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11060181
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7689 PEACH BLOSSOM DR CONTRACTOR:JIM KRAUSE PERMIT NO: 11060181 ROOFING OWNER'S NAME: WRENSCH DELMAR D AND ELLEN J 2310 DIANA AVE DATE ISSUED:06/21/2011 VNER'S PHONE: 4089739016 MORGAN HILL, CA 95037 PHONE NO:(408)779-0704 I LICENSED CONTRACTOR'S DECLARATION f— F_ / \ BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# S S,�4 3 F_ MECH RESIDENTIAL COMMERCIAL Contractor I.,VA 1% C Date (� Z t 4 1 L 1 herebyaffirm that 1 am licensed unde a provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF 29 SQ TEAR OFF EXISTING SHAKE,RESHEET p p WITH 7/16 OSB INSTALL 40YR COMP CLASS A (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 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. Sq.Ft Floor Area: Valuation:$13900 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 APN Number:36611 149.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. f agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY FROM LAST CALLED INSPECTI N. 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 Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18 RE-ROOFS: Signatur Date ZI I f All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,I agre ove all new materials for inspection. ❑ WNER-BUILDER DECLARATION : hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date the following two reasons: ALL ROOF O GS TO BE CLASS"A"OR BETTER 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 sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will 1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25514- //__ Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date:(J permit is issued. 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 -non the above mentioned property for inspection purposes.(We)agree to save emnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION .osts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9 18, Signature Date 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(j�cupertino.org O(0 6� PROJECT ADDRESS / q P_; G� I G` APN# OWNER NAME �/ n 7 PHON b E-MAIL Z Zt!V G C7 7 O STREET ADDRESS CITY, STATE,ZIP FAX CONTRACTOR NAMELICENSE NUMBER LICENSE TYP BUS.LIC.# - 2 COMPANY NAME E-MAIL F X q 7 STREET ADDRESS CITY,STATE,ZIP PHON 2-2,,, i I MIJA /K/1 oiz A J , 11 G O v 7.7 F U �o I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00— 3:30pm(Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. 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 must 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. 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 ith the re-roof policy stated above. Signature of Applicant/Agent: Date:L04 Z_� -' RerooJPo1icy_2010.doc revised 05/17/10 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 7689 Peach Blossom dr DATE: 06/21/2011 REVIEWED BY: MENDEZ APN: BP#: *VALUATION: 1$13,900 "PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00 USE: PERMIT TYPE: WORK SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 2,900 NOTE. Thesefees are based on the preliminary information available and are o ly an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 09-051 Eff. 7/1/101 FEE QTY/FEE MISC ITEMS F-1 Permit Fee: $377.00 Work Without Permit? © Yes E) No $0.00 3trongMotion Fee: IBSEISMICR $1.39 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $379.39 $0.00 TOTAL FEE: $379.39 Revised: 03/01/2011 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36611149 . 00 DATE ISSUED. . . . . . . : 06/21/2011 RECEIPT # . . . . . . . . . : BS000013845 REFERENCE ID # . . . : 11060181 SITE ADDRESS . . . . . : 7689 PEACH BLOSSOM DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : WRENSCH DELMAR D AND ELLEN J ADDRESS . . . . . . . . . . : 7689 PEACH BLOSSOM DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5248 RECEIVED FROM . . . . : JEFF RAINEY CONTRACTOR . . . . . . . : KRAUSE, JIM LIC # 21415 COMPANY . . . . . . . . . . : JIM KRAUSE ROOFING ADDRESS . . . . . . . . . . : 2310 DIANA AVE CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037 TELEPHONE . . . . . . . . : (408) 779-0704 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 13 , 900 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 13 , 900 . 00 1 . 39 0 . 00 1 .39 0 . 00 1REROOFRES SQ FEET 29 . 00 377 . 00 0 . 00 377 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 379 . 39 0 . 00 379 . 39 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 379 . 39 visa --------------- TOTAL RECEIPT 379 . 39 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 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: Vo537 Rvirwd 'IS655om PERMIT# OWNER'S NAME: E <-H PHONE# 40Q 777 - 0 70 GENERAL CONTRACTOR: Tim — C)C�Fr.v BUSINESS LICENSE # ADDRESS:-2-310 7>,A-,Jq Aric CITY/ZIPCODE: M0JZ6,,J *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE Q=AINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: 6 Zf r gnature Dale Please check applicable subcontra and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum /Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile I Owner-7rontractor Signature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building -cuoertino.org PROJECT ADDRESS ,/J/ �H 'Oe,, Co`� �� APN# ' /9-( f OWNER NAME ' � P" NE� ,C/ / E-MAIL STREET ADDRESS CITY, STATE,ZIP I �j FAX 7�g`/ ��iH ��cSsn►+1 13)2 ct!jtR-71,1, �A , Sa/ Lf CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME A LICENSE Uh IBER LICENS T PE BUS.LIC.# COMPANY NAME ./ E-MAIL FAX Iwi "(,)5c Fcz�(,Jrf q0 9 ,77 51- '07 STREET ADDRESSCITY,STATE,ZIP-J PHONE Z31C3 !7(hN'� CfZ-6- Hlu 'A .`7S 0 7 0 77 -Co ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF �4,SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: El Commercial `C,C ro I / 70n C- EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES O WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE YES IF NO, PLYWOOD Cl -/," ❑ PLYWD �,OSB PITCH: ROOF A 11 NO #LAYERS: THICKNESS: 115/8" TYPE: ❑ CDX 4:.12 CLASS: A PROPOSED ROOF TYPE ❑BUILT-UP ROOF ?'ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: _� (LIZ 01T� &� 1 S 71 ,J! S 7 (./ I 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 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 buildin ruction. authorize representat' enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: Z l SUPPLEMENTAL INFO ON REQUIRED OFFICE USE ONLY _If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER: ReroofApp_2011.docrevised 03/16/11