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12010009 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRE'S'S: 11781 SIERRA SPRING CT CONTRACTOR:WILLIAMS ROOFING PERMIT NO: 12010009 OWNER'S NAME: ANWAR SUHAIL 42683 BRANTWOOD CT DATE ISSUED:01/03/2012 OWNER'S PHONE: 4088067071 FREMONT,CA 94538 PHONE NO:(510)882-4642 fir LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB &�?3 cl` License Class 6_ 3 Lic. MECH RESIDENTIAL COMMERCIAL Contractor L"('' Date Ol b 3 �-- I hereby affirool m that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKE AND REPLACE WITH COMP (commencing with Section 7000)of Division 3 of the Business&Professions SHINGLES CLASS A 17SQ 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. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$6500 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:36653050.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per th u rtino Municipal Code,Section 9.18. Issued by: Date'//" Signature Date L� ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to re ve all new materials for the following two reasons: inspection. 1,as owner of the property,or my employees with wages as their sole compensation, 311 will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date: Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupert' o Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 255 ,25533,and 25534. 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 Owner a ized ag nt: Date Pl v7 l become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY ## 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36653050. 00 DATE ISSUED. . . . . . . : 01/03/2012 RECEIPT #. . . . . . . . . BS000015644 REFERENCE ID # . . . : 12010009 SITE ADDRESS . . . . . : 11781 SIERRA SPRING CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER ANWAR SUHAIL ADDRESS . . . . . . . . . . : 11781 SIERRA SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : STEVE G WILLIAMS CONTRACTOR . . . . . . . : STEVE WILLIAMS LIC # 32413 COMPANY WILLIAMS ROOFING ADDRESS . . . . . . . . . . : 42683 BRANTWOOD CT CITY/STATE/ZIP . . . : FREMONT, CA 94538 TELEPHONE . . . . . . . . : (510) 882-4642 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 6, 500 . 00 1. 00 0. 00 1 .00 0 . 00 1BSEISMICR VALUATION 6, 500.00 0.65 0. 00 0 .65 0 . 00 1REROOFRES SQ FEET 17 .00 238 . 00 0. 00 238 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 239.65 0 . 00 239.65 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 239.65 VISA --------------- TOTAL RECEIPT 239.65 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 C> REROOF PERMIT APPLICATION - COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO. CA 95014-3255 CUPERTINO (408)777-3228 • FAX(408)777-3333 • building(cDcupetno.orti PROJECT ADDRESS / ! AFN# �3L OWNER NAME +f� �1 � PHONEMD�*M _707/ E-MAIL STREET'ADDRESS �J CITY, STATE,ZIP 1 FAX Le CA— APPLICANT NAME PHONE E-MALI. STREET ADDRESS CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENG NEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMELICENSE NUMBER` p/ LICENSE TYPE -37 BUS.LIC.# COMPANY NAME 5,7- } //! 7Z' E-MAIL FAX STREET ADDRESS j r) V`nL _` CITY,STATE,ZIP o�. � , PHONE� ARCHITECT/ENGINEER NAME G O:Yl LICENSE NUMBER BUS.LII,C.�A COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ;ERDSFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: �,�3 E•`J STRUCTURE: ❑ Commercial r 79-- EXISTING ROOF TYPE: ❑BUMT-UP ROOF ❑ASPHALT SHINGLES �CWOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE IFNO, PLYWOOD ❑ h" ❑ PLYWD ❑ OSB PITCH ROOF ❑ NO #LAYERS. / THICKNESS: ❑ 5/8" TYPE: ❑ CDX 12 CLASS: A PROPOSED ROOF TYPE: ❑B=-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK 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 application and the information I have provided 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 relating to bu' constryction/ I a . ' representatives of Cupertino tc eab vnter the e-iden'feed prope�;for inspection purposes. Signature of Applicant/Agent ;e Ir Date: l�Q� ` Z— SUPPLEMENTAL INFORMATION REQUIRED925� � _ s _If building is associated with a Home Owner's Association,provide letter'? atG of approval from HOA. e»R L � Ait_x>; v _Provide Planning approval to verify If there any restrictions. — Provide copy of Manufacturer's Installation Specifications. C-M`5vilde signed copy of Cupertino's Tear-Off Policy. Q oTs T ReroofApp_201 Ldoc revised 03/02/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11781 sierra springs ct. DATE: 01/03/2012 REVIEWED BY: bob s. 91APN: I BP#: "VALUATION: 1$6,500 -� 'PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF USE: P PERMIT TYPE: WORK tear off shake and replace with comp shingles. SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 1,700 F-1 LJ 0 L NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimna information available and are only an estimate. Contact the Dept for addn'l info, FEE ITEMS (Eee Resolution 11-053 Ef '-1.'111 FEE QTY/FEE MISC ITEMS Permit Fee: $238.00 Work Without Permit? Yes (F) No $0.00 Stron 7 Motion Fee: 1BSEISMICR $0.65 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $239.65 $0.00 TOTAL FEE: $239.65 Revised: 12/04/2011 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-building(aD-cugertino.org PROJECT ADDRESS < 615e f C APN k OWNER NAME PHONE, E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX -7 CONTRACTOR NAME U�Y_ LICENSE NUMBER LICENSE TYPE BUS.LIC.# COMPANY NAME , ll L E-MAIL FAX ho"J STREET ADDRESS CITY,STATE,ZIPPHONE 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$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 8315 of the 2010 California Residential Code. / fi rr Signature of Applicant/Agent: Date: G Z— ReroofPolicy 20/1.doc revised 02/16/11 Building Department City Of Cupertino LM 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: I&WA 4 S -S CT PERMIT# Z 2- OWNER'S NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: L�z(,ok3 g ' 0- CITY/ZIPCODE: *Our municipal code requires all businesses working in the city 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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. — / I am not using any subcontractors: Dl 1 Z Signature Date Please check applicable subcontractors and complete the following information: 6/ 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