13030015 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:. 10572 CEDARTREE CT CONTRACTOR:CD ROOFING PERMIT NO:13030015
OWNER'S NAME: SPILLER CHARLES AAND MARILYN 2909 WILBUR AVE DATE ISSUED:03/04/2013
OWNER'S PHONE: 4082523311 SAN JOSE,CA 95127 PHONE NO:(408)898-6605
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL Ll COMMERCIAL
License Class Lic.# SC"'2. TEAR OFF(E)WOOD SHAKE,INSTALL NEW OSB_,40 YR
COMP
Contractor
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-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:$13500 `
1 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:31634026.00 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.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAY F 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 M T CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Is Date:
granting of this permit. Additionally,the applicant understands and will comply y
with all non-point source regula' pe perti unicipal Code,Section
9.18.
RE-ROOFS:
Signature DateLY ^ )i':�) All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspec a ee to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION 3 �e Z
Signature of Applicant: Date:
I 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
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) .
HAZARDOUS MATERIALS DISCLOSURE
I,as owner of the property,am exclusively contracting with licensed contractors to
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
I 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-imme 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 lity,Management District I
performance of the work for which this permit is issued, will maintain compliance with the Cupertino pa ,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Cod;Sections 2550 , 255
Section 3700 of the Labor.Code,for the performance of the work for which this Owner or authorized agDate: t��
permit is issued.
I certify thatin the performanceof 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 CONSTRUCTION LENDING AGENCY
Compensation laws of California. If,after making this certificate of ekemption,I
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 -
upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,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 PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIONI;." ') R
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•buildinG Mcuoertino.om \
PROTECT ADDRE I APN# `I / 2 � O '7
OWNER NAME PHONE E-MAI. J
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STREET.ADDRESS CITY, STATE,ZIP FAX
LA CONTACT NAMEPHONE E- n
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STREET ADDRESSCITY,STATE,ZIP FAX
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[I �f OWNER ❑ OWNER.BUBDER ❑ owNERAGENT nr CONTRACrOR ❑CONTRACmRAGENT' ❑ ARCHITECT ❑ENGINEER ❑ DEvE oPER ❑TENANT
CONTRACTORNAME LI SE NUMBER LICENSE TYPE
2166 at s ?
CONTANY NAME EMAIL - FAX
0 ..Q 1V
STREET ADDRESS CrrY,STATE,ZIPPHONE
2 -OCT X113 fa c.I S 5 2 `f'
ARCHITECT/ENGINEER NAME LICENSE IM.mER BUS.LIC.#
COMPANY NAME E-MAILit All FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ulti-Family, ROOF AREA: VALUATION:
STRUCTURE ❑ Conunercial 3.
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOODSRAKES ❑WOODSHINGLES ❑OTHER(SPECIFY)
REMOVEIREPLACE ❑YES TNO. PLYWOOD ❑./ ❑ PLVWD ]IF=- PITCH: ) n ROOF
❑ N # OS TYPE �L.1L ICLASS. A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-FS REPORT#
DESCRIPTION OF WORK: t
By my signature below,[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 he Desai ' of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. >flto re tat of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanNAgenC Date: -z
SUPPLEMENTAL f95FFORMATION REQUIRED `i OFFICE USE ONLY
_If building is associated With a Home Ownees Association,provide letter PLAN CHECK TTTE' _ROUTING SLIP
of approval from HOA. 0DVER•TRE COUNTER- BUILDING PLAN REVIEW
_Provide Planning approval to verify if there any restrictions. Op EXPRESS ❑ PLANNING PLAN RcvlEw
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino s Tear-Off Policy. OTHER:
ReroofApp_201 Ldoc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10572 CEDAR TREE CT DATE: 03/04/2013 REVIEWED BY: MELISSA
APN: 342 29 024 1 BP#: 'VALUATION: $13,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: p PERMIT TYPE:
WORK TEAR OFF E WOOD SHAKE INSTALL NEW OSB 40 YR COMP
SCOPE
k w.�
.vtech. Plan Check - Plumb.Plan Check Elec.Plan Check
Meeh. Permit Fee: Plumb. Permit Fee: Elec. Permit Tee:
Oihcr btech.Insp. Other Plumb Insp. LD Other Elec.Insp. Li
.Ilech.Insp. Fee: Plumb. h sp. Tee: Elcc.Insp. Fee.
NOTE:This estimate does not ine/udejees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District etc.). Thesefees are based on there Wha information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS(Fee Resolution 11-053 E . 7{� 11/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 00 s.f. Re-roof
2,8
Suppl. PC Fee: Q Reg. 0 OT O,0
7 hrs $0.00 $420.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee:O Reg. 0 OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tac:
Administrative Fee: O
Work Without Permit? 0 Yes 0 No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential 19
Travel Documentation Fees: Building or Structure 0,
Strong Motion Fee: IBSEISMICR $1.35 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
NMI
$2.35 $420.00 GiTOTAL'FEE:' $422.35
Revised: 01/01/2013
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-buildinc(rDcuoertino.oro
PROJECT ADDRESS APN#
OWNER NAME PHONE EMAIL
M A, St L A O — 252 - 33
STREET ADDRESS CITY, STATE,ZIP FAX
k 7- 2
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.M
t C Cl 2-f CIA
COMPANYNr Rmo E-MAIL FAX
STREET ADDRESS - CITY,STATE,ZIP PH NE
O �n L f i YYL O
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to one business day before the requested inspection date.
Please call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pm (Friday) to schedule
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.
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. 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 havd 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.
7. 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. 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 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 Code.
Signature of Applicant/Agent: Date:
RerooJPolicy_2012.doc revised 10/7/12