10070139 CITY OF CUPERTT.40 BUILDING PERMIT
BUILDING ADDRESS: 1035 WEST HILL CT CONTRACTOR:WESTERN ROOFING PERMIT NO: 10070139
SYSTEMS
NER'S NAME: SHUBHA RAGHURAM 1328 WHITE OAKS RD DATE ISSUED:07/20/2010
OWNER'S PHONE: 4087257596 CAMPBELL,CA 95008 PHONE NO:(831)278-1837
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG f— ELECT r PLUMB
License Class (/,3� Lic.#
MECH r- RESIDENTIAL r- COMMERCIAL r
Contrac Date �'t;�
I her y irm hat I am li ed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF TEAR OFF WOOD SHAKE,SYNTHETIC
(co mencing with Section )of Division 3 of the Business&Professions UNDERLAYMENT,BATTENS.INSTALL METAL TILE PER ICC
Code and that my license is in full force and effect. 5218 CLASS A 32SQ
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 t Sq.Ft Floor Area: Valuation:$19500
permit is issued.
APPLICANT CERTIFICATION APN Number:36227047.00 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 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
,a/re,� Date /
—7Issued
❑ O3ftWBUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs 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, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Appl• Date: T Z.%'/d
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS T ASS"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 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. 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 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 b the Ba Area Air
y y Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain 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 ner ut ed t: _
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
APPLICANT CERTIFICATION �_2i_STRUCTION LENDING AGENCY
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.)
r�building construction,and hereby authorize representatives of this city to enter Lender's Name
i the above mentioned property for inspection purposes.(We)agree to save
.__..emnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting 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 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36227047 . 00
DATE ISSUED. . . . . . . : 07/20/2010
RECEIPT #. . . . . . . . . : BS000010912
REFERENCE ID # . . . : 10070139
SITE ADDRESS . . . . . : 1035 WEST HILL CT
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER SHUBHA RAGHURAM
ADDRESS . . . . . . . . . . : 1035 W HILL CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : MICHAEL D LUNNEBORG
CONTRACTOR . . . . . . . : MICHAEL LUNNEBORG LIC # 25896
COMPANY . . . . . . . . . . : WESTERN ROOFING SYSTEMS
ADDRESS . . . . . . . . . . : 1328 WHITE OAKS RD
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (831) 278-1837
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 19, 500 . 00 1. 00 0 . 00 1. 00 0 . 00
1REROOFRES SQ FEET 32 . 00 416 . 00 0. 00 416 . 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 417 . 00 0 . 00 417 . 00 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
FEE ESTIMATOR-- BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: "VALUATION: j$19,500
°PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY TOTAL APPLICATION 1 R3SFDADD/REM
USE: SFD or Duplex ROOF AREA: EE2S f TYPE:
x
a a.
OO
3 �
FEE ID
1RERCOFFRES
77
NOTE: Theseees are based on the preliminaryinformation available and are onl an estimate. Contact the Dept or addn'1 in o.
FEE ITEMS (Fee Resolution 09-051 EI/. ELL09) FEE QTY/FEE MISC ITEMS
Permit Fee: $4113.00
Work Without Permit? Q Yes 0 No $).00
Strong Motion Fee: 1BSEISMICR $ Select an Administrative Item
131dc-, Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $413.95 $0.00 TOTAL FEE: $418.95
Revised: 6/30/2010
CITY OF
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APPLICATION
APN# --7 Date:
I �; (P 9, A`7 J` -zo ( -D
Building Address: .
oz S-
Owner's Name: S �10�,A- � � 1 Phone #: o�
HOA: Yes ❑ No If yes, provide letter from HOA
Contractor: S yrkMj. Phone #:,�
Fax#: mos si� i7s S
Cupertino Business License #: Contractor License #:
&-4qq r-
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)
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: J, s��, s7� uN tA��,�,. l b�v4e,
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed:voith_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 Cupertino's Tear-Off Policy:
S'gna a --
Revised 02/05/09
M.Indoor Air Quaft and Finishes
1.Use LOr1Na-VOC Paint 1 IAQA-i"th pts y=yes p
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes p
3.Use Lowft VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts yeses 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes p
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y--yes 0
.� aU PAi&Jeboardor.MDF 4IAQ/Health pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 lAQ/Health pts y--yes0
N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y--yes 0
2.Use Rapidly Renewable Flooring Materials 4 Resource pts y--yes D
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
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
Total Points Available: 1 1401 130 57
Total Points Project Received: 0 51 7Q1
G:datalpmgs/greuuildingguidelines/remodelerslgreenpointsfinal rot d.xis
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPAR'-MENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O.,BUI-DING OFFICIAL
10300 TORRE AVENUE•CUPERTINO CA 95014-3255
CUPERTINO
(408)777-3228•FAX(408)777-3333•Wilding
(cDcupertino.org
PROJECT ADDRESS /W 5- 1_1 1
/"I C_t__ APN#
OWNER NAME PHOT 7 ZSR ` E-MAIL
STREET ADDRESS r G` CITY, ST. TE1ZIP FAX
CONTRACTOR NAME 4v 7 LICENSE NUMBE R LICEN E YPE BUS.LIC.#
MlChAf/C-y �9_;Z.2-k
COMPANY NAME E-MAIL/ 71e R - a- �J ,� .f ob'
G./llTC�i/ .chJr FA
STREET ADDRESS 0,4 ?-.Ll— CITY,ST/TE,ZI /I Q P J Y PHONEur 3G
I UNDERSTAND AND A13REE TO T(H\E 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)7 77-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please ca.l 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 availabl: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 inspe.-tion is required.
5. In-Progress roof inspection is required. Call far 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 dow i to the sheathing so a proper inspection can be
performed.
7. A final inspection and approval shall be obtainec 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 f)ot of slope and must demonstrate there is no ponding.
b. Listings from approved testing agencies for ill pre-manufactured products used shall be available
on-site to review at the time of the inspectio i.
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 r.--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 unde and a agre( to comply with the re-roof policy stated above.
Signature of Applicant/Agent: I< Date: ��'
ReroofPolicy_2010.doc revised 05/17/10