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13040178 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 878 FERNGROVE DR CONTRACTOR:ABRIL ROOFING,INC PERMIT NO:13040178 OWNER'S NAME: ARUN KANNAN 3490 PACHECO BLVD DATE ISSUED:04/24/2013 OWNER'S PHONE: 6503050712 MARTINEZ,CA 94553 PHONE NO:(925)228-0160 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:.RESIDENTIAL 11S COMMERCIAL License Class &3)01 Lic.# tH RE-ROOF 21 SQ-OVERLAY OVER TAR AND GRAVEL... Contractor 44— Aprel /G Date _Z�" /3 . CLASS A 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:$10500 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 37538035.00 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 WIT 8 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 D OM LAST CALLED INSPE TI N. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Dater / with all non-point so a regulations per.the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date 1�' All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaAanntion,I agree to remove all new materials for inspection. OWNER-BUILDER DECLARATION Signature of Applicant: Date:I hereby affirm that I am exempt from the Contractor's License Law for one ofthe following two reasons: ALL ROOF CO 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 to 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 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: permit is issued. 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 must 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,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. Signature Date RfROOF PERMIT APPLICATION F91, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 b (408)777-3228 FAX(408)777-3333•buildingCaDcupertino.org �' ) CUlpiERTiNO'. PROJECTADDRESS 9 j c APN#2 / � 2 M0717- O 2S OWNERNAE / I�./.f/�T/�/ v� P �) 6s� 071 - EMAIL FAX STREET ADDRESS = CITY,STATE,ZIP1/v / f„ /b AePA1jJjk CONTACT NAME E-MAIL STREET ADDRESS"© P'ji////A a L/�ir 0 D/-vz-- CTTY, T Fy )PA p&-Z r, C -49"-;S-3 FAX El OWNER ❑ OwNER-Bu LDEER ❑ owNER AGENT 19CONTRACTOR 11CO/NTRAACTTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME P41- /� LICENSE NUMBER W1 �f j p j LICENSE TYPE /I 3 q BUS.LIC.�ka # COMPANY NAME A 2 II ....1`/N_ //' /�) E-MAIL O FAX STREET'ADDRESS /T l�d D :/ C•CJj�rNa�.� Iv CITY,STATE,ZIP dpi?d p�A Zc-, / PHO��.�.` �7_Q�,� ARCHITECT/ENGINEERNAME LICENSENUMBER 'V CT`/`', BUS.LIC.# J s'v COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF . : 1 b-SFD or Duple: ❑ Multi-Family . ROOF AREA: I VALUATION: l D STRUCTURE: . 0 Commercial /�► / EXISTING ROOF TYPE: ❑BUILT-UP ROOF '❑ASPHALT SHINGLES 13WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY) REMOVE/REPLACE OYES IFNO, , PLYWOOD 0% ❑ PLYWD ❑OSB PITCH: ROOF NO #LA THICKNESS: ❑5/8" TYPE: 13 CDX 12 CLASS: L1 ICC-ES REPORT# PROPOSED ROOF TYPE: ❑BUILT-UP ROOF' ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES MOTHER/�'`"- 1 DESCRIPTION OF WORK �r� / �,w By my signature below,I certify to each of the following: I am the properly owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct-4 have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building constru uthorize representatives of Cupertino to enter the above-identified property for inspection purposes... Signature of Applicant/Agent: Date: SUPPLEMENTAL INFO I N REQUIRED -- If building is associated with a Home Owner's Association,provide letter. ° tip i of approval from HOA. Provide Planning approval to verify if there any restrictions. ' Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ° �h ReroofApp_2011.doc revised 03116/11 CITY OF CUPERTINO FEE ESTIMATOR=BUILDING DIVISION ADDRESS: 878 Ferngrove dr DATE: 04/24/2013 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$10,500 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROO USE: PERMIT TYPE: WORK re-roof 21 sq-overlay over tar and ravel... class a SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 2,100 FFIN A IN gd ma Meeh. Plan Check Phimb,Plan Cheek Elec.Plan Check kfech.Permit Fee: Plumb.Permit Fee: Ellec. Permit Fes: Ocher;Meeh.Insp.` Other Plumb InsP. ET (1her Elec.Insla. Li Meeh.Insp..Fee: Plumb. hisli.Tee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are-based on the relimina information available and are onlyan estimate Contact the Dept or addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/12, FEE QTY/FEE MISC ITEMS Plan Check fee: Suppl. PC Fee Plum b.Alfecti/Elec Permit Fee: $315.00 SuI)pl. InSf)Fee Plum h./Mech.,'Elec Plumb.lMech.iElec Permit I*'rye: (:onslrzuclion :Tar: Administrative Fee: Work Without Permit? ®Yes iq No $0.00 Advanced Planning Fees: Travel Documentation Fees: Strong Motion Fee: IBSEISMICR $1.05 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 _r. $317.05 $0.00y �0A +e $317.05 Revised: 04/01/2013 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 CUPERTIINO (408)777-3228•FAX(408)777-3333•buildingCa)cupertino.org ROJEcr ADDRESS b � ' N# • Vy1 /I� E-MAIL EONAE AdWaV �rP %A�WCITY,STATE,ZIP FAX SRFSS t ��•e-rbc CONTRACTOR NAME LICENSE NUMBER LICENSE TyPEa BUS.LIC.# �r✓b,Qk .� �:J COMPANY NAME E-MAIL FAX ��— 9?J�—l�l► IJG - STREET ADDRESS `VD •' CrTY,ST TE MEy A t_ . 1UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. Please call (408) 777-3228 from 7:30-3:30pm(Mon-Thurs) or 7:30-2:30pm(Friday)to schedule inspection. For Tear-Off and Nailing Inspections,you must also call on the day of the inspection only. after that phase of the work is completed. The building inspector will be available within one hour. Final Inspections will be given a two hour window. 3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either completely knocked-down or removed prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required. 5. Roofing.shall not be applied without first obtaining all prior inspection 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. 6. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 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 demonstrate there is no ponding. b. Listings from approved testing agencies for all pre-manufactured products used shall be available oti-site to review at the time of the inspection. c. Proper spark arrestor installation,vents painted, gutter/downspouts installed, debris removed. 7. 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. 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 understantand ee to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxidrs are required to be installed in accordance with Sectiod R315 of the 2010 California Residential Code Signature of Applicant/Agen ReroofPo1icy_2012.d6c revised 1017/12