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15040119 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10161 PARK CIRCLE E CONTRACTOR:GEORGE A JULIAN PERMIT NO: 15040119 CONSTRUCTION OWNER'S NAME: H&J PROPERTY MGT LLC 1360 DONOHUE DR DATE ISSUED:04/16/2015 OWNER'S PHONE: 4084893558 SAN JOSE,CA 95131 PHONE NO:(408)464-8991 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL [:] 10161 PARK CIR E UNITS 1-4-INSTALL OVER(E)T& License Class_ Lic.4 goZ to G,NEW CLASS A B.U.R.TORCH DOWN ROOF SYSTEM Contractors 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:$4000 Oand will maintain Worker's Compensation Insurance,as provided for by Sec ion 3700 of the Labor Code,for the performance of the work for which this APN Number:32632018.00 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 DAY C ED IN SPE TION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the lr granting of this permit. Additionally,the applicant understands and will compl sued b te: with all non-point source regulations per the Cupertino Municipal Code,Seiffibn 918. ROOFS: Signature Date !b ! All roofs shall be inspected prior to anyny 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 Signature of Applicant: Date: (4 f-S 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) 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 255q5,25533,and 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 918. Signature Date r REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building(cDcupertino.org �O PROJECT ADDRESS O Jr ((-r [ pA 191 9 APN f Z_ D/� OWNER NAME D h M PHONE Qr_��f�j�Z[�(J_ E- AIL STREET ADDRESSi (�� r ( li/�', CITY, ATE,ZIP FAX CONTACT NAME M i PHONE r!! ^2� E-MAIL k `�l J STREET ADDRESS t 0 f �� F_- CITY,STATE,ZIP � �t� ' ��f FAX 1:1 OWNER El0 WjNER--BIUILDER ❑ OWNERAGENT CONTRACTOR 1:1 CONTRACTOR AGENT El ARCHITECT El ENGINEER El DEVELOPER 11 TENANT CONTRACTOR NAME V �`R� LICENSE NUMBER0�[03� ISE TYPE BUS.LIC.# l O COMPANY NAMEI E-MAIL FAX MOM1 STREET ADDRESS ,M,�u c. CITY,STATE,ZIP 'otpe /� ` �l� PHONE I/r �r1fJ r (f ARCHITECT/ENGINEERNAME WW,l V�/ LICENSENUMBER ( l BUS.LIC.9 rDT COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex 14 Multi-Family ROOF AREA: ppy� c VALUATION: STRUCTURE: ❑ Commercial 6 ", y4 EXISTING ROOF TYPE: BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE 11 YES IF NO, PLYWOOD ❑ %" ❑ PLYWD ❑ OSB PITCH: ROOF ❑ NO #LAYERS: THICKNESS: El518" TYPE: ElCDX '12 CLASS: L1 PROPOSED ROOF TYPE: 'BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT 2 DESCRIPTION OF WORK W2 i/WW G(a*5 A 104/ 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 bui nst ction. I authorize representatives of Cupertino to enter the a bove dentifi d property for inspection purposes. Signature of ApplicanUAgent: — Date: 7 71 ��ls SUPPLEMENTAL INFORMATION REQUIRED . - _If building is associated with a Home Owner's Association,provide letter x �� PLnt`C>�c�TYPE ; RovTu�c`sL� t � of approval from HOA. Pp �YEk TEiE Co TER L Bi7ILDII�G PLAN REVIEW Provide Planning approval to verify if there any restrictions. sfl FxPREss � ® rl >rGrL�Iv+REtiEtY _Provide copy of Manufacturer's Installation Specifications, Provide signed copy of Cupertino's Tear-Off Policy. `g- ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10161 PARK CIRCLE W#1-4 DATE: 04/16/2015 REVIEWED BY: MELISSA APN: BP#: *VALUATION: 1$4,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Buildina is PENTAMATION 1 R2ROOF USE: Multi-Family Dwelling >3 Stories ® Yes (D No PERMIT TYPE: i WORK INSTALL OVER E T& G NEW CLASS A B.U.R. TORCH DOWN ROOF SYSTEM SCOPE FEE ID ROOF AREA s.f. 1 REROOFMRES 3,100 0-0 a € a' We<,h. flan Check Plumb. Plan Check E/ec.Plan Chuck ;Wo- .Permit Fee: Plumb.Permit fee: Iaec. Permit hire: F ;laech. Insp. t?ther Plumb Insp. Other E,lec.Insp. . Insp� Fee: P/, I" Insp. fee: 1>lec.Insp.fee: NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the relimina information available and are only an estimate. Contact the Dept or addn7 info, FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: S'uppl. PC.'Fee Plumb./iW ch./Elec Permit Fee: 27.00 Su/rpl. Insp 1'ee �Q Plurn b.;':�tec:{z.'ls l ec Plurnh./1k,1��ch.iElec.l'er-niit Fee: Consiructuon Tax: ,ldininkstrative Fee: Work Without Permit? ® Yes (E) No $0.00 Advanced Planning/Fees: Travel Docurnentation fees: Strong Motion Fee: IBSEISMICR $0.52 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 (400,�T7 r $528.52 $0.00 .. $528.52 Revised: 04/01/2015 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildino(dcupertino.org PROJECT ADDRESS (o, Ai 1' C(`R C eg!Lys/,L APN# OWNERNAME !7 T J P r Ot"n` I �t�nf PHONE (W) i I qe%3S� E-MAIL STREET ADDRESS 1©/63 a,[71 il'�I Q f= CITY,STATE,ZIP , 'ic i lQ ��� A I FAX CONTRACTOR NAME T/��t �lie LICENSENUMBER g a mom` LICENSE TYPE /y BUS.LIC.# COMPANY NAME V E-MAIL / FAX STREET ADDRESSr Q 1_&J A,1CITY,STATE,ZIP 6 \ / a PHONE1�1 �o ( I UNDERSTAND AND AGREE TO THE FOLLOW'ING: 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 7:30-3:30pin (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 monoxide detectors are required to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Code. Signature of Applicant/Agent: Date: ReroofPolicy_2014.doc revised 01/15114