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B-2017-0924CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0924 22555 CRISTO REY DR CUPERTINO, CA 95014 (342 63 005) SHELTON ROOFING OWNER'S NAME: ROMAN CATHOLIC BISHOP OF SAN JOSE OWNER'S PHONE: 408-923-0223 License Class C.:$$ Lic. #261091 Contractor SHELTON ROOFING CO INC Date 07/31/2017 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. I hereby affirm under penalty of perjury one of the following two declarations: t. I have and will maintain a certificate of consent to self -insure for Worker's CO INC MOUNTAIN VIEW, CA 94043 DATE ISSUED: 06/12/2017 PHONE NO: (650) 961-7699 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: RE-ROOF;TEAR-OFF;REPLACE FELT; INSTALL TILE (33 SQ) (EXISTING TILE ROOF) Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this 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 this permit is issued. Sq. Ft Floor Area: Valuation: $49000.00 APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for APN Number: Occupancy Type: 342 63 005 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 06/12/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without fust obtaining an inspection, I agree to remove all new materials for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 06-12-2017 I hereby affirm under penalty of perjury one of the following three declarations: r. 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. 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 this permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's 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 forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous 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 the Health & Safety Code, Sections 25505, 25533, and 25534. I Owner or authorized agent: / Date: 06-12-2017 CON TRucTioNLENbiNGAGENcy I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Date 06-12-2017 professional REROOF PERMIT APPLICATION INEEMIL COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildina aacupertino.ora PROJECT ADDRESS �Z ��J• / `� �/j _ ` �e APN4✓� S O"AR'ER NAME PHONE GiA P' f 3 E-MAIL -7, i L'Z 2 STREETADDRESS I�S� N' �( � wi• ITY, STATE, ZIP ��� �/ �1�JC-�/� FAX CONTACT N.gA4E 6 E-MAIL STREET ADDRESS TTY TE, ZIP �L FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENgl`''r CON?RACTOR NAMEZt LICENSE NUMBER LI E T I Bus a;F'f�v 1 COMPANI' NAME E-MAIL STREET ADDRESS/ �,g STATE. IP l [[G l ARCHITECT/ENGINEER NAME LICENSE NU OBER BUS. LIC: COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF 1!§.,SFD or Duplex ❑ Multi -Family ROOF AREA: VAj FATJOON: STRUCTURE: E3Commercial�� - 'UT - bov [[ EXISTING ROOF TYPE: 11BUILT-UPROOF El ASPHALT SIIINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES IKTHER (SPECIFY) V�� REMOVE/REPLACE; $tF IF NO, PLYWOOD ❑ /•• ❑ pLYWD ❑OSB PITCH: ROOF ❑ NO L.A1'ERS: 7HICIQ'ESS: ❑ 5/8" TYPE: ❑ CDX :12 A CLASS: PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT' SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES OTHER , , ICC -ES REPORT m DESCRIPTION OF WO : 1,4 01 �" —(•'t ` y my signature below, l certify to each of the following: I am the property owner or authorized agent to act the on 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 buildinVonst ion. I authorize representatives of Cupertino to enter the above -i ntif d property for inspection purposes. Signature of ApplicanUAeent: Date: f(i /,� SUPPLEMEN L INFO RMA N REQUIRED- '. If building is associated with a Home Owner's Association, provide letter -�� �PLAA:CHECKTYPE ; ?i �3 -'r.4t a ROTJTL�GSLIP of approval from HOA. OVERTEECOTER' ❑r BUILDII�GPL4�RES'IEw � — Provide Planning approval to verify if there any restrictions. gE, ��JEJCPRESS� x ©i PL/al��IAGPLAjI REViE`[ . ' y _ Provide copy of Manufacturer's Installation Specifications. #�� fl=STAIQDARD�` � �: s'❑e 7'rRFDEP�_ �� �`' � ' S � _Provide signed copy of Cupertino's Tear -Off Policy. Reroof.9pp_2011.doc revised 03/16/11 CUPERTINO 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 (408) 777-3228 - FAX (408) 777-3333 - buildina(c cuoeriino.ora PROJECT ADDRESSZZ ��� I APN i OWNER NAME I t �j� �j(,� G I PHONE &3E -MAIL l STREET ADDRESS jIZlyet. CI TATE, Z%6 /-y1 J ' FAX CONTRACTORNAA4E ,i � uC y� LIC 'SET E BL' C. COMPA vY NAME /_ _ /% 1 _ - 9/ `� 6 E-MAILr�4 1 STREET ADDRESS C STAITIE, ZJ1` p O 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 7:30-3:30pin (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 r/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 monoxid7dtors are re icedto be installed in accordance with Sections R314 and R315 of the 2013 California Residential Code`Signature of Applicant/Agent: Date: l 7 Reroo)Policy 2014.doc revised 01/15/14