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12080306CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19926 BEEKMAN PL I CONTRACTOR: A L ERCIAL I PERMIT'NO: 12080306 OFVNER'SNAM1i: SUBBARAMAN SRINIVASAN AND CHANDRASE 1 1212 FORRF,STAL ANT IDATE ISSUED: 08292012 O\VNPUS PBONE: 4082160766 1 SAN JOSF, CA 95110 I PRONE NO: (408)729 -6100 LICENSED CONT'RACTOR'S DECLARATION License Class G 3 q Lic. N % 1 Z 3 V7 Contractor 4­1­2 f S10 GL fit F4< Date 2—'2 hereby affirm that I nm licensed tinder the provisions o Chapt r 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in fall force and effect. hereby affirm under penalty of perjury one of the following mo declarmiims: I have and will maintain a certificate of consent to self- insure for Worker's BUILDING PERMIT INFO: BLDG (- ELECT rt PLUMB r MECH r RESIDENTIAL rl COMMERCIAL JOB DESCRIPTION: REMOVE SHAKE ROOF INSTALL COMP SHINGLES ON ONE BLDG, INSTALL 4 PLY BUILT UP AT ADDITIONAL BLDG (CONNECTING BLDGS) 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. Sy. Irt Plane Area: . \PPLICAN'I' CFR9'IPIC. \'1'10\ I cenil'-v 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 construction, and hereby authorize representatives of this city to enter upon the above mentioned properly for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilitics,judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Ad 'tonally, the applicant understands and will comply With all non- unit sour rcg lations per the Cupertino Municipal Code, Section 9.18. pp. Signature - Date ❑ O \VNF.R- BNi.DF.R DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the follmvi ng two reasons: I, m 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 construct the project (Sec.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self-insurc for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the perfommnce 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. I cenify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. A PPLICANr CERTIFICATION I cenify 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, 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 -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date ANN Number: 31630117.00 Valuation: $7400 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: . S - Date RE- 110017S: All roofs shall be inspected prior to any ro fit material being installed. If a roof is installed without first obtni ' g an ins ecti n, 1 agree to remove all new materials for inspection. /( Signature of Applicant: Dater ALI, ROOF COVERINGS TO BE CLASS "A" OR BETTER I IA7.ARDOUS MATERIAL S DISCLOSURE have read the hazardous materials requirements under Chapter 6.95 of the California Ilcalth & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Day Area Air Quality Management District I will maintain compliaref with the Cupertino Municipal Code, Chapter 9.12 and the lealth & Safety Coe, Sections 25505, 25533, and 25534. Date: Z - //P-- I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCIIITECT "S DECLARATION I understand my plans shall be used as public records. Licensed CUPERTINO 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 (408) 777 -3228 • FAX (408) 777 -3333 • building0cupertino.orci PROJECT v' o� 'C- a- Cl APNd wNE N ME PNDNE L E -MAIL COL ✓ Q' ,a — t7 0 STREd DD WS CITY. STATE, ZIP G)— FAN 2 b I Inll. CONTAAROMy NA LICENSE NUMBE LICE 7YZPF� BUS. LIGa Pr 72a:z COMPANYNA .� E -MAI F 7 '1l _Y ✓l9 FLV STREET ADDRESS CITY. STATE. ZIP J PHONE 1 UNDERSTAND AND AGREE TO THE FOLLOWING: 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. 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. 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 Y<" 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 property owner's behalf. I understand and ree to con smoke detectors and carbon monoxide det�rs are re( the 2010 California Residential Code. of e: I am the property owner or authorized agent to act on the y wit 1 the re -roof policy stated above. I also understand that ed to %e installed in accordance with Sections R314 and 8315 of Date: RerooJPoliev_201 Ldoc CITY OF CUPERTINO ly^_y0 FEE ESTIMATOR — BUILDING DIVISION L. ADDRESS: 19926 beekman place. DATE: 0 812 9/201 2 REVIEWED BY: bobs. \ APN: BP #: 'VALUATION: $7,400 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex Elcc. /tap. Fee: PENTAMATION PERMITTI'PE: 1SFDWLR00F WORK remove shake roof install comp shingles on one bldg, install 4 ply built up at additional bldg. SCOPE $0.00 NOTE: This estimate does not include jeer due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District etc.). These fees are based on the prelintinan v information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11 -053 F_li' 7/1/11) Meth. Plan Cheek Plumb. Plan Check F.lec. Plan Check blech. Permit Fee: Plumb. Permit Fee: Elec. Permit Fee: Other,llech. Insp. Other Plumb insp. Other 1.1cr. Insp. ,tdech. bap. Fee: Plumb. tosp. Fee: Elcc. /tap. Fee: NOTE: This estimate does not include jeer due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District etc.). These fees are based on the prelintinan v information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11 -053 F_li' 7/1/11) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 F2,100 s. f. $315.00 Re -roof IREROOFRES Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Admi iistreltive Fee: 1 1 E) Work Without Permit? O Yes (F) No $0.00 Advanced Plannine pee: $0.00 Select a Non- Residential Building or Structure E) Q i Travel Documentation Fees: Strong Motion Fec: IBSEID11CR $0.74 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.74 $315.00 TOTAL FEE: $316.74 Revised: 07/01/2012 Owner / Contractor Signature I CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 - FAX (408) 777 -3333 • buildina(a)cunertino.oro 1202o3o(I PROIELT ADDRESS / I/ igg? b tr�L` 1 ! I4. APN p ✓l' OWNER AhfE n �' G PHONE _ E- hIALL STREET AD RESS CA 01 -7 C'IV_hA CrrY, STATE, ZIP FAX CONTACT NAME PHO E -hL111 - _ - S s .r- STREET ADDRESS - ^ i rS CITY. TAM D S- �/I V" L A ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONIRACrORAOENr ❑ ARCNTECr ❑ ENGINEER ❑ DEVELOPER ❑ TENANT N `L Ci0 i4 AhfE LIC ENUhfBER LICENSE TIDE ;;5 v BUS. LIC.N 2 3 COMP NY NAht % VL 1I " F q: .t D /-' r Cl` O (' C VI'\ - Z V D STREET .4ODRESS CITY STATE c�1 PHONE rS" zIZ o� es na S — - a ARCHITECTIENGINEER NAME LICENSE NUhIBER BUS. LIC. tl CONVANY NANIE E -h1ALL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi- FNnily. ROOF AREA: VALUATION: STRUCTURE: E] Commercial 'D 7 EXISTINGROOFTYPE: FA( UILT -UP ROOF ❑ ASPHALT SHINGLES )6t K'OOO SRAKES ❑WOODSHINGLES ❑ OTHER (SPECIFY) RE110A'E IREPLACEIYES IF N0. PLI }yODD ❑ 15- ❑ PLYR'D ❑ OSB PRCH: /� � 1 I' ROOF ❑ N�� tl LAYER ' -dT SS' Cl A,s- ❑ I IZ ' LAS PROPOSED ROOF TYPE: 1 BUILT -UP ROOF ❑.ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLFS ❑ OTHER ICC -ES REPORT p DESCRIPTION OF \VON:: Kev-Mi-e 4 "4 1 I I S S!1A ono lti�6 �1� _ C 45+t - r -1 6 F By my sigrmture below, 1 certiry• m ead I -The iollowiI I am a property owner or audiorized agent to act on die property• owner's behalf. 1 have read this application and the information I have r< •ided is Corr . I hal read the Description of Work and verify it is accurate. I agree w comply with all applicable local ordinances and state laps relating to b it r conswc . I a ize presentatives of Cupertino to enter the above -' entifted perty for inspection purposes. C Signature of ApplicanU.4genr. Date: SUPPLEMENTAL INFORMATI&V REQ ED - ;OFFICE USE ONLY - CIIECK TYPE - ROUTING SLIP, If building is associated with a Home 011nerS A ciati m, provide letter � �PLAN L-t'o ER- THE.COun-iES _ � � 'LJ— DING PLAF REVIEW _ of approval from HOA. Provide Planning.Tproval to verify if there any restrictions. ❑ EXPRESS. ❑ PIIANNINC FLAN REVIEW Provide copy of MarmfacturePs Installation Specif ications. •❑ S'ANp.ARD ❑ FIRE DEPT' rovide signed copy of Cupervno's Tear-Off Policy. ❑: OTHER: Reroojipp_2011.doc revised 03/16/11