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12080164CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20649 GARDENSIDE CIR OWNIiR'S NAMF: MURUI IAN PAI7ARAIVAKKAM ON'NP,R'S PIIONE: 4082469930 ❑ LICENSED CON`FRACI'OIVS [DECLARATION License Class 9 Lic.91`7f73S6 Cantmctor �Jl CsCSc^ -1 Date 0 1Z I hereby affirm that I am licensed under the pro%kimrs of Chapter 9 (commencing with Section 7000) of D[vision 3 of the Business & Professions Code and that my license is in full force and effect. 1 hereby affirm under penalty of perjury one of the following two 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 Cade, 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 die perfomrance of die work for which this Pennant is issued. Al'1'I,ICAN'I' CER'1'IFICA'I'ION I certify that I have read this application :tad state that the above information is correct. I agree to comply with all city and county ordinances mid 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 dye grunting of this pemhit. Additionally, the applicant understmrds mid will comply with all non-point source re- ulations per the Cupertino Municipal Code, Section 9.18. Signature Date -4� ❑ OWNER -Blil LDER QFCLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as 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 S Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business R Professions Code). hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Cenificale 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 whichthis pemhit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Cade, for die performance of the work for which this permit is issued. I certify thin in the performance of the work for which this permit is issued, I shall not employ any person inane 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 Compensar ion provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be devoted revoked. Arrl.ICnN'r clsR'ru locrloN I certify than 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. Date CONI•RACI'OR: BRADS[ -IAW ROOTING I'liRMITNO: 12080104 INC 1821 S BASCOM AVE PMB 160 DATE ISSUED: 08/172012 CAMPBELL, CA 95008 PIIONF, NO: (408)246-9930 JOBDF,SCRIP'I'ION: RrsIDENIIAL CO�WIERCLU, TEAR OFF EXISTING SHAKE AND INSTALL 12 SQRS CLASS A ASPHALT COMP SHINGLES, COLOR AGED 13AIlK Sy. PI Moor Arcs I Valmllion: $6000 ANN Number: 36232026.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: VA," /C 'fort Date: RE ROOFS: All roofs shall be inspected prior to may roofing material being installed If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signatureof Applicanu Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BE 17ER IIA %ARDOIIS MATERIALS DISCLOSURE have read the hazardous materials requirements under Chapter 6.95 of the California Ilealth S Safety Code, Sections 25505, 25533. and 25534. 1 will maintain compliance with the Cupertino Municipal Code. Chapter 9.12 and the Ilealth S Safey Code, Section 25532(x) should I store or handle hazardous material. Addition illy, should 1 use equipment or devices which cinit hazardous air contaminants as defined by the Buy Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipaf Code, Chapter 9.12 and the Health A Safety Code. Sections 255y,5/ 255 , and 2553. II // Owner or authorized agent: e Date: &4 CONS'IRUCHON LENDING AGENCY 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 Nacre Lender's Add ARCIIITECI "S DECLARATION I understand illy plans shall be used a public records. Licensed Professional CUPERTINO I CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408-777-3228 'Fax: 408- 777 -3333 JOB ADDRESS: QOLLA SUBCONTRACTOR e PERMIT # OWNEWSNAME:�J k -% PHONE# L(o . ate. GENERAL CONTRACTOR: \ - a BUSINESS LICE SE # (o ADDRESS: -.?)a CITY /ZIPCODF: Cam, 1 ()( *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 13E SCHEDULED -UNTIL TIIE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS IiAVE OBTAINED A CITI, OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date' Owner / Contractor Signature �� /-//,70/-2- Date. 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 �� /-//,70/-2- Date. 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 • buildingRcuoertino.ora PROTECT . APNY 3- L-�Q& �� L� PHONE ER NAAD ME it Ib qCjd E-MAIL STREET ADDRESS CITY. STATE. ZIP FAX C0. CTOR,NA.7E LIC SE NUMBE LICENSETYP BUS.Lc.gSO C Ilrl ` C I1 �Y COMPANY NAME Rrnl, `_ y FAX - STREETADDRESS `' CITY. STAYTE.IZIP I ONE 3ta ` , \ S C� I 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 1/0 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. 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, 1 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- roorpolicy 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: Date: - Reroo/Policy_201 Ldoc revised 0 ?116111 CITY OF CUPERTINO lye/ /I FEE ESTIMATOR- BUILDING DIVISION NOTE: This estiumte doev not includejecv due to other Departments (i.e. Planning. Public Works, Fire, Sanitary Server District, School Dirtriri. atrJ. Three feev ore haver/ on the nrelinzinarr information available and are only nn estinhate. Contact the Dent for arldn'l info. FEE ITEMS (Fee Resohnion 11 -053 E/f Ul /ll) A DDRESS: 20649 gardenside circle DATE: 08/14/2012 REVIEWED Bl': bobs. Meek Permit Fee: ARV: BP #: S-0/40v 'VALUATION: $6,000 *PERMIT TYPE: Building Permit =PLAN CIIECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex rice. hup. Fee: PENTAMATION PERIIIITTI'PE: 1SFDWLROO i WORK remove existing shake install comp shingles. 1 67 S SCOPE f"�_ s a5 NOTE: This estiumte doev not includejecv due to other Departments (i.e. Planning. Public Works, Fire, Sanitary Server District, School Dirtriri. atrJ. Three feev ore haver/ on the nrelinzinarr information available and are only nn estinhate. Contact the Dent for arldn'l info. FEE ITEMS (Fee Resohnion 11 -053 E/f Ul /ll) Meth. Plan Check Phurrh. Plan Check Flee. Plan Check Meek Permit Fee: Phhmh. Pamir Fee: Flat Permit Fee: Ohher,ifech. Insp. Other Plumb Invp. Ocher Fier. /nay. mcch. Imp. Fee: Plumb. htcp. Fee: rice. hup. Fee: NOTE: This estiumte doev not includejecv due to other Departments (i.e. Planning. Public Works, Fire, Sanitary Server District, School Dirtriri. atrJ. Three feev ore haver/ on the nrelinzinarr information available and are only nn estinhate. Contact the Dent for arldn'l info. FEE ITEMS (Fee Resohnion 11 -053 E/f Ul /ll) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 1,2001 s.f. $180.00 Re -roof IBFBOOr•RES Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee Q Reg. Q OT F0 .0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consnttction Toa :• Administrative Fee: E) Work Without Permit? 0 Yes t) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure G 0 Travel Documentation Fecst Strong Motion Fee: IBSEISA -tICB $0.60 Select an Administrative Item 131d-, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.60 $180.00 TOTAL FEE: 1 $181.60 Revised: 07/01 /2012 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUPERTINO I (408) 777-3228 • FAA ( 408) i i7 -3333 • builtlinala�cuceRino.orG C y_ n i PROIECT ADDRESS O / 4 r' c+n `lit .aPN tl . / a "' 32 - a MnO ( ` f.. PHONE ` b �l� E-0fA11 STREET t y(o L' _l IA% CI �. CITY. STA U f (LC.� A� IC' I FAX l CONTACT N"E PHONE E -SLARL 'STREET ADDRESS CRY, STATE. ZIP FAX ❑ OIVNER ❑ OWNER- BLTLDER ❑ OWNER.AGFM CONmACTOR ❑CONTTLYCTORAGEn ❑ ARCHITECT ❑ ENGINEER ❑ DEViJ.OPEA ❑ TENANT CONTRAR RNAAIE LICENSEW \ ®ER LICENSE TYPE BUS.LIC.• 3os, 9 CO,YNANY NAA¢ r FAX _ _ n' `U STREET ADDRESS kL _ c Cm', STATE ZIP n C PHONE ARCUTECT/ENGU+EER NAME LICENSE NUMBER BUS. LIC. e CONUTANY NAME E -NIAIL FAX STREET ADDRESS CRY, STATE. ZIP PHONE USE OF ❑ SFD or Duplex STRUCTURE. ❑ Commercial ❑ Mul0-Family. ROOF.AREA: kWo st VALUATION: C+ Ono EXISTDIOROOFTYPE: ❑BUILT- UPROOF ❑ASPHALTSHIY•GLES ErWOODSHAKES ❑WOODSHINGLES ❑ OTHER(SPECIFY) REAIOFE iREPLACE 90 ❑ 0 IF 140. i /I1 J,, PLYII'OOD 15" ❑ C. ❑ q3' PLYWD ❑ OSB PE ❑ COY PITCH: ROOF :I2 PROPOSED ROOF TYPE: ❑ BUILT- UPROOF .ASPHALT SHINGLES ❑ WOOD SHARES ❑ WOOD SHINGLES ❑ OTHER ICC-ES REPORT a DESCRIPTION OF WORK: 1 G By my signature below, I certify to each application and die information I have provided ordinances and state laws relating ro bu�d Signatureof.Applicant/Agen[ ��1.(ti� of the Following: 1 am the property owner or authorized agent to act on die propem• owner's behalf. 1 have read this is correct. 1 have read the Description of Wont and verify it is actuate. I agree to comply with all applicable local //qqm/g w on. I au �� preseatatives of Cupertino to enter the above- identif/ted praperry far inspection purpose. /___y`s} Due: i �a� SUPPLEMENTAL INFOMLJLTION _ If building is associated with a of approval from HOA. Provide Planning approval to verity _ Provide copy of Manufacturers Provide signed copy of Cupertino's REQUIRED Home Owner's Association, provide letter if there any restrictions. Installation Specifications. Tear -Off Policy. OFFICB USE O VCY PLAY CHECK TYPE ROUTING SLIP ❑ OVER - THE - COUNTER ❑ EXPRESS ❑ STANDARD ❑ BUILDING PLAN RINILw' ❑ PUNNING PLAN REYTEvv ❑ FERE DEPT ❑ OTHER: Reronf 1pp_201 /aloe revised 01!16.11