Loading...
16010020CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1211 STAFFORD DR CONTRACTOR: MARCO ROOFING PERMIT NO: 16010020 OWNER'S NAME: KARUPPAN PALANIAPPAN AND PALANIAPPA P 0 BOX 1691 DATE ISSUED: 01/05/2016 OWNER'S PHONE: 4084649110 FREMONT, CA 94538 PHONE NO: (510)656-6400 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL ❑ TEAR OFF (E) COMP; INSTALL (N) COMP, FELT PAPER, License Class L Lic. 44_t* 40c]� CLASS A ROOFING. r Contractor It< k /bZC0 g.97r, la; Date%1 r I hereby affirm that I am licensed and • he 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 Sq. Ft Floor Area: Valuation: $14210 p rfo ance of the work for which this permit is issued. will maintain Worker's Compensation Insurance, as provided for by riand 3700 of the Labor Code, for the performance of the work for which this APN Number: 36211031.00 Occupancy Type: 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 DAYS FROM 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 g Date: Issued by: l 1 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. RE -ROOFS: Signature Date J ' 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 DER DECLARATION Signature of Applicant Date: I hereby affirm that I am exempt from the Contractor's License Law for one of _ the following two reasons: ALL ROOF COVER T 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 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 the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: 40 Date: permit is issued. I certify that in the performance of the work for which this permit is issued, I shall ZINGGENCY 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 CONSTRUCTIO 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. S ignature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255: CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • build ingQcupertino.orq 1150100)10 PROJECT ADDRESS V e7 APN # 56Q t1-05/ 05 ` OWNER NAME / N 1 4f?2fi PtIQNF 0-7 I I O E-MAIL STREET ADDRESS I, o�,TA �j .� CIT rr"jA� er)/ T� /-MCA/IL FAX CONTACT NAME & PH �lE d 27 4220 J (-ZE f- 9AOLYG A77, STREET DDRESS E eta9 �'1 et�l CITY, STATE, ZIP �%� �5� FAX /p • % —%C) `f ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR •2'CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �E_P4 i 1 LICENSE NUMBER , %�� p/ / r, LICENSE TYPE BUS. LIC. # COMPANY NAME � f � � E-MAIL FQ; STREET ADDRESS �� ^ CITY, STATE, ZIP PHON ^_%_ -6 — i/`71 vo (7 u ARCHITECT/ENGINEER NAME LICENSENUMBER BUS. LICC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OFT'SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial ROOF AREA: VALU TION: / r� EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT S14INGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE/REPLACEYES ❑ NO IF NO, # LAYERS: PLYWOOD THICKNESS: ❑ %" ❑ ❑ 5/8" PLYWD ❑ OSB TYPE: ❑ CDX PITCH: ' 12 ROOF CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF XASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK: /(•Z. art- i / i -� r ► w1 By my 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 to building construction. I ntatives of Cupertino to enter the a "ed -proper for ins ection purposes. Signature of Applicant/Agent: Date: SUPPkjMr5TAL INFORMATION' D _ If building is associated with a Home Her`S-ASSOc1at1017, provide letter 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. OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ EXPRESS ❑ STANDARD ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ FIRE DEPT ❑ OTHER: ReroofApp_20/ /. clot revised 03116111 167 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION im,ADDRESS: 1211 Stafford Dr FEE DATE: 01/05/2016 REVIEWED BY: Phuong APN: 362 11 031 1 BP#: EVALUATION: 1$14,210 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: Permit Fee: $493.00 PENTAMATION PERMIT TYPE: 1SFDWLR00F WORK Tear off (e) comp; Install (n) comp, felt paper, Class A roofing. SCOPE Amlech. I'llon 1 1 Phpwb. Al,r,-,iii T'00: P�Hnib. fiee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works., Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate Contact tneueptjor aaan-t into. FEE ITEMS (Fec Resolution .1.1-053.Lf 7,7113) FEE QTY/FEE MISC ITEMS Plan 1"e"': Permit Fee: $493.00 Ln q.13 T': Work Without Permit? 0 Yes (j) No $0.00 TFa-Vel Strong Motion Fee: IBSEISMICR $1.85 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $495.85 TOTAL FEE ......... $495.85] Revised: 10/01/2015 REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingQcupertino.orp e � o E- - PROJECT ADDRESS^ i % B ( TA APN # OWNER NAME ';y/ 0 I�q ,-j -` PHQNG A -q ® cSTATE, E-MAIL STREET ADDRESS,` j ( r rf Z CITY, ZZIPFAX e_CJ_2—T(,Jo c14 ? ,�0o CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC. # �� COMPANY NAME glen wZPo , / �C r N W116 E-MAIL F5 /0 1 30? STREET ADODRESS 15 ©x Ct C Y, STATE � J/( �� O , ,53,9to PHONE. C JS6 I UNDERSTAND AND AGREE TO THE 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)777-3228 between 7:30-3:30 (Mon -Fri). 3. Tear -off roof inspection is required. Please call 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 available 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 nailinIZ inspection is required. 5. In-Proeress roof inspection is required. Call for 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 down to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained 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 foot of slope and must 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. 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 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 a comply with the re -roof policy stated above. Signature of Applicant/Agent: RerooJPolicy_2010.doc revised 05/17110