12100044 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10251 BRET AVE CON'I'R,ACI'OR:WORK FORCE ROOFING PERMITNO: 12100044
WFR
OW'NER'S NAM E: MATTANA STEFANO A 761 M16ABURY RD APT 100 DATE ISSUED: 10/082012
O%VNER'S PHONE: 4084460543 SAN JOSE,CA 95133 PHONE.NO:(408)892-5096
®_ LICENSED CON'TRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG r ELECT F7 PLUMB[t
License Class C-3q Lie.q TI 6 6 3 3 r G rl
' 111ECF1 RESIDENTIAL COMMERCIAL
Contractor 6AM4 Go-c-c ke4,tDate 1010q/ 20t
. 2
I hereby'nlTinn That I nm licensed under the provisions of Chnpter') JOB DESCRIPTION: REMOVE EXISTING TAR AND GRAVEL ROOBINSTALL
(commencing with Section 7000)of Division 3 of the Business& Professions THREE
Code and that my license is in full force and effect. PLY HOT MOP WITH BASE,2 INTER-PLY LAYERS AND
GRANULATED CAP SHEET 22 SQ CLASS A
hereby affirm under penally of peri are 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 IDr 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 perfomtance of the work for which this
permit is issued. �A. �- 1 I ` Sq.F1 FloorArea: Valuation:$9467
APPLIC,AN'f CER'FIFICA'110,N W
I certify that I have read this application and state that the above information is APN Number:37510015.00 Occupancy Type:
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, PERMIT EXPIRES IF WORD IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicmunderstands and willcomply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature�1 , jc� rnel\ Datc 16 J 'j Issued by: Date:
❑ OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for line of RE ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without fust obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Cale)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
constmet the project(See.7044,Business&Professions Code).
1 hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETI'IiR
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS NIATERLAI S DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for theerformance of the work for which this compliance with the Cupertino Jl uniei pal Code.Chu pier 9.12 and the Ilealth&
F Safety Code.Section 25532(x)should I store or handle hazardous material.
permit is issued Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work forsvhich this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain com plin are with the Cupertino\I uniei pal Code.Chapter 9.12 and the
Compensation laws of California. If,alter making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions ofthe Labor Code,I must
lorthwith comply with such provisions or this pencil shall be deemed revoked.
Owneror authorize gam
Date; 2
APPLICAN 1'CERTIFICATION CONS'IRIICI'ION LENDING AGENCYI certify that I have read this application and state that the above information is
correct.I agree to comply with all cit'and county ordinances and state laws relating I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ Q
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against Iinbilities,judgmnus,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
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.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
121
REROOF PERMIT APPLICATION
Ell COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildincl(dcuperiino.oro
CUPERTINO
PROJECT ADDRESS -/0 I .A � APN M&��i
OW9kNER NAME /II v2 PIIONE eeJJ El-NAIL C/
e -�
STREET ADDRESSZ. /� A,V� CITY, SrA. f7 /� FAC
I L7
CONTACT NAItE I GYe MR. 1 PIIONlE.1 E-NAIL
STREET ADDRESS C-' t M� CITY,STATE, ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT Eq CONTRACTOR ❑CONIRACTORAGE.Yr ❑ ARCHITECT` ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME I LICENSENUMBERclI b33 LICENSETYPE BUS.LIC./
COMPANYNAME 11�� - C-AIAIL FAX
"V r
STREET ADDRESS CITY,STATE,ZIP PHONE
M 'b - loo S --er a 2e8
ARCHITECDENGINEER NAME LICENSE NUMBER BUS.LIC.u
COMPANY NAME E-NAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF IK SFD of Duplex ❑ NlUhl-fanlll)' ROOF AREA: VALUATION: e( 67-0'0
STRUCTURES ❑ Commercial ��
EXISTING ROOF TYPEeq BUILT-UP ROOF 11ASPHALT SI IINGLES ❑WOOD SI TAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE[REPLACE 19 YE IF NO. PLYWOOD ❑ 'A" ❑ PLYWD ❑ OSII PITCH: ROOF
❑'NO MLAI•ER THICKNESS ❑ SIR" TYPE- ❑ DY �'12 _LASS
PROPOSED ROOF TYPE: RWLT.UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD S)TINGLES ❑OTHER ICC-ES REPORT X
DESCRIPTION OF WORK:
CS�p f
I - I
III L J — o �i raE�k e
By my signature below,I certify to each of the Ibllowing: I am the property owner or authorized agent to act on the property owner's behalf. 1 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 building c(onswetion. 1 authorize representatives of Cupertino to enter the above-iidentfified property for inspection purposes.
Signature of Applicam/Agcm: f Date: OSpl
SUPPLEMENTAL INFORMATIONREQUIRED - OFFICE Use ONLY
_If building is associated with a I tome Owners Association,provide letter PLANCuecs'n'PE: _ __ RbUTI's,G SLIP, _
of approval from HOA. .❑ OVFR.TIIEICOUNfF:N ❑ BUILDIN'6.PLAN REVIEW
_Provide Planning approval to verify if there any restrictions. ❑ EXPRESS, ��� PLAMNING PLAN REPII W
_Provide copy of Manufacturer's Installation Specifications. '❑ STANDARD ❑ EIRE DEPT'
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTIIF.R:
ReroojApp_201 l.doe revised 03/16/11
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
CUPERTINO
(408)777-3228• FAX(408)777-3333•buildino(okuoertino.ora
PROJECT ADDRESS I 0 2S") Ib, C/C I\v,,e,. APNn
ON'NERNAME S�.evC ^A` / I PHONE q, Y3 6NAIL
STREET ADDRESS I D 2f1 !3�E AUS CITY. STATE,ZIP C A 01
FAX
CONTRACTOR NAME CII LICENSENUMBER LICENSE TYPE BUS.LIC.p
/ 6G
COMPANYNAME I- -LL y� E-MAIL FAX
STREET ADDRESS 7/ 1 !NA - L �. n1`W— /O� CITY.STATE.ZIPS �� cA tn33 PHONE
o ,-VIP 1(� D't` 2—fa f6
1 UNDERSTAND AND AGREE TO THE FOLLOWING:
I. 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 plvwood 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 S 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
Oil the property owner's behalf. I understand and agree to comply with the re-roof policy stated above.
Signature of Applicant/Agent: Date:
RerooJPolicr_2010.doc revised 05717710
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
2 ADDRESS: 10251 Bret Ave. DATE: 10/08/2012 REVIEWED BY: RDW
APN: BP#: *VALUATION: $9,467
*PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK Remove existingtar and ravel roof. Install three I hot mo with base 2 inter-ply layers and
SCOPE granulated cap sheet.
FEEID ROOFAREA
s.f.
1REROOFFRES 2,200
Mech. Plan Check Phunh Plan Check Flee.Plan Check
hlech. Permit Fee: Plumh. Permii Fee: Elect Permit Fee:
Other Mech. Insp. Other Plumb Insp. L1 I Other Elec.Itsp.
,t/ech. htsp.Fee: Phanb. I,"/). Fee: Flee.hasp.Fec: El
NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public IVork.s, Fire,Sanitary Sewer District,School
District,etc. . Thesefees are bused on Ore prelirninat3 information available and are onh,an estintme. Contact the De t or addit'I info.
FEE ITEMS (Fee Resolution 11-053 ED' 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Sryppl. PCF ee
Ptumb.111ech.lElec
Permit Fee: $330.00
Supp/. lnsp Fee
Phtmh.ljt/ech.lFlec
Plunlh.lMech.10ec Permit Fee:
Construction Tae:
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Advanced Naming Fees:
Truvel Documentation Fees:
Strong Motion Fee: IBSEIS,IHCR $0.95 Select an Administrative Item
Bldg, Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $331.95 $0.00 TOTAL FEE: $331.95
Revised: 10/01/2012