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B-2016-1324 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1324 1022 CRANBERRY DR CUPERTINO,CA 95014-4926(362 04 055) (BLACK DIAMOND ROOFING INC) ANTIOCH,CA 94509 OWNER'S NAME: PAPPAS GEORGE L TRUSTEE DATE ISSUED:02/08/2016 OWNER'S PHONE:408-828-3245 PHONE NO:925-783-6112 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C_39. Lic.#996268 Contractor(BLACK DIAMOND ROOFING INC 1 Date 02/08/2016 X BLDG —ELECT PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL— COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: (PARTIAL)TEAR OFF(E)TILE(NO PLY)&INSTALL(I)CLASS A I hereby affirm under penalty of perjury one of the following two declarations: COMP ROOF SYSTEM(11 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 this permit is issued. 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. Sq.Ft Floor Area: Valuation:$7000.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above information is correct.I agree to comply with all city and county APN Number: Occupancy Type: ordinances and state laws relating to building construction,and hereby 362 04 055 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 FROM LAST!g SPECTION. Code,Section 9.18. Issued by:MELISSA NAV�`,,,'! Signature f' Cia, 06ADate 02/08/2016 Date:02/08/2016 R-BUDER DECLARAT RE-ROOFS: I hereby of in 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. I,as owner of the property,or my employees with wages as their sole inspection, 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:02/08/2016 contractors to construct the project(Sce.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. 1 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 2. 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 s. I certify that in the performance of the work for which this 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,Sections 25505 533,and 255/34./ exemption,I become subject to the Worker's Compensation provisions of they' c V Labor Code,I must forthwith comply with such provisions or this permit shall Owner or authorized agent be deemed revoked. Date:02/08/2016 APPLICANT CERTIFICATION CONST IJCl ION I ENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm'that there is a c struction lending agency for the performance correct.Iagree 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 02/08/2016 fi µ REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 C U P I-Rt I N 0 (408)777-3228• FAX(408)777-3333•building(a)cupertino.org l PROJECT ADDRESS fCWriberyy ✓Ses✓ L� ®'y ! S�/ t OWNERNAME P� E-MAIL _ ra STREET ADDRESS p9� CITYw, P CONTACT NAME E-MAIL yl ST .. ftZ V1 CITI 122L5- T3 Y TAT IP ❑OWNER ❑OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTORCU` O—.CTOR AGENT ❑ ARCHrTECT D ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORN ,, J LICENML .LICENSE TYPE BUS.LIC.# COMPANY 07,5 , F ZZ STRE TDRESS CITY,ST TE,ZIP - � PHONE ARCHITECT/ENGINEERNAME 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 l 15 ri —�O — r EXISTING ROOF TYPE: ElBUILT-UPROOF D ASPHALT SHINGLES 11 WOOD SHAKES ❑WOOD SHINGLES ❑ (-OTHER(SPECIFY) t e REMOVEIREPLACE S IF NO, PLYWOOD 0 w, ❑ PLYWD El OSB PITCH: ROOF ❑ O #LAYERS: THICKNESS: El 5/8- TYPE: 11CDX _A4,:12 1 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF D ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: U�e 5tumte_ on "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 pr vided is correct ave read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rel"gtuil ing construe K n. I authorizzeerepresentati s of Cupertino to enter the above enti led property for inspection purposes. Signature of Applicant/AgenDate: [ SUPPLEMETL INFORMATION REQUIRED P olc> zlsl©+IL „ _If building is associated with a Home Owner's Association,provide letter �A of approval from HOA. ' x xL� Brw>Nir' Ix Provide Planning approval to verify if there any restrictions. ❑ v'A.N nvcLv w a� t3 x _Provide copy of Manufacturer's Installation Specifications. g Provide signed copy of Cupertino's Tear-Off Policy. Y' M. ReroofApp_2011.doc revised 03/16/11 REROOF TEAR-OFF POLICY its 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-building(a cupertino.org PROJECT ADDRESS U^aa, cra n �Pty!d APN# �I Z - tOWNERNAME JJPHONE f E-MAIL - `l STREET ADDRESS CITY, STATE,ZIP FAX CONTRACTOR NAMF�6C, LICENSE NUMBER LICENSE 7Pt BUS.LIC.# Z J COMPANY NAMEn (� E-MAIL FAX D CL STREET ADD l^ CITYATE, IP �,p PH YINCf 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 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 Resident 1 , ode. Signature of Applicant/Age Date: ReroofPolicy_2014.doc revised 01/15/14 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION a ' ADDRESS: 1022 CRANBERRY DR DATE: 02/08/2016REVIEWED BY:: MELISSA APN: 362 04 055 BP# 'EVALUATION: $7,000 0��' PERMIT TYPE Minor Building Permit PLAN CHECK TYPE Re-roof PRIMARY PENTAMATION USE: SFp or Duplex PERMIT TYPE: 1 SFDWLROOF WORK I TEAR OFF E TILE & INSTALL N CLASS A COMP ROOF SYSTEM 11 SQ'S SCOPE FEE ID ROOF AREA (s.f.) 1 REROOFFRES 1,100 P,r:nb f3 ai'Chect pr P r"t'P: Ot&,r Phjj r�t9..sz, ty3sr 1:"I"'(% ,f3�.R f?�) ��ii "s''s`:, 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 prelinzina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 1.1-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS r - , qq.-,,l. 1'(y l eLJ Permit Fee: $187.00 3 ..o Si7"netiO Ta\': , A,'3„'7n1i1i.51r 1h f'f`('e: Work Without Permit? 0 Yes G) No $0.00 at?•LIQ t'f. I i 1 Yl 7, Fees, Strong Motion Fee IBSEISMICR $0.91 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SBTUTAlS. $188.91 $0.00 TaTAI SEE: $188.91 _ Revised: 01/01/2016