15090185 CITY OF CUPERTINO BUILDING PERMIT
13UILDING ADDRESS: 10684 S TANTAU AVE CONTRACTOR:KENNY CONSTRUCTION PERMIT NO: 15090185
OWNER'S NAME: RAJ SUKH L AND VIDYA W 10227 BEARDON DR APT 3 DATE ISSUED:09/29/2015
OWNER'S PHONE: 5103963393 CUPERTINO,CA 95014 PHONE NO:(408)318-2739
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
,7 TEAR OFF(E)COMP,NO NEW PLY,INSTALL(N)CLASS A
License Class
D, C/0 Lic.#�7'S g COMP ROOF SYSTEM(30 SQ)
Contractor eh n Y LLC Date O z ZZyd/
1 hereby affirm that 1 am licensed under the provisions of Chapter 9
(commencing with Section 70110)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations: Sq.Ft Floor Area: Valuation:$13000
t 1 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 APN Number:37537005.00 Occupancy Type:
performance of the work for which this permit is issued.
2. I have and will maintain Worker's Compensation Insurance,as provided for by
Vection 3700 of the Labor Code,for the performance of the work for which this
permit is issued.61 PERMIT EXPIRES IF WORK IS NOT STARTED
APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR
I certify that I have read this application and state that the above information is 180 DAYS FROM LAST CALLED INSPECTION.
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 Issued by: Date: I I
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
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 RE-ROOFS:
all non-point source regulations r the Cupertino Municipal Code,Section 9.18.
All roofs shall be inspected prior to any roofing material being installed.If a roof is
Signature Date o9 3 9 ZO/(' installed without first obtaining an Tton,I agree to remove all new materials for
inspection.
❑
OWNER-BUILDER DECLARATION Signature of Applicant: Date: % Z U��
1 hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COV 1 O BE CLASS"A"OR BETTER
the following two reasons:
t. 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 HAZARDOUS MATERIALS DISCLOSURE
sale(Sec.7044,Business&Professions Code) I have read the hazardous materials requirements under Chapter 6.95 of the
2. 1,as owner of the property,am exclusively contracting with licensed contractors to California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
construct the project(Sec.7044,Business&Professions Code). compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(a)should I store or handle hazardous material.
I hereby affirm under penalty of perjury one of the following three declarations: Additionally,should I use equipment or devices which emit hazardous air
t. I have and will maintain a Certificate of Consent to self-insure for Worker's contaminants as defined by the Bay Area Air Quality Management District 1 will
Compensation,as provided for by Section 3700 of the Labor Code,for the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I
performance of the work for which this permit is issued. lealth&Safety Code,Sections 25505,25533,and 25534.
2. 1 have and will maintain Worker's Compensation Insurance,as provided for by Owner or authorized agent:
Section 3700 of the Labor Code,for the performance of the work for which this Date:
permit is issued.
3. 1 certify that in the performance of the work for which this permit is issued,I shall CON RUCTION LENDING AGENCY
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 I hereby affirm that there is construction lending agency for the performance of work's
become subject to the Worker's Compensation provisions of the Labor Code,I for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
must forthwith comply with such provisions or this permit shall be deemed
revoked. Lender's Address
APPLICANT CERTIFICATION ARCHITECT'S DECLARATION
I certify that I have read this application and state that the above information is I understand my plans shall be used as public records.
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 Licensed Professional
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
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 9.18.
Signature Date
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
(408)777-3228 • FAX(408)777-3333• building a()cugertino.orq �_50�10 /E �
CUPERTINO
PROJECT ADDRESS _ APN
I ,J
OWNER NAM; PHONE _ E"M?I
STREET ADDRES J (l/\ CITY, STATE,ZIP FAX
DDR
CONTACT NAME PHE E-MAIL
�a 3 - ;
STREET ADDRES i CITY,STATE, ZIP .7f W t/ FAX
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tL/OWNER ❑ OWNER-BUILDER ❑ O'A`NERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENA1.7
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS,LIC.X
r1 GK 13`
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHO 'E
/ O —2
ARCHITECT/ENGTNEER NAME LICENSE NUMBER BUS.LIC.k
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA. � f� ,VALUATION:
STRUCTURE: ❑ Commercial
• 30 i/7ig o I t/3611r/
EXISTING ROOF TYPE: ❑BUILT-LIP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑tVOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE YES FIFLNO, PLYWOOD ❑ 'h" ❑ PLY1+T) ❑ OSB PITCH: 12 ROOF❑ NO YERS TH] KNESS ❑ 5/8" TYPE ❑ CDX
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT
DESCRIPTION OF WORK:
7 C
By my signature below,I certify to each of the follo+ving: 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 providedis rrect. 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 building cons coon. I authorize representatives of Cupertino to enter the above-identified rope rty for inspection purposes.
Signature ofApp]icant/Agent: Date.
SUPPLEMENTAL INF ION REQUIRED (1I FICE USI;ONLY
_If building is associated With a Home Oa'nei s Association,provide letter ITAN CIIFCK TI TF KO L-T INN SLIP _
of approval from HOA. of Fi,-TIlF-cot Nria< J' BUILDING I'LaN IIE IF-N
Provide Planning approval to verify if there any restrictions. ❑ r�i Iiia, iL�N�h:c ri ��rr�I} ,
Provide copy of Manufacturer's Installation Specifications. ❑ InNI„I;I, ❑ t 1i:e I,f Pr
Provide signed copy of Cupertino's Tear-Off Policy.
ReroofApp_201 1.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 10684 S TANTAU AVE DATE: 09/29/2015 REVIEWED BY: PHUONG
APN: 375-37-005 BP#: 'VALUATION: 1$13,000
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1 SFDWLROO
WORK: [TEAR OFF E COMP NO NEW PLY INSTALL N CLASS A COMP ROOF SYSTEM 30 SO
SCOPE
FEE ID ROOF ARE:
s.f.
1REROOFFRES 3,000
1lrrA l'l,,r�('hrl
1/r<h l'rrriiil hr
(Wit It.,11. 111 i)nccr t'hinrLi
NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Puhlic Works,orks, Fire,Sanitary Sewer District,School
District,etc.). Thesefees are based on lire preliminarj information availahle and are onlY an estimate. Contact the De t or addn7 info.
FEE ITEMS (Fee Resolution 11-053 I:(1 , 1 13) FEE QTY/FEE MISC ITEMS
r .k
!'Irm,h llcch. /.lrc
Permit Fee: $ 00
0
S1 /1. 1,ra1,
l'hrrnh_ .I h'Ch. 1;lrc
PhIn,i, I/"(/,. F/ccc I cl-mit Fee:
on.m.14ction lux:
Administrative Fc'e:
Work Without Permit? O Yes 0 No $0.00
Strong Motion Fee: IBSEISMICR $1.69 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $512.69 $0.00 TOTAL FEE: 1 $512.69
Revised: 07/02/2015
REROOF TEAR-OFF POLICY
24 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
INS
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
( U
(408)777-3228 • FAX(408)777-3333• buildinoCcDcuDertino.org
PROJECT ADDRESS ' APN H C r i 1 C
OWNERNAME PHONE
Q zj ! Gf
STREET ADDRESS CITY, STATE,ZIP I FAX
CONTRACTOR NAME le nNy LICE N NU BER LICEKSET E BUS LIC 4
/o C/ 27
COMPANY NAME E-MAIL _ FAX
Pr.n LCL h CG l' ;JJ
STREET ADDRESS CITY,STATE,ZIP PHO M
GZ CI(
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 7:3040:30am 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-roofmg is
completed. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of J/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 Iny 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 2013 California Residential Code.
Signature of Applicant/Agent: Date:
RerogJPo1icy_2014.doc revised 01/1.5/14