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13120110NN CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10676 AMULET PL CONTRACTOR: O.D.R. ROOFING PERMIT NO: 13120110 OWNER'S NAME: RAO PADAKANDLA K AND YADGIRKAR HEMA 5334 KNIGHTS ESTATES DATE ISSUED: 12/13/2013 OWNER'S PHONE: 4084203756 SAN JOSE, CA 95135 PHONE NO: (408) 590-5512 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALE] ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # ��(q ) O O RE -ROOF 33 SQ WOOD SHAKES, CLASS A Contractor© . Date -13 — f I hereby affirm that I am licensed ,Z 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. 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. Sq. Ft Floor Area: Valuation: $12500 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32643060.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the aboveinformation 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 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued b 2 13" 3 Y� Date: granting of this permit. Additionally, the applicant. understands and will comply with all non -point uEcg-regu ' ns per the Cupertino Municipal Code, Section 9.18. Sign re Date_Q=13 13 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first ob i c I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applic t: Date: l I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF C TO BE CLASS "A" OR BETTER I, 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, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I 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 I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I 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 A' Quality Management District I performance of the work for which this permit is issued. will maintain compliance with upertmo al Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code ons 4. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized ag Dater 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 any manner so.as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. ff after making this certificate of exemption, I 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 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of.Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting 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 4,. CUPERTENO. REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION. \�(% 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (� (408) 777-3228 • FAX (408) 777-3333 • building okupertino.org PROJECT ADDRESS /D APN # ,^ / 2 6 4P Q OWNER NAME OE-MAIL • Jqn QV :3qT�l V STREET ADDRESS CITY, STTATE, ZIP I FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑.OWNERAGENT CONTRACTOR ❑ CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMELICENSE NUMBER D LICENSE TYPE BUS. LIC. # COMPANY Man 1 EMAIL` At. FAX ' 0 `v`19 O O (STATE, STREET D CITY, ZIP PHONE a t ARCHTTECT/ENGWEERNAME LIC ENSENUM 3ER COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi -Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial f� EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OILER (SPECIFY) REMOVE /REPLACE 11 YES IF NO, PLYWOOD ❑ w, ❑ �TPLW)WD k0SB PITCH: 12 ROOF A ❑ NO # LAYERS: THICKNESS: ❑ 5/8^ E: CDX CLASS PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF KASPHALTSHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT it DESCRIPTION OF WORK i� les 1 IvJs a a,,&kac.d (VIAl . By my signature below, I certify to each of the following: I am the pro erty owner or authorized agent to act on the property Owner's behalf. I have read this application and the information I have provided is c Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b ' s n I oof Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent:Date: SUPPLEME ORMATIO QUIRED a c sL� If building is associated with a Home Owner's Association, provide letterCK�YP7��olrrmo oy> R_T a lx �BUILDINGPLR(F1 of approval from HOA. Provide Planning approval to verify If there any restrictions. _.EXPRESS .�" �3AZV3� 'G PLAN,;.REVtESV. Provide copy of Manufacturer's Installation Specifications.. g -~ x�tD DEBT r _ Provide signed copy of Cupertino's Tear -Off Policy. Reroof,4pp_2011. doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 10676 amulet pl DATE: 12/13/2013 REVIEWED BY: larrys APN: BP#: 'VALUATION: 1$12,500 'PERMIT TYPE: Manor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF USE: PERMIT TYPE: WORK remove and replace roof.. wood shakes class a SCOPE 3'SE'ch. Plla,-1 (,hei.` L C) Baer :A,Ie J?. NOTE: This estimate does not include_feeA Plumb. Pkv? Check I I;..I'=far, C€aer;4 I'i opbn Pel-aul Fee: 1<:ec, 1'ermh 1".,e: Other 1'daiw I .5, ;. ()Ther Elec. Ir p;, due to other Departments (i.c Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminar FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) Plan C'heck bee: Suj)pL .P ' 1 ee; Permit Fee: ("f nstructio i Tax', Admini,straiii,e Fee: Work Without Permit? , .0 Yes 0 No ,1.rlvanc", l.t'1czrrnh1,(-.-ees,, iiwvei l:)rrcume nt alion .Fees: Strong Motion Fee: IBSEISMICR Bldg Stds Commission Feer IBCBSC FEE $528.00 $0.00 $1.25 $1.00 $530.25 [able and are only an estimate. Contact the Dept -for addn'l QTY/FEE I MISC ITEMS $0.00 Select an Administrative Item $530.25 Revised: 10/01/2013 e CUPERTING REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • building ol-cupertino.org PROJECT ADDRESSD n ^ G / APN 4 OWNER NAME ^ OlvE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX CON*fRACTOR NAME ©,5i LICENSE / 0/) LICENSE TYPcal- BUS. LIC. # COMPANY NAME ` h E M% II/� � (J Cia( ^ I L FAX — STREET AD CITY ZIP C PIiO� �r�c., Q U 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 one business day before the requested inspection date. Please call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pm (Friday) to schedule 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. 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. ied 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. A Final Inspection and approval shall be obtained from the building inspector when the re-roofirig is completed. To receive a final sign -off, the following items will be verified: ZD a. Flat roofs shall have a minimum of I/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. 7. NOTE: Ifyou call for a tear -off or plywood nailing inspection and the work is not complete, you will be charged a re -inspection fee. The re -inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the follov property owner's behalf. I understand and agree smoke detectors and carbon mon Me the 2010 California Residential Co ..AI Signature of I am the property owner or authorized agent to act on the with the re -roof policy stated above. I also understand that rtDJ .e installed in accordance with Sections R314 and R315 of Date: /1�d — 113— / 1� . ReroofPolicy_2012.docrevised 10/7/12