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12070091 CITY Or CUPERTINO BUILDING I"EMMIT BUILDING ADDRICSS: 20090 PEACHTREE LN CONTRACI'Olt: BARRIOS CONSTRUCI'ION PERMITI VO: 12070091 OWNEIVS NAME: YOUNG HELEN NI TRUS'I'lili 876 PACIFIC A\'P: U,\TIS ISSUED:07/122012 OWNER'S PHONE: 650450&156 SANJOSE.CA 95126 PDONF NO:(408)461-1623 © LICENSED CONI RAM OWS DECLARA HON BUILDING PERM IT INFO: I31,Uc f L1,r•.cr f PLUM 13 r License Class 13 Lic.p, r�1 �3 �/ / �// AIECII r It rslurNTIA 1, r COi\I AI EIEC IA I,r Contractor //ti�ei^l2 oa//ie,'� D:nc��/z ' I hereby affirm that I on licensed under the pruyisions of(Ampter'9 .1013 DESCRIPTION: 17AR 0171:EXIS'HNG SHAKE ROOF,INSTALL NEW COMP (commencing o'ith Section 7000)of Division 3 01[INC BusineS'\ 1'rdessions SHINGLES 23 SQUARES Codc and Thal Inv license is in full force and effmi. I hereby affirm under penally of perjury one of the follooing loon declarations: I have and will maintain a certificate of consent to sell'-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this perntit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Sq. FI Floor Area: Valuation:56800 Section 3700 of the Labor Code,for the perfomumce of the work for mhich this Permit is issued. APN Number:31633062.00 OccupanCN Type: APPLICANT CERTI FICATION I certify that I have read this application and state that the above information is correct.1 agree to comply with all city and count•ordinances and state laws relating to building construction,and hereby authorize representatives oflhis city to enter PIiRA'i rr LUPI RISS 11' WORK IS \'�'1• S"1•A R"I•LU upon the above mentioned propeny for inspection purposes. (%Vc)agree to s:wc indenmilylaid keep harmless the City o'Cupertino against l iabilities.judgments. WITHIN 1811 DAPS OF PERI'll'11T ISSUANCE OR costs,and expenses trhich may accrue against said Cily in consequence ofthe ISO DM'S FROM LAS"I CALLED 1NSPI C-KION. graining of this permit. Additionally,the applicant understands and will comply with all non-point-source regulations per the Cupenino Municipal Code Section 9.18. / Issued IN - _ Dale: �112 T Signature Dille �� ❑ OWNER-BUILDER DECLARATION RE.-ROOFS: All roots shall be inspected prior to any roofing material being installed.II'a roof is I herelq':dlirw that I am exempt tram the Contractor's License Lino for oar of installed without first obtaining an inspection,I agree Eo remove all new materials for ate following too reasons: inspection. I,as owncr of Elie property,or city cmplo)'ces with wages as Ihcir sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date: Business&Professions Code) I,as owner of the property.ant exclusively contracting with licensed contractors to construct the project(Sec.70,14,Business&Professions Code). ALL ROOF COVERENGS TO RE Cl.,\SS",\" Olt BE ITER I [let rby alirm under penally of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and trill maintain a Ceni forte of Consent to self insure for Worker's I have read the Iriza1'duus ma l erials rvq ui remen is under Chu peer 6.75 oft lie Compensation,as provided Nor by Section 3700 of the Labor Code•for the Ca li fern is Inca l lh\Sit fent Code.Sections 25511$•25533,and 25534. 1 will maintain performance of the work for which this perntit is issued, compliance reit,the Cupenino Municipal Code.Chapter 9.12 and the(kali,& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Seetiou 25532(x)should I store or handle hazardom mane,hit. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air pennil is issued. Contamina ts:u dclined by the Bav Area Air Quality,\I:ma_emenl District I Evill maintain campfinnce with the Cupert ino?Iunicipal Code,Chapter 9.12 and the I certil'y thin in the performance ol'the work lin which this permit is issued.I shall Ileallh&S:fef_v Code.Sections 25505.25533.and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of Caliliunia. If.alter staking this certificate ofexcniption' O/w/nrr)t authorized'ngent: become subject m the Worker's Compensation provisions of the Labor Code.I must �lb�fr:�o Lg!({65 Date: X4-2— /J7 forthwith comply with such provisions or this perntit shall be deemed revoked. CONSTRUC'f1oN 1-h;Nl)IN'G ACENCY AVP LICA:N 1'CE RTI FICAI'ION I hereby affirm that there is it construction lending agency for the performance of work's I certify Thal I have read this application and stale that the above information is for which this permit is issued(Sec.3097,Civ C.) correct. I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize represnIIatives of this city to enter upon Elie above mentioned property I'or inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City ol'Cupertino against liabilities•judgments. costs,and espenses which only accrue against said City in consequence of the AItCI II'I'P:C'1"S DECLARATION grinning oflhis permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Doc REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228 FAX(408)777-3333-building(cDcuoertino.ora PROJECT ADDRESS APN a 200 O e 4,n0 JKI OWNER NAME PHONE E-MAIL G " a STREET ADDRESS CITY,STATE ZIP FAX CONTRACTOR NPME - LICENSE NUMBER LIC SE TYPE BUS.LIC.< yy C MPANY AME / E-MAIL FAX 7r1oS n5 fi/Cw iOn STREET ADDRESS CITY,STATE,ZIP H(]j.' I o' p o tr 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.`/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. 8. NOTE: If you call fora 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, 1 certify each of the following is true: 1 am the property owner or authorized agent to act on the property owner's behalf. 1 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 d Signature of ApplicanUAgcnt: Date:_ _/y _ _ Re,oo(Policr_201 Ldoc rewsed 02116111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: DATE: 07/12/2012 REVIEWED BY: bob s. APN: '�,00'To pec BP#: loZO 717G9VALUATION: $6,800 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration I Repair PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF USE: PERMIT TYPE: WORK tear off eXistinq shake install new comp shingles. SCOPE Plinth. Plan ChetA E'luc. Plan Chlvk Mock Prrnril Fee Plumb. 1'01-nril Fce:' /ilec-. Pormit 1"'o: i 111e, Urth. ln.ryi. Other-Plumb Insp. Other Or( It,ep. R.C.h. bap. Frc.' P/urnh. Lisp. Fee: tiler.Imp.Fre. NOTE. This estimate does not includejees due to other Departments(i.e.Planning,Public{Yorks, Fire,Sanitary Sewer District,School District,etc. . These fees are based on the prelimina information available and are only an estimate Contact the Dept for addn'l info. FEE ITEMS(Fee Resolution 11-053 E/L' 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 2,300 s.f. Re-roof Suppl. PC Fee: 0 Reg. 0 OT FO.OThrs $0.00 $345.00 1REROOFRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.Q Reg. 0 OT FooThrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C'onstruclion lily: Admilli.vnrnn•e Fir: 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fce: $0.00 Select Non-Residential O Building or Structure 0 Trurel DoctinwMation Fees: A Strong Motion Fee: IBSEISMICR $0.68 Select an Administrative Item Bldg Sids Commission Fee: IBCBSC $1.00 '. SUBTOTALS: 1 $1.68 $345.001 TOTAL FEE: $346.68 Revised: oAL-1ti' REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CU PERT/N O (408)777-3228• FAX(408)777-3333•buildingicDcuoertino.org /,207eWl PROIECT ADDRESS APN k / ��J v - r G°J I t� OWNER NAME ✓IG PHJIVE E�MALL 6—d — � " sTRE Or E) RESS iQY� U �F CITY. ST .ZIP /17T(J L�IJ „ 2Y��D FAx CONTACT NANI PHONE E.NIAIL STREET ADDRESS CITY.STATE, ZIP FAX ❑ OWNER ❑ O%NIX WJ1LDER ❑ OWNEIIAGENT r COMRACrOR ❑COMRACFORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CO TRAC OR NAAIE LI WS NUNS R LICENSETYPE BUS.LIC,9 C AN'NAME ! E-� IL FAX J�(/ rV U i S;OREEr.ADDRESS CITY,fTATEO,ZIP HO E �J ^ ARCHITECTIENGINEER N AME LICENSE NUNm ER BUS.LIC.a COMPANY NANIE E.NIAIL FAX STREET ADDRESS CITY.STATE,ZIP PHONE USE OF ,�- FD or Duplex ElMulti-FamilyROOF AREA. V.4LUAT10N. STRUCTURE. ❑ Commercial ROnA3�)' o EXISTING ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER tSPECIFYI REMOVE/REPLACE /YESIF NO. ❑ :W' 11PLYWD ❑ OSB PrtCH: ROOF ❑ O iiL R PLYWOOD ❑ <I' AbTYPE ❑ PROPOSED ROOF TYPE ❑BUILT-UP ROOF (A ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT 4 DESCRIPTION OF WORK n By my Signature below.I certify to each of the following: Iran the property owner or authorized agent to act on the property comer's behalf. I have read this application and the information(have provided is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to bui construction, 1 authorize representatives of Cupertino to enter the above-identified property, Tor inspection purpose, Signawre of Applicant/Agenr Date: 4z 1r, 42- SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY _ If building is associated with a Home Ownees Association,provide letter Pt-4N CHECK TYPE �� ROUTING SLIP of approval from HOA. oYER { -THEDUNTER LO BUILDING PLAN REVIEW _ Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNINC PLAN REVIEW Provi a copy of ManWacturer'S Installation Specifications. ❑ STANDARD ❑ FIRE DEPT rovide signed copy of Cupertino's Tear-Ott Policy. ❑ OTHER: Reroojdpp_2011-doe revised 0376111