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10080070 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22572 ALCALDE RD CON'CRACTOR:RUFF'S ENTERPRISES PERMIT NO: 10080070 OWNER'S NAME: PATRICK NIPOLITO 3643 TKASTRIDGE DR DATE ISSUED:08/10/2010 VER'S PHONE: 4087991350 SAN.LOSE,CA 95148 PHONE NO:(408)528-6227 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r- PLUMB r License Class �) Lic.# �"[ a T F MECH r RESIDENTIAL COMMERCIAL Contractore—C44 &t4 Date ^( O 10 I hereby affirmJhat I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:DUPLEX(22572&22574)-RE-ROOF REMOVE SHAKES& (commencing with Section 7000)of Division 3 of the Business&Professions RES LL NEW DECK OSB 3SLBS FELT NEW TL P Code and that my license is in full force and effect. RES DENTIAL CLASS A 27Q 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.F Floor Area: Valuation:$15000 permit is issued. APPLICANT CERTIFICATION APN Number:34216095.00 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 WITHI 80 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply ]80 FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. �� d'Y Issued by:D 2-10 -1 Date: Signature Date J OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All ro ifs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspet tion. will do the work,and the structure is not intended or offered for sale(Sec.7044, //�� / '( 0 Business&Professions Code) Signa ure of Applicant: y�� '� ,r/ Date: I,as owner of the property,am exclusively contracting with licensed contractors to 1 construct the project(Sec.7044,Business&Professions Code). ALL Rtr COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I hav,,read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. Califi,rnia Health&Safety Code,Sections 25505,25533,and 25534. I 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 Safet:1 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,I shall maim ain 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 Worker'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 Own,r ized age}t:� L forthwith comply with such provisions or this permit shall be deemed revoked. G�4� Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I here 3y 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 Lend-r's Name upon the above mentioned property for inspection purposes.(We)agree to save in,'Pmnify and keep harmless the City of Cupertino against liabilities,judgments, Lend:r's Address and expenses which may accrue against said City in consequence of the Ring 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. I undt rstand my plans shall be used as public records. L 3 Signature ii � Date ��^ Licensed Professional CITY OF [I CITY OF CU PERTINO REROOF CUPERTINO PERMIT APPLICATION APN # I � q � Date: ��l��f> Building Address: p Owner's Name: rA L-- k 1�, Phone #: HOA: Yes ❑ No ®. If yes, provide letter from HOA Contractor: Phone #: Fax#: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: P roposed: • Built-Up Roof ❑ Btu'It Up roof • Asphalt Shingles :Asphalt Shingles ol"Wood Shakes ❑ Wood Shakes • Wood Shingles ❑ Wood Shingles • Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Residential [�' - Commercial ❑ Green Building: Please complete relevant portion -)f the Congrmed kith 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: I Have Read, Understand and Will Comply with Cuportino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CU.PERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: FATE: 08/1012010 REVIEWED BY: gs APN: I BP#: "VALUATION: 1$15,000 PERMIT TYPE: Minor Building Permit I PLAN CI[ECK TYPE: Re-roof PRIMARY SFD or Duplex 11t1! °a' I APPLICATION 1SFDWLR00F USE: P 1 !riot,' fit;_.?. TYPE: a al OoI 3UI FEE ID ROOF AREA (s.L) 1REROOFFRES 2,700 I I I ,J�. r Ch" I I NOTE: These fees are based on the preliminary information availa5le and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 09-051 Eft.' 7,/1:09) FEE QTY/FEE I MISC ITEMS Permit Fee: $351.00 { tcir1 ti w; Ii+tI firt 1 t'a' Work Without Permit? Q Yes 0 No $0.00 Strom Motion Fee: 1BSEISMICR $1.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $353.50 $0.00 TOTAL FEE: I $353.50 Revised: 8/06/2010 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34216095. 00 DATE ISSUED. . . . . . . : 08/10/2010 RECEIPT #. . . . . . . . . : BS000011142 REFERENCE ID # . . . : 10080070 SITE ADDRESS . . . . . : 22572 ALCALDE RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : PATRICK NIPOLITO ADDRESS . . . . . . . . . . : 22572 ALCALDE RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : RUFF'S ENTERPRISES CONTRACTOR . . . . . . . : RAFAEL G. NINFFERT LIC # 25172 COMPANY . . . . . . . . . . : RUFF'E ENTERPRISES ADDRESS . . . . . . . . . . : 3643 EASTRIDGE DR CITY/STATE/ZIP . . . : SAN JCSE, CA 95148 TELEPHONE . . . . . . . . : (408) E28-6227 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----- ----- ---------- ---------- ---------- 1BCBSC VALUATION 15, 000 . 00 1 .00 0. 00 1. 00 0 .00 1BSEISMICR VALUATION 15, 000. 00 1 .50 0.00 1. 50 0.00 1REROOFRES SQ FEET 27. 00 .51 .00 0 .00 351.00 0. 00 ----- ----- ---------- ---------- ---------- TOTAL PERMIT ?53 .50 0 .00 353 .50 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -- ------------------ CREDIT CARD 353 .50 VISA --------------- TOTAL RECEIPT 353 .50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF 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•buildiraecupertino.orq. PROJECT ADDRESS 7 1 (d APN# OWNER NAME 1 PHONE p' C 8 E-MAIL STREET ADDRESS CITY, STATE,ZIF / FAX CONTY.,ACTOr NAM " LICENSE NUMBER LICENSE TYPE BUS.LIC# COMP jE-MAIL IC'h.-�- FAX 72—C STREET ADDRESS _ CITY,STATE,ZIP POOKE �l,lr 'S �►G?( 1� Ii0f` <�" CIA 7 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 wit tin 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% )f 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 t le 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 it.-ms will be verified: a. Flat roofs shall have a minimum of 1/4"per foot o- slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pr-.-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 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. Signature of Applicant/Agent: a/C1/ t=� Date: � �� k-` d ReroofPolicy_2010.doc revised 05117110 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: ��-57 4-- 7 a 6-z-c 01-1—C C PERMIT# /00�m 7 OWNER'S NAME: P,7 61Z& y �t a PHONE# GENERAL CONTRACTOR: 12,1,,0(- j H BUSINESS LICENSE# ADDRESS: S w,. CITY/ZIPCODE: *Our municipal code requires all businesses working in the ,,ity 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. I am not using any subcontractors: e 7a O 4ignature Date Please check applicable subcontrlors nd complete t 1e following information: SUBCONTRACTOR BUSINESS Is AME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood I I JI Glass / Glazing Heating Insulation - Landscaping Lathing 1 Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank I 1 Sheet Metal Sheet Rock -Tile — - — -- — - — -- - Owner/Contractor Signature Date