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15100118I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10660 JOHNSON AVE CONTRACTOR: I PERMIT NO: 15100118 L I OWNER'S NAME: CHRISTINE HANSEN I�r;,(j-t-��,, I ��� �! �Uj��•�f�,�y DATE ISSUED: 10/15/2015 I OWNER'S PHONE: 4083346776 I , .�^/ _77,�� PHONE NO: A ;dl6 ,06 ca ❑ LICENSED CONTRACTOR'S DECLARATION License Class C,-�j' Lic. # Contractor 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: 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. 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 permit is issued. APPLICANT CERTIFICATION 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, 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 /,aP ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of 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 sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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. 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 permit is issued. s. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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, 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 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REMOVE EXISTING T&G AND INSULATED CEILING PANELS AND INSTALL 2X8 TONGUE AND GROVE WITH 2 INCH ISOBOARD AND PVC ROOFING (1100 SQ FT). Sq. Ft Floor Area: I Valuation: $14200 APN Number: 37528022.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: /✓ Date: RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air 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 Health & Safety Code, Sections 25505, 25533, and 25534. Owner or aut ize ent: -Date: /V -/S-IS i CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional r CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildina(a)cupertino.orq 1,5160116 PROJECT ADDRESS I APN OWNER NAME PHONE ,, E-MAIL 5-(4W 7 r -7 7 STREET ADDRESS CITY, STATE, ?_IP - FAX f COA"I'ACT NAME // PHONE�d I � � E-MAIL ti STREET ADDRESS Ave-, CITY, STATEZIP � 4 C, FAX ' J� ON'1W ITER ❑ OWNTER-BUILDER ❑ OVINTER AGENT ❑ CONI ACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGLNEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAA4E��S � LIC E I�TU11B LICENSE 41,BUS. LIC. R L � VV42,� 8t7.1� ( COMPAW. NAME E -MA FAX STREET ADDRESS i�2 �3�✓d CITY, STATE, ZIP --- r,,,( .7 Z � PHONE 190 C' I .�z0 2.1 , r-7-r0-6coell ARCHITECT/ENGINEER NAME LICENSE NUMBER I BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF 2f SFD or Duplex ❑ Multi -Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE YES IF NO, PLYWOOD ❑ /v, ❑ PLYWD ❑ OSB PITCH: 1 ROOF ❑ NO 4'LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX ' 12 CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES JeOTHERPI/c, ICC -ES REPORT DESCRIPTION OF WORK: ' 64 C* -.v e. !/ I ,/� O i Get � A.. 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 constr n. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. S i -nature of App] icant/Agent: [� Date: SUPPLEMENTAL INTFORMATION REQUIRED._ - e 4 P ANCHECKWPE z, ROUTING SLIP - If building is associated With a Home Owner's Association; provide letter - .F OVER THE -COUNTER i- ` t ; r BUILDLNGPLAl�'REVIEW -� of approval . pp l fHOA Provide Planning approval to verify if there any restrictions. - E�.PREss t i PL9TIaTL'1GPLANREViEW' Provide copy of Manufacturer's Installation Specifications. jM ❑ STDAxD s 4 ` Provide signed copy of Cupertino's Tear -Off Policy. t ' D OTHER Reroof,4pp_2011. do revised 03/16/11 CITY OF CUPERTINO IN�/JI FEE ESTIMATOR -BUILDING DIVISION . ADDRESS: 10660 Johnson Ave DATE: 10/15/2015 REVIEWED BY: Sean I1ech. Perwil I-' APN: BP#: *VALUATION: 1$14,200 XPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: "1111rrb. Insp. bee: PENTAMATION 1 SFDWLROOF PERMIT TYPE: WORK Remove existing T&G and insulated ceilinganels and install 2x8 ton ue and rove with 2 inch SCOPE Isoboard and PVC roofing. 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 vreliminary information available and are onlv an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution I1-053 Eff T"l,"13) Mech. Pltm Check Phwih. Plon (.'heck 'TC, Pian Check I1ech. Perwil I-' Plumb. Permit I ear Isley. Permit l°c,,. Other Alech. Insp. ?cher Plumb Insp. )fher Elec. Insp. Mech. Insp. Fee "1111rrb. Insp. bee: ' Jec. 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.). These fees are based on the vreliminary information available and are onlv an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution I1-053 Eff T"l,"13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =s.f. Re -roof $187.00 IREROOFRES Suppl. PC Fee: Q Reg. © OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee. -(F) Reg. OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 i '011SI uctiMl 7 (t:r: Administrative Pee: 0 G Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential O Building or Structure I 1:y.._ aEFt,��ttlalitln Fees: Strong Motion Fee: 1BSEISMICR $1.85 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $2.85 $187.00 TOTAL FEE: F $189.85 Revised: 10/01/2015 r CUPERTINO 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 - buddinaQcupertino.ora PROJECT ADDRESS APN # I �c V f7.n� AV?, OWNER NAME , PHONE 7/ E-MAIL STREET ADDRESS CITY, STATE, ZI I FAX r c>00. V0AA1,<_a---' AVe CONTRACTOR NAME I LICENS ,NUMBEP LICENSE TYPE BUS. LIC. n 5 r ve,) i f MY (s 2 COA ANY NAME � /� E-MAIL FAX dr x 2J a J r-eW ��. wu 1 0' -Z&aj2(od STREET ADDI SS CITY, SATE, ZIP `Z PHONE44 0 - L/^ n 0 ! NC �r lv 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 7:3040:30arn 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 are -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 R3 15 of the 2013 California Residential Code. Signature of Applicant/Agent: Date: ReroofPolicy_2014.doc revised 01/15114