13010100 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10170 E ESTATES DR CONTRACTOR:DADDARIO ROOFING PERMIT NO: 13010100
OWNER'S NAME: ARAGONDA PRATHYUSHA 716 CAPITOLA AVE STE E2 DATE ISSUED:01/182013
OWNER'S PHONE: 6502106254 CAPITOLA,CA 95010 PHONE NO:(831)476-9109
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL
License Class L?7 Lie.N o TEAR OFF(E)WOOD SHAKE,INSTALL NEW O.S.B.,40 YR
COMP(25 SQUARES)
Contractor C' Date Ol 2t9/
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I 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 Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$7845 -
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 APN Number:36907032.00 Occupancy Type:
Permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,'and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FRO CALLED INSPECTIO .
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the r
granting of this permit. 'Additionally,the applicant understands and will comply Issue Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signatur Date D/ (a 2ti' All roofs shall be inspected prior to any roofing material being installed.if a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATIONeI
Signature ofApplicant Date: ZO/�
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1,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&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's.Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533 an 25534.
Section 3700 of the Labor Code,for the performance of the work for which this 3
permit is issued. - Owner or authorized agent: .Date: O/
I certify 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,aftermaking this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and state that the above information is
correct:I agree to comply with all city and.countyordinances 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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses whichmayaccrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant.understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
A
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �O
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777.3228•FAX(408)777-3333•building0cuoertino.ore 47
PROJECT ADDRESS j0 I-70
zCS-5 APNN 30
� - 0 ;I - 0-3 2 -
OWNERNA { PHONE 50 DO-
G26EMAIL
0 1-70
STREET ADDRESS STATE.Z C -40,/ FAX
CONTACT NAME I PHON 5^z 11O o r Move a
STREET ADDRESS / CrrY,STATE,ZIPFAX
ElOWNER ❑ O_WNNEekR-BUILDER ❑ OwNERA(R mT Iy��/,69iRACrOR ❑CONTRACrORAGENT 11ARCH IECT ❑ENGINEER 13 DEVELOPER ❑TENANT
CONTRACTOR NAmL /A LI SE LICENSE TYPE BUS.LIC.M
Ce
COMPANYNAME I�UTA E-MAIL FAX
STREET ADDRESS�, ICU CITY,STATE,ZIP _ n „ jo PH�'E�, Q
ARCHRECT/ENGINEER NAME LICENSENIIMBER 1,/� ! BUSS,LIC.#
COMPANY NAME &MAR. FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ElCommercial '2,5 ' $ t70
EXISTING ROOF TYPE' O BURT-UP ROOF ❑ASPHALT SHINGLES 1111VI D SHAKES ❑WOOD SHINGLES Cl OTHER(SPECIFY)
REMOVE)REPLACE (RYES IF NO. PLYWOOD 11 ❑ PLY" l -M" PITCH: ROOF
❑ N p ❑ 5 TYPE ❑ DX '12 A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF A-ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICGES REPORT#
DESCRIPTION OF WORK: �` I C
CIL� CL Cr.E7yvP - I
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the Property owner's behalf I have read this
application and the information 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 to building con c. a I authorize representatives of Cupertino to enter the above-, entifie property for inspection purposes.
Signature of Applicant/Agent: Date: 47f 20
SUPPLEMENTAL INFO TIONREQUIREDV„�' oF"�"FrcusEONiv}`�
>P - "-
If building is associated with a Home Oweers Association,provide letter rLANc��cxmeta-.. �`� d^�1:
sW F '
of approval from HOA. 'ER'-THF COUtNTER�+ �a°IRIm.DTryG PLA Reyrew i;.
Provide Planning approval to verify if there any restrictions. O''�'rYrtwNNUNceLANrh
Rev¢w,,
iry` 5J'" .P:.4 Y` 3 4& stomp S y tp)
Provide copy of Manufacturer s Installation Specifications. El'm/enr +s x;�
Provide signed co of Cu rtino's Tear-OffPoti oTmsR- �� `
gn PY Pe cy. px -
u
ReroojApp_2011.doc revised 03/16111
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 10170 E ESTATES DR DATE: 01/18/2013 REVIEWED BY: MELISSA
APN: 369-07-032 BP#: *VALUATION: $7,845
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex PENTAMATION 1SFDWIL
USE: PERMIT TYPE:
WORK TEAR OFF E WOOD SHAKE INSTALL NEW O.S.B. 40 YR COMP 25 SQUARES
SCOPE
g'�'
:Flt zP, p�5wy�I�I` xw'�f1�i
`.} 4 ib`W4 fii d;.!'r~�C,ad'_ d�� Y '�` �`,fr ...45 {k1^ir,^�'
Nferlr. Plan Check Plumb. Plan Check Elec. Plan Check
hfech. Perini(Fee: Plumb. Permit Fee: Elec. Permil Fee:
Other-Hech. Insp. Other Plumb Insp. O/her Elec./nsp.
Mcch. Insp, PecPlumb. Insp. Fee: Elec.Insp.Fee:
NOTE:This estimate does not includejees due to other Departments(Ie.Planning,Public Works,Fire,Sanitary Sewer Distric4 School
District;etc). These fees are based on the reGmina to orm adon available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 Eff 7/1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 IZFJO s.£ Re-roof
Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 $375.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee:Q Reg. 0 OT 0.0 his $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tai-:
Administrative Fee: 0
Work Without Permit? 0 Yes Q No $0.00 (E)
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Trm'e1lJoczunentulion Fees: Building or Structure . 0
i
Strong Motion Fee: IBSEISMICR $0.78 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
$1.781 $375.00 _ O: $376.78
t \ Revised: 10/01/2012
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•building ancuper ino.ora
PROJECT ADDRESS APN 4
r—
OWNER N "1
0-f1 L^`a
STREET ADDRESS O O - S MYY STATE,ZIP FAX
'YJO C- SU1 U
CONTRACrORN LICENSE NUb1BE LICENSETYPE BUS.LIC.9
COMPANYNAME X11 L1 E-MAIL FAX
STREET ADDRES ✓ C STA ZD' C PHO �` y O
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 one business day before the requested inspection date.
Please call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pm (Friday) to schedule
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.
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. 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 havd 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.
7. 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. 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 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: Date: CJ
RerooJPolicy_2012.doc revised 1017/12