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15100189 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21929 OAKDELL PL CONTRACTOR:A-1 ROOF MANAGEMENT PERMIT NO: 15100189 AND OWNER'S NAME: CHANDLER TIMOTHY R F AND ZAMOONNA 14100 DOOLITTLE DR DATE ISSUED: 10/23/2015 OWNER'S PHONE: 6508772337 SAN LEANDRO,CA 94577 PHONE NO:(510)347-5400 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REMOVE 8 SQ'S OF(E)TILE FOR FUTURE PV INSTALLATION.REPLACE WITH(N)CLASS A COMP/TILE License ClassB,C-3`7,C--3-1 Lic.# ��-a13 Y �-C ROOF POST INSTALLATION OF PV SYSTEM Contractor Date I hereby affirm that I am licensed Ider 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: Sq.Ft Floor Area: Valuation:$4200 1. I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:32639001.00 Occupancy Type: 7 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. PERMIT EXPIRES IF WORK IS NOT STARTED APPLICANT CERTIFICATION WITHIN 180 DAY ISSUANCE OR I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating 180 D OM �ED INSPECTION. to building construction,and hereby authorize representatives of this city to enter l upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,—""oIssu Date: costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature (2__22 __F(__ Date k '3 3]1$` 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 Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER the following two reasons: 1. 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 HAZARDOUS MATERIALS DISCLOSURE sale(Sec.7044,Business&Professions Code) 2. 1,as owner of the property,am exclusively contracting with licensed contractors to I have read the hazardous materials requirements under Chapter 6.95 of the construct the project(Sec.7044,Business&Professions Code). California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I hereby affirm under penalty of perjury one of the following three declarations: Safety Code,Section 25532(a)should I store or handle hazardous material. 1. I have and will maintain a Certificate of Consent to self-insure for Worker's Additionally,should I use equipment or devices which emit hazardous air Compensation,as provided for by Section 3700 of the Labor Code,for the contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the performance of the work for which this permit is issued. Health&Safety Code,Sections 25505,25533,and 25534. 2. 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 Own or authorized agent: permit is issued. Date: to 3&T 3. 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 I hereby affirm that there is a construction lending agency for the performance of work's become subject to the Worker's Compensation provisions of the Labor Code,I for which this permit is issued(Sec.3097,Civ C.) must forthwith comply with such provisions or this permit shall be deemed Lender's Name revoked. Lender's Address APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is ARCHITECT'S DECLARATION correct.I agree to comply with all city and county ordinances and state laws relating I understand my plans shall be used as public records. to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Licensed Professional indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE- CUPERTINO, CA 95014-3255 CUPERT(hl0 (408)777-3228 - FAX (408)777-3333- buildina(a-cupertino.org 5 PROJECT ADDRESS -2 iq Zq APN# Z,6 OWNER NAME \ •` P ONE E-MAIL STREET ADDRESS CITY, STATE,ZIP I FAX CONTACT NAMEP ONE E-MAIL Ao.��) s t-(14c,_Z_ STREET ADDRESS CjzY,STATE, ZIP FAX 0410-D c,%l i l L31 r mac",, �,r��-� t-�14 `Z`q o ii 0 ❑ OWNER ❑ 0lk'NER-BUILDER ❑ OVINTER AGENT )<CO1\RACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGWEER ❑ DEVELOPER ❑ TENANT CON1:TtkCTOP,NAN4E LICENSE NUMBER ICENSE TYPE I BUS.LIC. COMPANY NAMErr E-MAIL FAX �9r TY)r-k ne <51 U x`7—7 STREET ADDRESS CITY,STATE,ZIPPHO tPHONE17c;v 1'l �� l7 Y -��/�U C-,A- 2`15 I C 3-17 a-3 ARCHITECT/ENGINEER NAME LICENSE NUMBER ( BUS.LIC.n COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF jg�SFD or Duplex ❑ Multi-Family I ROOF AREA: VALUATION: STRUCTURE! ❑ Commercial 9U EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY T� >I�-a-�- ids REMOVE/REPLACE% YES IF NO, PLYWOOD ❑ 'w, ❑ PLYW`D ❑ OSB PITCH: 1 ROOF ❑ NO n LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX '1 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF 9ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT n DESCRIPTION OF WORK: nL v�� L�� Ci� ](Y i(' _ _ 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 construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Si-nature of Applicant/Agent: _�L�_ Date: SUPPLEMENTAL INTFO ZATION REQUIRED = OFFICE USE OIVLI If building is associated with a Home Omner's Association.provide letter CHECKTITE RovTlncsLiP - fay of approval from HOA. OVER THE BUIIDLNG PLANREVI$�V t z Provide Planning approval to verify if there any restrictions. { L3=PLANN'II1G PLAN REVIEW: -� Provide copy of Manufacturers Installation Specifications. sT = C� FIREnEPT _ Provide signed copy of Cupertino's Tear-Off Policy. Y t oTrR ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 21929 PAKDELL PL DATE: 10/23/2015 REVIEWED BY: MELISSA APN: 326 39 001 BP#: *VALUATION: 1$4,200 "PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROO USE: PERMIT TYPE: WORK REMOVE 8 SQ'S OF E TILE FOR FUTURE PV INSTALLATION. REPLACE WITH N CLASS A SCOPE COMP/TILE ROOF POST INSTALLATION OF PV SYSTEM FEE ID ROOF AREA s.f. 1REROOFFRES 800 mech.Plan Check r'llwh. Pion Chec,A' 1aec..Ptan("heck I Iec,h_ Ferrari Fce: t'lurnb. Permit 1c _ Fee. P, .. tither Alech.Insp. Other Plu"nb tn:t;n Other Elec.Insp, 11ech.InsIr Fee, Tlrwib. Elea.Insp. 1 eCII: 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 prelimina information available and tyre only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 11-053 E . L11/13, FEE QTY/FEE MISC ITEMS Plan Check Fee: S'uppl. .PC Fee Plumb.tHech./Elec Permit Fee: $136.00 Suppl. Insp Fee Plumb./Alfech./Elec Plumb.11lech./Elec Permit Fee: Construction Tax: Administrative Fee.- Work ee.Work Without Permit? 0 Yes (j) No $0.00 Ildvanced Planning Fees: -cn,el Documeniatiun Fees: StronaMotion Fee: 1BSEISMICR $0.55 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 7 SUBTOTALS: $137.55 $0.00 TOTAL FEE: $137.55 Revised: 10/01/2015 a. REROOF TEAR-OFF POLICY r COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE- CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228 - FAX(408)777-3333- building cDcupertino.org PROJECT ADDRESS 1 Q Q:�-,V_ APN$ _ 3 7 o c) OWNER NAME 1 I P ONE E-MAIL TI M Cho.rJL l.,e t-1-7 " Z33-7 STREET ADDRESS CITY, STATE,ZIP I FAX 2 -I�p2 Oa Ic.��l 1 Avr-o c_,� S-b i y CONTRACTOR NAME -" �� LICENSE NUMBER LICENSE TYPE BUS.LIC. D4PANY NAME C) V �,,,�, E-MAIL t FAX COU `-/-7 SAO STREET ADDRESS CITY,STATE,ZIPPHONE (T D 1'; Dr. 1 ; -er_ .1� c--ff -7 1 S-7 1-' 3`-c 7 7"l c-O 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 7:3040:30am 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 AppIicant/Agent: Date: `� �-3 ReroofPolicy_2014.doc revised 01115114