11110057 CITVOFpCUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20777 FARGO DR CONTRACTOR:KEVIN SULLIVAN PERMIT NO: 11110057
ROOFING
OWNEWSNAME: LEECROTHERS 1696 VALLEY OAKS DR DATE ISSUED: 11/10/2011
,� /NER'S PHONE: 4082532832 GILROY,CA 95020 PHONE NO:(408)842-1057
Li/ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class CP'54? Lie.k S7(S� RE-ROOF 9.5 SQ REMOVE EXISTING BUILT UP ROOF
ContractorI IO�I� INSTALL NEW SINGLE PLY
yL'7CS1t+V Date
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:
I have and will maintain a certificate of consent to self-ins ore 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:54000
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:32630127.00 Occupancy Type:
permit is issued. ,meq'�
APPLICANT CERTIFICATION OQ�/S.JJ
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.1 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. F M 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 24 /
grunting of this permit. Additionally,the applicant understands and will comply Issued by: Date: l7
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature//%moi DatclkC All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
OWNER-BUILDER DECLARATION
Signature of Appli Dete:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons; ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1,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 exclusvely 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(x)should I store or handle hazardous
1 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 1
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 25534.
Section 3700 of the Labor Code,for Aha performance of the work for which this
Owner or authorized agf �j �l�.�at4E
permit is issued.
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person inany 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 1 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.1 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
n the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
and keep harmless the City of Cupertino against liabilities,judgments,
„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
• CITY OF CUPERTINO
3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32630127. 00
DATE ISSUED. . . . . . . : 11/10/2011
RECEIPT #. . . . . . . . . : BS000015285
REFERENCE ID # . . . : 11110057
SITE ADDRESS . . . . . : 20777 FARGO DR
SUBDIVISION . . . . . . .
CITY : . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LEE CROTHERS
ADDRESS . . . . . . . . . . : 20777 FARGO DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : KEVIN SULLIVAN
CONTRACTOR . . . . . . . : KEVIN E. SULLIVAN LIC # 23810
COMPANY . . . . . . . . . . : KEVIN SULLIVAN ROOFING
ADDRESS 1696 VALLEY OAKS DR
CITY/STATE/ZIP . . . : GILROY, CA 95020
TELEPHONE . . . . . . . . : (408) 842-1057
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- -------—-
1BCBSC VALUATION 4, 000 . 00 1. 00 0 . 00 1 . 00 0 .00
1BSEISMICR VALUATION 4, 000. 00 0 .50 0 . 00 0 .50 0. 00
1REROOFRES SQ FEET 10 .00 140.00 0. 00 140 .00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 141.50 0. 00 141 .50 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
•
REROOF TEAR-OFF POLICY
2 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•buildingacupertino.org
PROJECT ADDRESS 6 /.�� /u may/ , APNp
OWNERNAME : (6 ' `'-�• (� R&73-192 0 E-MAIL
STREET ADDRESS , / /��W��w� CITY, STA3TE,2/IP T J6 FAX
CONTRACT L� G' �DIt• LICENSE B ' / LICEN E TYP BUS.LIC.p
COMPANY NAME /A� E-MAIL/i�n ��rj_�O Cf1.I �I,- FAX
STREETADDRESSt6G / ,. " _ mn CITY.S TE.ZIP 13-010
U-0 _ PH NE -�
GG(/J 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/<" 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 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: 1 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. 1 also understand that
smoke detectors and carbon monoxide detectors are r5�ciuired to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential
Signature o pplicant a Date: b
RemofPoliev_20//.doe revised 01//6111
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
U P E RT I N O Telephone: 408-777-3228
Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: PERMIT#
OWNER'SNAME: &) PHONE# L —10,1'
GENERAL CONTRACTOR: BUSINESS LICENSE#
ADDRESS: CITY/ZIPCODE:
*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 OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
t/ 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
c�OwneF`Contractor Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
• ADDRESS: 10665 minette dr. DATE: 11/1012011 REVIEWED BY: bobs.
APN: BP#: "VALUATION: $10,000
"PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK remove existinq install asphalt shingles for less than 2:12 sloe over 2:12 comp shingles.
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 1,800
dfeeh. Plan C':hatk Phmrh, flan Cheek iaen. Plan ChacA°
Vech. 1'erwit Pte Plunih. Perrnn Fce: l.Pac. Permit Fee.
('bGev M,rlr.hxep. Oth,:o,Plumb lusp, (bile, Eler.. bnsp. Li
D4acli.Imp. Pee: Muurb. Itx'p.Fi"' filer.Imp. Fee:
NOTE:This estimate does not Include fees due to other Departments(le.Planning,Public Works,Fire,Sanitary Sewer District,School
District etc. . These fees are based on the prelinina Information available and are only an estimale. Contact the Del for addn'l infa
FEE ITEMS/Fee Resolution 11-053 EB' 7/UI11 FEE QTY/FEE MISC ITEMS
Plan Check Fee:
.Supp!. P(.'Fee
PG rrn b.�;14ech.;'is'l ac
Permit Fee: $252.00
Suppt /ov) Fee
Plumb.%Mtach,iF,{ec
1'hrmb.!91e:cb.:'fsler Permit Foe:
(:'onstruction 7i7.a
Adntinislrative Fee:
Work Without Permit? O Yes 0 No $0.00
A JVwnue'd Planning Feer:
Travel Doctunen>ation Fees.
• Strom Motion Fee: IBSEISMICR $1.00 Select an Administrative Item
Bide Stds Commission Fee: IBCBSC $1.00
I'SUBTOTALS: $254.00 $0.00 TOTAL FEE: $254.00
Revised: 10/01/2011
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT' BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO. CA 95014-3255
® CUPERTIPI6 (408)777-3228 ' FAX(408)777-3333 ' buildingacuoertino.om p
PROJECTADDRESS
OWNER NAME
STREETADDRESS —�/ C=, STA G� QyyV FAX
APPLICANT NAME LR+' PHONE
ADDRESS P2. Crrt',STA ZIP
❑OWNER ❑ OWNER-BUILDER ❑ OWNER✓AGENT IrfCONPRAROR ❑CONTRACtn AGENT ❑ ARCHITECT ❑EN@rpl ❑ DEVELOPER ❑ TENANT
COMW LICENSE NUN9EALICENSE TYFE EUS.LIC.9
COMPANY NAME b E-MAI. FAX
V(7 y
M192rd
CTIY,ST TE, PHONE �i'�
AACHrPECIENOAlmtNAME 1 LICENSE NLWER EUS.LIDO
COMPANY NAME I^ E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF or Duplex ❑ Muld-Family ROOF AREA.r„� VALUATION:
STRUCTURE: ❑ Comme5 !. O V� 1'J.4 to,�,&Zm;,
EXISFWo ROOF TYPE: UI.T-UP ROOP ❑ASPHALT SHINoLES ❑WOOD SHAKES ❑WOOD SKNcI ES ❑OTHER(SPECIFY)
PMAOVEIKEPLACE IF NO. PLYWOOD ❑ K. ❑ _ PLYWDEE PrrCR RDOP
13 29 a ❑ n• ❑ ►L �r:12 A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHED ❑OTTER ICC-Es REPORT O
DFS ON OF WORK:
Y .P•cn15v � S
l L `3o 716
By my signature below,I certify to each of the following. I am the property owner or authorized agent to act on the property owners behalf. I have read this
application and the information I have provided is comet 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 buil co toon. representatives of Cupertino t enter the above/---i�iden ted pro my for inspection purposes.
Signature ofApplicanNAgent Date: v[� rj
SUPPLEMENTAL INFORMATION REQUIRED
If building is associated with a Home Owner's Association,provide letter a rRCk'P!C .e7L7+'kRk ..�_....,.,.�..�.�.Y
IVA
t
of approval from HOA. 'r" p/dIirpy9V,or1iv8FsRR`y'° �,� ,8 _ Eu1n�lJ,mev ,rte F«J1
_Provide Planning approval to verify if there any restrictions. ' s 9"• '< a _ '-u. By w .47T%A
l 'N 7E+a . wv
_Prov'de copy of Manufacnner's Installation Specifications.
rovide signed copy of Cupertino's Tear-Off Policy.
Reroof lu_201Ldocrevised03/02/11