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11070129 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22774 MAJESTIC OAK WAY CONTRACTOR:DRAEGER PERMIT NO: 11070129 CONSTRUCTION INC OWNER'S NAME: MECHLING LAUREL A 605 COMMERCIAL ST DATE ISSUED:07/20/2011 t ER'S PHONE: SAN JOSE,CA 95112 PHONE NO:(408)536-0420 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class � Lic.# 17 UM `O MECH f- F RESIDENTIAL COMMERCIAL� Contractor ( � � Date � G I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REROOF,13.33 SQ,REMOVE WOOD SHAKE,INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions NEW 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 permit is issued. Sq.Ft Floor Area: Valuation:$12882 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:34232115.00 Occupancy Type: 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, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Addition ,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source reg ti s per the,C no Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signature Date % Issued by: Date: L OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any r mg material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an ins c n,I agree ve all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) Signature of Applicant: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to O construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE 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. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 2550.5,25533,and 25534. 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. Oy�r or a,th}ri ed agg t: kj/ Date ii APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name i° nify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE 7 ESTI�MA OR - BUILDING DIVISION ADDRESS: -Z-2-7-7,f C "P ATE: REVIEWED BY: APN: L-A$4--) �j 115 BP#: (--)-I N a---) *VALUATION: 1$12,882 „PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F USE: PERMIT TYPE: WORK SCOPE FEE ID ROOF AREA (s.f.) IREROOFFRES 1,300 F-1 I NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'l info. FEE ITEMS(],'ee Resolution 11-053 Lff 1) FEE QTY/FEE MISC ITEMS Permit Fee: $182.00 Work Without Permit? 0 Yes E) No $0.00 Strong Motion Fee: IBSEISMICR $1.29 Select an Administrative Item Bldg,) Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $184.291 $0.00 TOTAL FEE: 1 $184.291 Revised: 07/04/2011 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION -2Z-7�L_Z2.7-Z.2— 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(d)cupertino.org PROJECT ADDRESS 9:�74 / + o / am APN# C� (/l OWNER NAME PHONE E-MAIL STREET ADDRESS C STATE,Z A FAX CONTRACTOR NAME J LIC ENS MBER LIC i E TYPE BUS.LIC.# vG COMPANY NA E cD. l k. FAx E- A STREET ADDRESS CITY,STATE ZIP� PHONE 'l/OI 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 RI 14 and RI I I of the 2010 California Residential Code. Signature of Applicant/Agent: Date: ReroofPolicy_2011.doc revised 02/16/11 2-7,7k Z Z2'►5 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION +� 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �V CUPERTtNQ (408)777-3228• FAX(408)777-3333 • building(d),cupertino.org PROTECT ADDRESS """']� /J�J � /r 7 � � AIN# Lf OWNER NAME 9 //l l,✓�/ (/ PHONE E-MAIL L�-I 24 STREET ADDRESS CrrY, STATE,ZIP FAX APPLICANT NAME i) -�I� �-1 L/ PHONW-2-1 E-MAIL STREET ADDRESS UK4S CTI Y,STATE.ZIP �)_ _ lam! ll F O / ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT PKGNTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTFAC�Q j NA �'A LIC E NUMBER_ LI�S�TYPE BUS.LIC.# JF COMPANY l� VI�In��U(i�l E2M[AI4 FAX TCII d/� P�/�'CY �'GcOnC STRVo DRESS K� (�a 11k �� :T S�TE Z O C � �2__ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ulti-Family ROOF AREA: VALUA ON: STRUCTURE: ❑ Commerciall ,� 12- 2 Zv ✓ , CFO EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES 5;::(YOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE PK*ES IF NO, PLYWOOD A'%" ❑ J`LI� ❑ OSB PITCH: ROOF ElNO I #LAYERS: THICKNESS: El 5/8- TYPE: ElCDX 12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF PHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: ZZ 1,71 �i l By my signature below,I certify to each of the following: �=ze.repres rop owner or thorize agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. a Descripti of Work d verify it is accurate. I agree to co ply with all applicable local ordinances and state laws relating to building construction t es of Cupe no tc enter the above-iden ed pro ert; for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED _If building is associated with a Home Owner's Association,provide letter ?�K of approval from HOA. PP pvEx c�iux�x _ ❑_BUII n�G PTAH xEEt�i�w` f l - _Provide Planning approval to verify if there any restrictions. []; EXPxEss` ❑ PLANNINGPLANREVIEW a. Provide copy of Manufacturer's Installation Specifications. — ❑ xzR> DF>Yr _Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/02/11