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12090021 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20667 GARDENSIDE CIR MVFRAC`fOR:BRADSHAW ROOFING INC PERMI.1'NO: 12090021 O\\'NER'S NAME: PARDESHI CHITTARANIAN AND REKIIA 1821 S BASCOM AVE P\IB 160 DA'Z'E ISSUED:09/102012 OWNER'S PHONE: 4085677044 CAMPBELL,CA 95008 PHONE NO:(408)246.9930 LICENSED CO\TRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB Cl License Class C- 3e, Lic.H 6 A1ECH r RESIDENTIAL r COMMERCIAL r' Contraclo Date_I_c)112= 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REMOVE EXISTING WOOD SHAKE ROOFING.INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions 1200 Code and that my license is in full force and effect. SQIT NEW CLASS A COMPOSITION SHINGLES(AGED BARK) hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain acertificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the perfomnance of the work for which Jnis permit is issued. 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of One work for which this Sq.Ft Floor Area: Valuation:$6000 permit is issued. - API'LICANI'CER'TIPIC,%TION APN Number:36232004.00 Occupancy Type: I certify that I have read this application and sate that the above information is correct.I agree to comply with all city and county ordinances and slate Imus relating to building construction,and hereby authorize representatives of city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify osts,a dexpenses which amiless the City ofCupertinosato against liabilities,judgments, WITHIN 180 DAYS` OF PERMIT ISSUANCE OR costs,and expenses which may acerae against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point sour egulalions per the Cupertino Municipal Code,Section 9- ID— _1 D_ i SgnatureL�x Date 9.18. / Issued by: Date: i ❑ OWNER-BUILDIiR DECLARATION RF:ROOFS: hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shallbe inspected prior to any roofing material berg installed.If a roofis the following tvvo reasons: installed without first obtaining anis ction,I agree to remove all new materials for I,as owner of the properly,or my employees with wages as their sole compensation, inspection. will do the work,and the slructUre is not intended or offered for sale(Sce.7044, 1.4 //�/1� Business&Professions Cade) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BF.CLASS"A"OR RE FITR hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to set(-insure for Worker's 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 of the work for which this permit is issued. California Ilealth&Safen.Code.Sections 25505.25533,and 25.534. 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 Ilealth& Section 3700 of the Labor Code,for the performance of the work for which this Safety Cade,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of One work for which Jnis permit is issued,I shall maintain compliance with the Cupertino Municipal Cole,Chapter 9.12 and the not employ any person in my manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensmion provisions of the Labor Code,I muss )Waco o hor'. J agent forthwith comply with such provisions or this permit shall be deemed revoked. Dale: A PILI CANT CERTI F'ICATION CONSTRUCTION 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 lending agency for the performance of work's correct.1 agree to connply,with all city and county ordinances and 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(his permit.Additionally,the applicant understands and will comply ARCIIITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional Revised: 07/01/2012 o� Z REROOF PERMIT APPLICATION �. COMMUNITY DEVELOPItiIENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERI-INO (408)777-3228 • FAX(408)777-3333•buildingeMcuoertino.orD PROTECT ADDRESS OWNER NANO; (fbb (1 ` P ONETy .r �- EMAIL STREET ADDRESS Y CRY, STATE,ZOIP b FAX CONTACT NAME PHONE EMAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑ovvNEt ❑ OWNERUTLnM ❑ OlvNERAGENT CONTRACTOR ❑CONTRACIORAGENT ❑ ARCHITECT ❑e4GWEEK ❑ DEVELOPER ❑TENANT CONTRACT rtNAN@ LICENSENU,\MFR LICENSE TYPE BUS.LIC. CONIPANYNAME EALA �C n� FAX _ Jam• . STREET ADDRESS STATE IP PHONE .1�0T-er-i lgin , ARCHITECDENGMER NM(E LICENSE NUN(BER BUS.LIC.4 COND'MY NAA0 EMAIL FAX STREET.ADDRESS CITY,STATE ZIP PHONE USE OF ❑ SFD or Duplex IdMuld-Familq ROOFAREA::�� VALU. TION: C STRUCTURE. ❑ ContmerctN �� / O�O, EXISTIVGROOFTYPE,^:: /0BUILT.UPROOF ❑.ASPHALT SHINGLES 67WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFYI RENIOVE!REPLACE &'YES 1 IFNO. /I1 PLY.YOOD !]" ❑ PLYWD 11 OSB PITCH: -4=—: IZ ROOF ❑ O r Rc y-,.,� THI K, C ❑ l ❑rD CLAM PROPOSED ROOF TYPE: ❑BUILT-UP ROOF &I''ASPHALT SHMGLES ❑WOOD SH:.KFS ❑WOOD SHINGLES ❑OTHER ICGES REPORT< DESCRIPTIUNOFWORI: �Aged \/�� .� enr \J By my sigmture below,I certify to each of the following: I am the property owner or authorized agent to act on die property owner's behalf. t have read tho application and the intonrainion I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating t�oy^bbu�d�/Qi//ngg ons .on. I au adz epresenratives of Cupertino m enter the abo//ve-identif d property(or inspection purposes. Signatureof.Applicand 9Mt: A/L,l/[i� Date: 71a�S��2}2 SUPPLEMENTAL INFORIvLITION REQUIRED OFFICE USE ONLY _If building is associated with n Home Owners Association,provide letter _ PLAN CHECK TYPE . ROUTING SLIP ofapproval from HOA. ❑ OVER-THE-COUNTER ❑ 13UHAING PLAN RENTEW _Provide Planning approval N veriry if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FURE DEPT Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTNER. • Rerool4pp_2011.doc revised 03,'I&ll I SUBTOTALS: I $181.601 $0.001 TOTAL FEE: I $181.601 Revised: 07/0112012 REROOF TEAR-OFF POLICY 2 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 950143255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(a)cuoertino.org PROJECT ADDRESS APN< _ OWNER NAM S NDN ��_ E-MAIL STREET ADDRESSCITY. STATE.ZIP FAX C TRACTO NA,tE LICENSEXUMBE LICENSETYP BUS.LIC.0 . L COMPANYNAME E-MAI FAX (�C i-s-n - - TO STREET ADDRESS ` , iC! CIT Y,STAT&ZIP 1 NONE 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 ofS 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. 1 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: Dale: (�( RemoJPolicy_201 Ldoc revised 01/16/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20667 Gardenside Cir DATE: 09/04/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: $6,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Multi-Family Dwelling Building is PENTAMATION 1R2R00F USE: 3 Stories O Yes 0 No PERMITTYPE: WORK Remove existing wood shake roofing. Install new Class A composition shingles (Aged Bark). SCOPE FEE ID ROOFAREA s.f. 1REROOFMRES 1,200 Alech. Plan Check Phuuh.Plan Check Flee.Plan Check ,Meeh.Permit Fee: Plamh. Permit Fre: Glee. Permit Fee: other Afech. Insp. Other Plumb Imp. Other Fler.Insp. Alech.Insp. Fec: Plush. hccp.Fre: filer.Imp.Fee: A'O"E: This estimate does not include jeer clue to other Departments(i.e. Planning, Public li'orks, Fire,Sanitary Sewer District,School District,etc.). Thesefees are baser/on lite preliatinart•information available and are only an estimate Contact the Dept for addn't info. FEE ITEMS (Fee Resolution 11-053 E/T 7/I/II) FEE QTY/FEE MISC ITEMS Plan Check Fee: .Supp/ PC Fee PhtmbJA•lech./Clec Permit Fee: $180.00 Supp/. Insp Fee Phtmh./Adech./Clec Pluruh./Meeh./Clec Permit Fee: Consnvection Tar: Administrative Fee: Work Without Permit? O Yes Q No $0.00 Advanced Planning Fees: Travel Docionenta6017 Feca': � Strong Motion Fee: IBSGISAIICR $0.60 Select an Administrative Item Mcle Stds Commission Fee: IBCBSC $1.00 . SUBTOTALS: $181.60 $0.00 TOTAL FEE: $181.60 Revised: 07/01/2012