12050192 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7553 HEATHERWOOD DR CONTRACTOR:11M KRAUSE ROOFING PERMIT NO: 12050192
OWNER'S NAME: NIKHIL AND BINA BHATT 2310 DIANA AVE DATE ISSUED:05/252012
OWNER'S PHONE: 4082558275 MORGAN HILL,CA 95037 PHONE.NO:(408)779-0704
LJc LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMDIERCL\L
EI
License Class
TL�T Lic.q S 5 y 3 S/ RE-ROOF 37 SQ-TEAR OFF SHAKE, RE-SHEET W/OSB,
Contractor J t vv) )-:ILA JSC �he% Dates 2-5 j Z CLASS A
1 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 penally of perjury one of the following two declarations:
1 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 peril is issued. Sq.Ft Floor Area: Valualion:$17700
1 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:35926056.00 Occupancy'rype:
permit is issued,
APPLICANT CERTIFICATION
I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 18 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above ementionedhanl property for inspection purposes. (We)agree to save 180 DAYS qR'I LAST CALLED INSP T
indemnify and keep harmless the City of Cupertino against liabilities,judgments, �/e�,L
IO
costs,and expenses which may accrue against said City in consequence of the /l.-�
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: 2J
with all non-point source regulations per the Cupe unicipal Code,Section
9.18.
< RE-ROOFS:
Signature Dale l 2-5 2 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.
❑ O\VNF:R-R1I11.DF.R DECLARATION
1 hereby affirm That 1 am exempt from the Contractor's License Lew for one of Signature of Applicant: Date:
the following Mn 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 is not 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&Sorely Cade,Sections 25505,25533,and 25534. 1 will
1 hereby affirm under penally or perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code.Section 25532(x)should 1 store or handle hazardous
I have and will maintain a Certificate of Consenito self-insure for Worker's material. Additionally,should 1 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 Qualify Management District l
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
1 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
permit is issued. Owner or authorized agent: Dale: S 2 S
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person many manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,1 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 remit 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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
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 peril.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 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)777-3:333•buildinw&cuoertino.orn
PROJECT ADDRESS 7553 He� I'--1`�1jro 1 V •L33�1 ` /� APN0
I�OWNER NAME 1 y 1+A TT `� PIIO4 ol,IS r,92 S7 E-MAIL
STREET ADDRESS 7 55 3 J /e��H� I,__ N CIGUTt�'I�vG Gl
CONTRACTOR NAMES / J /'e-� P W"Y LICENg`?"7351
"73 5 LICENSE TYBE3 7 BUS.LIC.u
COMPANY NAME S1M K2/1054 E-MAIL� C. / F( 9'7. qV0
STREET TEES D 1A>J ^ A 'C CI STATE,21P J 1 ' ' /}I �SO "l61 "72-
0�hOL
LL /' '1I UNDERSTAND AND AGREE TOTHE (2) 5'10
I. 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 aooroval 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/<" 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 properly 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 Inst accordance with Sections 8314 and R315 of
the 2010 Califomia Residential Code.
Signature of Applicant/Agent: Date:
R.•rou/Pnlier 111//.dnr rrri.nal lC//h/!!
CITY OF CUPERTINO
3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: 'Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35926056 . 00
DATE ISSUED. . . . . . . : 05/25/2012
RECEIPT #. . . . . . . . . : BS000016917
REFERENCE ID # . . . : 12050192
SITE ADDRESS . . . . . : 7553 HEATHERWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : NIKHIL AND BINA BHATT
ADDRESS . . . . . . . . . . : 7553 HEATHERWOOD DR
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5840
RECEIVED FROM . . . . : PERMIT SERVICES
.CONTRACTOR . . . . . . . : KRAUSE, JIM LIC # 21415
COMPANY . . . . . . . . . . : JIM KRAUSE ROOFING
ADDRESS . . . . . . . . . . : 2310 DIANA AVE
CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037
TELEPHONE . . . . . . . . : (408) 779-0704
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 17, 700.00 1. 00 0. 00 1 .00 0. 00
1BSEISMICR VALUATION 17, 700.00 1.77 0. 00 1 .77 0 .00
1REROOFRES SQ FEET 37.00 518. 00 0. 00 518 .00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 520. 77 0.00 520 .77 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
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 7553 Heatherwood Dr. DATE: 05/25/2012 REVIEWED BY: RDW
APN: BP#: 'VALUATION: $17,700
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD Or Duplex PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK Tear off shake resheet w/osb install 37 sq. of lifetime comp class A.
SCOPE
FEE ID ROOFAREA
s.f.
1REROOFFRES 3,700
14rch. flan C'herk P/mnh. Plan Cheek 1Jee. !Tarn Clock
meth. Pernril Pew P/omh. Permit Fev: filer. Pe,"iil Fre:
Odrer,Vr.•eh. lny. Other Plumh Insp. Li I Orhe, Elec. hrsp.
34"c h. hi,p. Per: Ptunrh. lnnp. Fe..' liter.lay.Fcc.
NOTE: This estimate does not includejees due to other Departments(ie Planning,Public Works, Fire,Sanitary Sewer District,School
District,ere.). Thesefees are based on the prelind9na information available and are only an estimate. Contact the De t or addn't info.
FEE ITEMS (Fcc Resolution 11-053 F_lL 7/1/11) FEE QTY/FEE MISC ITEMS
Plzen ('hack Fee:
.Supp/. PC Fee
Phunh.L1•leclr.//i lee
Permit Fee: $518.00
3uppl. hrsp Fee
l'lmnb.i:hlech./1 ile•c
Plunrh. llech.ililcu Permit Fee:
Cunsnuction Tine:
Admiui.cunlice Fee:
Work Without Permit? O Yes Q No $0.00
Admvnu'ed Pluton?e Fees.
Travel Duullmewellinn hues.
Strone Motion Fee: 1BSEISMICR $1.77 Select an Administrative Item
Bide Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $520.77 $0.00 TOTAL FEE: $520.77
Revised: 05/01/2012
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•buildina(a�cupertino.orG OIG 1
PROIECTADDRESS �#i(aijonP TZ All 5C5
�J (.0o5j�.,
O\VSER\AME / K I PIJO\'O E-HAIL w
STREETADDRESS 75 ,5 J (; ` M 1 CITY. STATE./IP n/ /) C� ��OI FAX
2ECS
CONTACT NAME Jr�t- IN' INL C'\'WV^9'Yl PITO\i/O- �/
STRF1NUE5LjD&CPG� G - CIr';jjZIP CA9`" F /Xj 3 l0`1
1
❑OWNER ❑ OWNER'BUIMER ❑ OWNER AGENT ® CONTRACTOR ❑CON'TRACIOIt AGENT ❑ ARCHITECT ❑ ENGINEr:R ❑ DIAHOPFR Cl TI[NAN7
CONTRACTOR NAME JIM KRAUSE LICENSENU.MBER 554351 LICENSE TYPE C39 ells I.IC.a
COMPANY NAME JIM KRAUSE ROOFING EMAH. FAX 408-779-8807
STREET ADDRESS 2310 DIANA AVE. EDY.STATE.ZIP MORGAN HILL,CA 95037 PHONE 408-779-0704
ARCHITECT/ENGINEER NAME LICENSE NU.1IEkR PUS LIC.'
COMPANY NAME r-MAII. 1'AX
STREET ADDRESS CITY.STAI'17,ZIP PHONE
USE OF p.Q SFD or Duplex ❑ Multi-Family ROOF ARR rr�A. VATI ATION
Cl
STRUCTURE Commercial > /�d -# 17
EXISTING ROOFTYPE. ❑BUILT.UP ROOF ❑ASPHALTSHINGLES ?W-OODSIIAKES ❑W'OODSHINGLES ❑OTHER(SPECIFY)
REMOVEIREPLACE RrYFS IF NO. PLYWOOD ❑ ''A. ❑ I'L. WD Fy OS8 PITCH ROOF
❑ NO a LAYERS TIIICKNIiSS ❑ LX" r1"Pli ❑ CDS :12 CLASS
'A
PROPOSED ROOF TYPE. ❑BUILT.UPROOF P(ASPHALTSHINGLES ❑WOODSIL\KES ❑WOODSENGLE-S ❑OTImIt I IC(-LSRFPORI =
DESCRIPTION OF WORK
_r'7'�
By my signature below,1 certify to each of the following: I am The prolxny owner or autlito led agent to act on the propcny owner's behalf hare read This
application and the information I have provided is correct. I have mad the Description relWork and verily ii is accurate. I agree to comply with all applicable local
ordinances and Stale laws relating to building constru `.c mpresentalkes of iter the above-iQenti lied propene for inspection pwposes,
Signature of Applieanl/Agent: Date:
SUPPLE11i INF AT UIRED OFFICE USEONLY
_ If building is associated w ome Owner's Association,pmvidc letter PLAN CHECK TYPE ROUTINGSLIP
of approval from HOA. ❑ OVER-TIIE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW'
Provide copy of Manufacturer's Installation Spec i lications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
Rerooflipp_20/1.Bloc I eased 0311611 l