14110092 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7512 LEEDS AVE CONTRACTOR:R E ROOFING& PERMIT NO: 14110092
CONSTRUCTION INC
OWNER'S NAME:
SAN JOSE,CA 95124 PHONE NO:(408)626-9320
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑
_ (� q� RE-ROOF 26 SQ;RE-ROOF REMOVE EXISTING 2 LAYERS
r1hereby,
nse Class L/ l Lie.# OF
!lROOF SHAKES CLASS A
tract Date
affir 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:$12500
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:36616022.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PE T Et: PERMIT
ORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WI 1ISSUANCE 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 D CALLED INSPEC ION.
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: `�
granting of this permit. Additionally,the applicant understands and will comply Issue by:
with all non-point source regulations per the Cupertino Municipal Code,Section
8.
f RE-ROOFS:
nature Date L L All roofs shall be inspected prior to any roofing material being installed.If a roof is
in ed wit first obtaining ection,I agree to remove all new materials for
spection. I ( ( l
❑ OWNER-BUILDER DECLARATION Date:
Si ure
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)
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 ants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. ilI maintain mpliance with the Cupertino Municipal Code,Chapter 9.12 and
the Health&Sa ty
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 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
918.
Signature Date
REROOF PERMIT. APPLICATION ba
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �a
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•building clicupertino.org 1
PROJECT ADDRESS A.._f APN# �(r�//� /of
OWNER
(��j�' FAX
CONTACT NAME ] 2_0�� �� 1� �, PHONE /I J _q ry 2 0 E-MAIL
STREET ADDRESS CITY,STATE,ZIP C� 7
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT XCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME' LICENSE NUMBER In �(f� LICENSE TYPEBUS,LIC.#
COMPANY NAME ,(� t 'y,/� E-MAIL r f r o 0 J�-l�� 4�_ 6 CLO ` FAX
STREET ADDRESS �n�A,� LYi. �� �0� ry CITY,STATE,ZIP C, �/�^ PHONE
ARCHITECT/ENGINEERNAMEY� LIC ENSENUMBER 1 7 L BUS.LIC`.`# ( (/
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SF or Duplex ❑ Multi-Family ROOF AREA: ( VALUATION: ({ AV
STRUCTURE: ommercial 2k � / (i
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES�OOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE IF NO, PLYWOOD }/s" ❑ PLYWD 11 OSB PITCH: ROOF
ElNO #LAYERS: THICKNESS: ❑ 5/8" TYPE: CDX 12 CLASS: L1
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK:
[WU M4� liz CD
Ltl` e0 mr
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
applicationand the 'on I have provided is correct. I have rea the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and ate laws rela' I ction. I thoriz eprese atives of Cupertino to enter the above-i iltifieproperly for inspection purposes.
Date:
SUPPLEMENTAL ION REQUIRED ; _ oic> IrsEyornY
f„
If building is associated with a Home Owner's Association,provide letter 5 nivCaEcxTYP� r RovTcsLiP
° Shy'• A Pc k t
of approval from HOA.
NTE ' uirnvvG PL�v>zi REVIEW
u'�Gi ER
. —Provide Planning approval to verify i£there any restrictions.
Provide co of Manufacturer's Installation Specifications. #- �
copy IJ ❑QST BARD !❑ DEPT
—Provide signed copy of Cupertino's Tear-Off Policy. fir, r ❑ Uzrr>R
qs
�0101.. _,R
ReroofApp_2011.doe revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 7512 leeds ave DATE: 11/17/2014 REVIEWED BY: Mendez
APN: BP#: *VALUATION: 1$12,500
-PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Du lex PENTAMATION 1 SFDWLROOF
USE: P PERMIT TYPE: A
WORK re-roof 26 sq; re-roof remove existing 2 layers of roof shakes class a
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,600
TME
a
i9c,Ch. Plant( a�t.x llhamb. 111crr1Check 1Yec'. 1,/,v?Check
l�>c;b_ P�tartit
Fee: Plumb. Pe nnit/'Cc. Flea Peri z
C7;hca ale-eHa. Irrsa� 7_ Other Plumb[n n. 0her Liec.lnsj"�.
Li
r„
AIC", _Ire/). 1~ Phinub. hisp.
NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These fees are based on the prelimina inormation available and are onl an estimate. Contact the Dept/or addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7ff /1/13) FEE QTY/FEE MISC ITEMS
Plan C'"W("I;
Plrrt�al. ielcrcr't.;Zlec
Permit Fee: $442.00
SI(ppl.
_I`'llfr�zf;.;';1 tc�c•It.:'I>le�.
l�ltfr,f i,<ieclt.;'1..>`lec Permit Fee:
Construction Tax:
Work Without Permit? 0 Yes No $0.00
Piarlaing
fT'i:t','a't 1%fJ:'7,z.t72c'PZIa17 1f7 /`k'.es:
Strong Motion Fee: 1BSEISMICR $1.63 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
gilk . $444.63
$444.63 $0.00 °. TOTAL FEE:
�'
Revised: 10/01/2014
1
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINQ
(408)777-3228•FAX(408)777-3333•buildinp(a-)cupertino.org
PROJECT ADDRESS �J I n �s APN#
OWNER NAME
STREET ADDRESS CITY, STATE,ZIP , /1 FAX
CONTRACTOR NAM r' ' U [V�/ / LICENSE NUMBER rJ�� LI ENSE TYP BUS.LIC.#
COMPANY NAME CV UF' L 1�5T�V�I t Ne E-MAIL �/',e.rV l I YI `l v, Ci GLO I �.iM�'l F "C U t� !
STREET ADDRESS !} 2 r i ��`I�� , ,- CITY,STATE,ZIP � �i f I PHONE L+I�& / ,�n /I4
L 1V I`UNDERSTAND AND AGREE TO THE FOLLOWING: y
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 mCCode.
to stalled in accordance with Sections R314 and R315 of
the 2013 California Residentia
Signature of Applicant/Agent: Date:
ReroofPolicy_2014.doc revised 01/15/14