09080090 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: '038?CLIFDF.PJ WAY CONTRACTOR:KEViN SULLIVAN PERMIT NO:09080090
ROOFING
t""NM:R'S NAME: JUNG DONALD T AND YOUNG M
1696 VALLEY OAKS DR DATE ISSUED:08/10/2009
►, GI.ROY,CA 95020 PHONE NO:(408)842-1057
CT:.wER'S PHONE: 4082571186
LICENSED CONTRACTOR'S DECLARATION BUILDiNG PERMIT INFO: BLDG ELECT PLUMB
License Class V-?J 1 — Lic•# n3!7( MECH [_ RESIDENTIAL[_ COMMERCIAL
Contractor �i Bate —
c_�_ ►., JOB DESCRIPTION:RE-ROOF;T/O SHAKES&WOOD SHINGLES,
i hereby affi that i am licensed under the provisions of Chapter 9 INSTALL 7/16
(commencing with Section 7000)of Division 3 of the Business&Professions OSB&30LB FELT&LIFETIME ASPHALT SHINGLES CLS A
Code and that my license is in full force and effect. 3(SQ
i hereby affirm under penalty of perjury one of the following two declarations:
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
performance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation insurance,as provided for by Valuation:$10000
Sectio,1,700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area:
permit is issued.
APPLICANT CERTIFICATION APN Number:36937013.00 Occupancy Type:
1 certify:hat I have read this application and state that the above information is
correct. !agree to comply•kith 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
I indemnity and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses whicrr may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granfing 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 Z111 9.18. Issued by: Date:
10 S;: +lure .._..-'�gQ
t
Ir
(] OWNER-BUILDER DECLARATION RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of ,UI 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 rernove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, nspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044, iignat of A plicant: ��'
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to 14
construe',the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I 1 herehy affirm under penalty of perjury one of the following three
declarations: HAZARDOUS IMIATERIALS DISCLOSURE
i have and will maintain a Certificate of Consent to self insure for Worker's
I have read the hazardous Compensation,qs provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,aSections 25505,ls `25533,and pter 9 h
25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
i have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code;for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air
permit rs 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 pennit 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.
ICompeasation laws of California. if,after making this certificate of exemption,1
become subject to the Worker's Compensation provisions of the Labor Code,I must Owu oriz
forthwith comply with such provisions or this permit shall be deemed revoked. I
I
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
`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 end 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 Lenders Name—
I,,
amei,, c above mentioned property for inspection purposes (We)agree to save
i; Afy and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Signature
Date—_—
Licensed Professional_ --- -
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C)q 0 ft)(D9 D
CITY OF CUPERTINO
REROOF
CUPCInEi�TINO PERMIT APPLICATION
APN # Date:�r
5 957o13
Building Address:
Owner's Name: _ [P�h�on7e #:
HOA: Yes ❑ No If yes, provide letter from HOA
Contractor: Phone #:
S6am907 , Fax #:
Cupertino Business License #: C /V Contractor License #:
Type of P.00f Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ ngles r�sphalt Shingles
od Shakes ❑ Wood Shakes
f00d ❑ 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:
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 wit]1 Cupertino's Tear-Off Policy:
Sig ature
Revised 02/05/09
CITY OF CUPERTINO
` REROOF
CUPEkT1NO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof REaident'`1 B 1SFDWLR00F
---------------
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1 REROOFMRES Re-roof M alti-Family B 1MFDWLROOF
I 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1 1BSEISMICRE Seismic Rosidential B
1BUSLIC Business License B
Community Development Department
Building Division
City of Cupertino
10300 Torre 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 a iy 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 pe formed.
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.
Homeowner's Name: 1/!s ' - �.J l• �r--�
Job Site Address: itzy? '
Roofing Company Name: �y' '
Applicant's Signature:
Greg Casteel
Building Official
Revised 07/30/08