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11090001 Cil PI91 W.N.N. N.\.1 NIVIA ■ ■ ■K - K■ 101 0551%l■ ■N■ V0�22 ■iW CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 8165 HYANNISPORT DR CONTRACTOR:ROOF ROOFING PERMIT NO: 11090001 OWNER'S NAME: WANKE CARL A AND RUBY L 5577 VASSAR DR DATE ISSUED:09/01/2011 OINNER'S PHONE: 4087810566 SAN JOSE,CA 95123 PHONE NO:(408)265-9270 L LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB 6&� � License Class l Lic.# V MECH RESIDENTIAL COMMERCIAL Contractor 1./oo��1200j= Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE THE EXISTING SHAKE ROOF& (commencing with Section 7000)of Division 3 of the Business&Professions INSTALL OSB PLYWOOD ANDA 30YR COMP CLASS A 28SQ 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. 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:$8700 permit is issued. APPLICANT CERTIFICATION APN Number:35611021.00 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 appl'cant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regul i er t upertino Municipal Code,Section 9.18. / Issued by:,�, ,•�` _Date: Signature Date 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 materia;.being installed.If a roof is the following two reasons: installed without first obtaining an inspec' gr o 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, 1 Business&Professions Code) Signature of Applicant: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 1 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 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. I 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 1 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,Sectio s 2 ,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 forthwith comply with such provisions or this permit shall be deemed revoked. Date:—4-11 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 cork'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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address r and expenses which may accrue against said City in consequence of the �g of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional vel REROOF PERMIT APPLICATION -- COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION Lai 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTIN4 (408)777-3228• FAX(408)777-3333 • building(r�cupertino.org PROJECT ADDRES \ �` C ` TA_FN# I f OWNER NAME `F �C PHOJ I,0& 0 � 2 S� E-MAIL o. " STREET ADDRESS CITY, STATE ZIP FAX APPLICANT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT RACTOR ❑CDNTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME `DQ.�_ I�ICF�NS�E UM E LICENSE 7 BUS.LIC.# COMPANY NAME `C (,js E-MAIL r FAX ,a V*,-\,- efoc "Z 63--, 7n. STREET ADDRESSS Z "C'S 5 0 n CITY,STATE—ZIP�v,t S-C PHONE ARCHITECTIENGINEER NAME V 11 LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF e,9!rSFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ;�601)SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE IF NO, 7L��C;__ OOD ❑ 'h" ❑-� PLYWD )OSB PITCH ROOF NO #LAYERS: KNESS: ❑ 5/8" TYPE: ❑ CDX 12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK ` 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 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 I autho ' ,representatives of Cupertino tc enter the above-identified7P,roperty for inspection purposes. Signature ofApplicant/Agent Date: `n7 ( SUPPLEMENTAL INFORMATION REQUIRED _If building is associated with a Home Owner's Association,provide letter 'Y`�'�' _ ! _ ` of approval from HOA. : _Provide Planning approval to verify if there any restrictions. `g _L i A. Pr vide copy Of Manufacturer's Installation Specifications. ,�� _Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/02111 I ( �9 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•building(a)cupertino.org PROJECT ADDRESS'�J ` y' ©�1 (� 7APN# / OWNER N� PHONE'/s��. E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX CONTRACT R NAM ^�v `1' LIC�yN$ FyR� L►�CENSE^P� BUS.LIC.# COV9ANYNAQM �UOC_C J- `� E E�G_. L0\0"(Z ��Gl7�� �7U STREE E� ,t Q ��. CITY,STATE,Z� `_ �0 1` n l p� PHONE / ` Q 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 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 I/" 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: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agree to compl h the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide det ctor e re to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Co Signature of Applicant/Ag q Date: Reroomolicv_2011.doc revised 02/16/11 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: (2 s- o.,t- PERMIT# i i �' 1-1 :- OWNER'S NAME:, %o- `,J�„ ,,�k.� PHONE # 2 6 S- ? 0 GENERAL CONTRACTOR: �.,-f deo �.. BUSINESS LICENSE # 6 k> "6 Y ADDRESS: �X>> V,)),-, �)2 E , :�j- a' 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: 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 -r Owner Contractor Signature Date