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14080086 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10385 S DE ANZA BLVD CONTRACTOR:TB - 9-T�—4� PERMIT NO: 14080086 OWNER'S NAME: BDC HAYWARD LP �� � ('� 4ef DATE ISSUED:08/12/2014 OWNER'S PHONE: 9517103216 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL (CHIPOTLE)REMOVE UNUSED A/C UNIT AND CURBS; License Class — J ` Lic.# G1' (o �{� INSTALL BASE AND FR-10 FIRE RATED MEMBRANE aa WITH 60 Contracto �c � Date Uy'�„�nSS ''1 MIL TPO WHITE GAF 20 YR SYSTEM. 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 erflormance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$22000 ave 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:35917019 10385 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I MCe ify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED c.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 FROM LAST CALLED 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 Issued by: �ti�/�r� ��GIT Date: (/G granting of this permit. Additionally,the applicant understands and will comply le with all non-point source regula'ons per the Cupertino Municipal Code,Section - 2_ 1 d RE-ROOFS: Si hat Date 1 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: 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) 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 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 Cuper u un'cipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505, 5 nd 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or auth rize nt: Date: e-12- 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 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building(cDcupertino.oro PRO DCT D�,E APN# -33 (/7 OWNER AME PHONE E/-/MAIL STREET ADDRESSCITY,$TATE,Z1P FAX CONTACT NAME PHONEE-MAIL blip STREET ADDRESS CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR N LICENS NUMBER 7LICEN E TYPE BUS.LIC.# �4�sG U J� COMPANY NAME E-MAIL FAX STREET ADDc S CIT„Y,ST TE,ZIP ZPHHONEo ��X 11 alp 2 c C-- ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS - CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: / VALUATION: STRUCTURE: Commercial , 60 ( i�f 0L! EXISTING ROOF TYPE: X' BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE ❑YES IF NO, I PLYWOOD ❑ '/:" ❑ PLYWD ❑OSB PITCH: � ROOF NO #LAYERS: THICKNESS: `195/8" TYPE: CDX JJJ :12 CLASS: PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER- Y ,b ICC-ES REPORT# DESCRIPTION OF WORK: % \ �C v+� Q C i�►A�i +t- 1 �i si4A r� j;--\�, o Pa LO�*- 6-1H1 --4, 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 convect. ave re the escription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relati ilding construction. I nz r sentatives of Cupertino to enter theovvee-identified property for inspection purposes. Signature of Applicant/Age Date: 4S,_ (2- l`7 SUPPLEMENTAL INFORMATION REQUIRED .;ti. ', ,,.rY „, ,: ©t cEvsE rIL. . If building is associated with a Home Owner's Association,provide letter' = RouTnvc sr1P of approval from HOA. f �R n�rc pL,>ty tsEviEw Provide Planning approval to verify If there any restrictions. T, AIVNiNc PLrw REVIEW-, -. Provide copy of Manufacturer's Installation Specifications. T �ypSRE nEPr. _Provide signed copy of Cupertino's Tear-Off Policy. e xx, .otaER ReroofApp_2011.doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10385 S De Anza Blvd DATE: 08/12/2014 REVIEWED BY: Sean APN: BP#: "VALUATION: 1$22,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROO USE: PERMIT TYPE: A WORK Remove unused A/C unit and curbs; Install base and FR-10 fire rated membrane with 60 mil TPO white SCOPE GAF 20 yr system. rt 1'hwlb. Plan C'Greci; Pier:.1'n n �1�'z. Plan.czre 'rrc k "T,r_ t c;-wil Fee: iiV.z-: {)71W fiumb Iris, 0"I'lei'"'R,( l.nst) "k uh, 1 hispz[i?e: />tec.Ins/, 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 relimina information available and are onlyan estimate. Contact the Det or addn'I info. FEE ITEMS (Fee Resolution I1-053 E . 7/1/13,) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 6,000 s.f. Re-roof Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $1,020.00 IREROOFRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes (j) No $0.00 E) Advanced Plarming Fee. $0.00 Select a Non-Residential 0 Building or Structure 0 Strom Motion Fee: 1BSEISMICR $2.86 Select an Administrative Item Bldg Stds Commission.Fee: IBCBSC $1.00 _ 3.861$1,020.00 TOTAL FEE: $1,0913, 23.86 Revised: 07/10/2014 REROOF TEAR-OFF POLICY y 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(cDcugertino.ora PROJECT ADDRESS /� ? Q� �, � APN# OWNERNANM ,, 21 PHONE - / E-MAIL. STREET ADDRESS CITY,STATE,ZIP FAX CONTI RC-MGNAME �L ✓ LICENSE NUMBEFay LICENSEePE' BUS.LIC.# COMPANY NAME ,F ` ' E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP P . 7,4 0 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 un 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 properly 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 ar ire to be installed in accordance with Sections R314 and R315 of the 2013 California Residential G Signature of Apphcant/A Date: z ReroofPolicy_2014.doc revised 01/15114