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12100201 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10564 WHITE FIR CT CO\FRAC`VOR:FOUR SEASONS ROOFING PERMITNO: 12100201 OWNER'S NAME: MISHRA VIDYESIi AND PRATIMA PO BOX 1668 DATE ISSUED: 10292012 OWNER'S PRONE: 4087211412 SAN.IOSE.CA 95109 PHONE NO:(408)278-0330 Cl LICENSED CON-rRACfOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT I-. PLUMB ❑ License Classr_36> Lic.H / GC3 l MECrI r RESIDENTIAL r1 COMMERCIAL r Contractor Date � � 1 hereby affirm that 1 em licensed under the provisions of Chapter 9 JOB DESCRIPTION:BLDG 17-TEAR OFF EXISTING WOOD SHAKE (commencing with Section 7000)of Division 3 of the Business S Professions ROOF.INSTALL Code and that my license is in full force and effect. I2"CDX PLYWOOD THEN 30A FELT UNDGRLAYMENT.INSTALL 13 SQrT CERTAINTEED 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 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. - Sq.Ft Floor Area: Valuation:$4500 APPLICAN1'CERTIEICATION I cerify that I have read this application and state that the above information is APN Number:35905114,00 Occupancy Type: correct.1 agree to comply with all city and county ordinances and state Imus 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 indemnify and keep harmless the City of Cupertino against liabilities.judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands mndwvill conmply WITHIN ISO DAYS OF PERMIT ISSUANCE OR wvithallnon-point urce regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. Bignami DaQw� Issued by; J��/V� ��l/�I Date:/,0 -�•/C�Z ❑ OWNER-BUILDER DECLARATION hereby affirm that I am exempt from the.Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a(`oof is I,as owner o(the property,or my employees with wagesas their sale compensation, installed wilho btainir an inspecli m,I r to remove all new a1r<rialsIII will do the Work,and the structure is not intended or offered for sale(Sec.7044, inspection. `([1- y Business R Professions Code) 4 / I,as owner of the property,am exclusively contracting with licensed contractors to Signature f A �e Date: construct the project(Sec.7044,Business&Professions Code), hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's IIA%ARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for Which this permit is issued. 1 hoe read the hazardous materials requirements under Chapter 6.9.5 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health S Safety Code,Sections 25505,25533,and 25534. 1 will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health S Safety Code,Section_553_(a)should 1 store ur handle hazardous material. permit is issued. I Additionalh',should I use equipment or devices which emit hazardous air I certify that in the performance of One work forwhich this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ my person in my manner so as to become subject to the Worker's manum compliance with the Cupert'no Municipal Code,Chapter 9.12 and the Compensation laws of California. If,atter making this certificate of exemption,I 11 'It Snfery•C de.$e s_5 833,an 5534�jj' 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. Ow r or aot 'zed a e t: �✓ le: APPLICANT CERTIFICATION CONSTRUCTION[,ENDING AGENC\' I cenify 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 I hereby affirm thin there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Leader's Name indemnify and keep harmless the City of Cupertino against Iiabilitics,judgments, casts,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ,\RCIII'1'I'CI"S DECLARATION9.18. I understmmd my plans shall be used as public records. Signature Date Licensed Professional REROOF PERMIT APPLICATION EM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333 • buildinofa>cupertino.oro I I PRUIECr: ✓� 4. :APNe iR AME PHONE E-MAIL 9��rL G 6 - i STREET' pR - CIT ' STATE.LIP FAX (f e r CONTACT NAME PHONE -0 '30 E-MAIL I-Crej 0 2.are STREE'I'ADDRESSC'67- ^ a5 CITY.STATE, FAX WaCAJA ❑Ow NFR ❑ OWNER-RUILDER ❑ 0k NF.RAGENT A(CONTRACTOR' ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINF.F.R ❑ MFVELOPER' ❑ TENANT CONTRACTOR NAME LICENSENCNIBER LICENSE PE BUS.LIC. pc�r SotgS, 2 0 — COMPANY NAME I E-MAIL FAX STREET ADDRESS CIT\'.STATE ZIP PHONE SoZ A os¢ C 8-0 ARCHI'rECRENGINFERNAME LICENSE NUMBER BUS.LIC.a COMPANYN,\ME I E-MAIL FAX STREET ADDRESS I CITV.STATE ZIP PHONE USE OF ❑ SFD or Duplex MI Multi-Family ROOF AREA: VALUATION: y� —919 STRUCTURE: ❑ Commercial S `R 5-0 EXISTING ROOF TYPE: ❑BUILT-UPROOF ❑ASPHALTSHINGLES ��XIWOODSHAAFS ❑µ'00D SHINGLES ElOl'l1ER(SPECIFY) REMOVE REPLACE YF.S IFNO. -PLYWOOD /l"F' ❑ PLYWD ❑OSB PITCH ROOF ❑ NO a VF.R THICKNESY ❑ L8" T)PF CD3 12 CLAS.' A PROPOSED ROOF TYPE: ❑BUILT-UPROOF 4SPHALT SHINGLES ❑W'OODS11.4KES ❑IbOODSHINGLES C3 OTHER ICC-ES REPORT. DESCRIPTION OF WORK: ood s4,oltela __Sns ! RC1! I w_o ad ll s e 3 d_eA-o f►s_e+._F_It.eall3j_�_%es X11 eerjcy�m106A Qresidea+igl Como s6inwles `Coler : Ccaunl By mw signature below.1 cenify to each of the following: I am the property owner or authonmd agent to act on the property owner's behalf. I have read this application and the information I have provided is correct 1 have read the Description of Work and verily it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons tma. 1 q0tonze rep"ese tiv of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicam/.AgenC Date: O SUPPLEMENTAL INFORMATION REQUIRED OFFICE USF.ON'LY _ If building is associated with a Home Owner's Association.provide letter PUN CHECK TYPE ROUTING SLIP of approval from HOA: ❑ OYER-THE-COUNTER ❑ BUILDINGPLANREVIEW Provide Planning approval to verify if there any restrictions. ❑ 'EXPRESS ❑ PLAN\INC PLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE'.OEP'r Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER: ' XeroafApp 2011.doc revised 03116111 REROOF TEAR-OFF POLICY 0 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-buildim(akupertino.orci PROJECT. DfrS / APun PHO E& I _2E-MAIL STREETAD KESS 9JS0 I FAX C, T CONTRA \AME LICENS 'UMBER /O LICF71$.EN BUS. COM 'NAME E-MAIL FAX STREX.S .S ZIP o I TyNDFRSTAND AND AGREE TO THE FOLLOWING: V 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 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. 3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection. Unles's 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. Progress Inspection is required when approximately 50% of roof covering is installed. 7. 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. 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. 1 understand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detect s quired to be installed in accordance with Sections R314 and R315 of the 2010 California Reside ' de. Signature of ApplicanUAgent Date: RerooJPolicv_201 Lrloc revised 02/16/11 CITY OF CUPERTINO . FEE ESTIMATOR - BUILDING DIVISION ADDRESS:/Q /WHITE FIR DATE: REVIEWED BY: S APN: BP4: 'VALUATION: 1$4,500 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F USE: PERMIT TYPE: woRK TEAR OFF EXISTING WOOD SHAKE ROOF.INSTALL 112" CDX PLYWOOD THEN 30# FELT SCOPE OAR 13 SQ CERTAINTEED PRESIDENTIAL COMP SHINGLES.COLOR: p FEEID ROOFAREA (s.f. 1REROOFFRES 1,300 Afth. Plan Cheek Plumb. Plan Chexk Eler,Plan Check Afecn. Permit Fee: Plumb.Pero,a Fee: Elec.Pernat Fre., Other Afeeh.-Insp. 01her Plumb 1, 01her Ele<..hnp. Af•ch..lava Fee: Plumb. ba,,p.Fee: rice.Ing. Fee: NOTE: This estinmte does not include fees due to otter Departments(i.e. Planting, Public H'orks, Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prelininanv in orniation a,nilnble and are otdv an estimate. Contact the Dept or addn'l into, FEE ITEMS (Fee Resolution 11-053 Eff7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee.: SuppL PC Fee Planb.IAlech.:Elee Permit Fee: $195.00 Suppl, htsp Fee Plumb.:iMlech.iElec Plumb.GWwh./Elec Permit Fee: Cnnstruc•ticnn Tax: Administrative Fee: Work Without Permit? O Yes Q No $0.00 Advanced Planing Feew: Travel Documentation Fees: A Strong Motion Fee: IBSElSMBCR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $196.50 $0.00 TOTAL FEE: $196.50 Revised: 10/01/2012