11110059 CITY OF CU�PERTINO BUILDING PERMIT
;N2S
DING ADDRESS: 1052 WEST HILL CT CONTRACTOR:PRINCIPLE ROOFING, PERMIT NO: 11110059
INC
EWS NAME: MADHU&LAXMI ALUR 10160 STERN AVE DATE ISSUED: 11/10/2011
PHONE: 4082482509 CUPERTINO,CA 95014 PHONE NO:(408)898-7298
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
LI
License Class kl Ci j Li,,q 9fli I RE-ROOF 33 SQ,REMOVE EXISTING WOOD SHAKE,
Lt INSTAL
Contractor Date 11414,111 STONE COATED METAL ROOF CLASS A
I hereby affirm that 1 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.
1 hereby affirm under penalty of perjury one of the following two declarations:
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
performance of the work for whichthis permit is issued. Sq.Ft Floor Area: Valuation:$18000
1 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 APN Number:36227043.00 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 DA ;10:M LAST CALLED 1NSPUTIO
indemnify and keep harmless the City of Cupertino against Iiabilities,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 Issued by: / Date: �
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS;
Signature Date f z/ 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 Applicant: " Date:
1 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
1,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,son exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
1 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 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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
performance of the work for whichthis 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 25505,25533,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 my manner so as to become subject to the Worker's
Compensation laws oiiCalifamat. 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 thin 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,and hereby authorize representatives of this city to enter
the above mentioned property for inspection purposes.(We)agree to save
nify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records,
i,g 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
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rnq: Sub: Blk: Lot:
APN . . . . . . . . : 36227043 . 00
DATE ISSUED. . . . . . . : 11/10/2011
RECEIPT #. . . . . . . . . : BS000015288
REFERENCE ID # . . . : 11110059
SITE ADDRESS . . . . . : 1052 WEST HILL CT ,
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MADHU & LAXMI ALUR
ADDRESS . . . . . . . . . . : 1052 W HILL CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : DERECK LOI
CONTRACTOR . . . . . . . : DERECK LOI LIC # 27564
COMPANY . . . . . . . . . . : PRINCIPLE ROOFING, INC
ADDRESS . . . . . . . . . . : 10160 STERN AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . . : (408) 898-7298
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 18, 000 .00 1.00 0 . 00 1. 00 0 .00
1BSEISMICR VALUATION 18, 000 .00 1.80 0 . 00 1. 80 0 . 00
1REROOFRES SQ FEET 33 . 00 462 . 00 0. 00 462 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT : 464 .80 0. 00 464 .80 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 464.80 visa
---------------
TOTAL RECEIPT 464.80
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
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333-buildinc0cupertino.orn
PROJECT ADDRESS/ / O51' T G— APN0
OWNER_PMIP'f E-MAIL
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STREET O 2 Alo - ,- L �I FAX
CONTRACTOR NAME ry/ LICENSE NUMBER LICENSE TYPE BUS.LIC.p
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COMPANY NeME E-MAIL FAX
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ST ET D KESS CIN,STATE.ZIP PH NE
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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/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.
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, 1 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. 1 also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections 8314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date: ////0///
Reroo/Policv_1011.doc revised 02/16/11
REROOF PERMIT APPLICATION -
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333 • buildinG(8cuoertino.orG
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PROJECT ADDRESSAPN/ G 5 2 WcS 7-411(L L G a p3�2 2� .
OWNER NAME /4,40HO /- 4AX.4,0 /'aGu� PFIDNE OQ� 2t/!/ -Z E-IME.
STREET ADDRESS d L H�L-S T LL — cm.s7Ar{ffi /y FAX
APPLICANT NAME PHONE E-MAIL
STREET ADDRESS CM,STATE,ZIP FAX '
❑OWNER ❑ OWNER-BUILDER ❑ OWNBRAOENT ❑ CONTRACTDR ❑C0trr%ACTOR AOBNT ❑ AMMUCT Cl ENGINEER. ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME !�r/j �G �i. LICENSE NUA03EA LI C BUS.Uc.9
COMPANY NAME E-MAE. FAX
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ARCHTTECS/ENOIN ER NAME LICENSE NUMBER BITS.LIC/
COIRANY NAME E-MAIL FAX
STREET ADDRESS CRY,STATE,ffi FHONE
USE OF SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
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STRUCTURE: ❑ Commercial y73,�j ��ij 61a
mann o ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHItOLES ErWOODSFAM ❑WOOD SH NDT ❑OTHER(SPECIFY)
REMOVE/RFSLACE ❑YE1 I.F NO / OOD W. PLYWD SH P—IT/CL ROOF
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PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES C'�iTlmt ICC-ES REPORT a
DESCRIPTION OP WORK
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By my signature below,l certify to each of the fallowing: I Ron 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 W ork and verify it is accurate. I agree re comply with all applicable local
ordinances and state laws relating to buildin construction. I authorize.representatives of Cupertino enter the above-identified property for inspection purposes.
Signature of Applicant/Agent Date:
SUPPLEMENTAL INFORMATION REQUIRED
_Ifbuilding is associated with a Home Ovvner's Association,provide letter T "20 - i au�und�syTe I sfi
of approval from HOA. •a. a' i""
Provide Planning approval to verify if there any restrictions.
_Provide copy ofManufacttner's Installation Specifications. a_ -
_Provide signed copy of Cupertino's Tear-Off Policy. -
3
NW
ReroofApp_2011.doc revised 03/07!11