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12070211 l CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: 20678GARDENSIDECIR CONT'RACI'OR:BRADSHAW ROOFING PERMITNO: 12070211 OWNE.R'S NAME: SOURIA RAYA&TRUPFI OHAVLE 1821 S BASCOU AVE PM13 160 DATE ISSUED:07272012 OWNER'SPlIC1,NE: 4083688610 CAMPBELL.CA 95008 PHOSENO:(408)246.9930 ❑ LICENSED CONI'RACI'OR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB (- License Class L— Lic:q 1 -7-376 /� Ol@:CH r RESIDENTIAL r— COAU111iRCIAL(- Contrrcmr � 2 - Doe hereby affirm that I am licensed under the provisions of Chaptrr!) JOB DESC121P'r10N: RE-ROOF-12 SO.REMOVE EXISTING WOOD SHAKE (commencing with Section 7000)of Division 3 of the Business S Professions ROOFING Code and that one license is in full force and effect. AND INSTALL NEW CLASS A ASPHALT SHINGLES (CERTAINTEED-AGED BARK) hereh)'affirm under penalty of perjury one of the following boo 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 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.Pt Fluor Area: Valuation:$6000 APPI-IC\N'1'CF.R'I'IFIC\TION I certify that I have read this application and state that the above information is APN Number:36232027.00 OccupancyType: ype: 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 indeninitV and keep harmless the City ol'Cupertinougainst liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting ofthis pernit. Additionally,the applicant understands and swill comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section Igo DAYS FROM LAST CALLED INSPECTION. 9.18. �/1-�-7 / //J ✓ �7 Signamrc Date--J�l�J1�. Issued by: � /1� /`'//�T�ir/ Date: 7-a7�JP' ❑ OWNER-RUILDER DECLARATION 1 hereby affirm that 1:un exempt from file Contractor's License lane formic of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to act roofing material being installed.Ifs roof is I,as owner of the property,or my employees with wages as their sole comRnsation, installed without first obtaining an inspection,1 agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(See.7044, inspection. Business K Professions Code) I,as owner of the property,tan exclusively contracting With licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business S Professions Code). 1 hereby olTrrm under penalty of perjury one of the following three ALI.ROOF COVERINGS TO BE CLASS"A"OR BE;1-I'F.R declarations: I have and will maintain aCertifieate of Consent to self-insure for Worker's IIA%ARDOUS,,NIATERLO:S DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the performance oflhe 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 I lealth S Safety Code,Sections 25505.25533,and 25534. 1 will maintain Section 3700 of the Labor Code,for theerfomnance of the work for which this compliance with the Cupertino Municipal Code.Chapter 9.1'_and the I leallh S p Safely Code.Section 25532(x)should 1.store or handle hazardous material. permit is issued Additionally,should 1 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 definedby the Bay Area Air QuulitpManagement 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 of Califomia. If,,after making this certificate of exemption,I Ilealth&Safety Code.Sections 25505,25533,and 25534. beconm subject to the Worker's Compensation provisions of the Labor Code,I must Ow'nerar f11ri' gent: 7 k,., ^ / forthwith comply with Such provisions or this permit shall be deemed revoked Dale: /.L�l/l APPLICANT CERTI FIC TION CONSTRUCTION LENDING AGENCY I certify that I have read this application;tad slate that the above information is correct. I agree to comply with all city and county ordinances and state laws relating I hereby of inn that there is a construction lending agency for the performance of ssurk's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ Q upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the Cit of Cupertino against Iiabilities,judgmenls, costs,wind expenses which may accrue against said City in consequence of the Lendcr's Address granting of this permit.Additionally,the applicant understands and will comph• With all non-point source regulations per the Cupertino Municipal Code,Section ARCHITEACI"S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 20678 Gardenside Cir DATE: 07126/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: 86,000 *PERDIIT TYPE: Minor Building Permit PLAN CHECK Tlt'PE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF USE: PERMIT TYPE: WORK Remove existing wood shake roofing and install new class A asphalt shingles. SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 1,200 Mech.Plan Check Plumb.Plan Check Elec.Plan Check dfech.Permit Fee: Plumb. Permit Fee: Elec.Permit Fee: Other Mech.Insp. Other Plundt Insp. Other Elec.Insp. Mech.1nep.Fee: Plunnb.lisp.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 ees are based an the preliminari information available and are onto an estimate Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 Efl WUll/ FEE QTYIFBE MISC ITEMS Plan Check Fee: SuppL PC Fee Phonb./A4ech./Elec Permit Fee: 8180.00 Suppl. Insp Fee Plumb./Afech./£lec Plumb./DfechAlce Permit Fee: Construction Tax: Administrative Fee: Work Without Permit? O Yes Q No $0.00 Advanced Planting Fees,- Travel ees,Travel Documentation Fees: Strong Motion Fee: IBSEISA9CR $0.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $181.60 $0.00 TOTAL FEE: $181.60 Revised: 07/01/2012 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(g)cupenino.org PR RAD RS l -T7PN OWNER NAME ` l PHONE 'HH� E-MAIL ii re u STREET ADORES \t-eke CITY,STATE,ZIP FAX C TRACTO NA. E LICENSE NUMBS LICENSE TYP BUS.LIC.N 1 t 11 COMPANY NAME E-MAI t^< FAx STRi ADDRESS ` , ; C� CITY.STATE-LP 1 HONE 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 oft" 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$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: 1 am the property owner or authorized agent to act on the property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Code // Signature of Applicant/Agent:M Date: Z[a Rei oo/Policv_201 l.doc revised 01/16/11 1 am not using any subcontractors: Signature Date Phnom.. .•6.,.•1, n.,..l:.•n F.ln cu lvnnfranb.rc ..nrl nnm nlnrn h6n fnllnw•:nn :nfnrm otinn• REROOF PERMIT APPLICATION �� 1 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION -10300 TORRE AVENUE •CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228 • FAX(408)777-3333• buildina(acuoertino.oro 1 (� PROJECT ADDRESS .� O/ (� C ` APN - _ 2 / J=NAME \ ; 1 PHONE Lc O E1111 STREET.AD 5 \ CITY. STATE,eZIP � c� ^ FAX 141 CONTACT NAME PHONE `.-�, E-0111 STREET ADDRESS CITY.STATE.ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT CONTRACTOR ❑CONRtACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACT RNAM1IE LICENSE NUMBER LICENSE TYPE BUS.LIC.9 COMPANY NAME FAX STREET ADDRESS CITY,STATE ZIP PHONE C C C ARCHITECDENGINEER NAME LICENSE NUMBER BUS.LIC.d COMPANY NAME E-MAIL FAX STREET ADDRESS CRY.STATE.ZIP PHONE USE OF ❑ SFD or Duplex ❑ [vluld-FBnI IY, ROOF AREA: yn1 VALUATION: STRUCTURE. ❑ Conimercial �1� OQ S EXISTING ROOF TYPE: ❑BUILT-UPROOF 13 ASPHALT SHINGLES �EYWOOD SHAKES ❑WOODSHMGLES ❑OTHER(SPECIFY, REMOVE aEPLACE CJ'Y'FS IF' PLYWOOD L1 t5^ ❑ PLYWD 11 OSB PRCH: ROOF ❑ NO ti LAYER ICKNESS ❑ ,Js" TYPE ❑ [DX 'l? LA .' A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF 2 ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT N DE$[RIPTION OF WORK: ( '^ By my sigtmture below,I certify to each of the following: Iran the property owner or authorized agent to act on the property oamer's behalf. I have read this application and the information 1 have provided a correct. I have read the Description of Work and verify it is accumte. I agree to comply with all applicable local ordinances and smie Imus relating to bud�/m cons//try}��Q�on. I nut orrz preservatives of Cupertino to enter the�ablo/ve-identif property for inspection purposes. Signature of.4pplicant/AgenL 1 LSC Date: /10�c,f Tai nl 2- SUPPLEMENTAL SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY - _ If building is associated With a Home Owners Association,provide letter PLANCHECKTYPE ROUTING SLIP of approval from HOA. OVER-THE-COUNTER BUILDING PLAN REVIEW Provide Planning ripproval to veri t-y if there any restrictions. EXPRESS ❑ PLANNING PLAN REVIEW _Provide copy of MBmfacturer's Inslnllation Specifications. ❑. n-rANDARP ❑ FIRE DEPT Provide signed copy of Cupertino's Teat-Off Policy. ❑ OTHER:. ReroofADq_?011.doc revised 03/16111