12080241 CITY OF CUPERTINO BUILDING PERMIT
1 UILDINC ADDRESS: 20677 GARDENSIDE CIR CONTRAC'T'OR:BRADS[ AW ROOFING INC PERMITNO: 12080241
ON'NEWS NAME: CI11iR1'AOUI MOURAD AND KIIIi1,117A]IASS113 1821 S BASCOM AVE PMB 160 DATE ISSUED:08232012
ON'NERSPHONE: 4083688610 CAMPBELL,CA 95008 PHONF-NO:(408)24:9930
LICENSED CONTRACT'OR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C 39 Lie.H -T02961 r r r
� hlECll RESIDENTIAL COMMERCIALCantmctore)(3nj \o a[ ,J Date -
I hereby alfrin ilial Juno licensed under the provisions of Chapter 1 JOB DESCRIPTION: REMOVE EXISTING WOOD SHAKE ROOF.INSTALL 12SQ
(commencing with Section 7000)of Divisiim 3 of the Business S Professions NEW
Code and dud my license is in full force and effect. CLASS A ASPHALT SHINGLES:AGED BARK
hereby afftrnn under penally of perjury'one of the following two declarations:
I have and will maintain it 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 pemnit i5 issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the pertom once of die work for which this Sy.PI Pleur Area: Valuation:$6000
permit is issued.
,U'1'LIGW'I'ClilYl'I FIG\'PION Al'N Number:.36232019.00 occupnocyType:
1 certify that I have read this application and slate 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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenseswhich may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and Will comply z r
with all non-point source regulations per the Cupertino Municipal Code,Section
180 DAYS FIZOl�7�AST CALLED INSPECTION.
9.18. 5
/ Issued by: �• Date:
Signature_ �` �V �Date.�
❑ OWNER-BUILDER DECLARA'T'ION
RI R00FS:
1 hereby affirm that I nen exempt from the Contractor's License Lewy for one of All roofs shall be inspected prior to any roofing material being installed.Ira roof is
the following two reasons: installed without first obtaining an inspection.I agree to remove all new,materials for
I,as owner of the property,or any employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044. ��., _
Business&Professions Code) Signature of Applicn kALL Date: CJ fXJ�2
1,as owner of the property.am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business fi Professions Code). ALL ROOF COVERINGS TO 13E CLASS"A"OR BE"I-1'F,R
hereby affirm under penally of perjury one of the following Ihrce.
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IIA"/.ARDOUS MA T ERLU S DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance ofthe work for which this permit is issued. California Health&Safety 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 Cuperlino Municipal Code.Chapter 9.12 and the Health S
Safety Code.Section 25532(x)should 1 store or handle ha>mrdous material.
Section 3700 of the Labor Code,for the per(onnancc Orlin,work far which this Additionally,should I use equipment or devices which evil hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certily that in the performance of die work forwhich this pemnil is issued,I shall maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
not employ any persalt In any nannerso as to become subject to the Worker's I lealth S Safely Code,Sections 25505.25533,and 25534.
Compensation laws of Califomia. If,a0er making this cenificate of exemplion,I
became subject to the Worker's Compensation provisions ofthe Labor Code,I must 0w'r�c uo a ized cel:
Forthwith comply with such provisions or this permit shall be deemed revoked. i F.4 Dile'
CO,NSTRUCf10N LENDING AGENCY
\I'I'LICA N'I'CIiR'I'I PIC,\"PION
I certify that I have read this application mid state 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 ad county ordinances aid state laws relating for which this permit is issued(Sec.3097,Civ C.)
tobuildina construction,mid 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 hanmdess the City of Cupenino 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
with all non-paint source regulaticns per the Cupertino Municipal Code,Secli ,\RCI11'I'ISCI"S DECLARATION
ai
9.18. 1 understand my plans shall be used as public records.
Signature Date Licenced Professional
i 2c:) R 02-q
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION R 10300 TORRE AVENUE'CUPERTINO.CA 95014-3255
CUPERTINO (408)777-3228 • FAX(408)777-3333•building ancuoertino.ora
PROJECT ADDRESS
PHONE tJ O E-MAIL 1
r- `\ O
STREET ADDRESS C '• STATE,2IP 1 CT I r' FAX
CONTACT NAME PHONE E-MAIL -7
STREET ADDRESS CITY.STATE. ZIP FAX
❑O%VNER ❑ OWNEt-BUILDER ❑ OWNER AGENT CON B'CIOR ❑CONTRACTOR AGENT ❑ ARCHTWT ❑EGUA R ❑ DEVELOPER ❑TENANT
CONTRAR RNAA� LICENSE�MBER21 LICENSETIPE BUS.LIC.. 3O
COMPANYNAME E�tu �C_2'17_
FAX --hC 75U
ilo
STREET ADDRESS - C(TY•STATE @ PHONE
C n
ARCHTTECTIENGMEER NAME LICENSE NUMBER BUS.LIC.i
COMPANS'NAME EMAIL FAX
STREET ADDRESS CITY.STATE.ZIP PHONE
USE OF ❑ SFD or Duplex �Muld-Family- ROOF AREA: VAAU1ATION:/,'/'t�
STRUCTURE ❑ Coninrercial //P� sq F Irl Ll� �,'
EXISTINGROOFTYPE: ❑BUILT-UPROOF ❑ASPHALT SHINGLES �Afti'OOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECffY)
REMOVE AkEPLACE I3�4Es �M NO. /I1 PLYwrpD G .5 ❑ PLYtyD ❑MB I CLASS
PITCH: .(2 ROOF a
❑ a Ro- y, ICKNES. ❑ vY ❑ f
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT e
DFSCR�TION OF WORK: � .i
ns VC Oe OAQC�s C'
r�
By my signature below,[certify to each afthe fallowing: I am the property owner or authorized agent to act on th<properry owner's behalf. I have read this
application and the information I have provided is correct. 1 have read the Description of Work and verify it is accurate. I agree to mmpiy wvith all applicable local
ordinances and state IaWs relating torbbu'i/llJg`I/iinn`g(tons ion. I am oriz apresenrativa of Cupertino to enter the obove-idcndf/ud properry for inspection purposes
.
SignatureofApplicand.4gent:�,V.L�l� Date:
SUPPLEMENTAL INFORA-ULTION REQUIRED OFFICE USE ONLY
— If building is associated with a Home Owners Association,provide letter PIAN Cr¢Lx TYPE ROUTING SLIP
ofapproval from HOA. •7,OVER-TIE-COUNTER BUILDING PLAN RntTEW
Provide Planning approval ED verify if there any resuictiens. ❑ EXPRrss ❑ PLANNING PLAY REVTEw
_Provide copy of M1tarmfacnt¢r s Installation Specific itiens. ❑ STANDS_ ❑ FIXE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
Reroofdpp_301l.doe revised 03/16111
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20677 Gardenside Cir. DATE: 08/22/2012 REVIEWED BY: Sean
` APN: BPH: 'VALUATION: $6,000
*PERMIT TNTE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Building is PENTAMATION 1R2R00F
USE: 3 Stories Yes � No PERMITTYPE:
YORK Remove existing wood shake roof. Install new Class A asphalt shingles: Aged Bark.
SCOPE
FEE ID ROOFAREA
1REROOFMRES 1,200
Meet?. Plan Check Plumb. Plan Check Flet.Plan Check
dlech. Permit Fee: Plumb.Permit Fee: Elec. Permit Fre:
Other,tlech./nsp. Other Plumb Insp. Other Flee.Insp.
,Neel. Insp.Fec: Plumb. hrsp.Fee: Elec.Insp.Fee:
A'OTE: This estln tte does not include jeer due it;other Departments(i.e. Planning, Puhlic Warks, Fire,Sanitary Server District,School
District, etc.). These ees are hased on the prefintinan in ornmtion available and are onh,an estimate Contact the De t or nrltln 7 info.
FEE ITEMS (Fee Resolution 11-053 Elf 7/1/1l) FEE QTY/FEE MISC ITEMS
Plan Check. Fee:
r
Suppl. PC Fee
Phtntb./A1ech./Flee
Permit Fee: $180.00
Supp/. lisp Fee
Plamb.%Aleclr./Flee
Plumh.%A'lech./Elec Permit Fee:
Constntcaion Tax:
A dininistrative Fee:
Work Without Permit? O Yes (F) No $0.00
:Idvaneed Planning Fees•:
Travel Docrunentation Fees:
Strong Motion Fee: IBSFISMICR $0.60 Select an Administrative Item
13lda Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $181.60 $0.001 TOTAL FEE: $181.60
Revised: 07101/2012
L — -- _ _- —__--_— –
REROOF TEAR-OFF POLICY
2 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(aDcuoertino.org
PROJECT ADDRESSD_Q APN+ —U
'ER NAME C /lam PHONE / E-MAIL
STREEr ADDRFSS CIIP. STATE.ZIP /` FAX
`-�
C RRACTO NA,fE LICENSE NUMBER LICENSE TYP BUS.LI C
t I t �
COMPANY NAME E-MAI FAX `� - '
Rro.
STREET ADDRESS ` . ; S CG CITY.STATE ZIP 1 HONEI yc
�
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 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/4" 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: 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. 1 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: Date:� t�_[
RerooJPolicv_2011.doc revised 02716111