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12080034 CITY OF CUPERTINO BUILDING PERMIT BUILIIING ADDRESS: 20634 GARDENSIDE CIR CONTRACTOR:BRADSHAW ROOFING INC PERMIT NO: 12080034 O\VNEWS NAMII: GABRIEL BERGER 1821 S BASCOAI AVE PM11 160 DATE ISSUED:081072012 OWNER'S PHONE: 4082469930 CAMPBELL,CA 95008 PHONE NO:(408)2469930 ❑ LICENSED CON rRAC'I'OR'S DECLARATION BUILDING PERMIT INFO: BLDG r— ELECT r PLUMB r License Class ^ J Lie.# 3 O v e r r r � RIECIi RESIDENTIAL COMMERCIAL Contractor Date hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REMOVE.EXISTING ROOF SYSTEM AND INSTALL NEW (commencing with Section 7000)of Division 3 of the Business S Professions CLASS Code and that ury license is in full force and effect. A ASPHALT SHINGLES,12 SQUARES herebyaflirm under penalty 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 permit is issued. 1 have and will maintain Worker's Compensation Insurance,.s provided for by Section 3700 of the labor Code,for the performance of the work for which this Sq. Ft Floor Area: Valuation:$6000 permit is issued. APPLICANT CERTIFICATION APN Number:36232042.00 Occupancy Type: I certify that I have read this application mrd 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 PERN'IIT EXPIRES IF WORK IS NOT STARTED indemnifyand keep harmless the City of Cupertino against liabilities.judgments, costs.and expcnscS which may accme against said City in consequence ofthc WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal 'Code, �Section 9.18. (—(—/—` Issued by: ,�`A�✓ ATo� Date: /�-7/a- Signature �V Date ' ❑ OWNER-BUILDER DECLARATION Rh:ROOFS: hereby affirm that I out exempt from the Contractor's License Lan for one of All roofs shall be inspected prior to any roofing material being installed.If 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 property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sce.7044, Business R Professions Code) Signature of Applicant: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business K Professions Code). ALL ROOF CONTRINGS TO IIF CLASS"A"OR BETTER I hereby affirm under penally of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERI I S DISCLOSIIRE Compensation,as provided for by Section 3700 ofthe labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for Which this petit is Issued. California Health S Safety Code,Sections 25505,25533,and 25534. I 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 Health S Section 3700 ofthe Labo(Code,for the performance o(dhe work for which this Safet) Code.Section 25532(x)should 1 store or handle hazardous material:' .\dditiunally,should 1 use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the(Say Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any maser sons to become subject to the Workers I lealth S Safety ode,Sections 2550.5,25533,and 25534. Compensation laws of California. If,atter making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Cade,I most O)/gryrir forthwith comply with such provisions or this permit shall be deemed revoked t Dole, Arrllc\NT celrruac\r1oN CONS'TRUC`TION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction leading agency for the performance of work's correct.I agree to comply with all city and county ordinances mrd state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for 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 ,\RCI11'I'PCI"S DECLARATION all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 171 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: �H )/DATE: 08/0612012 REVIEWED BY: Beth APN: 13P#: Aa6060311- 'VALUATION: $6,000 *PERtAHT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLRO0F USE: 1 ERMIT TYPE: WORK [remove existing roofs stem and replace with Class A asphalt shingles SCOPE FEEID ROOFAREA (S.f.) 1REROOFFRES 1 ,200 Alech. Platt Check Plhonh. Plan Check Flee. Platt Check Alech.Permit Fee: Plumb. Pennit Fee: Cler. Permit Fee: Other Aterh.hzcp. Other Plamb heap. Other Clec. In Meek Insp. Fee: Plumb.hup.Fee: Eire.hasp.Fee: NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Smhitaty Server District,School District, etc.). These fees are based on the preliminarl information available and are only an estimate. Contact the De t or attdn 7 info, FEE ITEMS (Fee Resolution 11-053 E/i 7/1/111 FEE QTY/FEE D11SC ITE\1S Plan Check Fee: Suppl. PC Fee Plumb./dlech./Flee. Permit Fee: $180.00 Suppl. lnsp Fee Plumb./fWech.LElec PlunrbAllech./F_lec Permit Fee: Construction Tax: A(Iminisirative Fee: Work Without Permit? 0 Yes (2) No $0.00 Ativanceal Planning Fees: Travel Documentation Fees: Strong Motion Fee: IBSEISARCR $0.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC 1 $1.00 1 1 SUBTOTALS: 1 $181.60 $0.001 TOTAL FEE: $181.60 Revised: 07/01/2012 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RTI N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# OWNER'S NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: :Z %44. e_ \l t C1T1 /ZIPCODE: ScLes 3.0se VC AS *Our municipal code requires all businesses working in the ciq'to have a City of Cupertino business 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. 1 am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAD1E 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 Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date 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-buildino(D cuoertino.oro PROTECT ADDRESS. `.J/1 C1 1� ` APNq 0-i Q OWNER NAME i PHONE E-MAIL rt: y STREET ADD S ` ; CIN eTATE,ZIP f %l1 I D SO• FAX C TRACTO NA.fE LIC SE NUMB `}- LICENSE TYP BUS.LIC.k COMPANYNAME E-MAI Ve F t' 3 SgEETDRESS ` \ C� CITY.STATE.ZIP 1 HONE V 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 Nailine 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. Proeress 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 S 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 are required to be installed in accordance with Sections 8314 and R315 of the 2010 California Residential Code Signature of Applicant/Agent: Date: RerDg1P01icn_2011.dac rerimd 02116111 REROOE PERMIT APPLICATION R .v.. �' COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTlNO (408)777-3228 • FAX(408)777-3333•building0cupertino.or0 Ja0,6o034 PROJECT ADDRESS . e APN M OWNER NAA j /� PH�E b E-MAIL STREET 111 C 1� Aen CtTF' SPATE,ZFPC1 11 `4 • O` I FAX CONTACT NMIE PHONE r E-WNL 1 STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER 11Ow HERa=ER ❑ OwtrER AGENT re,ONTR.aCTOR ❑CONTRACTOR AGENT ❑ ARCHRECT ❑ENGINEER ❑ DEVELOPER ❑TENAFrr CONTRACT RNAMIE LICENSENUMDER LICENSE TWE aUS.L .. OCr COMPANY NAA E-MU It �C INC FAX �j C J STREET ADDRESS CIi1',STATE PHONE `ice C r7 1 ARCHITEMENGLNEER NAME UCENSE NUMBER BUS.UC.! COMPANY NAME E.AD. FAX STREET ADDRESS CITY,TATE.ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Falriilq ROOFAREA: //�� TI/ VALUATION m : STR IL rURE. ❑ Contelcial ` -P-}- 10 �Q• r EXISTING ROOF TYPE::: /❑BUILT-UP ROOF ❑ASPHALT SHINGLES 9111O01)SHAKES ❑WOOD SHINGLES ❑OTHER(SPEL FY) RE.tOVE/REPLACE OYYFS IF NU, /,t1 PU'RPIKap ;5' ❑ PLYWD ❑OSB PITCH: ROOF ❑ O c y, t c ❑ qS' 4 ❑ DX PROPOSEDROOFTYPE: ❑BUILT-UPROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-FS REPORT DESCNPTIONOFtVORK: `1 G By my signature below.I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. t have read this application and the information 1 have provided is correct. 1 have read the Description of Work,and verify it is accnate. 1 agree to comply with all applicable local ordinance and staff laws relating to buil/rQ�m o�m/y�gion, I au nz presenatives of Cupertino to enter the-n-bfo/ve-iden[iC/,pd property for inspection purpose. Signammof.4pplicant/Agem: �.1��,(l�L�f—Y Date: /Ie1 ;Dny2 SUPPLENIENTAL MORAMATION REQUIRED OFFICE USE 0XLY _If building is associated with a Home Owners Association,provide letter PLAN CHECKTRTe - ROU`nNG sue of approval from HOA. ❑ OVER-TIE-COUN ER ❑ BUILDING PUN REVIEW Provide Planning approval to verity if there any restrictions. ❑ E--6WS ❑ PL6NNING PLAN RCYtEw _Provide copy ofManufacnt¢r's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT Provide signed copy of Cuperiino's Tear-Off Policy. ❑ OTHER: Reroofdpp_201 Ldoc revised 0311611