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12060023
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10939 NORTHSIIORE SQ CONTRACTOR:17OUR SEASONS ROOFING PERMIT NO: 12060023 OWNER'S NAME.: PURANDARE GIRISI1 V AND SONALI G PO BOX 1668 DA'Z'E ISSUED:06/052012 OWNER'S PHONE: 4089963734 SAN.IOSE,CA 95109 PHONE NO!(408)278-0330 }ia— LICENSED CONT'RACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class C-39 1.10.8 412 ( 0 O r r r ��--±r 1 ��12 MECH RESIDENTIAL COMMERCIAL rs e== Date 6� 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RF-ROOF'fEAR 0I71:EXISTING CAL-SI IAKE ROOFING (commencing with Section 7000)of Division 3 of the Business&Professions SYSTEM,INSTALL 30H FELT UNDERLAYMENT AND INSTAI"I" Code and that my license is in full force and effect. GAF GRAND CANYON SHINGLES,COLOR:STONEWOOD CLASS 1 hereby affirm under penally of perjury one orlhe following two declarations: I have and will maintain a cerli0cate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the perfomnmce of the work for which[his 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 Sq.F'1 Floor Area: Valuation:$6500 permit is issued. APPLICANT'CF.RTIFICATION ,\PN Number:31638028.00 Occupancy Type: I cenil'y 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 cons[ruc[ion,mid hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN I8� DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the grumingof(hispernhil. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all 11011-point Source regulations per the Cupertino Municipal Code,Section ,2 Issued by:t 7,f Date:Signature Date Date 4 �� ❑ OWNER-BUILDER DECLARATION RE-ROOFS: 1 hereby affirm that I am exempt from the Contractor's License Low for one of All roofs shall be inspected prior io any roofing material being installed- I a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the propcny,or my employees with wages as their sole compensation, inspection. will do the work,mud the structure is not intended or offered for sale(Sec 7044, '� I Business&Professions Code) Signature of Apph©m: Date: 6 I,as owner of(he property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). .\LI.ROOF COVE. ORE:CLASS",\"OR RF:1'I'E:R 1 hereby affirm under penally 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 Compensation,as provided for by Section 3700 of the Labor Code,for the 1 have read the hazardous materials requirements under Chapter 6.95 of the performance of the work Rx which this permit is issued. California Ilealth&Safely Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the I Iealth& Section 3700 of the Labor Code,for the performance of the work for which this Safely Code.Section 25532(a)should I store or handle hazardous material. Additionally,should 1 use equipment or devices which emit hazardous air permit is issued. contaminants as defined be the Ray Area Air Qualilv Management District l will I cenify(hat in the performance ol'dme work for which this permit is issued,I shall maintain compliance with the Cupertino 111 mhicipal Code.Chapter 9.12 and the not employ a%,person in any manner so as to become subject to the Workers Ilealth&Safely Code.Sections 25505,25533,and 25534. Compensation laws of Califomia. II:alter making this certificate of exemption,I become subject to tie Worker's Compensation provisions of the Labor Code,I must Owner or horized ap forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGF.NCV APPLICANT CERTIFICATION I cerlil}'that I have read[hies application and stale that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec 3097,Civ C.) to building construction,mid hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property lir inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCI IITE"CT'S DECLARATION with all non-point source regula[ioms per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Dale Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 18 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31638028 .00 DATE ISSUED. . . . . . . : 06/05/2012 RECEIPT #. . ... . . . . . : BS000017000 REFERENCE ID # . . . : 12060023 SITE ADDRESS . . . . . : 10939 NORTHSHORE SQ SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER PURANDARE GIRISH V AND SONALI ADDRESS . . . . . . . . . . : 10939 NORTHSHORE SQ CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . : AL DIAZ CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323 COMPANY . . . . . . . . . : : FOUR SEASONS ROOFING ADDRESS PO BOX 1668 CITY/STATE/ZIP . . . : SAN JOSE, CA 95109 TELEPHONE . . . . . . . . : (408) 278-0330 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 6, 500.00 1. 00 0 .00 1 . 00 0 .00 1BSEISMICR VALUATION 6, 500 .00 0 .65 0 .00 0.65 0.00 1REROOFRES SQ FEET 14 .00 196 .00 0. 00 196 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 197. 65 0. 00. 197 .65 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: 10939 Northshore Sq DATE: 06/05/2012 REVIEWED BY: Sean APN: I BPtl: -VALUATION: $6,500 xPERMIT TYPE: Minor Building-Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF USE: PERMIT TYPE: WORK Tear off existingcal-shake roofing system, install 30#felt underla ment and install GAF Grand Canyon SCOPE shingles, color:.Stonewood. FEE H) ROOF AREA s.f. 1REROOFFRES 1,400 lh•eh. Plan CheeA' Plamh Plan C hecA litre. Plan Check mesh. 1',mdt Fee: Mwnh. Per'mil Fee: Elec. Penah Fre: Orhrr,l lrc h, lap, Odwr Phimh Insp. Li Otho Elcc. hny. 11.1"C It, /nep. Fec: P/umh. hup. Fed: lilcc.Insp. Fcr: NOTE: This estimate does not include fees.due to other Departments(ie. Planning, Public Works, Fire,Sanitary Sewer District,School District,eta). Thesefees are based on the prefimina information available and are on an estimate Contact the Dept for addn'l info. FEE ITEMS (l ee Resolulion 11-053 EIC 7/1/1 U FEE QTV/FEE MISC ITEMS Plan Check Fee. Supp/. PC Fee l'hun h.!,I-lech.!El cr. Permit Fee: $196.00 slq)1d. hr.rp Fcc P runh.Allech.!Elec Plumh.1,1-lech.iElec Permit Fee: Conxn-ucrion fax. Adminisirulive Fet, Work Without Permit? C) Yes (j) No $0.00 .I di•rniced Plannh7,L: FLUS: Trarel Ducmnnnruion Fees: Strong Motion Fee IBSEISMICR $0.65 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $197.65 $0.00 TOTAL FEE: 1 $197.65 Revised: 05/01/2012 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(d)cugertino.org PROJECT ADDRESS APN u 10999 d r i SQ. OWNER NAME PHO. E E-MAIL STREET ADDRESS CITY. S TE.ZIP FAX 0 iC0.1 / CONTRACTOR NAVE LICENSgN MZ 10^ LICEVC- PE BUS.LIC.d COMPANY NAME E-MAIL �f FAX e✓. u STRF ET A CITY.DDRF.SS ST TE.ZIP '04 O . 278-omr . z : S . vrx CA- gsrr P- C( Q4o I UNDERSTAND AND AGREE TO THE FOLLOWING: 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 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/<" 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, 1 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 R315 of the 2010 California Residential Code. Signature of Applicant/Agent: Daze�'S/Z Rrron7Po7iry 207 Ldar revised 02/76/77 R- OCi PERMIT APPLICATION r CO!.:MUNITY DEVELOPMENT DEPARTMENI • BUILDING DIviSIGN 10300 TORRE AVENUE •CUPERTINO, CA 95014.3255 '-U P E RTI N O (,08)777-121 - FAX(408)777.3333 • buildinarcDcu erti lu)O(U -- .- -. Ui'i, 91' 1L ZP 1 ... MWIE i t111:),ArE. 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