11090011 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21761 SANTA BELLA PL CONTRACTOR:KEVIN SULLIVAN PERMIT NO: 11090011
ROOFING
OWNER'S NAME: PU HUANG 1696 VALLEY OAKS DR DATE ISSUED:09/02/2011
'NER'S PHONE: 4088651541 GILROY,CA 95020 PHONE NO:(408)842-1057
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class �'3 Lie.# (5 b I S/ RE-ROOF 28 SQUARES,REMOVE SHAKES,INSTALL 7/16"
,�n � I Z.�lr OSB,30LB FELT CLASS A
Contractor�f Date �� L
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:$11000
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 fn/4
APN Number:35622025.00 Occupancy Type:
permit 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 M LAST CALLED INSP TON.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, w /�
costs,and expenses which may accrue against said City in consequence of the Issued b Date: "` 2
granting of this permit. Additionally,the applicant understands and will comply y'
18
with all non-point source regul i s per the Cupertino Municipal Code,Section
9.18.
e�ZRE-ROOFS:
Signatu e Date12)11 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
Signature of Applic - Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE 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 the Health&Safety Code,Sections 5505,25 ,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dater
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
+emnify and keep harmless the City of Cupertino against liabilities,judgments,
.,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
..sting of this permit.Additionally,the applicant understands and will comply
with all non-point source regul "ons per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature ate
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 35622025 . 00
DATE ISSUED. . . . . . . : 09/02/2011
RECEIPT #. . . . . . . . . : BS000014656
REFERENCE ID # . . . : 11090011
SITE ADDRESS 21761 SANTA BELLA PL
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . . PU HUANG
ADDRESS 21761 SANTA BELLA PL
CITY/STATE/ZIP CUPERTINO, CA 95014
RECEIVED FROM KEVIN SULLIVAN
CONTRACTOR . . . . . . . : KEVIN E. SULLIVAN LIC # 23810
COMPANY KEVIN SULLIVAN ROOFING
ADDRESS 1696 VALLEY OAKS DR
CITY/STATE/ZIP . . . : GILROY, CA 95020
TELEPHONE (408) 842-1057
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
---------- ---------- --
1BCBSC VALUATION 11, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 11, 000 . 00 1 . 10 0 . 00 1 . 10 0 . 00
1REROOFRES SQ FEET 28 . 00 392 . 00 0 .00 392 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 394 . 10 0 . 00 394 . 10 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- ---------------
CREDIT CARD 394 . 10 me
---------------
TOTAL RECEIPT 394 . 10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----
309 EXTERIOR LATH 311 SCRATCH COAT
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: PERMIT#
OWNER'S NAME: (/ PHONE# S
GENERAL TRACTOR: �/ BUSINESS LICENSE#
ADDRESS: CITY/ZIPCODE:
*Our municipal code requires all dor mg i e ci 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 Z
RACTORS HAVE OBTAINED A CITY OFF"t�
CUPERTINO
BUSINESS LICENSE. 7
I 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
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(dcupertino.org
PROJECT ADDRESS `24
GJ(}P7
OWNERNAME J PHONE E-MAIL
STREET ADDRESS CITY, STATE,ZIP FAX
CONTRACTOR NA / lLICE S NUMBE x LICENSE TYPE BUS.LIC_#
COMPANY NAME E-MAIL FAX
STREET ADDRESS /G�/ CITY,STATE, ` PHONE
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 1/" 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. 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 Co �a I
C
Signature of Applicant/Agent: Date:
ReroofPolicv_2011.doc revised 02/16/11
REROOF PERMIT APPLICATION _-
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333 •buildingecupertino.org
CUPERTINO � � Uq
PROJECT ADDRESS � / 7 ` # J � 22 0 '9<
OWNERNAN!M n PRO 7MAJL
r
STREET ADDRESS A , CITY, ST TE ZIP FAX
APPLICANT NAME C PH E-MAIL
STREET ADDRESS I t Cm S ZIP �J'7„ FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT G�"�N"ACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRA R LICENSE NUMBER LICENSE TYPE BUS.LIC.#
COMPANY N ;fUE-MAIL ,` FAX
a S
6=S 5 ,/ CITY,STATE ZIP O A`
ARCHITECT/ENGIr1EEIL NAME LICENSE NUMBER BUS.LIC.# V
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF Spo=/ercial
Duplex ❑ Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑
EXISTING ROOF TYPE: ❑BUn T-UP ROOF ❑ASPHALT SHINGLESZ14/00'D SHAKES ❑WOOD SH NGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE IF NO, PLYWOOD ❑ 'h" ❑ PLYWD OSB PITCH ROOF
❑ NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX :12 CLASS: A
ICC-ES REPORT#
PROPOSED ROOF TYPE: ❑BUMT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER
DESCRIPTIO G WO 0 WV
1 �O ?e
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
app]ication and the information I have TpO.dpd 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 rela nstruction. I authorize representatives of Cupertino tc enter the above ntifie propert�;for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED
_If building is associated with a Home Owner's Association,provide letter
- CO-
of
approval from HOA.
_Provide Planning approval to verifY If there any restrictions.
�-—�
_Pr Vide copy of Manufacturer's Installation Specifications. `
Provide signed copy of Cupertino's Tear-Off Policy. _ �, � - T �0
ReroofApp_2011.doc revised 03/02111
CITY OF CUPERTINO BUILDING PERMIj5A-'E C BUILDING ADDRESS:ADDRESS: 10566 SANTA LUCIA RD CONTRACTOR:BG CONSTRUCTION INC PERMIT NO: 11050189
OWNER'S NAME: RAJIV&SUDHARANI PENDYALA 850 W SUNSET BLVD DATE ISSUED:08/03/2011
("NER'S PHONE: 6504385084 HAYWARD,CA 94541 PHONE NO:(510)432-6249
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG ELECT PLUMB
S (-I
C)
License Class Lic.#�� /
f—MECH RESIDENTIAL� COMMERCIAL
'A r
Contractor ' � c tiJ Ip M1 0 C Date � 2 Z� 2dr
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:CONSTRUCT NEW SFDWL(TWO STORY)3,107 SQFT WITH
(commencing with Section 7000)of Division 3 of the Business&Professions ATTACHED GARAGE 431 SQFT.-PREAPPLICATION PLANNER
G.SCHROEDER
Code and that my license is in full force and effect.
9/21/201 I-REV#1-REVISE PATIO DOOR,ADD 2 WINDOWS ABOVE&ADD
1 hereby affirm under penalty of perjury one of the following two declarations: TANKLESS WATER HEATER-REV#1 ISS'D 9/21/2011
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:$450000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:34216039.00 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 off Cuupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
grant and ex is permit. Additionally,the applicant unde undersnst�said City in tands will coquence of mply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
wi all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.
Sign �' Date - 2 ZGI I Issued b �—� ---
�" y; - Date: �' �, -- ti
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)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant:_ Date:
construct the project(Sec.7044,Business&Professions Code).
1 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. 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
1 have and will maintain Worker's Compensation Insurance,as provided for by
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 1 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
er or author' agents
forthwith comply with such provisions or this permit shall be deemed revoked. L CfTt _�"`?-- Date: Z G t
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,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
-tg of this permit.Additionally,the applicant understands and will comply
.l non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.itS.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional