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11050084 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10696 ROSEWOOD RD CONTRACTOR:GORMAN ROOFING PERMIT NO: 11050084 SERVICES,INC OWNER'S NAME: ESSEX PROPERTY TRUST 2229 E UNIVERSITY DR DATE ISSUED:05/23/2011 ER'S PHONE: 6508151622 PHOENIX,AZ 85034 PHONE NO:(602)262-2423 ❑ LICENSED CONTRACTOR'S DECLARATION I r **�� BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class # Itj �L MECH RESIDENTIAL COMMERCIAL Contractor .V �b 1 Date � a/ I hereby affirm that I am licensed under t e provisions of Chapter 9 JOB DESCRIPTION:APT A-D ROOF OVERLAY EXISTING ROOF WITH (commencing with Section 7000)of Division 3 of the Business&Professions POLYURETHANE FOAM CLASS A 27SQ 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:$9450 permit is issued. APPLICANT CERTIFICATION APN Number:31643005.10696 Occupancy Type: 1 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 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 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal C de,Sec'on 9.18. Signature Date �� Issued by: Date: r 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 roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove 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 o Appli t: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.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 MWCode, pter9.12andthe not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,2553Compensation 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 Own �thorized agent:forthwith comply with such provisions or this permit shall be deemed revoked. Date: � 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 i •nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address and expenses which may accrue against said City in consequence of the graL Ling 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 3 ITEMS OF 51 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31643005 .10696 DATE ISSUED. . . . . . . : 05/23/2011 RECEIPT #. . . . . . . . . : BS000013531 REFERENCE ID # . . . : 11050084 SITE ADDRESS . . . . . : 10696 ROSEWOOD RD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : ESSEX PROPERTY TRUST ADDRESS . . . . . . . . . . : 925 EAST MEADOW DR CITY/STATE/ZIP . . . : PALO ALTO, CA 94303 RECEIVED FROM . . . . : GORMAN ROOFING CONTRACTOR . . . . . . . : DANIEL J GORMAN LIC # 32440 COMPANY . . . . . . . . . . : GORMAN ROOFING SERVICES, INC ADDRESS . . . . . . . . . . : 2229 E UNIVERSITY DR CITY/STATE/ZIP . . . : PHOENIX, AZ 85034 TELEPHONE . . . . . . . . : (602) 262-2423 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 9,450. 00 1. 00 0. 00 1 .00 0. 00 1BSEISMICR VALUATION 9,450 .00 0. 95 0. 00 0 .95 0. 00 1REROOFRES SQ FEET 27 .00 351. 00 0. 00 351.00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 352. 95 0. 00 352 . 95 0.00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF i b�5 0agy REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333 • building a.cupertino.org CUPERTIN4 Inl09la Ro$ewo►© PROJECT ADDRESS APN# OWNER NAi1a r PHONE U,5 G / ID I ( ,, tA STREET ADDRESS CITY, STATE,ZIP /' FAX APPLICANT N nn PHONE E-MAa. 9 op G Ge ` 3.7 5 k(P60RAW CCOt A)6-St J' ©TMS STREET A�RE� t� °� 1, C d��� CI Y.STA 0. 0 ` �� b(i FAX J. �-)5- (S.3 1. ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT VI/O�RACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMELICENSE NUMBER +, l N LICENS�TYP�E BUS.LIC.# IL A.41 41 COMPANY NAME E-MAIL /Iba FAX STREET ADDRESS ��O ^C ' u)e CITY,P' ZIP D PHONE n�� __7 - V ARCHITECTIENGINEERNAME s �LIICENSE NUMBER (� BUS.LIC`.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ulti-Family ROOF AREA: VALUATION: ,TRUCTURE: ❑ Commercial loo q �- O+r1, , EXISTING ROOF TYPE: BUILT-UP ROOF El SHINGLES ❑WOOD SHAKES El SHINGLES ❑OTHER(SPECIFY) E REMOVE/REPLACE ❑YES IF NO, PLYWOOD F2 h" 11! _ PLYWD 11OSB PITCH: ROOF U-NO I #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX s :12 CLASS: A ❑ PROPOSED ROOF TYPE: BUILT-UP ROOF I-] El11 � ASPHALT SHINGLES WOOD SHAKES WOOD SHINGLES 1.16TIE:R VmA&­, ICC-ES REPORT# DESCRIPTION OF WORK: j b ► 1 �Od� 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 provid is correct. I have read the Description of Work and verify it is accurate. I agree o comply with all applicable local ordinances and state laws relating to bui on tru tion. I authorize representatives of Cupertino tc enter the above- entified property for inspection purposes. Signature of Applicant/Agent: Date: 01 SUPPLEMENTAL KFORMATION REQUIRED — _ j aTsE ativ%>t *; _If building is associated with a Home Owner's Association,provide letter ZON � � i _ ,%xouluva stip of approval from HOA. Q GSR T cotJiIIER ❑ srD� ALV REVIEW _Provide Planning approval to verify if there any restrictions. Q Ex�REss - T' r❑ p>�Av�vaPLaNREvtEw ' _Provide copy of Manufacturer's Installation Specifications. srnrmnxn � >s>E� 3 _ Provide signed copy of Cupertino's Tear-Off Policy. -� ReroofApp 2011.doc revised 03/02/11 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. CUPERTINO (408)777-3228• FAX(408)777-3333•building@cupertino.org APN# PROJECT ADDRESS / 9 Q$-cw d J I OWNER NAME � �' PHONE(-<C)- �15' �6�a &WIL _ STRFE T AD c =, ST . P FAX CONCItACrORNAME l• LICENSE ER LICENSE SUS.LIC.# ktflN Ari Qo© E-MAIL FAX COMPANY NAME f (� STREET ADD O S` , J'b1cr ATE,Z YS (O � JS-`B�6'1;i- q- Ae Ch fA ewc-CLyt foo-, 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 shall be scheduled 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. On the day of the inspection, a building inspector will be available within one hour for either a Tear-Off Inspection or Nailing Inspection if you call again on that day between the hours specified. 3. The following inspections are required: a. 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. b. If plywood is installed, a plywood Nailing Inspection is required. c. Progress Inspection is required when approximately 50% of roof covering is installed. 4. New roof coverings shall not be applied without first obtaining all 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. 5. 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 pending. 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. 6. 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 ins ep ction can be scheduled. By my signing below,I certify each of the fallowing 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 monoxided ors are required to be installed in accordance with Secti ns 14 and 8315 of the 2010 California Residential Code. Signature of Applicant/Agent: Date: ReroofPoli 2011.doc revised 02/16/11