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12020062 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22620 RICARDO RD CONTRACTOR:DADDARIO ROOFING PERMIT NO: 12020062 OWNER'S NAME: DAVID&LOU ISE SCHIE 1734 WILLA WAY DATE ISSUED:02/14/2012 OWNER'S PHONE: 4082525017 SANTA CRUZ,CA 95062 PHONE NO:(831)476-9109 ❑ LICENSED C'ONTRACTOR'S DECLARATION ,- I— F_BUILDING PERMIT INFO: BLDG ' ELECT PLUMB License Class Lic. »� 1•�»» MECH RESIDENTIAL COMMERCIAL Contractor e!00" Date C714 Ife,""L [hereby affirm that I a_ lac used IF under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF WOOD SHAKE&INSTALL OSB AND (commencing with Section 7000)of Division 3 of the Business&Professions 40YEAR COMPOSITION SHINGLES CLASS A 24SQ 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:$10450 Section 3700 of the Labor Code,tor'the performance of the work for which this permit is issued. APN Number:35601055.00 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 lanes relating to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF `'CORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnih•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 the Cupertino Municipal Code,Section 72 9.13. Issued b Date; —/ Signature Date ❑ OWNER-BU :DER 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 C'ontractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. €,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, Signature of Applicant: Date: 061 Business&Professions Code) €,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino 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 25505,25533,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 or authoriz I a nt: become subject.to the Worker's Compensation provisions of the Labor Code,I must Date: %4 forthwith comply=with such provisions or this permit shall be deenmed 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,fund 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 REROOF TEAR-OFF POLICY is, 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(d_)cupertino.org PROJECT ADDRESS ki I` APN# t �- OWNER NAME PHONE �../ E-MAIL G��IJ`e- FJ STREET ADDRESS ��U-d I n CI u ATEA C �� j FAX 2 1Z t,q4CONTRACTOR NAME/'� r`n 1 LIC EN EBO R LICENSE TYPE BUS.LIC.# COMPANY NAME Y` E-MAIL FAX STREET ADDRESS CITY,STATE,ZI - P NE l e ldaa , c 47.5-6) 10 0 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 Code. Signature of Applicant/Agent: Date: 9 E ReroofPo1icv_2011.doc revised 02/16/11 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS:,51-62* t QA PERMIT# OWNER'S NAME: PHONE# v "` 4 GENERAL CONTRACTOR: ,",` c ,`o BUSINESS LICENSE# ADDRESS:`71 & d(C., au%c -e_ CITY/ZIPCODE:Czj c 161 *Our municipal code req fres 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. A� I am not using any subcontractors: Q S' na ure 6ate Please check applicable subcontractors and complete the following information: V 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 ont ctor Signature 1&4 CITY OF CUPERTINO t FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 22620 ricardo rd. TDATE: 02/14/2012 REVIEWED BY: APN: BP#: VALUA.TION: 1$10,450 PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF [ISE: I I PERMIT TYPE: WORK tear off wood shake install comp shingles. SCOPE FEE ID ROOF AREA S.f 1 REROOFFRES 2,400 NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These Les are based on the relimrna information available and are onl an estimate. Contact the De t or addn'l info. FEE ITEMS : 111053L, ` ': i j FEE QTY/FEE MISC ITEMS Permit Fee: $336.00 Work Without Permit? 0 Yes O No $0.00 ` Fe,,-: IBSE15MICR $1.05 Select an Administrative Item PILE¢ ._ `_>.,r :i r� ':�: IBCasC $1.00 SUBTOTALS: 1 $338.05 $0.00 TOTAL FEE: F $338.05 Revised: 1/19/2012 CITY OF CUPERTINO 3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # I Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . 35601055 . 00 DATE ISSUED. . . . . . . : 02/14/2012 RECEIPT #. . . . . . . . . BS000016009 REFERENCE ID # . . . 12020062 SITE ADDRESS . . . . . 22620 RICARDO RD SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . DAVID & LOUISE SCHIE ADDRESS . . . . . . . . . . 22620 RICARDO RD CITY/STATE/ZIP . . . CUPERTINO, CA 95014 RECEIVED FROM . . . . DADDARIO ROOFING CO CONTRACTOR . . . . . . . EDGAR MONTOYA LIC # 26245 COMPANY . . . . . . . . . . DADDARIO ROOFING ADDRESS . . . . . . . . . . 1734 WILLA WAY CITY/STATE/ZIP . . . SANTA CRUZ, CA 95062 TELEPHONE . . . . . . . . (1831) 476-9109 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 10,450 .00 1.00 0 . 00 1.00 0. 00 1BSEISMICR VALUATION 10,450 .00 1.05 0 . 00 1.05 0 . 00 1REROOFRES SQ FEET 24 .00 336 .00 0. 00 336 .00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 338 .05 0. 00 338.05 0. 00 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 PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTEM4 (408)777-3228• FAX(408)777-3333 •buildingacupertino.om PROJECT ADDRESS APN#io d I �0= O d — C){ OWNERNAME PHONE E-MAIL t-6 , e STREET ADDRESSif C� CITY, STATE, FAX 0(� 'Y10C_ �f 4 APPLICANT NAME - PHONE E-MAIL STREET ADDRESS CrI'Y,STATE,/ (� FAX 13 OWNER 11OWNER-BUILDER ❑ OWNER AGENT C1 CONTRACTOR If��CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR N *o� LICENSE NUMBER �� LICENSE TYPE BUS.LIC.# COMPANY NAME V E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEEIt NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial EXISTING ROOF TYPE,:: ❑BUILT-UP ROOF ElASPHALT SHINGLES �AK//00D'SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE (d'YFS IF N0, PLYWOOD L'Tfi" ❑ PLYWD 2$5 P1TCFi ROOF 13 NO #LAYERS: THICKNESS: El 5/8- TYPE: ❑ CDX 12 CLASS: PROPOSED ROOF TYPE: ❑B=-UP ROOF HALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK )-I a.1/' u FC) 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 building construction. I a o 4 representatives of Cupertino tc enter the above-id ified pr--,t,.or inspection purposes. Signature of Applicant/Agent Date: d� SUPPLEMENTAL INF TI REQUIRED _If building is associated with a Home Owner's Association,provide letter of approval from HOA. m _ sivItE � _Provide Planning approval to verify if there any restrictions. = — •� —--` _Provide copy of Manufacturer's Installation Specifications. w MGM _Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03/02111