14080142CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10007 SPANISH OAK CT CONTRACTOR: IQV CONSTRUCTION PERMIT NO: 14080142
INC
OWNER'S NAME: ALAN KUTACH 820 CHARCOT AVE DATE ISSUED: 08/15/2014
OWNER'S PHONE: 4085591977 SAN JOSE, CA 95131 PHONE NO: (408) 582-9200
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 0
p / CARPORT - TEAR OFF (E) SHAKE, INSTALL (N) CLASS A
License Class % Li.. # / �� �-�/ `� COMP ROOF SYSTEM (7 SQ'S)
G
Contractor �{— V Date TJ — w
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: $2167
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: 34232081 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 ORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 D F 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 FR AST CALLED INSP CT ON.
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: Date: V
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source re Mations per the Cupertino Municipal Code, Section
9 18.
_/(% RE -ROOFS:
Signature Date �1 ! 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.
13OWNER-BUILDERDECLARATION <9 —�
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 ROO CO ERINGS 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
will maintain compli nee with the Cupertino unicipal Code, Chapter 9.12 and
performance of the work for which this permit is issued.
the Health
I have and will maintain Worker's Compensation Insurance, as provided for by &Safety and 25534.
Code, Sections 25505 , 5 ` ,
Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 9-" 2J7
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 ONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
I hereby affirm that there a construction lending agency for the performance of
become subject to the Worker's Compensation provisions of the Labor Code, I must work's for which this
forthwith comply with such provisions or this permit shall be deemed revoked. ermit 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 plan 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
a % Sill !-ll I IrI wr-%I IV 1•
COMMUNITY DEVELOPMENT DEPARTMENT a BUILDING DIVISION.
10300 TORRE AVENUE a CUPERTINO, CA 95014-3255 �O
(408) 777-3228 • FAX (408) 777-3333 • building(Mcupertino.ora
CUPERTINO.
PROJECT ADDRESS
0l3,'NERNAMP XkI-Ire/L
STREET ADDRESS CITY, STATE, ZIP I FAX
CONTACT NAME
PHONES E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARICHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER/
LICENSE TYPE
BUS. LIC. H—�
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COMPANY NAME 1
E-MAIL
FAX
161 Q -
STREET ADDRESS I
CITY, STATE, ZI
ARCIIITECT/ENGINEERNAME
LICENSE NUMBER
BUS. LIC. 1/
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE of ❑ SFD or Duplex ❑ Multi -Family Rr-- VALU TION: r
STRUCTURE: ❑ Commercial `
EXISTING ROOF TYPE: -BUILT-UP ROOF ❑ ASPHALT SHINGLES WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOvE/REPLACE M YES IF NO, PLYWOOD ❑ 'h" ❑ PLYWD ❑ On PITCH: ROOF
❑
NO A LAYERS: THICKNESS: ❑ 5/E" TYPE: ❑ CDX 2 CLASS:
PROPOSED ROOF TYPE: BUILT-UP ROOF ❑ ASPHALT SHINGLES E1WOOD SHAKES ❑ WOOD SHINGLES OTHER ICC -FS REPORT 1t
DESCRIPTION OF WORK -� �
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By my signature below, I certify to each of the following: I am the property owner or authorized agent to act o the property owner's behalf. I have read this
application and the information I de 's correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
4bu�il'
ordinances and state laws relating nstruction. I authorize representatives of Cupertino to enter the �bove-ideentifiedproperty for inspection purposes.
Signature of Appiicant/Agent:!� Date.
SUPPLEMENTAL INFORMATION REQUIRED
or. F1 USE.ONL1tvs:liw�
If building is associated with a Home O\vner'S Association provide letterrAn.cilL
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of approval from HOA.
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Provide Platming approval to verify if there any restrictions.
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_ Provide copy of Manufacturer's Installation Speci6cationS.
_ Provide signed copy of Cupertino's Tear -Off Policy,
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Reroofdpp_2011. do revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
191
ADDRESS: 10007 SPANISH OAK CT
DATE: 08/13/2014
REVIEWED BY: MELISSA
APN: 342 32 081
BP#:
*VALUATION: 1$2,167
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
USE:
PENTAMATION 1SFDWLR00F
PERMIT TYPE:
WORK
CARPORT - TEAR OFF E SHAKE INSTALL N CLASS A COMP ROOF SYSTEM 7 SQ'S
SCOPE
1tfe 1'lttiz {`"hc L:i,
004,;, vif:'s.`17, ,`ns 7
IK
! htnib, f'Itaai t. he,:,k
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
,uistrlct, etc.). i nese-tees are based on the preliminary information available ana are only an estimate. uontact the Dept_for aaan -1 info.
FEE ITEMS (Fee Resolution 11-053 E . 7/U13
FEE
QTY/FEE
MISC ITEMS
Permit Fee:
$119.00
Construcfion Tax:
t eFec,:
Work Without Permit? ® Yes (D No
$0.00
,
71,avel D£Jcun B(:iZTation F"ec;;s,:
Strong Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
.,,.,.
$120.50
$0.00 FEE:
$ 120.50
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(Wcupertino.org
PROJECT ADDRESS
•
///
(PHONE
7A11 #
OWNERNAME
E-MAIL
STREET ADDRESS
:170
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CITY, STATE, ZIP
FAX
CONTRACTOR NAME
LICENSENUMBER�?6JZlq
LICENSE TYPE
��
BUS. LIC.#
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
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 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 obtainedand 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 1/4" 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 bebefore 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 tectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential
e. � [�
Signature of Applicant/Agent: f �/ �� Date: 11 1 1
RerooJPolicy_2013.doc revised 10/20/13