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12030055I CrrY Or CUPERTINO BUILDING PER,iMIT I RDaDnG Auultr-SS: 10417 ANSONt AVE OwNElt'S NAaD;: ANIU13AN K CIIANCNAL SAIIA1 CoSrR,\Cfolt: RP—"''Q filaI mrIcNIl'f No: 12030055 i t'T_T 'MII _'rED DATE ISSu171):03/12/2012 owNrat'S PuoNE: 4082688512 I'11O,CE NO: ❑ LICENSP:D CO.N'I'It:\CI'Olt'S DICCL,\IL\'PION License Class 6_311 I.ic. B 929 Aff!y Y Contractor A RmC Ma.gecy scnc 3-(2-ZO/7 I hereby itflorin I[,:II I :un licensed under the prorisiuns of Chapter 9 (cum nnencing with Section 7000) of Division 3 ill* the Itusiness & Professions Code:md that my license is in till] leave and effect. I herrby al'linn under penalty of perjury otic of the lullowing nvu declarations I have and will maintain a certificate of consent to self -insure Ibr Worker's Compensation, as provided Ibr by Section 3700 of the Labor Code, for the perform, ice 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 fir which this permit is issued. A ITIACANI' CERTI FICATIO.N I certify that I have read this application and state thin the above inf'onnztiot is correct. I agrcc 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. (slVe) agrcc to save indenmify 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 with all non -paint source regulations per the Cupertino Municipal Code. Section 9.18. Signature_ //ate` IJ:uc 3-/2"2a/Z ❑ O\\:CIi14Ml LDIiR DECL,\It:\1'IoN I hereby affirm Thal I :tat c\crnpl from the Contractor's License L:nv for one of the following Iwo reasons: L as owns of the property, or in) employees with wages as their sole compensation, will do the work, and Life structure is not intended or oll'eed for sale (S:c.7044, Business & professions. Code) L as owner of the property, lin exclusively contracting with licensed contractors 10 construct the project (Sec.7044, lousiness & Professions Code). here[))affirm under penalty of perjury uric of lire falluo'ing three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided Ibr by Section 3700 of the Labor Code, fur file performance of the work for which this pcnnit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, lir the performance III the srork for which this pcnnit is issued. I certify that in the performance of the work, for \yhich this permit is issued. I shall not employ any person in any manner so as Io become subject to the Worker's Compensation Lases ofCalil2unia, u; -alter making this certificate of esemplion. I become subject to the Worker's Compensation provisions of the Labor Code. I must Imiliovith comply with such provisions or this permit shall be deemed revoked. ,U'1'LICAN"1' CERTIFICA'f ION I certify that I have read (his application and stat: thin the above inlr oration is correct. I agree to comply with all city and county ordinances ad state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property Ibr inspection purposes. (We) agree to save indemnity 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date r r r BUILDING PERMIT INFO: ut.DC ELECT PLUMB r r r 31 Ecu RESIDENTIAL COMMERCIAL 3011 DESCRIPHON: Rli-ROOF 10 SQ- REMOVE EXISTING WOOD SIIINGI.ES•INSTALL CONI' IN IM PORTION OP SFDWL Sq. FI Flour Arca: I Valuation: $3250 APS Smaller: 32641001.00 1 occupaflcy TN pv: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF 13ERNIH ISSUANCE OR 180 DAYS FROi\1 LAST CALLED INSPECTION. Issued by Date ItE ROOFS: All fours shrill be inspected prior to ally roofing material being installed. If a roof is installed without lint ubtainit :m inspection. I.agrce to remove :dl new materials Ibr inspection. 7 Signature of Applicant:_ _1111//_1 Date: 3 -/ L - ZOl - A 1,1. HOOP CON, lilt(SGS'I'O hr CLASS "A" Olt It ICI"That I IAZA LDOOS ,NIA'I' RIA :S DISCLOSURE. I hns'c rend the tolZarduus materials requirements under Chapter 6.95 ofthe Califurnin Ileal(h & Safely Code. Sections 25505. 25533. and 25534. 1 will maimnin comfit i;uree with the Cupertino Municipal Code. Chapter 9.12 and the I Iculth & S:fets' Cody. Section 25532(:) should I .dors ur handle hazardous material. Additionally, should I use equipment or devices which calif hazardous air nmtnntinants as defined by the Bay Arca Air Quality ?Innage mem District I will maintain compliance frith the Cupertino Niullicipal Code. Chapter 9.12 and the Health & Sall•IY Code, Sections?5505.25533, and' -5534. (honer or au l horized loge til: D:ne:_3=f?-.; CONSTIMCl'ION LESDISG AGENCI' I hereby al7inn that there is a construction leading agency for the pertinmance of work's Lir which this permit is issued (Sec. 3097. Civ C.) Lender's Same Lender's ARClll'I'ECI" S DI,CI.ARA'I'1OS I understand my plans shall be used ars public records. Licensed 4 ITEMS OF 4 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 32641001.00 DATE ISSUED.......: 03/12/2012 RECEIPT 4.........: BS000016248 REFERENCE ID 4 ...: 12030055 SITE ADDRESS .....: 10417 ANSON AVE SUBDIVISION ......: CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: ANUPAN & CHANCHAL SAHAI ADDRESS ..........: 10417 ANSON AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: SylviaM COPY 4 : 1 RECEIVED FROM ....: A-1 ROOF MANAGEMENT CONTRACTOR .......: TBD - TO BE DETERMINED LIC "1 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS ..........: CITY/STATE/ZIP .... , TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL 1BCBSC VALUATION ---- 3,250.00 ---------- 1.00 ---------- 0.00 --- - 1.00 0.00 1BSEISMICR VALUATION 3,250.00 0.50 0.00 0.50 0.00 1BUSLIC FLAT RATE 1.00 119.00 0.00 119.00 0.00 1REROOFRES SQ FEET 10.00 140.00 0.00 140.00 0.00 TOTAL PERMIT ---------- 260.50 ---------- 0.00 ---------- 260.50 ---------- 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT AMOUNT --------------- 260.50 --------------- 260.50 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF 604 ROOF IN -PROGRESS 3 REFERENCE NUMBER -------------------- 12980 VOICE ID DESCRIPTION -------- ---------------------------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 605 FINAL REROOF CUPERTINO 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 (408) 777-3228 • FAX (408) 777-3333 • buildino(dcupertino.org PROTECT ORESS APN p % p O WNEAt NAME - PHONE E-MAIL N Gl \ STREET ADDRESS CITY. STATE. ZIP FAX 4 G CONTRACfORNAME LICENSE NUMB R LICENSE TYPE BUS. LIC.# G E rEET E-MAIL F S CITY. STATE. ZIP PHONE e o0 I UNDERSTAND AND AGREE TO THE FOLLOWING: The re -roof project shall comply with all applicable provisions of the 2010 California Codes. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day 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. Progress and Final Inspections will be given a two hour window. 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. If plywood is installed, a plywood Nailing Inspection is required. 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. Progress Inspection is required when approximately 50% of roof covering is installed. 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/" 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 on-site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed. 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 S 126.00. The re -inspection fee shall be paid before another inspection can be scheduled. By my signing below, 1 certify each of the following is true: 1 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. 1 also understand that smoke detectors and carbon monoxide de)ectors are required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Codi. ., of Date: ReroofPolicv_201 Ldoc revised 02/16/11 CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingcuoetno.orc I") 0.557' MIECT ADDRESS^ O e -Gu orf -,'4a ca gsoly /l "P"A OWNER NAME PHONE E-MAIL LI 8 8 -SS/ 2 'STREET ADORESs O dG :?' Cr(Y, STATIL ZB' G a1-h'.ro FAX 6 90/W APPL[CAM NAA¢ PHONE E SLAFI:7 ADDRESS CITY STATE, IIP FAX V I sc . Su!c /1 d 6 /0 . ❑ OW:JEA ❑ OWNER -BUR -DEA ❑ 0WI AGENT ❑ CON, CTOR Li20NiRwCTD0. AGENT ❑ ARCIo=, ❑ ENGNEER ❑ DEVELOPER ❑ TENANT CONTRACTOR LICENSE NUMB I LICENSETYPE I BUS. LICA IAME A a«d COMPANY NAME E -MAB. FAX STREET ADDRESS I CIPl, SCAT$ZIP PHONE S/O-';. 7�/`S-Cj2Z ARCHTTECTIENGINEETI NAME LICENSENUMBER I BUS. LICA CO.VPANY NAME E -MAB. FAX STREET ADDRESS CITY, STATE, ZIP PHONE C USE OF FrSf5 or Duplex ❑ Multi -Family ROOF AREA: VALUATION: STRUCIUItE: ❑ Commercial 1Qd0 EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WDOD SHAKES ❑ WOOD SHNM -c ❑ OTHER (SPEC4n REMOVEIREPLACE IF NO. OkA - PLYWOOD PTsr'" ❑ PLYWO OSB P=tR �: ROOF ❑ ALA S' ❑ LS" E' ❑ X 12 A PROPOSED ROOF TYPE: ❑ BMT -UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SH.NGLFS ❑ OTHER I ICC -ES REPORT A DESCIUPTfON OF WORK: Ecr rtj S A, By my siguaue below, I certify m each of the following: I am the property owner or authorind agent m act on the property owner's behalf. I have read this application and the infomration I have provided is correct I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and sate laws relatut m t ing wnsmrrien. I authoriu_represenarlves of Cupertino to enter the above -identified prr em for inspection purposes. Signature of Applicant/Agenu r v� Data:— SUPPLEMENTAL INFORMATION REQUIRED Ifbuilding is associated With a Home Owner's Association, provide letter t'TyAgl - -a..RGutTNe;s _ of approval from HOA. _ W ���ti1IDI.CO•Rbw.l.RfiVIE.W _ Provide Planning approval to verity if there My reStrictions. WIN s'�- - ss_ -" I;R- rt y�-fEw, Provide copy ofMaDufactt>:er's Installarion Specifications. s8'3sT'w�� �Tovide signed copy of Cupertino's Tear -Off Policy. ReroofApp_201 I.doc revised 03/02111