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15010001 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7958 PUMPKIN DR CONTRACTOR:CUPERTINO ROOF,INC PERMIT NO: 15010001 OWNER'S NAME: SAN JOSE,CA 95129 PHONE NO:(408)973-9427 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL ❑ TEAR OFF(E)WOOD SHAKE,INSTALL(N)OSB,&(N) License Class 6 LLic.#E�� s��y 37 CLASS A COMP ROOF SYSTEM(23 SQ'S) Contractor �uPtrF•�d V"�'�, Date___L -2-' is 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$11000 NI 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:36203004 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 upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS F S ED 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 Date: 7/ l� granting of this permit. Additionally,the applicant understands and will comply Y with all non-point sours ations per the Cupertino Municipal Code,Sect 9 18. OFS: Signature Date 1-2—�� All roofs shall be in A�afin g in, being installed.If a roof is installed withoutfirst obtaining an ins ection,I agree to remove all new materials for inspection. ElOWNER-BUILDERDECLARATION / nDate• ['Z � ! _ I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicat: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,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 Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 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 T REROOF PERMIT APPLICATION \0 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING.DIVISION O 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTtNO (408)777-3228•FAX(408)777-3333•building(@cuipertino.org \ PROJECT ADDRESS �y��/ �r APN# 2 /� O —0 OWNER NAME ' FAX .k•�.c C� cr `nd !moi 9Shc CONTACT NAMEPH ONE E-MAIL 4la9= 973-9'127 a,,..,�,.ta�hso��'��-co-� STREET ADDRESS � �n i _ � CITY,STATE,ZIP SaA jo� 1� FAX X�(/ ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR 11 CONTRACTOR AGENT El ARCHITECT 6-1 FAX ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBLR LICENSE TYPE BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS10 CITY,STATE,ZIP JI`G y_Cl (1e- 9 PHO4d-973-GL1 2- ARCHITECT/ENGINEER NAME LICENSE NUMBER / '/ BUS.LIC.# 7 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial 2 ; / I X EXISTING ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES RfWOOD SHAKES ❑WOOD SHINGLES El OTHER(SPECIFY) REMOVE/REPLACE ,❑YES IF NO, PLYWOOD w' 1:3PLYWD XJ OSB PITCH: ROOF gN0 #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX 12 CLASS: `� PROPOSED ROOF TYPE: ❑BUILT-UP ROOF g ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: ge^VC Ikro Ove& 66,S 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 Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con aietio . horize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent:_ Date: J 2 SUPPLEMENTAL INFORMATION REQUIRED � # 1 s s v . OFFICE,[JSE;;,ONL1( _ _If building is associated with a Home Owner's Association,provide letter i 'ai• - _ T � ,�� RovTirc s%rr of approval from HOA. RUUNTER' © LDING�PLAN REVIEW a Provide Planning approval to verify ifthere any restrictions. r ��`I, ?i�ES s�:� �n t� * ANNII�GPLANREVIEW ' _Provide copy of Manufacturer's Installation Specifications. p T rak; ❑,,FdRE DErT Provide signed copy of Cupertino's Tear-Off Policy. i��a ❑ HER ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 7958 PUMPKIN DR DATE: 01/02/2015 REVIEWED BY: MELISSA APN: 362 03 004 BP#: *VALUATION: 1$11,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F USE: PERMIT TYPE: WORK TEAR OFF E WOOD SHAKE INSTALL N OSB & N CLASS A COMP ROOF SYSTEM 23 SQ'S SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 2,300 0 ,,..., P, "Pb.p f7; fee ,o.. ., Other 1'7trafrh/rs?; El NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 in o. 77FEE I .ITEMS(Fee Resolution 1.1-053.E 7/1113,) FEE QTY/FEE MISC ITEMS tt Permit Fee: $391.00 :'3i IIZ I7 Fee., Work Without Permit? 0 Yes G) No $0.00 Strong Motion Fee: IBSEISMICR $1.43 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 I IN AL $393.43 $0.00 TOTAL FEE: ` $393.43 Revised: 10/01/2014 • REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERT[NO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333-building aftupertino.ong PROJECT ADDRESS APN# 6 Z U O 0 OWNERNAME � E-MAIL STREET ADDRESS ^U CITY, STATE,ZIP/.U. FAX CONTRACTOR NAME �K. SM. LICENSE/NUMBER LICENSE TYPE BUS.LIC.# 1�V0,W41A0 54 COMPANY NAME E-MAIL FAX C, r+;nv STREET ADDRESSos) ��' �� CITS-_^STATE,Z�� q�_ PHOKOg F73_11i.7 6 L 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/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 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�deteare required to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Cod Signature of Applicant/Agent: Date: L_ 2- l5� ReroofPolicy_2014.doc revised 01/15/14