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11110021 r� CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 915 ROSE BLOSSOM DR CONTRACTOR:M C ROOFING PERMIT NO: 11110021 OWNER'S NAME: VASQUEZ EDMUND G AND ANGELA F 14800 MCVAY AVE DATE ISSUED: 11/04/2011 O NER'S PHONE: 4082535839 SAN JOSE,CA 95127 PHONE NO:(408)729-3436 LICENSED CONTRACTOR'S DECLARATION r_ r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class C 3ci Lic. 3 3 MECH r RESIDENTIAL r COMMERCIAL r Conimctor ate I hereby affirm th am licensed under the provisions of Chapter 9 JOB DESCRIPTION:R&ROOF TEAR OFF SHAKE ROOF REPLACE WITH COMP (commencing with Section 7000)of Division 3 of the Business&Professions SHINGLES CLASS A 31 SQ Code and that my license is in full force and effect. 1 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 Sq.Ft Floor Area: Valuation:$13000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:35903032.00 Occupancy Type: APPLICANT CERTIFICATION I certify that 1 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 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 by: ._ Date: Signatui ^ Date�/� ZJ • OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material beitg installed.If a roof is 1 hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,1 agree to remove all new materials for the following two reasons: inspection. I,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, Signal t Dat Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). L ROOF COVERINGS 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 6.95 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 I 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 contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. 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,I Ow r Rayz d ag become subject to the Worker's Compensation provisions of the Labor Code,1 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, SAJL and expenses which may acerae against said City in consequence of the ARCHITECT'S DECLARATION ng of this permit.Additionally,the applicant understands and will comply 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 Dale n 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-buildinotl1cuoenino.oM PROJECT ADDRESS APN p OWNS N E ^^ PHO53 - 3 E-MAIL STREET A RESS L� CITY, STATE.21P FAx U r NSOI CO TRA TOR NAME LICENSE NUM E LIC C_ IE3 BUS.LIC.p CO PA N E /' . E-MAIL FAX l STREE SCITY,STATE,21P PHONE �- 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 Insoection 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: I am the property owner or authorized agent to act on the property owner's behalf. 1 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 Residential Codg. Signature of Applicant/Agent: 45:�,7 Date: Reroq/Policv_201 l.doc revised 02116111 • CITY OF CUPERTINO 3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35903032 . 00 DATE ISSUED. . . . . . . : 11/04/2011 RECEIPT #. . . . . . . . . : BS000015230 REFERENCE ID # . . . : 11110021 SITE ADDRESS . . . . . : 915 ROSE BLOSSOM DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : VASQUEZ EDMUND G AND ANGELA F ADDRESS . . . . . . . . . . : 915 ROSE BLOSSOM CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4215 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 13, 000 .00 1. 00 0.00 1.00 0. 00 1BSEISMICR VALUATION 13, 000.00 1.30 0.00 1 .30 0. 00 1REROOFRES SQ FEET 31.00 434 . 00 0 .00 434 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 436.30 0. 00 436 .30 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 1, 013 .20 VISA --------------- TOTAL RECEIPT 1, 013 .20 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 • REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION L-I V 10300 TORRE AVENUE • CUPERTINO. CA 95014-3255 _ ® CUPERTINO (408)777-3228 • FAX(408)777-3333 • buildina(EDcupertino.orD PROTECT ADDRESS APN p �` 1 05 052—"�7 J yJ lJ L 0 NA u' J P NE _ E-MAa ADO SS , STATE,ZIP CJ C 47.SSI FAX 6 APPLICANT Nrk PHONE E-MAIL 51'R�FI' RFSS �.�P'VCrIYZATE, ZIP ^� S FAX . ❑/ 02)1 OWNER ❑ OWNER-BGILDER ❑ OWNER AGENT CONrRAC OR AGENT ❑ AR C`r ❑ENGDIE]t ❑ DEVELOPER ❑ TENANT CO OR NAMELICENS LICE??TYP BUS.LIC.J1` COE-MAD. FAX t+B' o� STREET ADDRESS CrrY,STATE,ZP PHONE S ARCHITECT/FNGINEER NAME LICENSE NUMBER BUS.LIC.0 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE 115E OF FD or Duplex ❑ Muld-Family ROOF AREA. VALUATION: �^ srttu 7URE: ❑ Commercial �/' EXISTNO ROOF TYPE: ❑BUMT-IIP ROOF CIHI ASPHALT SNGLES 12W000 SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE i,Z PLYWOOD ❑ A" ❑ PLYWD OSB PITCH, ROOF No #LA= THICICqua 0 5/8 TYPE: 0 Cox 12 All PROPOSED ROOF TYPE: ❑BUE.T-UP ROOF HALT SHNOLES ❑WOOD SHAKES ❑WOOD SHRJGLBS ❑OTHER ICC-ES REPORT Y DESCRIPTION OF WORK: L O S eAr By my signature below,I certify to each of the following: I one 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 some laws relating to buiid* g co ction. I au u en v D upernc to enter the above-ide bed piaperty for inspection purposes. Signature of Applicant/Agcm: Date: 6� / SUPPLEMENTAL INF ATION REQUIRED .� - r ., =,oa cF vs nir - - Ov If building is associated with a Home Owner's Association,provide letterG� PFA.. of approval from HOA. • xti 'corir .; ""y nae',>zi aN �r _Provide Planning approval to verify if there any restrictions. ,� t7gg= ©,,.EcAc'P psi a,,. N"-`= Provide copy of Manufacturer's Installation Specifications. 4J1 axe t s Ai xab 3 .z pde signed copy of Cupertino's Tear-Off Policy. ReraofApp_201 Ldoc revised 03/02111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION . ADDRESS: 915 rose blossom dr. DATE: 11/04/2011 REVIEWED BY: bobs. APN: BP#: *VALUATION: $13,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF USE: PERMIT TYPE: WORK tear off shake roof replace wth comp shingles. SCOPE FEE ID ROOF AREA s.E 1REROOFFRES 3,100 i ,Ife,/r. Plan Check Plumb, Plan Check fRec P:ou Chedt 4ech, Pernrii F1;er /°hind. Perwit Fee: F/eec pern�ie Nita: • Other;110r-lr.Imp. Other Plunrh heap_ OUre, E7ec- ln5p. 7,hIng). Fee: Plundr. l"'p.Fee: Elec.Insp. Fee: NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District etc. . These fees are based on therelhrina in ormation available and are onl an estimate. Contact the Dent for addn'l Info. FEE ITEMS (tee Resolution 11-053 Eff 7/J/££1 FEE QTY/FEE MISC ITEMS Man Check Fee: Supp£. PC fee PGanh.ittk:ch,LF;Jeu Permit Fee: $434.00 Sup/71, £rr<sp.Fee J'Jnmb.,:Nech.i£iJec Ne;rmU Fere: C(arstrrrc£ion nix Administrative Fee: Work Without Permit? O Yes Q No $0.00 A'lvanucVd Planning 1 ees: Travel Docinne:n£ation Strong Motion Fee: IBSEISMICR $1.30 Select an Administrative Item • BIdQ Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $436.30 $0.00 TOTAL FEE: $436.30 Revised: 10/01/2011 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: PERMIT# 2 OWNER'S NAME: PHONE# �' GENERAL CONTRACTOR: y p F- BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: 7 *Our municipal code requires all businesses working in the city to have a City of Cupertino bu ness 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: 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 i Septic Tank Sheet Metal Sheet Rock Tile caner/ ontractor Signature Date