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11010075 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11406 LINDY PL CONTRACTOR:R E ROOFING& PERMIT NO: 11010075 CONSTRUCTION INC OWNER'S NAME: BERNEDETTE&KELLY HIRANO 15230 CLYDELLE AVE DATE ISSUED:01/13/2011 `ER'S PHONE: 4085647301 SAN JOSE,CA 95032 PHONE NO:(408)626-9320 ❑ LICENSED CONTRACTOR'S DECLARATION F- BUILDING PERMIT INFO: BLDG ELECT PLUMB Gik Lic.# 2-� MECH RESIDENTIAL r COMMERCIAL r Date t licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING 1 LAYER OF TILE,INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions NEW 1/2"CDX,30#FELT&EAGLELITE LIGHT WEIGHT Code and that my license is in full force and effect. TILE CLASS A 36SQ 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 Sq.Ft Floor Area: Valuation:$25000 permit is issued. APPLICANT CERTIFICATION APN Number:35624011.00 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 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 18 AYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAY M LAST CALLED INSPECTION. non-wo*sou egulations per the Cupertino Municip Code,Section f! 9.18. Issued by: � / Date: Signature L"'-_ Date r, OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of Al--mf5 shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed wr ut f_itst taining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensate inspection. ' L will do the work,and the structure is not intended or offered for sale(See.7044, ature t 2 ( t I Business&Professions Code) SignAp 'cant: Date: l 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 BE CLASS"A"OR BETTER I 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 self-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 Health&Safety Code,Sections 25505,25533,and 25534. 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 Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,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 the work for which this permit is issued A shaYl intain 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 W6rker'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 Compensation provisions of the Labor Code,I must ° e° `-72 I forthwith comply with such provisions or this permit shall be deemed revoked. Date- CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 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.I agree to comply 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 i^-1­!mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address ,and expenses which may accrue against said City in consequence of the 6—sting of this permit.Additionally,the applicant understands and will comply ARCHITECT'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 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35624011 . 00 DATE ISSUED. . . . . . . : 01/13/2011 RECEIPT #. . . . . . . . . : BS000012468 REFERENCE ID # . . . : 11010075 SITE ADDRESS . . . . . : 11406 LINDY PL SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : BERNEDETTE & KELLY HIRANO ADDRESS . . . . . . . . . . : 11406 LINDY PL CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4814 RECEIVED FROM . . . . : R E ROOFING & CONST CONTRACTOR . . . . . . . : PROCTOR, PAUL LIC # 20615 COMPANY . . . . . . . . . . : R E ROOFING & CONSTRUCTION INC ADDRESS . . . . . . . . . . : 15230 CLYDELLE AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95032 TELEPHONE . . . . . . . . : (408) 626-9320 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 25, 000 . 00 1 . 00 0 .00 1 . 00 0 . 00 1BSEISMICR VALUATION 25, 000 . 00 2 .50 0 .00 2 .50 0 . 00 1REROOFRES SQ FEET 36 . 00 468 . 00 0.00 468 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 471 .50 0 .00 471.50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 471 .50 #3107 --------------- TOTAL RECEIPT 471 .50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11406 lindy PI. DATE: 01/13/2011 REVIEWED BY: gs APN: BP#: *VALUATION: 1$25,000 R�PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex lex I( 7.`tL PENTAMATION 1SFDWLR00F USE: 1`10011 1if t. PERMIT TYPE: WORK SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 3,600 tllcclr. Plan C"beck F P onh. Plot!Chcr; : eMyan(`l.cr ":1. Pct-mil P'C". 1ctmil .. 1,','V,, C)'hc r'.l1cr,'17. f� s.1>_ Oti;c'r P r�r,�Tl 7 '�>_ ElM,"i'1>lo, Ingp, Li Plumb, Ii y, Fe"', 1""10 limp, j,"C NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resohition 09-051 Eff. 7/Ii10) FEE QTY/FEE MISC ITEMS Plan Check Fec: ,.41!11/)!. P(l,FCC Plrlrrtll.-"1Ie<11.;`1;lec Pla11 t:.7lec:k: Permit Fee: $468.00 Supp/. hop Fee F P111r�1f7.::tlec�T1. "1 l�'c Z.�r1it t�"�r�': f'lunlh.;'1�1 rcjt.;'1'lt�' Perini! Fee: C �trzsti uc°lion 1 CLV Work Without Permit? 0 Yes No $0.00 Planni nor 1,'c 0S: 7'1-ovel 1)ac'ttinc nttatfr�n 1'c'e'.ti': Strong Motion Fee: IBSEISMICR $2.50 Select an Administrative Item Bldjz Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $471.50 $0.00 TOTAL FEE $471.50 Revised: 12/07/2010 Building Department City Of Cupertino Lai 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: (p 1 L PERMIT# / ( � OWNER'S NAME: t RA140 PHONE# —b L(r, - T-'720 GENERAL CONTRACTOR: BUSINESS LICENSE# v l ADDRESS: Cj2 CITY/ZIPCODE: U SIE q5A 2 *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 CONTRACTO ND A SU TRACT S HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. A f I am not using any subcont ctors: -Signature Date Please check applicable subcontractors and complete the following information: V 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 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(d)cupertino.orq PROJECT ADDRESS 1 I_ L-1` �n'J J APN# �j OWNER NAME M'� H ` jq4- �3o ( E-MAIL STREET ADDRESS CITY, STATE,ZIPbt t,uc-111 40 FAX CONTRACTOR NAM L 1 N /.. LICENSE NUMBER 2,-7�i LIC SE f E BUS.LIC# '�f o 5 1 f COMPANY NAME E-MAIL Y-�1(c)o ; 1+ l ' a0 I.� FAX �^� 1� IM STREET ADDRESS /n jV ��J ^ ,l A/c'' CITY,ST��E6ZJP_ C�i, ( Jo -I/l PHONEiG / -,•M Z '\ L I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm(Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. 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 must 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. 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 of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signirig"below, I cert, each othe following is true: I am the property owner or authorized agent to act on the prop� nrty owner's be uhe and agree to comply with the re-roof policy stated above. Signature of Ap�licant/Agent: ' (�—'' Date: 7 —.-�' ReroofPolicy_2010.doc revised 05/17/10 CITY OF ` U CITY OF CUPERTINO REROOF CUPERTINO PERMIT APPLICATION APN# Date: If residential, is house an Eichler? Yes ❑ No ❑ If yes, needs planning approval. Building Address: L 1 Owner's Name: - Phone #: HOA: Yes ❑ No If yes, provide letter from HOA `AL1 ' ! i" 0 Contractor: Phone #: CGS hm.n"i , �c. 1 �1 Fax#: q� -- 2,(0 (� Cupertino Business License #: 2-oI�� Contractor License #: 7 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles Other (Specify) )� Other (Specify) ❑ Provide I.C.C.E.S. Report# I Number of existing coverings � p To be Removed ❑ Provide Mfgr. Installation Specs. 5� S� Job Description:�p ��'�(l�'f �.�`'IG1f j1 L�, t 1� �fi��'L 1.. i�l kCtiJ VQ e �-► i 'r� 1. Residential Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: Z.S000 I Have Read, derstand and '11 Comfly.with upertino's Tear-Off Policy: r