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10070128 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6275 SHADYGROVE CT CONTRACTOR:ECONOMY ROOFING PERMIT NO: 10070128 OWNER'S NAME: DAVE THOMAS 2988 NEAL AVE DATE ISSUED:07/19/2010 WNER'S PHONE: 4083915589 SAN JOSE,CA 95128 PHONE NO:(408)866-1800 I LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License Class C, 39 Lic.# 8 2 2 6 RE-ROOF: ROOFING WITH COOL ROOF CLASS A 32 Contract"r� \-a� Date I _�c -20( C> SQUARES 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:$15000 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 APN Number:37541026.00 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 FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, ��,re.,L costs,and expenses which may accrue against said City in consequence of the n granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature \�\ Date 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. ta OWNER-BUILDER DECLARATION .� � I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applican. Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 t) 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. I 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 I 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,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this g 4 \j permit is issued. Owner or authorized agen4 V" � Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I mt st 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 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 iemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION sts,and expenses which may accrue 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. �_y Signature (,'" Dates/0 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk.: Lot: APN 37-41026 . 00 DATE ISSUED. . . . . . . : 07/19/2010 RECEIPT # . . . . . . . . . BS000010898 REFERENCE ID # 10070128 SITE ADDRESS 62'75 SHADYGROVE CT SUBDIVISION . . . . . . . CITY CU:?ERTINO IMPACT AREA . . . . . . OWNER DKIE THOMAS ADDRESS . 6275 SHADYGROVE CT CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014 RECEIVED FROM . . . . : ECONOMY ROOFING CONTRACTOR HORSAGER, PAUL B LIC # 19307 COMPANY ECDNOMY ROOFING ADDRESS 2988 NEAL AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95128 TELEPHONE (408) 866-1800 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 32 . 00 416 . 00 0 . 00 416 . 00 --- - 0 . 00 - --------- ---------- ---------- TOTAL PERMIT 418 . 50 0 . 00 418 .50 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -- CREDIT CARD 418 . 50 me --------------- TOTAL RECEIPT 418 . 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION __ -------- ---------------------------- -- -------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CITY OF CUPERTINO RE ROOF CUPERTIN0 PERMIT APPLICATION APN Date: Building Address: z 1 S— S AA 0� Owner's Name: '-Da,,e_ 1 4k0v%,xA3 Phone #: 37 (-5-37--y HOA: Yes ❑ No If ves, provide le-:ter from HOA Contractor: �� Phone #: 40 5- tat s -7'2,o 2-�l �� ��Q ��.-� S �4 u Q 46P Fax#. �� A. Cupertino Business License #: Contractor License #: �z� Type of hoof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify)-P,�p(p s4-Y ❑ Other (Specify) Number of existing coverings X Provide I.C.C.E.S. Report # rie ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: (2 v o F—I N5 to L o o k- iZa F' 11)0 ��/-1� ©c=r= i(vsCioti NF' �� P�o� F�%�.� T.vs�e ,- C TY Residential - Commercial Green Building: Please complete relevant portion of the Corfrmed.-fith_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. o� J Valuation: I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO FEE ESTIMATOR.- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: 1$89,105 PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex TOTAL APPLICATION USE: P ROOF AREA: 3,200 S f TYPE: 1 R3SFDADD/REM 9a OO 3U FEE ID 1REROOFFRES 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 0.I-051 F.ff' 7%1:'0g) FEE QTY/FEE MISC ITEMS 7- Permit Fee: $41600 FT Work Without Permit? Q Yes No $0.00 Strong Motion Fee: IBSEISMICR $8.91 Select an Administrative Item Bido Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $428.911 $0.00 TOTAL FEE: $428.91 Revised: 6/30/2010 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 CUPERTINO (408)777-3228•FAX(408)777-3333-buildingancupertino.orq PROJECT ADDRESS �(/ S S FiAL �'w� APN# OWNER NAME �(J - PHW E E-MAIL (Asz3. .L. STREET ADDRESS CITY, ST.ATE,ZIP /'V /�D L FAX 2 S ScF/� /js'w� (� CONTRACTOR NAME LICENSE NUMBS R LICENSE TYPE BUS LIC.# COMPANY NAME ' E-MAIL FAX ��-GAS 7 0 "wCaw � C� r C STREET ADDRESS 2 CITY,ST,.TE,ZIP PHONE I UNDERSTAND AND A 3REV TO THE FOLLOWING: 1. The re-roof project shall comply with all applica)le 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 a id 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 -or 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 dove n to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtaine i 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 1/4"per -bot 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 signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner' if I understand and agrt a to comply with the re-roof policy stated above. signature of Applicant/Agent: Date: ReroofPolicy_2010.doc revised 05/17/10