B-2016-1310 (2)CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1310
10131 CRAFT DR CUPERTINO, CA 95014-3475 (375 02 010)
(BRADSHAW ROOFING
INC)
CAMPBELL, CA 95008
OWNER'SNAME; WATSON DONALD TAND PEGGY I TRUSTEE&ET AL
DATE ISSUED: 02/04/2016
OWNER'S PHONE: 408-656-4264
PHONE NO: 415-892-8945
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-36 Lic. #717 738ii
Contractor I BRADSHAW ROOFING INC 1 Date 02/0412010
X BLDG _ ELECT _PLUMB
MECH X RESIDENTIAL COMMERCIAL
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.
JOB DESCRIPTION:
TRI-PLEX - TEAR OFF (E) WOOD SHINGLES, INSTALL (N) OSB, 30#
I hereby affirm under penalty of perjury one of the following two declarations:
FELT, CLASS A ROOF SYSTEM (33 SQ'S)
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 Oda 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
Sq. Ft Floor Area:
Valuation: $21000.00
this permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
Number;
Occupancy Type:
information is correct. I agree to comply with all city and county
ordinances and state laws relating to building construction, and hereby
75
375 02 OIO
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
PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City in consequence of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally, the applicant understands and will
comply with all non -point source regulations per the Cupertino Municipal
180 DAYS F M LA PECTION.
Code, Section 9.18. �-
Issued by: MELISSA NAMES
Signature ` Date 02/04,2016
Date: 02/04/2016
OWNER -BUILDER DECLARATION
RE -ROOFS;
I hereby affirm that I am exempt from the Contractor's License Law for one of the
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
1. 1, as owner of the property, or my employees with wages as their sole
i�pection.
compensation, will do the work, and the structure is not intended or offered
for sale (Sec,7044, Business & Professions Code)
Signature of Applicant:
2. I, as owner of the property, am exclusively contracting with licensed
Date; 02/04/2016
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
z. I have and will maintain Worker's Compensation Insurance, as provided for
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
by Section 3700 of the Labor Code, for the performance of the work for which
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
this permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
a. I certify that in the performance of the work for which thus permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
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
Worker's Compensation laws of California. If, after making this certificate of
the Health & Safety Code, Se ns 33, and 25534.
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
��{,/J
Owner or authorized agent:
be deemed revoked.
Date: 02/04/2016
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above Information is
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant
ARCHITECT'S DECLARATION
understands and will comply with all non -point source regulations per the
I understand my plans shall be used as public records.
Cupertino Municipal Code, Section 9.18.
Licensed
Professional
Signature Date 02/04/2016
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 ' buildinctna,cupertino.orp
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❑ OWNER ❑ OWNER-BUB..DER ❑ OWNERAGENT [1 CONTRACTOR ❑ CONTRACTORAGENT ❑ ARCHITECT ❑ ENGBiEEK ❑ DEVELOPER ❑ TENANT
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USE OF ❑ SFD or Duplex VL Multi -Family ROOFAREA: VALUATION:
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STRUCTURE: ❑ Commercial s `, ;2
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EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALTSHMGLES L�SWOOD,S.HHINGLES ❑OTHER(SPECIFY)
REMOVEIREPLACE YES
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THICKNESS: ❑ 5m"
TYPE: ❑ COX
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PROPOSED ROOF TYPE: ❑BUILT-UPROOO'F('� l ASPHALTSSHING``LES El WOOD SHAKES ❑ WOOD SHINGLES C1 OOT``UBE
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DESCRIPTION OF WORK: I.n0`t• ♦'P. 91Z L '„3t;)lIJ''5
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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 c tructi n. I authorize representatives of Cupertino to enter the abproperty for inspection purposes.
,�ovve-ide�ntJified
Signature of ApplicantlAgent: Date: „ 11//1 is
SUPPLEMENTAL INFORMATION REQUIRED
rtinN ceacR TrrERoirrNe
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If building is associated with a Home Owner's Association, provide letter
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of approval from HOA.
Provide Planningapproval to verify If there an restrictions.
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❑ EXPRESS
- `^
❑ _PLANNEVGPLAN' REVIEW
_ Provide copy of Manufacturer's Installation Specifications.
❑ STANDARD _
❑ �_GIRF Deer
Provide signed copy of Cupertino's Tear -Off Policy.
- -
❑--QTHER: -
ReroojApp_2011.doc revised 03/16Q1
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
III%i�3$�1�`�Il ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(c,cupertino.orp
PROJECT ADDRESS
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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 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/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 the re -roof policy stated above. I also understand that
smoke detectors and carbon monoxide detect t are r Cired to e installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code. q fr
Signature of Applicant/Agent: ( Date: p�1(t 1(6
RerooJPolicy 2014.doc revised 01115114
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10131 CRAFT DRjai I DATE: 02104I2016
REVIEWED BY: MELISSA
APN: 375 02 010 BPN:
`VALUATION: $21,000
*PERMIT TYPE: Minor Building Per
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex lex
PENTAMATION 1SFDWLR00F
USE:
PERMIT TYPE:
WORK
TRI-PLEX -TEAR OFF E WOOD SHINGLES INSTALL N OSB 30# FELT CLASS A ROOF 71
SCOPE I
SYSTEM ( 33 SQ'S)
:Vech. Nan Cheat
pl mb. p1cul Cheep k
Etc<;. Nor: CUeCl
;ttr.<a. P'ernxit 1`er:
Pduarhh, Par;nit Fee:
1't r Ptvstah fez. rr.
F3tner At •cA. hup.
Other Phrath tnyg
t)tire?-13cc, Irtsi;.
sblech Irnl;. fee'
Plumb, truth Pee:
Lilec. hasp. I ep
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitmy Server District, School
nicf,aef p>r ) Thomo feat are homed an flap nrpliminn•v information available and are only an estimate. Contact the Dept. for addn'l info.
FEE ITEMS (Fee Resolution I1-053 F..ff. 7L1113)PFEEQTY/FEE
MISC ITEMS
1 lan Clheck Fe::
Szppl,. PC't'eeP1I
M? t). 1 2:; lt. IS Iec
Permit Fee:
Suppl. Insp F,ra
. litFrtl3.:�cl r,'c7/Li1SIE?G Permit Fee:
( `onstr action T as:
F1d3'ni332:strcWre Pee:
Work Without Permit? ® Yes Q) No
$0.00
2dvancerl firar nWsf -.Fees.
71'am Doculn<77 afion Fees:
Strom Motion Fee: IBSEISMICR
$2.73
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$564.73
$0.00it
TOTAL FEE:'
$564.73
Revised: 01/01/2016