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14090078CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20875 VALLEY GREEN DR CONTRACTOR: NEMMER ROOFING PERMIT NO: 14090078 OWNER'S NAME: KORET FOUNDATION 5348 AUDUBON PARK CT DATE ISSUED: 09/15/2014 OWNER'S PHONE: 6505923960 FREMONT, CA 94538 PHONE NO: (510) 919-2930 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ BLDG 664 - 671 - TEAR OFF (E) ROOF & INSTALL OSB c� License ClassLic. # 7�� �p / (IF NEEDED), GAF LIFETIME COMP ROOF SYSTEM (57 d� nn !o V to {`IS �j / Contractor (�C�/�+ ti- SQ'S) 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: $17526 have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32609064.00 Occupancy Type: ection 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 K IS NOT STARTED PERMIT EX7LAST correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 IT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enterupon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FAL' LED 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: Date: granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9 18. _ Signatur Date �� Y RE-ROOFS: 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 4—/5, . Signature Applican • Date:4—/5­- I hereby affirm that I am exempt from the Contractor's License Law for one of 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) 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 for this the Health & Safety Code, Sect s 2550 , 2 3, and 25534. ,/S Section 3700 of the Labor Code, for the performance of the work which Owner or authorized ager Date:,;4 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 �D REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION q O 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 Al408) 777-3228 • FAX (408) 777-3333 • building aacupertho.org \ v GtJP��t'1ii�� PROJECT ADDPESS C G A� f - 67/ '7514 �j JM APN # r7 / ? OC6 1�1 p© OWNER N . - �o�t I E-MAIL P ct S9 3 96 STREET ADDRESS 20 CIT ST ZIP FAX CONTACT NAME PHONE E-MAIL i.% 2�i7Y1�J�'G 2% STREET ADD $q CITY, STATE, ZIP `/, — FAX E3 OWNER' ❑jjOWNER-BUSLDER ❑.ORTIERAGENT ONTRACTOR ElCONTRACTOR AGENT 13 ARCHITECT E3 ENGINEER E3 DEVELOPER 13 TENANT CONTRACTORNAME ' ` - LICENSENUMBS CEN 11 Tu Fs-Lic-# COMPANY NAME /J ^/ ^ ^ E-MAIL FAX STREET ADDRE CITY, STATE, ZIP Q� 8V J 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 sTRucruRE: ❑ Commercial ROOF AAR�EA ✓ VALUATION: ' / � � EXISTING ROOF TYPE:. ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ROOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE REPLACE AXES ❑ NO IF NO,PLYWOOD # LAYERS: fi&%" ❑ _ THICKNESS: 115/8" PLYWD OSB TYPE: ElCDX PITCH: _ ' 12 ROOF CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK �% / 7✓ %� oxo(fo( /VG,SP/ ,�( • >.n -s rq/I Low _7/_;41� By my signature below, I certifp'to each of the following: I at 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 Description of Work.and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to ding coristru I authorize representatives of Cupertino to enter the above-identifiedproperty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED 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 Manufacturers Installation Specifications. Provide signed copy of Cupertino's Tear -Off Policy. R _ - _ i ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20876 VALLEY GREEN DR DATE: 09/15/2014 REVIEWED BY: MELISSA APN: 326 30 064 BP#: *VALUATION: 1$17,526 'PERMIT TYPE: Minor Building. Permit PLAN CHECK TYPE: Re -roof PRIMARY Buildina is PENTAMATION USE: Multi -Family Dwelling >3 Stories 0 Yes E) No PERMIT TYPE: 1 R2ROOF WORK BLDG 664 - 671 - TEAR OFF E ROOF & INSTALL OSB(IF NEEDED),GAF LIFETIME COMP ROOF SCOPE SYSTEM (57 SQ'S) tzecl?. f Pin Chieck I'Zafmb. Plan C:'heek E,kc. z'?<::>r C;?ec FA ("thee yft r: k 1,,Isp, On?er 111.rmb Insp. 0:`"tz'.r Ekc, h7.>p. k,, l?, lns!r ,. F',.v Plumb, hop. Fee; ETc-c. A"311", , 'r e: NOTE: This estimate does not include fees due to other Denartments (i e. Planning. Puhlic Warks. Fire. Sanitary Sewer District School Distract, etc.). z nese_fees are nasea on the preumanary informanon avauante ana are only an esumate. contact the Dept_ for aaan -1 info. FEE ITEMS (Fee Resolution 11-053 E . 7111131 FEE QTY/FEE MISC ITEMS Plan Check P ee3. T'(-"e Permit Fee: $969.00 Supp1_11"'sp Fee Work Without Permit? ® Yes (E) No $0.00 .u, czc £.>c.F?crr�tirrng Fees: 1 r 1: �octcpnc:rtation Pees: Strong Motion Fee: IBSEISMICR $2.28 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $972.28 $0.00 gTOTACFEE: $972.28 Revised: 08/20/2014 11_ 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 75 !� G/( , 6 -7 APN # 3 J L �O CSV OWNER N /` f% n (��� { PA 5 J y - 3 % (S O I^ EMAIL STREET ADDRESS SO �� ��j/. _7CI1'i TATJ�` ZIP ,/�C !n[ fy �`�� FAX /© lCT� / ` ��Z'iG %/ �7 CONTRACTOR NAME LICENSE NUMBER LICENSE NUMB" 3d -3� BUS. LIC. # COMPANY NAME ,AJ E-MAIL FAX STREET ADDRES .CITY / � � CTTY ATE, ZIP �� 3 SL p 1 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 re uired to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Code. Signature of Applicant/Agent: Date: ReroofPolicy_2014.doe revised 01/15114 � � � \ /���Z ��,�`� § �� � � %= _f� � ®® m � � �! .k � � : &� � ƒ�