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11040102I CITY OF CUPEI'TING BUILDING PERMIT I I BUILDING ADDRESS: 968 NOVEMBER DR I CONTRACTOR: M & S ROOFING CO. I PERMIT NO: 11040102 I I OWNER'S NAME: RAMPI RAMBRASAD 1208 COPCO LN I DATE ISSUED: 04/15/2011 I vNER'S PHONE: 4087259261 1 SAN JOSE, CA 95123 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # 90 1,;2) Contractor fZ (YZ erg 1U14 Date Qv I I 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. 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. APPLICANT CERTIFICATION n 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 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 c ' L Date OWNER -BUILDER DECLARATION 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 & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I 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 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. 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, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 'ndemnify and keep harmless the City of Cupertino against liabilities, judgments, :s, and expenses which may accrue against said City in consequence of the d+.ting 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 JOB DESCRIPTION: RESIDENTIAL PHONE NO: (408)314-0870 RE -ROOF 26 SQ- TEAR OFF WOOD SHINGLES, INSTALL 1/2' OSB PRESIDENTIAL CLASS A Sq. Ft Floor Area: I Valuation: $14000 APN Number: 36213026.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHI ZERMIT ISSUANCE OR 180 DA +ROM LASLLED INSION. Issued by: Date: 47- RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I 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 Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: CONSTRUCTION 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 Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 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 • building�a-)cupertino.org PROJECT ADDRESS � � � �� (j � `� � (� A # OWNER NAMEZJ PrrV1\ CP1 fJ „ ^ �j^ \ (`- / V 1 C -t (, PHONE /`� -P' -N EMAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTRACTOR NAME _ / LICENSE NUMBER LICENSE TYPE c� BUS. LIC. # COMPANY NAME ` , E-MAIL FAX q ?�� A 6.25 rREETADIIIS,_�jCITY,CAJ I V STATE, ZIP �` PH �8 l� 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 shall be scheduled 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. On the day of the inspection, a building inspector will be available within one hour for either a Tear -Off Inspection or Nailing Inspection if you call again on that day between the hours specified. 3. The following inspections are required: a. 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. b. If plywood is installed, a plywood Nailing Inspection is required. c. Progress Inspection is required when approximately 50% of roof covering is installed. 4. New roof coverings shall not be applied without first obtaining all 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. 5. 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 I/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. Proper spark arrestor installation. 6. 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 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 Codes � 1. Signature of "l— Date: ,,IV - 1 3 ReroofPolicy_2011.doc revised 02/16/11 CUPERTINO 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: PERMIT # OWNER'S NAME: PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS:I C CITY/ZIPCODE: 5 *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. \� 1 am not using any subcontractors: � Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature 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 Date 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36213026.00 DATE ISSUED.......: 04/15/2011 RECEIPT #........-: BS000013196 REFERENCE ID # ...: 11040102 SITE ADDRESS .....: 968 NOVEMBER DR SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER ............: RAMPI RAMBRASAD ADDRESS ..........: 968 NOVEMBER DR CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: SylviaM COPY # : 1 RECEIVED FROM ....: M & S ROOFING CONTRACTOR .......: MIRSAD KRAJWIC LIC # 28360 COMPANY M & S ROOFING CO. ADDRESS ..........: 208 COPCO LN CITY/STATE/ZIP ...: SAN JOSE, CA 95123 TELEPHONE ........: (408)314-0870 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ---------- NEW BAL ---------- ----------------------- 1BCBSC VALUATION ---------- 14,000.00 ---------- 1.00 ---------- 0.00 1.00 0.00 1BSEISMICR VALUATION 14,000.00 1.40 0.00 1.40 0.00 1REROOFRES SQ FEET 26.00 338.00 0.00 338.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 340.40 ---------- 0.00 340.40 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT AMOUNT --------------- 340.40 --------------- 340.40 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- 2618 VOICE ID DESCRIPTION -------- ---------------------------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF CITY OF CUPERTINO FF.F F4TiMATnR - RITii,nTNG DIVISION FEE ID ROOF AREA s.f. 1REROOFFRES 2,600 NOTE: Thesefees are based on the preliminary information available and are only an estimate. c,'ontact ine ve t or aaan -i to o. FEE ITEMS (Fee Resolution 09-051 f,'/ 1/10) 1 FEE I QTY/FEE I MISC ITEMS Select an Administrative Item $0.001 TOTAL FEE: I $340.40 Revised: 01/15/2011 ADDRESS: 968 november dr. DATE: 04/15/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$14,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Du lex USE: P PENTAMATION 1 SFDWLROOF PERMIT TYPE: WORK tear off existing shingles replace with comp shingles. SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 2,600 NOTE: Thesefees are based on the preliminary information available and are only an estimate. c,'ontact ine ve t or aaan -i to o. FEE ITEMS (Fee Resolution 09-051 f,'/ 1/10) 1 FEE I QTY/FEE I MISC ITEMS Select an Administrative Item $0.001 TOTAL FEE: I $340.40 Revised: 01/15/2011 CUPERTI'NO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building cDcupertino.org 1/DAG/6a PROJECT ADDRESS 7A_PN #/ d ,% LA1 :3 uR7 I LAJ OWNER NAME �,, 1 PHONE A, �- E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX APPLICANT NAME i PHONE E-MAIL _� _Q zoo I STREET ADDRESS CITY, STATE, ZIP„ (� OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBERS I g LICENSE TYPE ^ BUS. LIC. # COMPANY NAME Aj E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP , s PHONE C C- o ARCHITECT/ENGIIVEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF D or Duplex ❑ Multi -Family ROOF AREA: (� a VALUATION: STRUCTURE: ❑ Commercial ,2G V &-Ood.� EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES �1VOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE YES IF NO, PLYWOOD M%" ❑ PLYWD WOSB ITCH PITCH. ROOF El NO #LAYERS: THICKNESS 135/8" TYPE: E3CDX 12 CLASS: A PROPOSED ROOF TYPE: ElBUILT-UPROOF qASPHALT SHINGLES ElWOOD SHAKES ElWOOD SHINGLES 13OTHER ICC -ES REPORT # DESCRIPTION OF WORK: AL 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 cons ction. I apthorize representatives of Cupertino tc enter the above -identified property for inspection purposes. l i Signature of Applicant/Agent: /L i Date: Ya>icEz�� SUPPLEMENTAL INFORMATION REQUEZID If building is associated with a Home Owner's Association, provide letterjg P "� �ouTlx� siP M Q'"OVER- GGII Rik _ of approval from HOA. § { Provide Planningapproval to verify If there an restrictions. PP Y Q .EXPRESS - r ❑ LEA G'PLANREVIEW _Provide copy of Manufacturer's Installation Specifications. sTAIVDAxD N `❑I> D> ea rovide signed copy of Cupertino's Tear -Off Policy. _ . ❑ $otx ReroofApp_M Ldoc revised 03/02/11