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10020085 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10100 MARY AVE (ONTRACTOR:RUFF'S ENTERPRISES PERMIT NO: 10020085 OWNER'S NAME: AVERY ET AL 3643 EASTRIDGE DR DATE ISSUED:02/16/2010 1ER'S PHONE: 4082535800 SAN JOSE,CA 95148 PHONE NO:(408)528-6227 LICENSED CONTRACTOR'S DECLARATION IWILDING PERMIT INFO: BLDG f— ELECT f— PLUMB 7i License Class Lic.# d_� MECH r— RESIDENTIAL I— COMMERCIAL r p �� o�Icc ) Contractor ' C Date .OB DESCRIPTION:RE-ROOF TEAR OFF EXISTING ROOFING&INSTALL I hereby affirm that I am licensed under the provisions of Chapter 9 LANDMARK TL CLASS A 28SQ (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. I have and will maintain Worker's Compensation Insurance,as provided for by iq,Ft Floor Area: Valuation:$10000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. tPN Number:32627003.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. l Issued by: Date: Signatur Date 1 L, OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 7 I,as owner of the property,or my employees with wages as their sole compensation, r� ho will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date: 1 Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Ow r a hori d nt: Date: become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address i- nify and keep harmless the City of Cupertino against liabilities,judgments, i and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. 16 /moi I Licensed Professional Signature Date (v CITY OF CUPERTINO / 3 ITEMS OF 3 PERMIT' RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: B1}:: Lot: APN 32627003 . 00 DATE ISSUED. . . . . . . : 02,16/2010 RECEIPT # . . . . . . . . . BSi)00009754 REFERENCE ID # 10020085 SITE ADDRESS 1OL00 MARY AVE SUBDIVISION . . . . . . . CITY CU?ERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . . AV3RY ET AL ADDRESS . . . . . . . . . . : 10100 MARY AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM ROL�TNING ROFING CONS CONTRACTOR RAFAEL G. NINFFERT LIC # 25172 COMPANY RUFF' S ENTERPRISES ADDRESS 3643 EASTRIDGE DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95148 TELEPHONE (408) 528-6227 r FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- -------- 1BCBSC VALUATION 10, 000 . 00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 10, 000 . 00 1 . 00 0 .00 1 . 00 0 . 00 1REROOFRES SQ FEET 28 .00 364 . 00 0 . 00 364 . 00 0 . 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 366 . 00 0 .00 366 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------- CHECK 366 . 00 #10486 --------------- TOTAL RECEIPT 366 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION - -------- ---------------------------- ------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF L CITY OF C UPERTINO Orr REROOF CIT`°F PERMIT APPLICATION CUPEiT1NO PPN Date: u2s—� ss: L Phone #: : /Jti��L❑ No ❑ Ies rovide lettE�r from HOA Phone#onrac :! Fax #: Cupertino Business License #: �� Contractor License C Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles t� Asphalt Shingles 2� ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ��L C'v ❑ Other (Specify) Number of existing coverings � ❑ Provide I.C.C.E.S. Report# ❑ Provide Mfgr. Installation Specs. To be Removed----------------- Job Description: Residential Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if ❑ Green Building Checklist & attach it to the a»plication 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: ignature Revised 02/05/09 2- CITY OF CUPERTINO REROOF CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Ccmmercial B 1COMMLROOF 1BCBSC Cal'Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMIC0 Seismic Commercial B 2 1RER00FRES Re-roof Residential B 1SFDWLR00F 1 B CB S C Cal Bldg Standards B ALL PERMIT TYPES Commission Fee I 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg S.andards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the city of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the Cit-,,the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed,a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another insyection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/ "per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O.report is required to be o:-1 the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: Job Site Address: Roofing Company Name: Applicant'sSignature:ature: fid "`-- Date: S Greg Casteel Building Official Rei ised 07/30/08