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12080031 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: 20637GARDENSIDECIR CONTRACI'OR:BRADSHAW ROOFING INC PERMITNO: 12080031 O\VNER'S NAME: RAJESI'I AGRAIVAL 1821 S RASCOM AVE 1'\113 160 DATE ISSUED:08/072012 OWNER'S Pl IONE: 4082469930 CAMPBELL,CA 95008 PIIONF.NO:(408)246-9930 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUNIR r License Class Lic.H 71 3 r r �� f 7 I MECII RESIDENTIAL COMMERCIAL Conuactor Date 1 hereby affirm that I am license(]under the prooisions of Chapter') JOB DESCRIPTION: REMOVE EXISTING ROOF SYSTEM AND INSTALL NEW (cummenci ng NN lh tice ion 7000)of Division 3 of the Business S Professions CLASS Code and than my license is in fall force mid effect. A ASI'HAUl'SHINGLES, 12 SQUARP.S I hereby affirm under penalty of perjury one of(lie follmring boo 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 die Work for which this Sq.F( Floor Area: Valuation:$6000 permit is issued. .U'I'LIG\N'1'Clilt'I'I FIG\'PION APN Number:36232041.00 Occupancy Type: I certify that 1 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,mid hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply >, with all non-paint source egulatians per the Cupertino Municipal Code,Section 180 DAYS FROM LA/ST/CAL.L/ED INSPECTION. 9.18. y i7 �T U / Issued b ��/� �!i Date: a-7-/�. .Signature w Date— / r2 ❑ OWNER-RIIILDER DECLARATION RE ROOFS: hereby affirm that I tan exempt from the Contractor's License Law for one of All roars shall be inspected prior to may roofing material being installed.If a roof is the following two reasons: installed without First obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation. inspection, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO 13E CLASS"A"OR BF:ITER hereby affirm under penally of perjury one of the follmving three 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 1 have read the hazardous materials requirements under Chapter 6.95 or the performance of the work for which this permit is issued. California Health.Y Safety Code.Section 25505,25533,and 25534. 1 Will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code Chapter 9.12 and the health S Section 3700 of the Labor Code,for the performance of the work for which this Safeq.Cade.Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit Inumrdous air perhit is issued. contaminants its defined by the Ray Area Air Quality Management District I%%ill I certily that in the performance of die work lorohich this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and tine not employ any person in any manner so as to become subject to the Worker's health&Safety Codc,Sections 25505,25533.and 25534. Compensation laws of California. If,after making this certilicate of exemption,I become subject to the Worker's Compensation provisions al the Labor Code,I must 0% or it 'gent: fanhwith comply With such provisions or this permit shall be deemed revoked. hale: L APPLICANT CERTIFICATION CONSTRIICI'ION LENDING AGENCY I certify that I have read this application mid state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and corny ordinances mid state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby anthorize representatives of this city to enter Leader's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep hamiless the City of Cupertino against liabilities.judgments, Lender's Address 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 ARCII ITECI"S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 0 FEE ESTIMATOR — BUILDING DIVISION 1"kk DDRESS: o6JJrfG Y � DATE: 08/06/2012 REVIENVEDBY: BethPN: BP#: /"7060031 'VALUATION: $6,000 "PERbI1T TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENFAMATION 1SFDWLR00F USE: PERiIMIT TYPE: WORK remove existing roofs stem and replace with Class A asphalt shingles SCOPE FEE ID ROOFAREA (s.f.) 1REROOFFRES 1,200 Alech. Plan Cheek Plumb.Plan Check Elec. Plan Chrrk hlech. Permrit Fee: Plumb. Permit Fee: Eler. Permit Fee: Othrr Aleck Gasp. Other Plumb lay. Other Etc(-. hap. Ll I Alech. Insp. Fee: Plumb.Insp. Fee: Eler. /asp. Fee: NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public IVorks, Fire,Sanitary Server District,School District, etc.). Thesefees are based on the preliminan•information available and are onh,an estimate. Contact the De t or addit 7 info. FEE ITED1S (Fee Resolution 11-053 F_R 711111) FEE Q"1171,EE MISC 1TEINIS Plan Check Fee: Suppl. PC Fee P1t mb.1A-tech./Flec Permit Fee: $180.00 Suppl. lnsp Fee P1wnb.1A,1ech./F1ee Phoub./jt1ech.1Elec Permit Fee: Construction Tax: Aclminisn arire Fee: Work Without Permit? O Yes 0 No $0.00 AtIvanced Plarming Fees: Travel Documentation h'eec: Strong Motion Fee: IBSEISHICR $0.60 Sclect an Administrative Item Bldg, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $181.60 $0.00 roTAL FEF:: 7 $181.60 Revised: 07/01/2012 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 C O P E RTI N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# G � OWNER'S NAME: PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: 2 kl4 e- \! t CITYMPCODE: S 05e $ *Our municipal code requires all businesses working in the city to have a City of Cupertipabusiness 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. 1 am not using any subcontractors: 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 Owner/Contractor Signature Date I 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(g),cupertino.orq PROJECT ADDRESS f�/ I n` AM 2 ON • NAME /-'nF uu, PHONE ^ E-MAIL STRE �ItESS_ n \ tic CITY.ST .�IP nIFAx C CT(OO�N.A, LICEN5EAluA/BE '�- tICENSETW BUS.LIC.a COMPANYNAME E-MAI lY F STREET DRESS ` , ; CE CITY,STATEnP , 1 5 HONE 'Tr 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 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. 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. 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 5126.00. 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: 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 detectors are required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Code Signature of Applicant/Agent: Date: Reroomolin, 20II.doc revised 02/l611I REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ' 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (40/8))777-3228• FAX(408)777-3333•buildinGCecucertino.ore PROTECT O S AD , i Ide. e .{PN 3`O 4 OWNER NAME 1 PH N _E-0W�(LL STREET.{DDRESC Z. STATE,ZIP O ` I FAY CONTACT NMIE PHONE E-NL\IL STREET ADDRESS CITY.STATE.ZIP FAX ❑OwNER ❑ OIVNER.BLTLDER ❑ GXVNERAGE:n' [ ,-.CrOR ❑coNTRACTDRAGENT ❑ ARciorECr ❑EVGINLER ❑ DEVEoPm ❑TENANT CONTRACT RNAAIE LICE'N5 'AfBER LICENSE TYPE BUS.LIC.4-3054,9 MP COANYNAA� E.4{ Or OC FAX -)(Y)- (Y) STREETADDRESS CIr1'.STATE ZIP PHGNE l� 'T-pc-C CY ARCHITELTIENGINEER NMIE LICENSE NUNMER BUS,LIC.. COAV ANY NA61 E.AIALL FAX STREET ADDRESS CRY,STATE.ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family, ROOF AREA: VALUATION: Q� mturnmE. ❑ Commercial ��// EMSTMOROOFTYPE: ❑BUILT-UPROOF ❑ASPHALTSH53 INGLES WOODSHAKES ❑WOOD SKINGLES ❑OTHER(SPECIFY) REN(OtE,REPLACE 9,46 IF NO. PLYw'OOD t5" ❑ PLYWD ❑OSB PITCH: :12 ROOF PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SH,-YLES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT. DESCRIPTION OF IVORK: � .� - By my sigmture below,I certify to each of the following: I=the property owner or authorized agent to act on the property owners behalf. I have read this application mid die information I have provided is correct. I have read the Description of\VorA and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating m budl4�m/gCot��/y ion. l au oriz presentative.of Cupertino to enter the a—bSove-identif)pd property for inspection purposes. Signature of.Appli=d.Agene 1�/& / v Date: /la7(ra/ anit2 SUPPLEMENTAL MORA ATION REQUIRED OFFICE USE ONLY _If building is associated with a Honie Owners Association,provide letter PLAN CHECK nTE ROUTING SLIP of approval from HOA. ❑ OVER-TRE-COUNTER ❑ BUILDING PLAN RE•VIEW Provide Plannins approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVTEw _Provide copy of Manufacturer's Installation Specifications. ❑ ;rANDW ❑ FIRE DEPT Provide sinned copy of Cupertinoi Tear-Off Policy. ❑ OTHER: Reroofdpp 2011.aocrevise:i O3;I6'II —.— _ rtrrvu�ruuc'}•_.m ruur,rrueu v_n vn, REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION R 10300 TORRE AVENUE•CUPERTINO.CA 95014-3255 C U P ERT!N O (408)777-3228 • FAX(408)777-3333•bui1cImq(acucertino.ora J0� 0 80031 PRORiCTADOnaz c ' d e APN° Q - - -o . OWNERNN'M ` PN E-0UIL STREET ADDRES h C , STATE,ZIPO I FAX CONTACT NMIE PHO E E-CLAIL STREET ADDRESS CITY.STATE.ZIP FAX ❑OWtMIt ❑ 0Wi4IUn.DEik ❑ OWNERAGE.YI' coN 'CrOR ❑CONTRACTORAGEYT ❑ ARCHITECT ❑EY(ataFEtt ❑ DEVQ.OPER ❑TENAM' CONTRACr RNAME LICENSENUMBER LICENSE TYPE BUS.LIC'az2gf.7 1 COMPANYNAME E-aLA �C ACFAX STREET ADDRESS CITI',STATE ZIP PHONE Pk' TP ^C n ARCHTTECTIENGINEER NAME - LICENSE NUNMER BUS.LIC.4 COMPANY NAME E-hUIL FAX STREET ADDRESS CRY,STATE,ZIP PHONE • USE OF ❑ SFD or Duplex ❑ DIUI(i-Femily, ROOFAREA: L VALUATION: n STRUCTURE. ❑ Commercial ��..t D l O_ •© ' EXIST(NGROOFTYPE: ❑BUILT-UPROOF ❑.ASPHALTSHINGLEc aawOODSNAKES ❑W'OODSHINGLES ❑OTHER(SPECIFY, REAIOkTi,REPLACE CMTS IF NU. /,t� PLYWOOD tY ❑ PL.11M ❑O5B PRIX -I7 ROOF ❑ a R 1i '� C. ❑ g, ll B ❑ PROPOSEDROOF TYPE: ❑BUILT-UPROOT 2 ASPHALT SHINGLES ❑ ICFS WOOD SHA ❑WOOD SHINGLES ❑OTHER ICC ES REPORTa DESCRI ItIN OF[YORK: ` ` G SAeM 1 ` DcJl By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on die property owners behalf. I have read tho application and dee information I have provided is correct. I have read the Description of\York and verify it is accurate. I agree m comply With all applicable local ordinances and stare IawS relating m buil in o ion. I arutyanz ppresentatives of Cupertino to enter the above-identif/yed propedy Cor inspection purposes. Signature ol'ApplicandAgenr.l 2L'b-�T� _ Date: 7/o��/ �n�Z SUPPLEMENTAL i1VFORMATIONREQUIRED OFFICEUSEONLY _If building is associated with a Home Owners Association,provide letter PLAN CTrECK n PE ROITMG SLIP of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _Provide Planning approval to verity if there any restrictions. ❑ EXPRMS ❑ PLANNING PLAN REVIEW _Provide copy of Manufacturer's Installation Specifreatiens. ❑ STANDARD ❑ FIRE DEPT Provide signed copy of Cupertino's Tear-Ott Policy. ❑ OTHEIC Reroof 1pp 201 Lace revised 03/1611