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09090125 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 884 COTTONWOOD DR CONTRACTOR:ABOVE ALL ROOFING PERMIT NO:09090125 OWNER'S NAME: FENTON RICHARD L AND SHIRLEY A 700 NORTHRUP ST DATE ISSUED:09/16/2009 !BR'S PHONE: 4082527246 SAN JOSE,CA 95126 PHONE NO:(408)292-4188 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG(_ ELECT f- PLUMB g 7] License Class �� / Lic.# / _ MECH RESIDENTIAL COMMERCIAL Contractor �i ate I hereby affirm that I am licensed under the provisions Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF EXISTING COMP INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions UFELT UN Code and that my license is in full force and effect. DERLAYMENT,INSTAL NEW 30YR CERTAINTEED COMPOSITION CLASS A ROOF 23 SQ 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:$7000 permit is issued. APPLICANT CERTIFICATION APN Number:36918009.00 Occupancy Type: 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 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 Code,Section 9.18. Issued q _ Date: �- Signature Date / � D ' CJ OWNER-BUILDER DECLARATION RE-ROOFS: 1 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 I,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 f Ap icant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to constrict 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: 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. 1 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 Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or author' eraaent,����forthwith comply with such provisions or this permit shall be deemed revoked. � Date>496 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- iify 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 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 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36918009 . 00 DATE ISSUED. . . . . . . : 09/16/2009 RECEIPT #. . . . . . . . . : BS000008698 REFERENCE ID # . . . : 09090125 SITE ADDRESS 884 COTTONWOOD DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER FENTON RICHARD L AND SHIRLEY A ADDRESS . . . . . . . . . . : 884 COTTONWOOD DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4623 RECEIVED FROM . . . . : ABOVE ALL ROOFING S CONTRACTOR KEN SULESKY LIC # 23092 COMPANY ABOVE ALL ROOFING ADDRESS 700 NORTHRUP ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95126 TELEPHONE (408) 292-4188 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 7, 000. 00 1 . 00 0. 00 1. 00 0 .00 1BSEISMICR VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00 1REROOFRES SQ FEET 23 . 00 299. 00 0. 00 299. 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 300 .70 0. 00 300. 70 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 300 . 70 #17715 --------------- TOTAL RECEIPT 300 . 70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CITY OF CUPERTINO lis REROOF C U P E RT I N O PERMIT APPLICATION APN# Date: ,5 oc>l 0 C) Building Address: (F O D/-/ O0 TJb^c.JOo Owner's Name: /� �� �o,.. Phone#: HOA: Yes No If es provide letter from HOA ya�� Z�Z �Z 1,16 Contractor: /� W Phone#: Q/) Zg2_L1/�Y Aboue Al( 4Oo�,, So �+�on.s �j� Fax#: O ' 2-9 2 Cupertino Business License#: Contractor License#: W,y 5' Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof Asphalt Shingles wAsphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: � �+j ' Rku`aCpdtiflo. 2�S 14;,.11 3/0 4�O q/c./f A4-101- Residential Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set&the sheet index. Valuation: I Have Read,Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 Community Development Department Building Division City of Cupertino 10300 Tone Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the City,the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed,a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/ "per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O.report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. r Homeowner's Name: L dJob Site Address: &z:2/7oo 0 Roofing Company Name: C Applicant's Signature. Date: 9 i Greg Casteel Building Official Revised 07/30/08 CITY OF CITY OF CUPERTINO REROOF CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1C0MMLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISNIIC0 Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee / 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B