15010114CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7964 MCS@ ( ( an
CONTRACTOR:-TB5--T-0431=
PERMIT NO: 15010114
OWNER'S NAME: MCCLELLAN ASSOCIATES LLC
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DATE ISSUED: 01/21/2015
OWNER'S PHONE: 4082577514
PHONE NO:
VC LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
UNITS 7964, 7966, 7968 & 7970; REPLACE MANSARD
License Class_ Lic. #
ROOF ON MFDWL; 170 SQ- REMOVE WOOD SHAKE &
INSTALL
Contractor _UAN (Ad calk I of DateHANDI
PLANK 12" SIDING
I hereby affirm that I am licensed under the provisio�hpter
(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
Valuation: $50000
p rmance of the work for which this permit is issued.
Sq. Ft Floor Area:
I f 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: 36212001 7964 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 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
180 DAYS F LA ALLED INSPECTION.
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
which may accrue against said City in consequence of the
Date: 2�
costs, and expenses
Issued by:
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
RE -ROOFS:
4�_installed
All roofs shall be inspected prior to any roofing material being installed. If a roof is
SignatureDate__V
-
without firobtaining an inspection, I agree to remove all new materials for
171 OWNER -BI DECLARATION
inspection.
Signature of Appli Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
ALL RO C VERINGS TO BE CLASS "A" OR BETTER
the following two reasons:
1, 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 (See.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
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Code, Section 25532(a) should I store or handle hazardous
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Health & Safety
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
ith the Cupertino Municipal Code, Chapter 9.12 and
performance of the work for which this permit is issued.
will maintain compliance
the Health & Safety Code, N s 25505, 25533, and 25534.
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
Owner or authorized age Date a 5`
permit is issued.
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
CONSTR TION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
I
I hereby affirm that there is a construction lending agency for the performance of
become subject to the Worker's Compensation provisions of the Labor Code, must
work's for which this permit is issued (Sec. 3097, Civ C.)
forthwith comply with such provisions or this permit shall be deemed revoked.
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 DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
C' I (408) 777-3228 • FAX (408) 777-3333 • building aacupertino.orq
UPERTINO
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PROJECT ADDRESS 71 /Sf/ # Ylp G C L e—Gt4o
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OWNER NAME
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❑ OWNER ❑ OWNER -BUILDER OWNERAGE.NT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
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LICENSE NUMBER
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COMPANY NAME
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USE OF ❑ SFD or Duplex '0( Multi -Family
ROOF AREA::y
VALUATION:
STRUCTURE: ❑ Commercial
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES WOOD SHAKES
❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE YES
IFNO,
----[
PLYWOOD ❑ %" ❑
PLYWD ❑ OSB
PITCH:
12
ROOF
❑ NO
#LAYERS:
THICKNESS: ❑ 5/8"
TYPE: ❑ CDX
CLASS: `�
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES
❑ WOOD SHINGLES MOTHER
ICC -ES REPORT #
DESCRIPTION OF WORK:
14,040 4;4
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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. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relatin t b ng construction. I authorize representatives of Cupertino to enter the ab o e -id tified property for inspection purposes.
Signature of Applicant/Agent:
Date:
SUPPLEME AL tFORMATION REQUIREDt'h
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If building is associated with a Home Owner's Association, provide letter
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of approval from HOA.®
_Provide Planning approval to verify if there any restrictions.Y�'
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_ Provide copy of Manufacturer's Installation Specifications.]
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Provide signed copy of Cupertino's Tear -Off Policy.
_
ReroofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 7954 me clellan rd DATE: 01/21/2015 REVIEWED BY: Mendez
APN: BP#: "VALUATION: $50,000
FPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair
PRIMARY Buildina is PENTAMATION
USE: Multi -Family Dwelling >3 Stories 0 Yes No PERMIT TYPE:
WORK units 7964 7966 7968 & 7970; replace mansard roof on mfdwl; 170 s - remove wood shake &
SCOPE Nandi plank 12" siding
LL,Ji. 1,ku-i (° Ie'�' l�11t1?Ih. l�:Lt11 i'11E'L'F
L9e7� IPet•tnit fee' Pla;mi�. Perm;,I'cre::
of!wvifcch ImP, other Plumb fnve .
plumb, h1sp. f
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc . These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l in o.
FEE ITEMS (Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (j) Reg. Q OT 0.0 hrs $0.00 -F7==]
PME Plan Check: $0.00
Permit Fee: Hourly Only? ® Yes (F) No $0.00
Suppl. Insp. Fee -.0 Reg. ® OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Coluvrvction Tc, 1x1-
0
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Work Without Permit? ® Yes (CE) No $0.00
Advanced Planning Fee: $0.00 hours Inspections E)
T, «3 �a1 cIc°t rt2ttx/ir,}r Fees., $286.00 ISTINSP Inspection, Hourly 0
Strong Motion. Fee: IBSEISMICR $6.50 0.5 hrs Admin./Clerical Fee
Bldg Stds Commission Fee: IBCBSC $2.00 $45.00 ]ADMIN
77 $8.50 $331.00 ToaL FEE: $339.50
Revised: 01/06/2015
CUPERTINO
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
(408) 777-3228 • FAX (408) 777-3333 • building
(a)cupertino.org
PROJECT ADDRESS 7
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re -roof project shall comply with all applicable provisions of the 2013 California Codes.
2. An inspection request can be scheduled up to one business day_ before the requested inspection date.
Please schedule inspections online or 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. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs)
and 7:30-10:30am and 12:30-2:30 (Friday). 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 have a minimum of I/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 mono ide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential `�
Signature of ADDlicant/Aeent: C _ Date: Z9rJ �, G
ReroofPolicy_2014.doc revised 01/15/14
JAN 2
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Basemap Labels
Abc Street Names
Primary Address Labels
Freeway
Basemap
a Street Centerline
----..-- County Major Roads
-- - County Freeways
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® City Boundary
Aerials - Sept 2013
S
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City of Cupertino
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