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12040132 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10135 SCENIC BLVD CONTRACTOR: PERMIT NO: 12040132 OWNER'S NAME: PUGH MYRON A AND GRAHAM MARY KK02 DATE ISSUED:0425/2012 OWNER'S PHONE: 4083988930 PRONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class 'O -r.o-.o 71-/ic.a.- 9Z8—Fry r r r — - MECH RESIDENTIAL COMMERCIAL Contractor A Ca G do co—',-,"'Date fl ZJ'— /ZZ 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING SHAKE AND REPLACE (commencing with Section 7000)of Division 3 of the Business&Professions WITH Code and that my license is in full force and effect. PRESIDENTIAL TL COMPOSITION CLASS A 4500 SQFT 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. 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 permit is issued. Sq.FI Floor Area: Valuation:$30000 APPLICANT CERTIFICATION I cenil'y that 1 have read this application and state that the above information is APN Number:35709075.00 Occupancy Type: cored.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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally.the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cu Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. -1 �/ Signature Date Issued Issued by: 1� ��G�( Date: / '9/1 ❑ OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one of RF.-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,mid the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) 1,as owner of the properly,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044.Business&Professions Code). 1 hereby affirm under penalty of perjury one of the following three AL1.ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for.Worker's HAZARDOUS MATERIALS DISCLOSURECompensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued- I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25.134. 1 will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Safety Code,Section 25532(x)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance Of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws ofCalifomia. If,after making this certificate of exemption,I Health&Safety Code,Seclians ,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,1 muss forthwith comply with such provisions or this permit shall be deemed revoked. Owner o raze _ _/L Date: APPLICANTCERTIFICATION CONSTRUCTION LENDING AGENCY 1 certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county ordinances and state laws relating I hereby affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned properly for inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Dale Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10135 Scenic Blvd DATE: 04/25/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: $30,000 *PERMITTYPE: Minor Building Permit PLAN CHECKTVPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROO USE: PERMIT TYPE: F WORK Remove existing shake and replace with presidential TL composition 4500 sq ft SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 4,500 it d lerh. Min Chc.k Phmrh. Plan Cherk Flec. Nor.Ched, ;llech_Permit Pee: Phurb. Permil Per: Ele(. Perrin her: Odwr:Veeh. liuji - O[her Plumb/n.sp. ED 011ie, 11C.hasp. .11;eeh. Ins). I?e: I'lunb.Inso.Fee: 1CIee. h:P. Pre: NOTE: This estimate does not includejees due to other Departments(i.e. Planning,Public Works, Fire,Sanitary Sewer District,School District,etc). Thesefees are based on therelimina information available and are only an estimate Contact the De t or addn'l info. FEE ITEMS (1 ee Resolution I1-053 1ff 7/1/11) FEE QTY/FEE MISC ITEMS Mein (."heck Fee: Suppi. PC Fey Permit Fee: $630.00 S•uppl. Imp Fee l'I umh.:'d-/a�ch.rli'Ic[• 1'lumh.:5l9rc/eiL:/ex Purinit Fee: Con.sirlic•tian 1 ac: A dinhliwi-Lrtir'. /C%% Work Without Permit? 0 Yes 0 No $0.00 Advance!Plannin",Fees: Travel Docmneutatiori Foes: Shiro Motion Fec: 1BSF.ISMICR $3.00 Select an Administrative Item Bide Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $635.00 $0.00 TOTAL FEE:, $635.00 Revised: 04/01/2012 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 CUPERTINO (408)777-3228- FAX(408)777-3333-building(cDcuoertino.org PROJECT ADDRESS APN a OWNER NAME PHONE, CJ E-MAIL STREET ADDRESS CITY.STATE.ZIP FAX CONTRACTOR NAME LICENSE NUMBER LIC SE TYPE BUS,LICd COMPANY NAME E-MAIL C / ^/Y'vre, C FA% 2, STREET ADDRESS CITY.STATE,Z�IIPss PHONE. O -C o- JG /7-,4< Z S . Oce—Y00^GVO 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 Y<" 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. I understand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detectors a to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Cod Signature of Applicant/Agent: DateZ Remollolict- 201 L.dor Peri ed 02116111 CITY OF CUPERTINO 3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35709075. 00 DATE ISSUED. . . . . . . : 04/25/2012 RECEIPT #. . . . . . . . . : BS000016619 REFERENCE ID # . . . 12040132 SITE ADDRESS . . . . . : 10135 SCENIC BLVD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PUGH MYRON A AND GRAHAM MARY K ADDRESS 10135 SCENIC BLVD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2724 RECEIVED FROM . . . . : ROLANDO CABRAL JR CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 30,.000.00 2. 00 0.00 2 .00 0. 00 1BSEISMICR VALUATION 30, 000.00 3 .00 0.00 3 .00 0.00 1REROOFRES SQ FEET 45.00 630. 00 0. 00 630.00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 635.00 0.00 635 .00 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 754 . 00 VISA --------------- TOTAL RECEIPT 754 . 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 c