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15050059 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10281 S DE ANZA BLVD CONTRACTOR:PLATINUM ROOFING PERMIT NO: 15050059 INC OWNER'S NAME: ROBERT ALLARIO 1900 DOBBIN DR DATE ISSUED:05/12/2015 OWNER'S PHONE: 4088673060 SAN JOSE,CA 95133 PHONE NO:(408)280-5028 + LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL „_ T APPLY(N)CLASS A FLUID APPLICATION ROOFING License Class Lic.# �` n SYSTEM } � OVER(E)ROOF(180 SQ'S) Contractor 1 Date r 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:$60000 r 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:35917001 10281 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 WITHEN 180 DAYS OF PERMI SUANCE 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 O +D 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 Z granting of this permit. Additionally,the applicant understands and will comp Iss b Date: with all non-point source regula'ons per the Cupertino Municipal Code,Sectio 9 18. !-ROOFS: Signature Date � � 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 C Signature of Applicant: Date: J 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 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) 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 1 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 505,255 3,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date:atc:: permit is issued. r 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,l 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 .-P REROOF PERMIT APPLICATION b COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION C O 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 J (408)777-3228• FAX(408)777-3333• building()cupertino.orq CUPERTINO PROJECT ADDRESS I ® ol- [" Oe., kza ni OA I APN# 9 — O/)/• p 62 S OWNER NAMEr�Q ///a,/ A �r( D I ruK PHONE M Z300 E-MAIL STREET ADDRESS 1 �! l 1 ® 'A y� �f C"STATE, FAX CONTACT NAME E-MAIL 4 ST A DRES CITY,STATE, ZIP A. FA MS ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT I CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMEMthLICENSE NUMBE LICENSE TYPE BUS.LIC.# COMPANY NAME A FAX�f STREET ADDRESS r CITY,STATE, C6 k33 PHONIES 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 ROOF AREA: VALUATION: STRUCTURE: Commercial np Ga's 0 e OUA 2 EXISTING ROOF TYPE: BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY) REMOVE/REPLACE 11 YES IF NO, PLYWOOD ❑ w, ❑ PLYWD OSB PITCH: /�. ROOF NO #LAYERS: THICKNESS: 5/8" TYPE: ❑ CDX /� '12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ElASPHALT SHINGLES 1-1WOOD SHAKES ElWOOD SHINGLES ❑OTHER IC -E:.R PORT# DESCRIPTION OF WORK: nn I I ,6 t 1.� t6uk'l+ i)n Cap 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 rov'ded 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 b Idin� nstruction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. S i gnature of Appl icant/Agent: Date:�� { �� SUPPLEMENTAL INFORMATION REQUIRED OFT ICE„USE A y u i _If building is associated with a Home Owner's Association,provide letter itily CHEcx TYPE xolrrlNcsLIP yEof approval from HOA. Provide Planning approval to verify ifthere any restrictions. fl EXPRESS "� �?PLANNII`GPLANREVIEW ', —Provide copy of Manufacturer's Installation Specifications. D`sr ARD Ok FIRE DEPT x ,, �' ❑+OTHER ` ' t ��a Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10281 S DE ANZA BLVD DATE: 05/12/2015 REVIEWED BY: MELISSA APN: 359 17 001 BP#: `VALUATION: 1$60,000 %PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1 COMMLROO WORK APPLY N CLASS A FLUID APPLICATION ROOFING SYSTEM OVER E ROOF 180 SQ,S SCOPE FEE ID ROOF AREA s.f. 1REROOFCOM 18,000 Mech. Plan Check Phrrnh.Plan Check f_lec.Plan Check FL1ech, Permit Fee: Plumb.Permit Fee: Elec. Permit Fee: Other A(cc r.Insp. F-1 I Other Plumb IrisLj I Other I'' ler..Insp. ET rllech.Insp. Fee: Plumb. Insp. Fee: Elec.Insp.Lee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These_fiees are based on the relimina information available and are only an estimate Contact the Dept or addn'1 info, FEE ITEMS (Fee Resolution 11-053 Eft' 7/1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: Sup1)1. PC Fee PlzmzbA.Uech./Elee Permit Fee: $1,468.00 Sitl2pl. Insp Fee Plzmzb.illlech.1Elec Phsnih./Mach.IE'Iec Pernfit Fee: Construction Tax: Adlnlnistrative Fee: Work Without Permit? 0 Yes (j) No $0.00 Advanced Plunning Fees: Travel Documentalion Fees: Strong Motion Fee: IBSEISMICO $16.80 Select an Administrative Item Bldy,Stds Commission Fee: IBCBSC $3.00 SUBTOTALS:_ $1,487.80 $0.00 �: TOTAL FEES $1,487.80 Revised: 04/01/2015 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 CUPERTINO (408)777-3228• FAX(408)777-3333• building a(),cupertino.org PROJECT ADDRESS O • oe APN# Q I OWNERNAME PHONE 4n7)67YZ-MAIL STREET ADDRESS CITY, STATE,ZI FAX I � 10 0 amq?&L 11 �OZ� CONTRACTOR NAME 10k I LICENSE NUMBER LICENSE YPE BUS.LIC.# Wm COMPANY NAME �'�A � CLE-MAILTATE, FAX ( A STREET ADDRESS rh b'I Zsa 1_ r/y PHO ' cso 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 7:30-3:30pin (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 monoxid4dete/to arerequired to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Code Signature of Applicant/Agent: Date: ReroojPolicy_2014.doc revised 01/15/14