13070150 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1436 S STELLING RD CONTRACTOR:RUFF'S ENTERPRISES PERMIT NO: 13070150
OWNER'S NAME: JAYASEKAR RAJAGOPALAN 3643 EASTRIDGE DR DATE ISSUED:07/24/2013
OWNER'S PHONE: 4082035248 SAN JOSE,CA 95148 PHONE NO:(408)528-6227
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE]
License Class _ Lic.# 7 a S RE-ROOF 30 SQ-REMOVE SHAKE/SHINGLE WOOD 30LB
p- Z 3 t 3 FELT;CLASS A
Contractor `< -�"'��_Date
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:$13000
1 have and will maintain Worker's Compensation Insurance,as provided for by
e tion 3700 of the Labor Code,for the performance of the work for which this APN Number:36617093.00 Occupancy Type:
it 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 DAY OM LAST CALLED INSPECTION.
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: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
4' -1 ^�3�t3 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.
❑ OWNER-BUILDER DECLARATION , 9, / Date: 3
� / '^7
I hereby affirm that I am exempt from the Contractor's License Law for one of `
Signature of Applicant:
the following two reasons: ALL ROC OVE GS TO BE CLASS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compensation, O/
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
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25553333,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Z/v / Y Date ?- -.P,3
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
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION �\
10300 TOR RE AVENUE•CUPERTINO, CA 95014-3255 O�
(408)777-3228•FAX(408)777-3333•building(5cuaertino.org 1�
CUP�RTINO:
PROJECT ADDRESS t l APN#
OWNERNAME �'I `l ' P �ryHONE 10 CLGFIJI
'IrCITY,S TE Z ^ FAX
STREET ADDRESS r tµ0 T V l
CONTACT NAME Vk
PHONE E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
OWNER ❑ OWNER-BURDER ❑ OwNERAGENT VCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME . a L LICENSE NUMBER LICENSE TYPE q BUS.LIC.#
COMPANY NAME t l '1S-� �t FAX wt L ,36r �
STREET CA ADD SS CrCY STA ZIP pSe A /j/� PH
ARCHITECTBNGINEERNAME LICENSENUMBER > 1' BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS. CITY,STATE,ZIP PHONE
USE OF SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
tom,
STRUCTURE: ❑ Commercial
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES I<OOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE`❑YES IF NO, PLYWOOD '/:" ❑ PLYWD ❑OSB PITCH: ROOF
❑NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX 12 CLASS:
^x ICC-ES REPORT# .
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF L N11HALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER
DESCRIPTION OF WORK: . M V4 „ u CQ S W O
Lk b t GC7 l t-c t
Byrny signature below,I certify to each of the following: I am the property 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. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating t it 'ng construe ion. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: /ZWDate: r
SUPPLEMEXTAL INFO TION REQUIRED 'SOT�WINNOW
_ = _
If building is associated with a Home Owner's Association,provide letter =_-WIN,
w of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturer's Installation Specifications. .
Provide signed copy of Cupertinos Tear-Off Policy. Taa:
ReroofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 1436 S STELLING RD DATE: 07/24/2013 REVIEWED BY: Mendez
APN: BP#: `'VALUATION: 1$13,000
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROO
USE: PERMIT TYPE:
WORK RE-ROOF 30 SQ- REMOVE SHAKE/SHINGLE WOOD 30LB FELT; CLASS A
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 3,000
MW
,L1ech.Plan(,'heck Plumb.Plan Check Elec.Plan{:;heck
Xfech..Pennit Fee: Plumb.Permit Fee: Elec. Permit Fee:
Other,kfech.Insp. Other-Plumb Insp. Other flee.Insp.
Alech.Insp.Pee: Plumb. hasp.Fee: 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 prelimina information available and are only an estimate. Contact the De t or addn7 info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS
Ilan Check Pee:
Supp/. PC:'Pee
Plumh./1fech./ lec
Permit Fee: $480.00
Su/p1, hasp ree
PIumb./1fech./Elec
Plumb.iMech.%f lee Pea nyit Fee:
Consovetivn Ta v:
Administrative.Fee:
Work Without Permit? 0 Yes (E) No $0.00
Advancc;d Planning Fees:
Travel Documentation Fees: �
Strong Motion Fee: IBSEISMICR $1.30 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
d
� $482.30 $0.00 v ._ $482.30
Revised: 07/01/2013
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
CUPERTINO
(408)777-3228•FAX(408)777-3333•building a.cupertino.org
PROJECT ADDRESS - �. (UL APN#
OWNER NAME j G p
dr1 O (�` PHONE,ro O �3 a IE d E-MAIL
STREET ADDRESS s _,�,� CITY,STATE,Z� , ^,�, FAX
CONTRACTOR NAM LICENS �B_ER LICENSE TYKE BUS.LIC.#
qf
COMPANY NAME � ,17 3 10 , to(0.
LL e f LtG t ll lY
STREET ADDRESS C6,STAT PHONE
4 k S CA �S f((� -- 52T z 2
I UNDERSTAND 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 I/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 on-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 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke.detectors and carbon monoxide detectors are required to be installed in accordance with Sections 8314 and 8315 of
'the 2010 California Residential Cod .
Signature of Applicant/Agent:,..x.,. .,, Date:
ReroofPolicy_2012.doc revised 10/7/12