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13080076 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7553 WATERFORD DR CONTRACTOR•TBD-TQRE PERMIT NO: 13080076 �D OWNER'S NAME: PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE] License Class G-39 Lic,# C01 RE-R000F 23 SQ TEAR OFF EXISTING,OSB,CLASS A 'S11p0 SEE NOTES* Contractor (1G\ C ty1G Date. (387- 2' �7�3 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:$11800 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:36617026.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXP WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHINOWAYS 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 DA ` RO ST CALLED INSPE TION. indemnify and keep harmless the City,of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date ©g—t X-2©1 3 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 20 Signature of Applicant:r \— � 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 isnot intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively 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:.I will Ihereby 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-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 I 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 the performance of the work for which this �� 2-20 permit is issued. Owner or authorized agent: Date: I certify that in the performance of 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 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 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 COMMUNITYDEVELOPMENT DEPARTMENT•BUILDING DIVISION O� f 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 {408)777-3228•FAX(408)777-3333•buildinp(a�cupertino.orp 30 CUPERTINO. ` PROJECT ADDRESS APN# ' OWNERN ' .. EMAIL STREET ADDRES$1. CIT E,ZIP `,^Q FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX 13*OWNER ❑ owNER-BUBAER ❑ OWNER AGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME e b _ ` LICENSE NUMBER I Ll�D LICENSE TYPE BUS.LIC.# COMPANY NAME �f EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE.OF )<SFD or Duplex ❑ Multi-Family ROOF AREA: 2 VALUATION: �7y STRUCTURE: ❑ Commercial N--- a3 1 1 "Do EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES WWOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) .REMOVE/REPLACE DYES 1.IFNO,' PLYWOOD ❑ '/:" ❑ PLYWD OSB PITCH: ROOF ❑NO #LAYERS THICKNESS: ❑ 5/8" TYPE: ❑ CDX 12 CLASS: ICC-ES REPORT# PROPOSED ROOF TYPE: ❑ BUILT-UP ROOFASPHALT SHINGLES 13 WOOD SHAKES ❑WOOD SHINGLES ❑OTHER DESCRIPTION OF WORK: � 0 / c) nod Comp_m I By:rliy 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. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relati ilding co ction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. . Signature of Applicant/Agent: Date: �g' `— SUPPLEMENTAL INFORMATION REQUIRED - If building is associated with a Home Owner's Association,provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 7553 waterford rd DATE: 08/12/2013 REVIEWED BY: Mendez 191APN: BP#: "VALUATION: 1$11,800 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1SFDWLR00 i WORK [EgILogof 23 sq tear off existing, osb class a SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 2,300 IRMO Room v_ � ME . . :Tech. J'tara Check Plumb,Pleat Check Flec.Ilan(,'heck blah.Permit Fee: Plramb. Permit Fee: lilec. Permit Fee: Other Alech.Insp. Other Plumb Insp. Other flee.Insp. Ifech.Insp.Fee: Plumb. Insp.Fee: Elec.Insp.Fee: NOTE:This estimate does not includefees due to other Departments(i.e.Planning,Public Works,Fire,SanitarySewer District,School District,etc.). Theseees are based onl the relimina information available and are onlyan estimate- Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: 5'uppl. P(;'Fee Plumb.;Mech.;Z.lec Permit Fee: $368.00 .Suppl. Insp Fee Plum b✓Akfecch./Elec PlurnhA,Wech.iL'lee Permit Fee: Consiruction Tax: Administrative Fee: Work Without Permit? 0 jYes (E) No $0.00 Advanced Planning Fees: Travel Documentation T'ees: � Strom Motion Fee: 1BSEISMICR $1.18 0 # Revisions Bldg Stds Commission Fee: IBCBSC $1.00 $0.00 IREVCOMNEW Commercial New NIP W<<. $370.18 $3$0.0" 0 70.18 Revised: 07/01/2013 _.i REROOF TEAR-OFF POLICY COMMUNITYiDEVELOPMENTDEPARTMENT•BUILDING DIVISION `. ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)7773333•buildingCa�cupertino.org PROJECT ADDRESS -75 55. .� � \` APN# OWNER STREET ADDRESS J _ ` CITY STATE,ZIP FAX CO CTOR NAME O�e\S�I�Y\J T 'vsOa LICENSE NUMBER 1 11 LICEC Fh BUS.LIC.# COMP NAME `'� FAX STREET ADDRESSmC Y,STATE�nvPHONE �t00 er y � c.�e CP, 9kvz u 02K1--3SaL, 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 un to one business day before the requested inspection date. Please call(408) 77773228 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: I/4"per foot of slope and demonstrate there is no ponding. a. Flat roofs shall have a minimum of 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 Resident' Signature of Applicant/Agent: Date: 8S-`) Z—Z©13 ReroofPo1icy_2012.doc revised 10/7/12