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10090114 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11663 FOREST SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 10090114 C.M NER'S NAME: SRIDHAR BETTADAPUR N AND UMA B 1703 CATHAY DR DATE ISSUED:09/15/2010 'ER'S PHONE: 4089969760 SAN JOSE,CA 95122 PHONE NO:(408)251-3565 ❑ LICENSED CONTRACTOR'S DECLARATIION BUILDING PERMIT INFO: BLDG r— ELECT F PLUMB r License Class 3 Lic.it �30-e.1567 1 MECH r r-RESIDENTIAL COMMERCIAL� Con , Date /57-/'o I hereby affirm t t I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF TEAR OFF EXISTING WOOD SHAKE,INSTALL (commencing wi Section 7000)of Division 3 of the Business&Professions 30LB FELT,INSTALL GAF GRAND CANYON COMP SHINGLES CLASS Code and that my license is in full force and effect. A 18SQ 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:$9000 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:36651060.00 Occupancy Type: 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, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. gn Date Signature . Issued bye,-�7 Date: Li OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business&Professions Code). -/ 5�- I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE 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 read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain 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. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must Ow r or sLulborized ent- forthwith comply with such provisions or this permit shall be deemed revoked. Date: ``S APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name i mify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR--BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: 1$9,000 *PERMIT TYPE: Minor Building Permit PLA N CHECK TYPE: Re-roof PRIMARY TC)7;1 Z; PENTAMATION 1 SFDWLROOF USE: SFD or Duplex 1�1,00A, )1 F,I: PERMIT TYPE: WORK SCOPE FEE ID ROOI'AREA .f. 1REROOFFRES 1,300 .Lic_'c-1r. 1'ruYt Cho k T7 I'll ib t'ho"( l7C'CA 17 L 11,!, i}/an c.r(L',k llr�:r. Pcrmil 1—c"' I'Inr7i ,. Pernut F"e, F,IU Powilr 1,k" {)rJx-r;tl�+h. IrcO r t�f Pr>r tt�Iri.th 1-1 L NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 09-051 E6 7:'1-)10) FEE QTY/FEE MISC ITEMS Plum Check Supp/. Pt,FCC Plutnf7.;'11cc/r. `I;lcc Plum Clrcc:k. Permit Fee: $232..00 Supp/. 11181)Fcv P/urrtlr.i:t It 11."J,lcu t i7it Fcc: l'Ittrtth.;'. lc c/t.lL7c c� Per mit Fcc: t.0U1;t0rciiott Kff tcousticctl l2c r is it% VC(!: Work Without Permit? © Yes E) No $0.00 111an ting Fecs: Tr�<e�ef 1)actrrnerttutiort lr�ei: Strong Motion Fee: 1BSEISMICR $0.90 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $'1.00 SUBTOTALS $23:-).90 $0.00 TOTAL FEE: $235.90 Revised: 9/14/2010 REROOF TEAR-OFF PC LICY COMMUNITY DEVELOPMENT DEPAPTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BLILDING OFFICIAL GUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(cDcupertino.org PROJECT ADDRESS 7PN OWNER NAME / ` 7 PH(NEt�?/_ �/_j'� E-MAIL STREET ADDRESS Flo CIT S"ATE,ZIP O l]d 'l FAX CONTRACTOR NAME odsh /� a/ /e_( CENSE NUMB-R �n i(�+� LICENSE TYPE BUS.LIC.# COMPANY NAME 0,45-h'1105' //Jyn! �/lj\ E-MAIL� /SlJ/��(0 `' ��A FAXS��l e STREET ADDRESS 7v /},4 V V ,(,J 9 CI ATE,Z !^- (1A , 1915.1C; R PH J a�J 2S/-3 r —J- 1 1 1 I UNDERSTAND AND AGREE JTTO THE FOLLOWING: J 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 min mum of one day before the requested inspection date. Please schedule inspections online or call (408)-,77-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please c�11 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 availab e 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 jbr 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 ie-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 un erstand d agree to comply with the re-roof policy stated above. Signature of A nt/A en . Date: 7`1S-,le ReroofPo1icy_2010.doc revised 05/17/10 M.Indoor Air Quality and Finishes 1.Use L:ow/No-VOC Paird 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use 1ow/,No VOG Adhesives 3 IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7.Sad a1E*bseel ' orU DF 4 IAQ/Health..pts y=yes 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 MA-lealth pts y=yes 0 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2 Use RapidlyF3enewataleFlooring lylaisraafs 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 S.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 Total Points Available: 1 1401 1301 57 Total Points Project Received: I 0 0 0 G:datalprogsh reenbuildn idelinesln:modelerstgreenpc intsfinal2.12D4protectedxrs CITY OF CITY OF C:UPERTINO . [9 REROOF CUPERTINO PERMIT APPLICATION APN# Date: U0 Building Address: a C Z . Owner's Name: Sri C1ha r Phone #: 6? .7 HOA: Yes ❑ No If yes, provide letter from HOA Contractor: Phone #: 8- S5-1--_35&,5- -74).3 &W:!LW4_ Fax Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ ilt-Up roof ❑ asphalt Shingles Asphalt Shingles a/Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Nu�ber of existing coverings ❑ Provide I.C.C.E.S. Report# r, T01 be Removed ❑ Provide Mfgr. Installation Specs. Job Description: i0�F' f� 1r�on4 Sn �; 57�p�� � s 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: 0W s I Have Read, Understand and Will Comply wits. Cupertino's Tear-Off Policy: r Signatur Revised 02/05/09