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12090178 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20643 GARDENSIDE CIR CONTRACTOR:BRADSHAW ROOFING INC PERMIT NO: 12090178 OWNER'S NAME: VISHNOI VIVEK AND ANAND SARIKA 1821 S BASCOM AVE PM 160 DATE, ISSUED:09/192012 OWNER'S PHONE: 4083091256 CAMPBF,LL,CA 95008 P[IONF,NO:(408)24&9930 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r. 1_ PLUMB , License Class - l( Lie.N DIECII r RESIDENTIAL n COMMERCIAL r Contractor Date C74Z I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE EXISTING WOOD SHAKE ROOF AND INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions NEW Code and[balm) license is in full force and effect. COMPOSITION SBlNGLES(AGED BARK)CLASS A 12 SOFT 1 hereby affirm under penalty of perjury one of the following Mn declarations: I 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,as 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. APPLICANI'CP;R'1'IFICATION APN Number:36232010.00 Occupancy Type: I certify 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 Imes 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 ofCupertino against liabilities,judgments, WITHIN 180 DAY OF PERMIT ISSUANCE OR costs,and expenses which may accrue 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 e r gulaticns per the Cupertino Municipal Code,Section q , / Signature Date /�� Z Issued by: Je5%, r�w� A7G�/ Date: `j-ao ❑ O\VNFR-RUILDER DECLARATION RE-ROOFS: hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected priorto any roofing material beiig installed.If a 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 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&Professions Code) Signature of Applicant: '—_ _ Date: /Z 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETITR hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's ILx7.ARDOUS\L�TFRIALS 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 of the work for which this permit is issued. California Ilealth&Safety Code,Sections 25.505.25533,and 25.534. 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 Ilealth& Section 3700 of the Labor Code,for the performance of the work for which[his Safety Code,Section 25532(a)should 1 store or handle hazardous material. Additionally.should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Day Area Air QualiqManagement 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 manner so as to become subject to the Worker's Ilealth&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 Compensation provisions of[he Labor Code,I must Ow/(t/ef/pr a rrzQep1�genC forthwith comply with such provisions or this permit shall be deemed revoked. '"' _ Da1v: �Z CONSTRUCTION LENDING AGENCY AI'1'I,ICANI'CER'1'IF'ICA'1'ION 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 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 ARCIIITECr'S DECLARATION with 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 c�)i -� REROOF PERMIT APPLICATION R COIv MUNITY DEVELOMMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTfNO (408)777-3228 • FAA(408)777-3333•building GncuoertinD.om PROJECT ADDRESS APN p _ OWNE0.NM� 1 r K ` I 1 PHONE EMAIL STREETAODRESSV r �/ e C .0 ATS ZIP Co' FAX CONTACT NMIE b PHONE ( E4,WL STREET ADDRESS Crn',STATE, ZIP FAX ❑ OWNER ❑ OWNkR-BUTLDEA ❑ OWNERAGENT CONTRiCTOR ❑CONTRACTOR AGENT ❑ .NRCFBTER ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACC RNAN� LICENS�MBER LICENSE TYPE BUS.LIC.. �O�f COMPANY NANSEE-NLA b< oc FAX STREET ADDRESSCITY',STATE�P PHONE rr ARCHITECTIENG[NEERNAh1E y LICENSENUN®ER BUS.LIC.a CONTANY NAME E.UR FAX STREET ADDRESS CRY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex P'IUII-Fmmly, RODE AREA: V IONi STRUCTURE. ❑ COnuneroial 'I EXISTING ROOF TYPE:...,,//❑BULLI{PROOF ❑ASPHALT SHINGLES &rWOOD SHAKES ❑WOODSHINGLES ❑OTHER(SPF WY) REMOVE!REPLACE ❑ 0 c V yM- ❑ PLYWD ❑ ROOFM - ❑ STYPE' ❑ fO PITCH: :12 SS' A PROPOSED RMF TYPE: ❑BUILT-UP ROOF 19 ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT C DESCNPTIONOFWORK: ` + 1 By my signature below,I certify to each of the follot ina: I am the property owner or authorized agent to act on die property owTer's behalf: I have read this application and the information I have provided is correct. I have read the Description of Wort:and verify it is acamate. I agree to comply with all applicable local ordinances and state lank relating to bbuil/Q�i/n}gt CO on. I no n/z�lrepresenatives of Cupertino to enter the �a-bfove-identifi d property Cor inspection purposes. Signature of.ApplicandAgent:-IA/,f,(/ti ^/_y�s.�i!�'t� Date: /Ia�C' -or)t SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY _if building is associated Yvith a Home OYYners Associadoo,provide letter PLAN CT¢CK'n'PE ROUTING SLIP of approval from HOA. .� OVER-THE-COUNTER r BUILDING PLAN RCVTEN Provide Planning approval to verity if thereany restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _Provide copy of Manufacturer s Installation Specifications. ❑ st'AN6MU) Cl FIRE DEPT Provide Signed copy of Cupertino's Tem'-Off Policy. ❑ OTUER: Reroojdpp 3011.doc revised 03/16'11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 20643 Gardenside Cir. DATE: 09119/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: $6,000 *PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION USE: SFD or Duplex PERMITTYPE: 1SFDWLR00 i WORK Remove existingwood shake roof and install new composition shingles (Aged Bark). SCOPE FEE ID ROOFAREA s.f. 1REROOFFRES 1,200 Atech. Plan Check Phumh. Plan,Cheek rlec..Plan Check Mech. Permit Fee: Plumb.Permit Fee: rlec•. Permit Fee: Other A1ech.Insp. Other Plumb Insp. 0/her Elec.Lisp. ,Ilech.Insp.ree: Plumb. bi.y. rue: rlec.Insp. ree: NOTE: This estimate does not include fees clue to other Departments(i.e. Planning, Public Works.. Fire,Sanitary Saver District,School District,etc). These fees are based air the preliminan information mailable and are only an estimate. Contact the Dept for adcln'I info. FEE ITEMS (Fee Resohnion I1-053 Ell' 7/1/1/) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee Phaiib.611ech./Elec Permit Fee: $180.00 Supp/. Insp Fee Plumb./Adech.lElec Plunih.lMecltlElec Permit Fee: Construction Tax: Administrative Fee: Work Without Permit? O Yes (F) No $0.00 Aclveniced Planning Fees: Travel Documentation Fees: Strong Motion Fee: IBSEISAPICB $0.60 Select an Administrative Item 131dg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $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 CUPERTINO 10300 TORRE AVENUE •CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildino(adcupertino.oro PROJECT ADDRESS APNO _ O OWNER NAMEPMON O C. E-MAIL STREET ADDRESS ^ t CITY TATE,zip 1 gSol q, FAX TRACTO NA IEL 1 `�' LICENSE`M E (. LICENSE TYP Bus.LI t l COMPANYNAME E-MAI T^!` FAX TR sEETADDRESs ` . ; C� CITY.sTATE ZIP 1 ONE l � 24 113 Cft V 1 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. I . ` ' 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 mitlimurn 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 ofS126.00. 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 re6Ir f policy stated above. 1 also understand that smoke detectors and carbon monoxide detectors are required to be install'ed in accordance with Sections R314 and 11315 of the 2010 California Residential Code f / Signature of Applicant/Agent: Dater RerooJPo1icv_701 l.doc revised 02/16111 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 ..CONTRACTOR RACTOR / SUBCONTRACTOR LIST JOB ADDRESS: L n PERMIT# OWNER'S NAME: PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: 5 CITY/ZIPCODE: l *Our.municipal code requires all businesses working in the city 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. / am not using any subcontractors: o)t- c/�----&a�L 9. / 0 ol2 Signature Date Please.check applicable subcontractors and complete the following information: %/ SUBCONTRACTOR BUSINESS NAME 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