12040088 CITY'OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10813 NORTHOAK SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12040088
OWNER'S NAIVE: BEAUDOUIN JACQUES R TRUSTEE PO BOX 1668 DATE ISSUED:04/17/2012
.OWNER'S PHONE: 6509644575 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
1_Z /LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C - Lie,q -21 O r r r
MECH RESIDENTIAL COMMERCIAL
Contractor Date
z
I hereby affirm that I am licensed under the provisions f Chapler9 JOB DESCRIPTION: RE-ROOF TEAR OFF EXISTING CAL-SHAKE ROOFING
(commencing with Section 7000)of Division 3 of the Business&Professions SYSTEM,INSTALL COMP SHINGLES COLOR AND TYPE TO
Code and that my license is in full force and effect. MATCH EXISTING CLASS A 13SQFT
I hereby affirm under penally 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.FI Floor Area: Valuation:$6500
permit is issued.
APPLICANT CERTIFICATION APN Number:31641023.00 Occupancy Type:
I certify that I have read this application and state that the above information is
correct. 1 agree to comply with all city and county ordinances and stale 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 Iiabililies,judgments,
costs,and expenses which may accmc 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 regulations per the Cupertino Municipal Code, ection
SignatureDate ( Issuedby: RT Date: V-17-IR
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
1 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 Cade) Signature of ApplimnlLz � Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(See.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1 hereby affirm under penally 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
perfomtanee of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation insurance,as provided for by compliance with the Cupertino Municipal Cade,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 1 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 perforrnance 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 Califamia. If,after making this certificate of exemption,1
become subject to the Worker's Compensation provisions of the Labor Code,1 most Owner or or'ze' d agent: ems/
forthwith comply with such provisions or this permit shall be deemed revoked. L/ Dale: l
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that 1 have read this application and state that the above infamtation is I hereby affirm that there is a construction lending agency for the perfomtance of work's
cored.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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
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 DF;C.LARATION.
9.18. I understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 15 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31641023 . 00
DATE ISSUED. . . . . . . : 04/17/2012
RECEIPT #. . . . . . . . . : BS000016556
REFERENCE ID # . . . : 12040088
SITE ADDRESS . . . . . : 10813 NORTHOAK SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . ..
OWNER . . . . . . . . . . . . : BEAUDOUIN JACQUES R TRUSTEE
ADDRESS . . . . . . . . . . : 623 TAMI WAY
CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 94041-2583
RECEIVED FROM . . . . : FOUR SEASONS ROOFIN
CONTRACTOR DIAZ, ALFRED LIC # 21323
COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING
ADDRESS . . . . . . . . . . : PO BOX 1668
CITY/STATE/ZIP . . . : SAN JOSE, CA 95109
TELEPHONE . . . . . . . . : (408) 278-0330
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
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 13 .00 182. 00 0 .00 .182 . 00 0 . 00
---------- ---------- ---------- ------ ----
TOTAL PERMIT 183 . 65 0 . 00 183 .65 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
2 3 19 4069960226 I NOPTHFOINTj
0 oint Home"Ov'itn" A oclation
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leaze note than the rth int Hommvners Associmcm as vj
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Ont' cted and appr 'ed Urk"Season's Roofing to perform rz-,-
. �I
current CAL Shake o0fing of our ho s�' -Th will replace the cu
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color fmbur roof$.
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`408'-996=3734'
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CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 10821 northoak square DATE: 04/16/2012 REVIEWED BY: bobs.
APN: BP#: VALUATION: $6,500
RPERMITTYPE: Building Permit PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE: At
WORK tear-off existing cal-shake roofing sysytem, install comp shingles Color and type to match exisitin .
SCOPE
W,,d, Plem Chdrk l'Innrh. Muff CbceAOec. Plan Chcek
Mock A.,wil Fee: Plnmb. Permit Fee: rlec.Poona Fre:
Odrer Me,h. ln.sp. Other Plumb Imp. Li I Other like. lnsp.
3loch. Lryt. F,x•: Phuoh. berp. Fee: Fhs. Lerp. Frtr:
NOTE: This estimate does not include fees due to other Departments(i.e. Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc). These fees are based on the prelinddna information available and are only an estimate. Contact the De ! or addn7 info.
FEE ITEMS (Fec Rcsohaion 11-053 LIT. 7111112 FEE QTYTFEE MISC ITEMS
Plan Check Fee: $0.00 13 s.f. Re-
Suppl. PC Fee: Q Reg. 0 OT FO.0 rhrs $0.00 $14.00 ROOFRES /v
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee:Q Reg. 0 OT 1 0,0 1 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
C'nnsn ug,cion T rl.r:
Arbniulisirafive Fee- 0
Work Without Permit? 0 Yes (F) No $0.00 E)
Advanced Planning, Fee: $0.00 Select a Non-Residential E)
Building or Structure 0
Truru!Doeumcntrnit,n Fears: �
Strong; Motion Fee IBSEISMICR $0.65 Select an Administrative Item
Bldg,Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: $1.65 $14.00 TOTAL FEE: $15.65
Revised: 04/01/2012
L2 3,:•16 41
NORITHPDINT;
4. 4
K� �� NI e< �, j
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0 oint Homdovin' A ociation
or
21
of Cdpertino-i 1:
larch 7 2012
kj
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o City of Cupertino
lease note that the VOrth int Homeowners Association nay
onie'kted and '.
Ur,Season's Roofing to pi�dorrn re-
i :aopr ea
h 7h will replace* 6 current bk-Shake
I
ooMg of our &he�f t
rand As
�j sternwitw ran anyo,
oor..'y G�Pqlsiiicr!
hi Stonew color fo"",.-L
Mes. Me,have MO
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jr roofs.
Sin66rely,
FC
Linda Starnes
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408; 9E5-3734,
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CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 7617 Kirwin Lane DATE: 04/17/2012 REVIEWED BY: Sean
APN: BP#: `VALUATION: $18,000
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: P I PERMITTYPE:
WORK Remove existing wood shakes and install new 1/2" CDX 30#felt and "Lifetime"composition shin les.
SCOPE
FEEID ROOFAREA
s.f.
iREROOFFRES 2,900
.11"'1'. l9un Ch' P/amh, Plan C rec-k /Ice. Plan Chcck
,VI,ch, A"'Ifir Fee: N...n r. Perini(F,e: Der. Penni(Fee.
0(lmr, .l/n h. In sp. 0drrr Plumb bo'p. Other liter. In'p.
1/c,h.hr.yr, P'w: Phunb. but'. Fe,r: /iter. hagr. F,:c:
NOTE: This estimate does not include fees due to other Departments(ie.Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on lite Preffintdrur information available and are only an estimate. Contact the Dept for addn7 info.
FEE ITEMS (Fec Resohclion I1-053 EIT 7/1/111 FEE QTY/FEE MISC ITEMS
Plan Check Fec:
Suppl. PC. lv:
l'luulhJ,1 dech./lilc•r.
Permit Fee: $406.00
Supp/. 111sp Fec
Plnnrh.1,11ech.11i7ec Permit Feu.
Cunsnvcrion Ka:
Admiuistralive Fee:
Work Without Permit? 0 Yes 0 No $0.00
A(h•unced I'lunnin,g Fees:
Trovel Docmrre(rlaliurr Fees: A
StronE Motion Fee* IBSEISMICR $1.80 Select an Administrative Item
131d,Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: $408.80 $0.00 TOTAL FEE: $408.80
Revised: 04101/2012
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
CUPERTINO
(408)777-3228•FAX(408)777-3333•buildinoCa)cuoertino.ora
PROJECT ADDRESS I- I r �P,1V 1J i I , I I A)� w APN0
OWNER NAME �/` I 1ti PHONE 9I _ E-MAIL
STREET ADDRESS CITY.STATE ZIP 'I�I IIJ _ FAX
CONTRACTOR NAME olr/ vly LICENSE NUMBER �{, LICENSETYIU�P - BUS-LIC-M (�
COMPANYNAME I-1 Vr EMAIL l I FAX /i 'V 7
STREETADDRESS t�1.,I�(,! CITY.STATE.21PI/1� PHONE u �2/
I UNDERSTAND AND AGREE TO THE FOLLOWING: L! -52
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.reguired 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 I/<" 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-inspeciion.fee of$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing bepI4, I cceach of the following is true: 1 am the property owner or authorized agent to act on the
property owner's ehalf. land land and atgcomply with the re-roof policy stated above. I also understand that
smoke detectors @nd carbon mon ide det@ ors are quir,, .to be talled in accordance with Sections R314 and R315 of
the 2010 Califom' Residential C
Signature of Applican r �Batc:
Rep oolpolicv_1011.doc revised 01/16111
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 950143255
CUPERTINO (408)777-3228•FAX(408)777-3333•building0cuoertino.om
PRO=ADDRESS n I I, t t ( I 1 /y� !r� APN 0
OWNERNAM1tE KVAAL L r� �PHONECi I I✓� E-MAIL
STREET ADDRESS I I ` 111 _•jIN CRY.STATE,ZP l .,yJ-1 No FAX
APPLICANT NAME - O\ f PHONE I I R _ /1D 1" 2\ SMAB.
1/' 11V l
STREET ADDRESS /) 1 C� l yy,6�t � CfrY.STATE, ZIP C \ /�1(��I Z FAX
b
❑OWNER ❑ OWNER-BUILD1ElR 0
y1'�OWNER A{OQ�r _ ONTXACrOR ❑CONTRACTOR AGENT ❑ ARCHTECT ❑FN@ ❑ OEVEIOPER ❑i ANT
CONTRACTOR NAME /tel V '1--1 I\ I.I'I✓ � 2��� llCENC€TYPE —�n BIAS.L.IC.d
b % I / l
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCHITECTIENGIJEER NAME LICENSE NUMBER BUS.LIG i
i
COMPANY NAME E-MAIL FAX
STREET ADDRESS l.- OTY,STATE,ZIP PHONE
USE OF X.S or Duplex ❑ Multi-Family ROOF AREA: ,ra ( VALUATION: r ;I 'n '
STRUCTURE: Ommercial. �"1 y 1.Xt V vu, 1121.
EXISTING ROOF TYPE:
❑BUILT-UP ROOF E3 ASPHALT SHINGLES ODD SHAKES ❑WOOD SHINrr, sc Cl OMERI (SPECIFY)
REMOVE/REPLACE pYYFS PNO. PLYWOOD - ❑ PLYWD ❑ OSB PR4l: ROOF
./❑ N a ❑ a/S" E. .1 Z CLASS A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHAL7 SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT 6
DFSCAIPnON OF WORK
By my signature bel ,I certify h 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 hav ided is correct,I have Description of Work and verify h is accurate. I agree m comply with all applicable local
ordinances and statr laws relating to b nstm I autho res 'ves of Cupertino to enter the above-id eqntified Pr^;cm, for inspection purposes.
Signature oCAppliwly\Bent -• � - Dere: I� 11
SUPPLEMENTALINFO TI 'REQUIRED
If building is associated with a Home Owner's Association provide letter �3`"
of approval from HOA. �7�-pyA'�"o �� i
_Provide Planning approval to verify if there any restrictions. '
B'�ns�ct���F ���-� F•�1 G-PLtfNRF.PIEw�Y�?
Provide copy of Manufacturer's Installation Specifications. �I 7—t =
s
_ Provide signed copy of Cupertino's Tear-Off Polity.
ReroofApp_101 Ldoc revised 03102111