A1, C
CITY, STATE, ZIP
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PHONE i. f37 C!'^�1 . r q S
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 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 2013 California Residential Code. /
Signature of ADDlicant/AQent: Date: / <
ReroofPo1icy_2014.doc revised 01115114