11010069 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10010 BRETT AVE CONTRACTOR:QUALITY FIRST HOME PERMIT NO: 11010069
IMPROVEMENTS
OWNER'S NAME: AZI PILLOW 6545 SUNRISE BLVD STE 202 DATE ISSUED:01/11/2011
C R'S PHONE: 4089619298 CITRUS HEIGHTS,CA 95610 PHONE NO:(916)788-2921
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB
Class Lic.# MECH r RESIDENTIAL COMMERCIAL
C w Date —
I hereby affirm that I am icensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR-OFF 2 LAYERS OF OLD ROOFING&RE-
ROOF
(commencing with Section 7000)of Division 3 of the Business&Professions 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
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$12720
permit is issued. -`�
APPLICANT CERTIFICATION J� APN Number:37511048.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
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
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Date
Issued by: Date; �
�— ��"/E
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044, i Date:
Business&Professions Code) Signature af� cant:
I,as owner of the property,am exclusively contracting with licensed contractors to 1-0 -11
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
declarations: HAZARDOUS MATERIALS DISCLOSURE
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 I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
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
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must. Owner autl rized a —1
Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby affirm that there is a constriction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection proposes.(We)agree to save
•mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
s,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
I understand my plans shall be used as public records.
9.18.
Signature Date Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 10010 brett ave. DATE: 01/11/2011 REVIEWED BY: bobs.
APN: I BP#: "VALUATION: 1$12,720
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
USE: __TPERMIT TYPE:
WORK tear off 2 layers install new shingles
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 2,400
;Lt,di: (Tart Chce ,k Phon!" Plu't(!R)'k I r'�>�'. 1'1""n C`htx°it
L1:>c,ft_ Pttrrtrt F:�t: 1'Irrrni. T':unit I`�'t.: I,7�c. 1'e;rtuit P�:�
t)lhNr'A1ec'h.In.ti,, C)lr;rrr•F'iun1T1 In 01h"'r:Cec.Insj�.
11 rh. h 1':< f'ha h. 1 >t;. ('4 1 i<r. Insp. V
NOTE: Theset or addn'l in ees are based on the preliminaryin ormation available and are onlyan estimate. Contact the De o.
FEE ITEMS (Fee Resolution 09-051 El 7%1.110) FEE QTY/FEE MISC ITEMS
111un ("heck Fec>:
Supp/. I't.`l"C"
T'laa C"llec:k:
Permit Fee: $312.00
Supp[ hisp Fee
Plum/�.i11°c'/7.;I:lcc t.'nir fee:
f'/untPe rfilii Fcep:
C0nstr7rctiOil TcLV F
11cousfic al Revive FCV
Work Without Permit? 0 Yes No $0.00
/'lana in Fees:
77-<n e'l l octrnrtenfolion 1I'c CS°
Strong Motion Fee: IBSEISMICR $1.27 Select an Administrative Item
Bldg-Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $314.27 $0.00 TOTAL FEE: $314.27
Revised: 12/07/2010
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 37511048 . 00
DATE ISSUED. . . . . . . : 01/11/2011
RECEIPT #. . . . . . . . . BS000012455
REFERENCE ID # . . . : 11010069
SITE ADDRESS . . . . . : 10010 BRETT AVE
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA
OWNER AZI PILLOW
ADDRESS . . . . . . . . . . : 10010 BRET AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : QUALITY FIRST HOME
CONTRACTOR . . . . . . . : GC ANDERSON LIC # 30398
COMPANY . . . . . . . . . . : QUALITY FIRST HOME IMPROVEMENT
ADDRESS . . . . . . . . . . : 6545 SUNRISE BLVD STE 202
CITY/STATE/ZIP . . . : CITRUS HEIGHTS, CA 95610
TELEPHONE . . . . . . . . : (916) 788-2921
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
---------- ---------- ---------
1BCBSC VALUATION 12, 720 .00 1 . 00 0 . 00 1. 00 0 .00
1BSEISMICR VALUATION 12, 720 . 00 1 .27 0 .00 1.27 0 .00
1REROOFRES SQ FEET 24 . 00 312 .00 0 .00 ----312_00 ------0_00
---------- ----------
TOTAL PERMIT 314 .27 0 .00 314 .27 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -----------
CHECK 314 .27 #2175
---------------
TOTAL RECEIPT 314 .27
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------ ---------------------------- ------
309 EXTERIOR LATH 311 SCRATCH COAT
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(Wcugertino.orp
PROJECT ADDRESS t ooW r_ 'L • APN#
OWNER NAME Zl �` UO w PHONE 4d 0-Q 4'^Q LQ11;�0"ff E-MAIL
STREET ADDRESS 'OO'c> Bret+- CTy, TAT_.E0ZI OP • 1 0-1 FAX
CONTRACTOR NAME 4' r LICENSE NNUUMBEtRI�^�5��.� LICENSE TYPE BUS.LIC.#
COMPANY NAM S' T;� {l�_1 E-MAIL FAX cr/6 T$X F Zg-MSTREET ADDRESS f?t" CITSTATE,ZIP g ��l b PHONE/9'6- ; 1r-��
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code.
2. You must schedule all needed inspections a minimum of one day before the requested inspection date.
Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be available within one hour.
There are special hours for this service: 7:30 — 10:30am and 1:00— 3:30pm (Mon—Thurs);
7:30 — 10:30am and 1:00—2:30pm (Friday).
4. If plywood is installed, a plywood nailing inspection is required.
5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is
weather tight after installation of approximately 25% of the roofing material.
6. New roof coverings shall not be applied without first obtaining all inspections 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.
7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is
complete. 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 must 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.
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$126.00. The re-inspection fee shall be paid before another
inspection can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act
on the property owner's behalf. I and stand and agree to comply with the re-roof policy stated above.
Signature of Applicant/Agent: Date: 1— t1 - 11
ReroofPo1icy_2010.doc revised 05/17/10
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: /00 10 8,-ef--- A-ve- PERMIT# 06
OWNER'S NAME: P Qnw PHONE# 9V6 79$ ^ Z9 Z 1
GENERAL CONTRACTOR: F'Y- .}- BUSINESS LICENSE#
ADDRESS:65-qS- ,Su, ,r,3e iTt%,-j 1 Gf•ti. He-, tih C44 I 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: —It
Signature Date
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/Contractor Signature Date
CITY OF
CITY OF CUPERTINO
REROOF
at�I
CUPERTINO PERMIT APPLICATION
APN # O Date:— ( I) r] 6 i I --
If residential, is house an Eichler. Yes ❑ No ® If yes, needs planning approval.
Building Address:
/o o 10 Ere -t4-
Owner's Name: 4.7 , PT Vo r,, Phone #:
,140-C q6 I — 929 8'
HOA: Yes ❑ No tK If yes, provide letter from HOA
Contractor: C�••.�1,� � Phone #: c)lG- 7&&- _ Z g 2
Fax#: 116 -- 3-t Ir -2g Lf 7-
Cupertino
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
0 Asphalt Shingles $ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings Z- ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
Residential Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: