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15070146I
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1574 JAMES TOWN DR
CONTRACTOR: RIDGETOP DBA CAL-
PERMIT NO: 15070146
PAC ROOFING
OWNER'S NAME: BALUSU MADHAVI AND PRASAD
1350 DELL AVE
DATE ISSUED: 07/21/2015
OWNER'S PHONE: 4084222600
CAMPBELL, CA 95008
PHONE NO: (408) 370-3332
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL[:]
TEAR OFF (E) SHAKE (NO RESHEET) INSTALL (N) METAL
License Class li 3 Li.. # �Z� S�1
SHAKE (UL LISTED OR EQUAL) CLASS A ROOF SYSTEM
Contractor R, ? Date 7 124 'IfSQ'S)(ESR
(27
3098 ON SITE)
I hereby affirm fiat Ian licensedand a provisions of Ch er 9
(commencing with Section 7000) of rvision 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
C en tion, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation:.` I SOun
e ce of the work for which this permit is issued.
I a d will maintain Worker's Compensation Insurance, as provided for by
ion 700 of the Labor Code, for the performance of the work for which this
APN Number: 36610072.00
Occupancy f} pc:
it is sued.
APPLICANT CERTIFICATION
I certify th I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I ee 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)�iesgree to sav
YS FROM- INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilit' ents,
costs, and expenses which may accrue against said City in co nce of the
2%
granting of this permit. Additionally, the applicant and ds and will
ssued b e:
with all non -point source regulations per the Cu ' o Municipal Code, Section
9.18.
2,
OFS:
Signature Date
All roofs shall be inspected prior o any roofing inbeing installed. If a r f is
installed without first obtaining an inspection, I agree to remov�niterials for
inspection.
❑ OW R -BUILD ECLARATION
Signature of Applicant -Date: 2(
I hereby affirm t at exempt from the Contractor's License Law for one of
the following two reasons:
ROOF CO 2IN OBE 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)
1, 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 nd
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 2557 and 25534. ^�
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent Date:
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
C NSTR LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is nstruction 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.
Signature Date
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org
R
Y-6
PROTECT ADDRESS 1574 ` �,.,-/IrLz�r�tj� `j )2
12� J i' ry�' C CU/
AI'Nn
OWNER NAME
0
PjN q 2 �^ �'
L /V
CC--S��TATTE,
E-`MAIL��--
STREET ADDRESS %t� I /2 .
CITY, ZIP / ©r , (
LtJ 611-17110490 C A `% `'f
FAX
CONTACT NAME - A r ? /1, (N
W ` `7
PH . 3 - X3)'2-
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT jZ"CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENAN i
CONTRACTOR NAME Tom Spading
LICENSE NUMBER 920596
I
LICENSE TYPE C39
BUS. LIC. #
COMPANY NAME CAL - PAC ROOFING ID61' 7
E-M
FAX 408-370T -3353
STREET ADDRESS 1350 Dell Ave
CITY, STATE, ZIP Campbell, CA 95008
PHONE 408-370-3332
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF SFD or Duplex ❑ Multi-FamilyROOF
STRUCTURE: ❑ Commercial
AREA:
-1'17Cr-
VLUON:
�/[� 1 O t
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES j2rwOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE AYES
❑ NO
IF NO,
#LAYERS-
PLYWOOD ❑ ./," ❑
THICKNESS: ❑ 5/8"
PLYWD ❑ OSB
PE: ❑ C X
PITCH:
2
ROOF
CLASS: A
PROPOSED ROOF TYPE: ❑ BUB.T-UP ROOF 11ICC-ES
ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES OOTHER r71 FA I r
REPORT #
DESCRIPTION OF WORK:
By my signature below, I certify to each of the following: I am the property owner or authorize nt 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 o r and verify it is accurate. I agree to comply with all applicable local
owoordinances and state laws relating to building construction. I authorize represent ' of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: 2-1
SUP AL INFORMATION
_ If building is associated with a Home Owner' sociation, 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 Cupettino's Tear -Off Policy.
OFFICE USE ONLY
PLAN CHECK TYPE
ROUTING SLIP
❑ OVER COUNTER
❑ EXPRESS
❑ STANDARD
❑ BUILDING PLAN REVIEW
❑ PLANNING PLAN REVIEW
❑ FIRE DEPT
❑ OTHER:
ReroofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,700
ADDRESS: 1574 JAMES TOWN DR
DATE: 07/21/2015
REVIEWED BY: MELISSA
Hach I"IPMi1Pe:rmil
APN: 366 10 072
BP#:
"VALUATION: 1$18,000
rtPERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
USE:
/'Iwiib. hasp. Fee:
PENTAMATION 1SFDWLR00
PERMIT TYPE:
WORK
TEAR OFF E SHAKE NO RESHEET INSTALL N METAL SHAKE UL LISTED OR EQUAL
SCOPE I
CLASS A ROOF SYSTEM (27 SQ'S)(ESR 3098 ON SITE)
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,700
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 the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-033 E,(f 7,,1%13)
Mech. Plan Check
QTY/FEE
Floc•. Plan Check
Hach I"IPMi1Pe:rmil
Oilier Mech. hasp
)tlwr l'itlinb lndvl.
Other 0"'C. lnup. E17
Mech 1.aap. Fee:
/'Iwiib. hasp. Fee:
Elec. Insp. Fee:
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 the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-033 E,(f 7,,1%13)
FEE
QTY/FEE
MISC ITEMS
flan Check Fc,
Suppl. P( Fee
Plzlmb.lAfech.iFlec
Permit Fee:
$459.00
Suppl. Insp Fee
Plumb.%Afech.,'Elec
Plumb. ItLfech./Elec Permit Fee:
Construction Tax:
9cllninl,ch�:tir� Fee':
Work Without Permit? 0 Yes 0 No
$0.00
Icl6wncM Pl<IYl11lYtg 1'c:cs.
1 ravel Docul'nenlalion Fe'es:
Strong Motion Fee: 1BSEISMICR
$2.34
Select an Administrative Item
Bld�4 Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$462.34
$0.00 TOTAL FEE:
$462.34
Revised: 07/02/2015
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
(408) 777-3228 • FAX (408) 777-3333 • buildina aacupertino.org
PROJECT ADDRESS I 5?4
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APN #
OWNER NAME �^
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E-MAIL
STREET ADDRESS
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CITY, STATE, IP
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FAX
CONTRACTOR NAMET�
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LICENSE NUMBER [] .J /`
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LICENSE 2 E
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BUS. LIC. #
COMPANY NAME ��
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STREET ADDRESSE,
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ZIP
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PHONE
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re -roof project shall comply with all applicable provisions of the 2013 California Codes.
2. An inspection request can be scheduled un to one business day before the requested inspection date.
Please schedule inspections online or call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-
2:30pm (Friday) to schedule 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. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs)
and 7:30-10:30am and 12:30-2:30 (Friday). 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. 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 %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, vents painted, gutter/downspouts installed, debris removed.
7. 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. 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 acco ections R314 and R315 of
the 2013 California Residential Co
of Applicant/.
Date:
ReroofPo1icy_1014.doc revised 01/15/14