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10070206 CITY OF CUPERTIN O BUILDING PERMIT
BUILDING ADDRESS: 10168 COLBY AVE CONTRACTOR:BAY 101 ROOFING PERMIT NO: 10070206
OWNER'S NAME: RAJEEV JOSHI PO BOX 925 DATE ISSUED:07/30/2010
'4ER'S PHONE: 4087779668 ALVISO,CA 95002 PHONE NO:(408)957-0531
❑�A LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT I- PLUMB
License Class e-3 9 Lic.#
� ( Q 9 // 6
MECH RESIDENTIAL COMMERCIAL r
Contractor Date -w
I hereby affirm t076,7_licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKE WOOD PUT ON"OSB"BOARD
(commencing with Section 7000)of Division 3 of the Business&Professions 30#
Code and that my license is in full force and effect. FELT&40 YRS COMP BARKWOOD 30SQ CLASS A
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 whifh this Sq.Ft Floor Area: Valuation:$12800
permit is issued. '`///)/-Z--
APPLICANT CERTIFICATION APN Number:31628033.00 Occupancy Type:
1 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,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source re tions pe e Cupertino Municipal Code,Section
9.18. �--�
© Issued by: �.�-7 Date:/ -l0
Signature Date _ L7 �-
t_ 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
1,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,
Business&Professions Code) Signature of Applicant: Date:
I,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
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&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
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 or author d t:
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
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 construction 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 purposes.(We)agree to save
it' -reify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
and expenses which may accrue against said City in consequence of the
giaLaing 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
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 3 PERMI" RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: B1}:. Lot:
APN . . . . . . . . : 31E:28033 . 00
DATE ISSUED. . . . . . . : 07/30/2010
RECEIPT #. . . . . . . . . : BS000011038
REFERENCE ID # • • . : 10070206
SITE ADDRESS . . . . . : 10:-68 COLBY AVE
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER RAJEEV JOSHI
ADDRESS . . . . . . . . . . : 10:-68 COLBY AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : BA" 101 ROOFING INC
CONTRACTOR . . . . . . . : JOSE RAMIREZ LIC # 30420
COMPANY . . . . . . . . . . : BA" 101 ROOFING
ADDRESS . . . . . . . . . . : PO BOX 925
CITY/STATE/ZIP . . . : AL`TISO, CA 95002
TELEPHONE . . . . . . . . : (408) 957-0531
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- - --------- ---------- ---------- ----------
1BCBSC VALUATION 12, 800. 00 1 . 00 0. 00 1 . 00 0 .00
1BSEISMICR VALUATION 12, 800. 00 1 .30 0 . 00 1 . 30 0 .00
1REROOFRES SQ FEET 30 . 00 390 .00 0 . 00 390 . 00 0 .00
- --------- ---------- ---------- ----------
TOTAL PERMIT 392 .30 0 .00 392 .30 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 392 .30 VISA
---------------
TOTAL RECEIPT 392 .30
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF ,CUPERTINO
FEE ESTIMATOR-. BUILDING DIVISION
ADDRESS: I REVIEWED BY:
APN: I BP#: I -VALUATION: 1$12,800
�PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
,
PRIMARY SFD or Duplex TOTAL APPLICATION
USE: ROOF AREA: E3,000 Is f TYPE: OLREROOF
�gw
04 0.
cc
FEE ID
1 RER00FFRES
NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'l info.
FEE ITEMS (Fee Resolution 09-051 Eff' -4/1,"09) FEE QTY/FEE MISC ITEMS
Permit Fee: $390.00
J
Work Without Permit? 0 Yes No $0.00
Strom,, Motion Fee: IBSEISMICR $1.28 Select an Administrative Item
Bld.c., Stds Commission Fee: IBCBSC
$1.00 1
SUBTOTALS: $3922.28 $0.00TOTAL FEE: $392.28
1
Revised: 7/27/2010
CITY OF } '
CITY OF (__XPERTINO
REROOF
CUPERTINO PERMIT APPLICATION
APN# Date:
Building Address:
e- B
04 A Owner's Name: Phone #:
V JO-5
HOA: Yes ❑ No [J-1/If Yes, provide letter from HOA o - 2 2
Contractor: Phone #:yas ?S-)
/1 Q S,tJ L Fax#: - ?5-'-)
Cupertino B siness License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
V Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: ,W O l�c Sh!qlclg Afoo�p U 7 D/J 170 O - 8
'3a2 0 3 o P vti► e.i A4 9 �46 y,Zs
30 &Ani ,voo
Residential JM7 - Commercial
Green Building: Please complete relevant portion of the Confirmed mith Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include ip plan set & the sheet index.
Valuation:
I Have Read, Understand and Will Comply with ( Ipe o's Tear-Off Policy:
Signature
Revised 02/05/09
Windows
1.inswlEreargy4-�_Wli}ndows
�otiE f?aoed 1 Energy pt Y=YeS 0
b.wry to Wrq
2 Energy pts Y--yes 0
c.Low.wam" 2 Energy pts Y--yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt Y--yes 0
J.Heating Ventilation and Air Conditioning
t,use DiXtURSWORAM PIA"M y-
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes1 1
0
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units
a.Fumaces 3 IAQ/Health pts Y--yes0
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts yeses 0
10.Install 13 SEER111 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC vAth Non-HCFC Refrigerants 2 Resource pts Y--yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stoves/inserts 1 IAQ/Health pt y--yes0
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt Y--yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15,Install High Efficiency Filter 4 IAQ/Health pts y--yes 0
16.Install Heat RecoveryVentilation Unit(HRV) 5 IAQ/Health pts y--yes 0
17.Install Separate Garage Exhaust Fan 3 IAQMealth pts y=yes 1 0
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=1 B points) Up to 18 Energy pts 0
6:Select Safs an QWoe FA)bgng MaWals 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
' 1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
M
1 1 1
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• )uildinq--bcupertino.org
PROJECT ADDRESS O t 7APN
13 Z7_1
OWNER NAME /< �� PHI fD -M 6 E-MAIL
AY-STREET ADDRESS6 e' / vC v CITY, ST ITE,ZIP✓� r,/ FAX
CONTRALTO NA�ytE / C— LICENSE NUM R_ LICENSE TYPE �V BUS.LIC#
COMPANY NAb4F- D/ 4_0 / E-MAIL FAX
STREET ADDRESS CITY,ST,TE,ZIP O �J
PHQ O l a
5 7i9 -T �(o S S
I UNDERSTAND AND AIJREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code.
2. You must schedule all needed inspections a mini num of one day before the requested inspection date.
Please schedule inspections online or call (408)717-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please ca l 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 availabl,,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 f)r 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 s 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 rc-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 Lux�ey.,Sjlbyd and agree to comply with the re-roof policy stated above.
Sig nature of Applicant/Agent: Date:
r
ReroofPolicy_2010.doc revised 05117110
REVIsioN# -
CITY OF CUPERTE40 BUILDING PERK tE
BUILDING ADDRESS: 21341 COLUMBUS AVE CONTRACTOR:SP HOME IMPROVEMENT PERMIT NO: 10020124
ER'S NAME: ALBERT CHANG 1030 WINDSOR ST DATE ISSUED:03/23/2010
OWNER'S PHONE: 4082577521 SAN JOSE,CA 95129 PHONE NO:(408)777-8918
❑ LICENSED CONTRACTOR'S DECLARATION r r r
1'zz BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class L Lic.# !911313 r r
1MECH RESIDENTIAL COMMERCIAL
Contractor S p klvM i` /MPAQ11Er_"Date_7-6-10
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:ADD NEW KITCHEN&NOOK AREA(416SQ)&RMDL
BATH(46SQ);NO RE-ROOF&NO STRUCTURAL
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect. 6/2/10-REVISION#1 STRUCTURE SUPPORT CHANGE ON CEILING BEAM.ISSUED
7/6/10
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
permit is issued. Sq.Ft Floor Area: Valuation:$60000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36204003.00 Occupancy Type:
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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
ture Date 7—X_/t) Issued by: Date:, �/C/
r
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this
Safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
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. Owau ed agent:
���jl. Date: b
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of work's
t-huilding construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
the above mentioned property for inspection purposes.(We)agree to save Lender's Name
_mnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional Y
v