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11110020 O CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22380 MCCLELLAN RD CONTRACTOR:M C ROOFING PERMIT NO: 11110020 OWNER'S NAME: RODRIGUES MANUEL 14800 MCVAY AVE DATE ISSUED: 11/042011 O NER'S PHONE: 4089961885 SAN JOSE,CA 95127 PHONE NO:(408)729.3436 LICENSED CONTRACTOR'S DECLARATION r r. r BUILDING PERMIT INFO: BLDG -" ELECT � PLUMB License Class if % Lie.q r r r MECH RESIDENTIAL COMMERCIAL Contractor ate / I I hereby affirm 1 I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKE ROOF REPLACE WITH COMP (commencing with Section 7000)of Division 3 of the Business&Professions SHINGLES CLASS A 41 SQ Code and that my license is in full force and effect. I hereby alarm 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. 1 have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$19000 Section 3700 of the Labor Code,for the performance of the work forwhich this permit is issued. APN Number:35604026.22380 Occupancy Type: APPLICANT CERTIFICATION 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 stale laws relating to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. 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. Issued b r/Datei'/—'� Signature i ate V 44 OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to only roofing material berg installed.If roof is 10 ere by affirm that 1 am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agrelto remove all new materials for the following two reasons: inspection. 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(Sce.7044, Signature of Applies Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF OVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's 1 have read the hazardous materials requirements under Chapter 6.9.5 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 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 1 store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as dented by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505 25533,and 25534. 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,1 Owner ut I agen r� become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnity and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the Ig of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION ., all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date • CITY OF CUPERTINO 3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35604026.22380 DATE ISSUED. . . . . . . : 11/04/2011 RECEIPT #. . . . . . . . . : BS000015230 REFERENCE ID # . . . : 11110020 SITE ADDRESS . . . . . : 22380 MCCLELLAN RD SUBDIVISION . . . . . . . r CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : RODRIGUES MANUEL ADDRESS . . . . . . . . . . : 22380 MCCLELLAN RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : MIGUEL CASTILLO CONTRACTOR . . . . . . . : MIGUEL CASTILLO LIC # 24741 COMPANY . . . . . . . . . . : M C ROOFING ADDRESS . . . . . . . . . . : 14800 MCVAY AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95127 TELEPHONE . . . . . . . . : (408) 729-3436 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 19, 000. 00 1. 00 0. 00 1 .00 0. 00 1BSEISMICR VALUATION 19, 000.00 1.90 0. 00 1 .90 0 .00 1REROOFRES SQ FEET 41.00 574.00 0. 00 574 .00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 576.90 0. 00 576.90 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF 1 I l l 0097 ZD Y REROOF PERMIT APPLICATION R COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION10300 TORRE AVENUE • CUPERTINO. CA 95014-3255 CUPERTINO (408)777-3228 • FAX(408)777-3333 • buiIcinGlZ)cupertino.org PROIECf ADDRESS APN# ^ 02—(,o OWNER NAME P DY L /00'7 E-MAB. KPa4ve—L SCREEI'ADORESS \\ Cm, STAT$ZIP• FAX r c O APPLICANT NAME ./ PHONE .3 3 E-MAIL STREET ADDRESS S ATE, QS C of PAX . �� - ❑OWNER ❑ OWNER-BUR ❑ OWNERAGENT LSTCONIAACTOR ❑COM4ACr0R AGENT ❑ ARCHrECr ❑ENGIMEER ❑ DEVELOPER ❑TENANT CO OR NAME LICENSE NUMB LICENSE 13E BUS. d -7(--(/ COMPANY N E-MAB, cJ FAX r o t� STREET AESS Cm,SLATE,ZIP PHONE WrEQ4 eqrz V a ARCHMCi/ENGINEER NAME LICENSE NUMBER BUS.LIC M CWOANYNAME E-MAIL FAX STREET ADDRESS Cm,SLATE,ZIP PHONE USE OF SFD or Duplex ❑ Multi-Family ROOF AREA. VALUATION: STRUCTURE: ❑ Commercial QQQ EmsTING ROOF TYPE: ❑BUB.T-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPEmFr REMOVE/REPLACE IF NO. PLYWOOD ❑ 'A" ❑ PLYWD OSB PfrCI-1 ROOF ❑ d ❑ /e^ ❑ x :12 CLASS, A PROPOSED ROOF TYPE: ❑BUILT-IIP ROOF V ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHNOLES ❑OTHER 1CC-ES REPORT 1 DESCRIPTION OF WORK: r eC By my signature below,1 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 relating to h 'ding ccoon. I o r m' es Cupertino to enter the above-Iden ed proJp rty for inspection purposes. _gaeTSignattueofApplicandAgene Date: 4ez / SUPPLEMENTAL ORNIATION REQUMED -a _ - ,'; OF.ELCE IISE,ONIY If building is associated with a Home Owner's Association,provide letter !r'9ECICTY2E»��.,... .va r_; -'RDu'ftNc`sDiP =y .1111,of approval from HOA. 1 oc'NToR '" mNO P1; NiiEVIDw _Provide Planning approval to verify if there any restrictions. �T.XP.IGtISS" 3- QYCANNING PLAlYR'EYPEW L-�. Provide copy of Manufacturer's Installation Specifications. ,� 'k]`.sT _ rovide signed copy of Cu ertino's Tear-Off PoioY RerocfApp_2011.doc revised 03/02111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION • ADDRESS: 22380 Mcclellan rd. DATE: 11/04/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: $19,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PERMIT 1SFDWLROOF USE: PERMIT TYPE: WORK tear off shake roof replace wth comp shingles. SCOPE FEEID ROOFAREA s.f. 1REROOFFRES 4,100 dfeah. Pian Cheek Phone). Plan Check Elec.Plan Check :Viech' Permit Fere: Plumb. Permit Fee: /71W Permit&:e: O!iter Rovb./fall, oche.Phunb Insp. ('hher F:ieo. Insp. ED ,t/rh.Ins). I�eer Plumb. Imp.Fee: lifer.Inc). Fee: NOTE: This estimate does not include fees due to other Departments(l.e. Planning,Public Works,Fire,Sanitary Sewer Distrlet,School District eta). These fees are based on the prelinina In ormation available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 EB /1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl, P(.Fee PGrrnt:'_ilech.!Li7ec Permit Fee: $574.00 Sappl. hap Fee Yhnnli.:":Idech.%llec i'LrmhJAli:clr.%Ztih:r.. Permit Fcc: Construction 74v IdntiniePrcrtna?Fee: Work Without Permit? O Yes E) No $0.00 Advanced Planning Deas: Trozrerl Docianemation F"ees: Strong Motion Fee: 1BSEISMICR $1.90 Select an Administrative Item • Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $576.90 $0.001 TOTAL FEE: $576.90 Revised`. 10/0112011 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-buildinciCcDcuoertino.orc PROJECT ADDRESS R., APN# OWNER NAME IF , ll PHON E-MAIL V STREET ADDRESSU , CITY,STATE,ZIP FAX CONTRACTOFQE LICENSE NUMB LICENS�TYPEC71 BUS.LIC.N COM AN E E-MAIL C //7 FAX ST LT RES CIN ATE,ZIP �� /.c 1 PH E - 1 L 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 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/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. 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: 1 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 8315 of the 2010 California Residential Code. Signature of Applicant/Agent: Date: ReroglPolicv_201/aloe revised 02/l6/ll Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: „3 PERMIT# OWNER'S NAME: PHONE# 8 GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino busy ess 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. A�i��Z �� 14 1 am not using any subcontractors: � 6 Signature Date Please check applicable subcontractors and complete the following information: t/ 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 _Ro4. 0J Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date