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11070133 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22732 MAJESTIC OAK WAY CONTRACTOR:DRAEGER PERMIT NO: 11070133 CONSTRUCTION INC OWNER'S NAME: GUSTAFSON KURT E AND LINDA M 605 COMMERCIAL ST DATE ISSUED:07/20/2011 ER'S PHONE: SAN JOSE,CA 95112 PHONE NO:(408)536-0420 ❑ LICENSED CONTRACTOR'S DECLARATION 017 n / BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Li,.# tY l MECH r RESIDENTIAL r COMMERCIAL F Contractor ^ S Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REROOF,13.5 SQ,REMOVE WOOD SHAKE,INSTALL NEW (commencing with Section 7000)of Division 3 of the Business&Professions SHEETING AND ASPHALT SHINGLES 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. 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 Sq.Ft Floor Area: Valuation:$12882 permit is issued. APPLICANT CERTIFICATION APN Number:34232123.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue Inst said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this pen-nit. Additional ,th applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regul i s r the Cupertino Municipal Cod ,Section 9.18. Signature Date 20(� Issued by: Date: Lr OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roo material being installed.If a roof is the following two reasons: installed without first obtaining an inspe ion, agree to r e all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: at, I,as owner of the property,am exclusively contracting with licensed contractors to / construct the project(See.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 er or th rized ag int: / forthwith comply with such provisions or this permit shall be deemed revoked. Date: 24 / 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 of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save it" nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address 11 and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 7 DATE: REVIEWED BY ` APN:' aj� � BP#: 'VALUATION: $12,882 '--PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF USE: PERMIT TYPE: WORK SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 1,350 NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (fee Resohltion I1-053 Eff %1:11) FEE QTY/FEE MISC ITEMS Permit Fee: $1 .00 Work Without Permit? 0 Yes No $0.00 C Strong Motion Fee: IBSEISMICR $1.29 Select an Administrative Item Bld Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $198.29 $0.00 TOTAL FEE: $ 8.29 Revised: 07/04/2011 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION d 7Z-7 _ZZ-772.2- ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 Z2nz2—22794 CUPERTINO (408)777-3228 FAX(408)777-3333•building Ca_cupertino.or( PROJECT ADDRESS -7,3 3 / ±' APN# OWNER NAME PHONE E-MAIL STREET ADDRESSC STATE,ZIP A FAX CONTRACTOR NAME / LIC ENS MBER LIC SE TYPE BUS.LIC.# vG COMPANY NA E l FAX Ir STREET ADDRESS CITY,STATE ZIP PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day 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. Progress and 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. Progress Inspection is required when approximately 50% of roof covering is installed. 7. 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/" 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. 8. 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 of$126.00. 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 2010 California Residential Code. Signature of Applicant/Agent: Date: ReroofPo1icy_2011.doc revised 02/16/11 Lo REROOF PERMIT APPLICATION \� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 ` GUPERTIN0 (408)777-3228• FAX(408)777-3333 •building(d)cupertino.org r PROJECT ADDRESS2,2 2, / L 4L— APN# :'3 OWNER NAME /_r( / PHONE E-MAIL STREET AD 5 (.} T d CITY, STATE ZIP FAX APPLICANT n .�C 1� � PHONE E-MAIL STREET ADRESS C STATE,ZIP FAX ' rd ❑OWNER ❑ OWNER-BUILDER OWNER AGENT ❑ CONTRACTOR 5,,C ONTPACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRA R NAME LICENSE NUMBER LIC tTSE TYPE BUS.LIC.# COMPANY NAME E ,ys�J�L FAX X �� 1/ .Zh e �r7rcGt. v STREETADD C CITY,STATE,ZIP G Oe, PHONE JIM ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or DuplexUlti-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial 3 (�� - O EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE IF N0, PLYWOOD -�^&" ❑ L ❑ OSB PITCH: ROOF ❑NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX 'i 2 CLASS: A PROPOSED ROOF TYPE: 11BUILT-UPROOF ❑ASPHALT SHINGLES ElWOOD SHAKES ElWOOD SHINGLES ElOTHER ICC-ES REPORT# DESCRIPTION OF WORK: e IV By my signature below,I certify to each of the following: I am r erty owner or on ed agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I e d the Descript1 of Wor and verify it is accurate. I agree comply 'th all applicable local ordinances and state laws relating to building constructio onze represent ' es of Cup rtino tc enter the above-identifie�opem _or inspection purposes. Signature of Applicant/Agent: Date: l SUPPLEMENTAL INFO N REQUIRED � . A` '=` QcE _If building is associated with a Home Owner's Association,provide letter c>0 cx3YrE 7� of approval from HOA. k aVExTRE VI ❑ BIIIIDII�QGPLAN 'I"I ` _Provide Planning approval to verify if there any restrictions. ❑_xxPxEsS ❑ PLANNING PLAxREVIEW _Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/02/11