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11070098 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11639 BIRCH SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11070098 OWNER'S NAME: BHATNAGAR SUDHIR AND KSHAMA 1703 CATHAY DR DATE ISSUED:07/15/2011 n`}'NER'S PHONE: 4088935534 SAN JOSE,CA 95122 PHONE NO:(408)251-3565 Le w LICENSED CONTRACTOR'S DECLARATION F !, BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class � Lic.# 7 �� MECH RESIDENTIAL COMMERCIAL r Contractor Date S �� I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REROOF,18 SQ,TEAR OFF WOOD SHAKES,INSTALL 30 (commencing with Section 7000)of Division 3 of the Business&Professions LB FELT,INSTALL GAF GRAND CANYON. EXISTING SOLID Code and that my license is in full force and effect. SHEETING TO REMAIN. 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. 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:$9000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:36654080.00 Occupancy Type: 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 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 and will comply WITHIN 180 S OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS LAST CALLED INSPECTION. 9.18. I Signaturp Date Issued by: Date: OWNER-BUILDER DECLARATION I 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 roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) C I,as owner of the property,am exclusively contracting with licensed contractors to Signature of pplic'T Date: construct the project(Sec.7044,Business&Professions Code). I 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 HAZARDOUS 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. I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. 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. Owner or a horize gent: ,7 Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that 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 Lender's Name indemnify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the Lender's Address mg of this permit.Additionally,the applicant understands and will comply a.. �all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional .r f REROOF PERMIT APPLICATION ^ 1 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 �V CUPERTINQ (408)777-3228• FAX(408)777-3333• building(cDcupertino.org PROJECT ADDRESS / _ I t APN# , - OWNER NAME S1 r \ � NE �] 753 E-MAIL STREET ADDRESS ry �l i CITY, STATE,ZIP FAX OA , APPLICANT NAME PHONES J J E-MAIL Q STREET ADDRESS CITY,STATE, ZIP D Se FAX 1:1 OWNER El OWNER-BUILDER ❑ OWNER AGENTS CONTRACTOR 13CONTRACTOR AGENT ❑ ARCHITECT 13GI ENNEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME L' S "' LICENSE ERLICENSE TYPE PE BUS.LIC.# COMPANY NAME C^ E-MAIL FAX STREET ADDRESSj�� CITY,STATE,ZIP ps (/P / PHONFj� f J�� ARCHITECT/ENGINaR NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF FD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial �y� O�. EXISTING ROOF TYPE: 1-1 BUILT-UP ROOF ❑ASPHALT SHINGLES Z WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE IBJ YES IF NO, D PLYWOOD ❑ 'h" ❑ PLYWD 13 OSB PITCH: ROOF ❑NO #LAYERS: THICKNESS: ❑ 5/B" TYPE: ❑ CDX 12 CLASS: A PROPOSED ROOF TYPE: 13BUILT-UPROOF -CJ ASPHALT SHINGLES ❑WOOD SHAKES -1 WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: l-E ), j r--- ` 6' 742,5-&d 6_1!r�: 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 buil 'ng cons ction. I authorize.representatives of Cupertino tc enter the above-identified proper,-for inspection purposes. Signature of Applicant/Ag / Date: SUPPLEMENTAL RMATION REQUIRED 4 anrrcusE _If building is associated with a Home Owner's Association,provide letter ` TSEourINc sL7P of approval from HOA. pR TEE�COiINTER C� BUIL�fING PTZALV RENTER Provide Planning approval to verify if there any restrictions. ( ExYltEsg PLANIIGPLANREVIEw 2 _Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. _ ReroofApp_2011.doc revised 03/02/11 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(D,cupertino.org PROJECT ADDRESS ( I C APN# OWNER NAME (� / PHONE � � E-MAIL STREET ADDRESS 1 '�� CITY, STATE,ZIP r r c7 CONTRACTOR NAME S LICENSE NUMBER C LICENSE TYPE BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS - CITY,STATE,ZIP j y PHONE��/r 20 �7 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 shall be scheduled 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. On the day of the inspection, a building inspector will be available within one hour for either a Tear-Off Inspection or Nailing Inspection if you call again on that day between the hours specified. 3. The following inspections are required: a. 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. b. If plywood is installed, a plywood Nailing Inspection is required. c. Progress Inspection is required when approximately 50% of roof covering is installed. 4. New roof coverings shall not be applied without first obtaining all 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. 5. 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. 6. 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 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 R314 and R315 of the 2010 California Residential Code. -----,_ Signature of Applic nt: Date: ReroojTolicy_2011.doc revised 02/16/11 _PA CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11639 Birch Springs Ct. DATE: 07/15/2011 REVIEWED BY: gs APN: L-j S--7f C9V BP#: 'VALUATION: 1$9,000 'PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex lex PENTAMATION 1 SFDWLROOF USE: PERMIT TYPE: WORK SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 1,$00 Li NOTE. These&0 are based on the preliminary information available and are only an estimate. Contact the Dept-for addn 7 info. FEE ITEMS d;ee Resolution 11-0531 f— 'I-l1) FEE QTY/FEE MISC ITEMS Permit Fee: $252.00 Work Without Permit? 0 Yes E) No $0.00 i Strong Motion Fee: IBSEISMICR $0.90 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $253.90 $0.00 TOTAL FEE: $253.90 Revised: 07/04/2011 Building Department City Of Cupertino LM 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: r r ; PERMIT# C OWNER'S NAME: r- h PHONE#10 ")- 51-- 35j9 SJ GENERAL CONTRACTOR: C{1S l oci N BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: jEt ,TGSeC,N "'S�J"i *Our municipal code requires all busin sses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE I am not using any in - I Signature Date Please check applicable subcontractors and complete the following information: &/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date Owner/ ontractor nature