15080121FU
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22670 SAN JUAN RD
CONTRACTOR: ABOVE ALL ROOFING
PERMIT NO: 15080121
OWNER'S NAME: ITEM WERNER AND GLORIA E
700 NORTHRUP ST
DATE ISSUED: 08/17/2015
OWNER'S PHONE: 4082577189
SAN JOSE, CA 95126
PHONE NO: (408)292-4188
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
3
TEAR OFF (E) TPO, (NO NEW PLY) INSTALL (N)
License Class Lic. #
SELF -ADHERED T/L COMP ROOF SYSTEM (25 SQ'S)
N � (J 5
Contractor Date
I hereby affirm that I am licensed under the provisiog of C apter 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
Sq. Ft Floor Area:
Valuation: $20636
performance of the work for which this permit is issued.
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: 34218029.00
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 IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WIT SOF PF T 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
AYS FROM LLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
City in the
costs, and expenses which may accrue against said consequence of
granting of this permit. Addit' ally, the applicant understands and will comply
sued b
with all non-pom ce r lati s per the Cupertino Municipal Co , Section
9.18.
If
RE -ROOFS:
Signature l
All roofs shall be inspected prior to any ofrng material being installed. If a roof is
ateri s for
inspection.
installed without first obtaining ani ection, I agree to remo10BETTER
❑ OWNER -BUILDER DECLARATION
/Signature
of Applic ate:I
hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROO COVERINGS TO BE CLASS "A"
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 My Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance w' Cu tino Muni i al Code, Chapter 9.V and
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
the Health & Safety Cod ions 33, nd 2
/�
Owner or authorized a 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
ARCHITECT'S DECLARATION
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
11
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a�cuperbno.or4 012 /
PROJECT ADDRESS 2�p/"70 5/fp J To ,/�-Pj P '� APN # 03 y e2_ _ ( 8
OWNER NAME L')50 i e� PHONE��y 2S-7(J/l / E-MAIL
STREET ADDRESS 2-4 r[/ 70
I �•, �� CITY, STATE, ZIPC v n (� ;` � FAX
CONTACT NAME PHONE L/';777E-MAIL
STREET ADDRESS CITY, STATE,/ZIP FAX
❑ OWNER ❑ OWN'ER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGIN-EER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMEA Q VBG LICENSE NUMBER --7r, LICENSETYPEC BUS. LIC. R
COMPANY NAME �j I� E-MAILµ y )� VC- /1-/G 5 � ()C / L d [ FAX 1� i
STREET ADDRESS �,Q IILA �j g CITY, STATE, ZIP C 2 C/ / PHONE L14002-92-9190
ARCHITECT/ENGINEER NAME ll` "r LICENSE NUMBER J ! BUS. LIC. #
I COMPANY NAME
STREET ADDRESS
E-MAIL
CITY, STATE, ZIP
FAX
PHONE
USE OF ❑ SFD or Duplex ❑ Multi -Family ROOF AREA: O VALUATION: /
STRUCTURE: ❑Commercial -7-5 ZOO 6 3�j� CEJ
EXISTING ROOF TYPE: El BUILT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES OTHER (SPECIFY) / 1 L1le
REMOVE /REPLACE ? I YES IF 110- PLYWOOD ❑ ,s' ❑ _ PLYWD ❑ OSB PITCH: ROOF
❑ NO I k LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX :12 CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑] WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT #
DESCRIPTION OF WORK / ^
SS LL
I% [, /L�Y� L G 0 MP 0S 1 i l v, q/J D jel F Yv d--b/'�-r -
I'N0 PL -V
ReroofApp 2011.doc revised 03/16/11
CITY OF CUPERTINO
FM__7 FEE ESTIMATOR - BUILDING DIVISION
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,500
ADDRESS: 22670 SAN JUAN RD
Numb. Plan Check
DATE: 08/17/2015
REVIEWED BY: MELISSA
1091
APN: 342 18 029
BP#:
Other Plumb Inv,ELI I
'VALUATION: $20,636
ERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
USE:
Permit Fee:
PENTAMATION 1SFDWLR00F
PERMIT TYPE:
WORK
TEAR OFF E TPO NO NEW PLY INSTALL N SELF -ADHERED T/L COMP ROOF SYSTEM 25
SCOPE I
SQ'S)
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,500
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, eta). These fees are based on the prelimina information available and are only an estimate. Contact the Dept or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff 711!13)
tfech. flan Check
Numb. Plan Check
.,ck
Mech. Permit Fee:
Plumb. Permit Fee:
Glec. Permit ree
Ocher ,Vech. InspE3__L_
Other Plumb Inv,ELI I
er 1 ,t:c. Insp.
ET-t-
tfzsGr_ /"�'C
ur+i� 1nv)
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, eta). These fees are based on the prelimina information available and are only an estimate. Contact the Dept or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff 711!13)
FEE
QTY/FEE
MISC ITEMS
Plan. (.'heck Fee:
Suppl. PC Fee
Permit Fee:
$425.00
Supp1. Insp Fee
Plumb.111ech./Elee
P1untb.4,'v1ech./E1ec Permit Fee:
Construetion .KLY:
Administrative Fee:
Work Without Permit? 0 Yes Q No
$0.00
,ldvanced Planning Fees:
Travel Doc°uinenlalion Fees:
Strong Motion Fee: IBSEISMICR
$2.68
Select an Administrative Item
1
Bldp_ Stds Commission Fee: IBCBSC
$1.001
SUBTOTALS:
$428.68
$0.00 TOTAL FEE:
1 $428.68
Revised: 07/02/2015
r
C=.UPERTINO
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 • buildino ancupertino.org
PROJECT ADDRESS '% Z %
APN 0
'
OWNER NAMEvC/ A LL/L 777---)
7
PHONE L(a` .J/7��
Cfcupr_Ip
E-MAIL
STREET ADDRESS SLn'�� 7 / f L3 L9 6,
�
CITY, STATE,, ZIP
Fl,,I O
FAX
CONTRACTORNA1vig&.
f�/
LICENSE NUMBER �r
/
LICENSE TYPE CQ
BUS. LIC. 9
COMPANY NAME , - � 1 /j�(�/
�V V 1 q�(vOV,9
E-MAIL
FAX
STREET ADDRESS --7wV /IID (Q 1f P C�
CITY, STATE, ZIP f.I S L �J S
PHONE (�� �f ?Z
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 1.2:30-3:30 (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 monox�deA ctorsrequired to be installed in accordance with Sections 14 d R315 of
the 2013 California Residential Cid€. /� (_ ".r7,
of ADDlicant/.
/5
ReroofPolicy_2014.doc revised 01/15/14