12050013 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20333 NORTLICOVE SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12050013
OW'NER'SNANIE: GOMEZJOSER PO BOX 1668 DATE ISSUED:05/0112012
OWNER'S PIIONE: 4089967858 SAN JOSE,CA 95109 PU0NF.NO:(408)278-0330
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT F PLUMB r
License Class C- 31 Lir.q 44-77-14541
MECH r RESIDENTIAL r COMMERCIAL r
Contractor RfLi jl c. Date S-2- 1Z
1 hereby affirm That 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: RE-ROOF TEAR-0171'EXISTING CAL-SI1A6E ROOFING
(commencing with Section 7000)of Division 3 of the Business&Professions SYSTEM
Code and that my license is in full force and effect. AND INSTALL 30p FELT UNDERLAYMENT AND INSTALL GAF
GRAND CANYON SHINGLES,COLOR:STONEWOOD
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(hc Labor Code,for the performance of the work for which this
permit is issued- Sq.F1 Floor Area: Valuation:$6500
APPLICANT CERTIFICATION
I cerlily that I have read this application and state that the above information is APN Number:31641068.00 Occupancy'Fype:
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 Ci(yofCupertino 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 per-mit. 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 LAST CALLED INSPECTION.
9.18.
Signature DateIssued b : Date:
❑ OWNER-BUILDER DECLARATION
1 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 rooting material heug 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 Cade)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applic:w Data:
construct the project(Sec 7044.Business&Professions Code).
1 hereby affirm under penalty of perjury one of the fallowing three ALL ROOF CO 'GS TO BE CLASS"A"OR BETTER
declarations:
1 have and will maintain a Certificate of Consent to self-insure for Workers I IA'J.ARDOUS 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. 1 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 Ilealth&Safely Code,Sections 25505,25533,and 25534. 1 will maintain
Section 3700 of the Labor Cade, far the performanceof the work far which(his compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ilealth&
Safely Code.Section 25532(a)should 1 store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in(he performance of die work for which this permit is issued.)shall contaminants as defined by the Bay Area Air Quality Management District l will
no(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 Ilealth&Safely 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. Own agenF. �
Dale: 5 Z-1
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGF.NCI'
1 certify that 1 have read this application and stale that(he above information is
correct. I agree to comply with all city and county ordinances and state laws relating 1 hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C)
upon the above mentioned properlyfor inspection purposes.(We)agree to save Lender's Name
indemnify and keep hamdess 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 pemnif Additionally,the applicant understands and will comply
with all non-point source regulatims per(he Cupertino Municipal Code,Section ARC111TF.CT'S DECLARATION
9.18.
1 understand my plans shall be used as public records_
Signature Date
Licensed Professional
�._ .-,- ,, -�-- �1.�-.-�-.r�i:/.:«V.'1,•''s"2.`"^•,-,n,.-.i-->i.+i.av isro.`G'W1ie?�.-.r�c`.i•�:: .-rr. .✓i.:. ... �
. 1.
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•building(a)cuoertino.org
PROJECTADDRESS U r APN0
OWNER NAMEPHONE E-MAIL
STREETADDRESS _ CITY.STATE.ZIP FAX
CONTRACTOR Nr.E LICENSE NU ER C ,LICENSE TYPE BUS.LICA
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY.STAT IP PHONE
�u L I-,uin (,r S�. �- —Sc• q c 51 1:' 1./.JF ' 2�i
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/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.
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: 1 am the property owner or authorized agent to act on the
property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide de ectors/are required to be installed in accordance with Sections R314 and R315 of
the 2010 Califomia Residential Cod G
Signature of Applicant/Agent: / - Date:
Remofl'olicr_?Oil doc revised 02116111
CITY OF CUPERTINO
3 ITEMS OF 24 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31641068 . 00
DATE ISSUED. . . . . . . : 05/01/2012
RECEIPT #. . . . . . . . . : BS00001667S
REFERENCE ID # . . . : 12050013
SITE ADDRESS . . . . . : 20333 NORTHCOVESQ
SUBDIVISION . . . . .
•CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER GOMEZ JOSE R
ADDRESS . . . . . . . . . . : 20333 NORTHCOVE SQ
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
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 BAL
---------- -------------' ---------- ---------- ---------- ---------- ----------
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 15.00 210.00 01. 00 210 . 00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 211.65 0. 00 211.65 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
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 20333 Northeove Sq. DATE: 0510112012REVIEWED BY: Sean
APN: BPk: 'VALUATION: $6,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK Tear-off existing cal-shake roofing system and install 30#felt underla ment and install GAF Grand
SCOPE Canyon shingles,.color: Stonewood.
FEE ID ROOF AREA
s.f.
1REROOFFRES 1,500
.4v,:/r. Ilan Cherk Phunh. Plan Check tiler.. Plan Owl
Mod). N•rmit Fre: Pbtmh. Permit Fec: Dec. Permit Fee:
Oil,,,, Af•ch. Imp. Other Plumb In.�p. Other Elec Insp. El
.Ncrh. I...p. Fce: Phtmh. hup. Fre: tiler. Irzcp. Fee:
NOTE: This estimate does not include fees due to other Departments(Le. Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on fire prefindna information available and are only an estimate Contact lite De t or addn7 info.
FEE ITEMS ([,cc Resohtlion 11-053 lift: 7/1/1 U FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
1'l n rn h.h1•!e c h./l'l c•e
Permit Fee: $210.00
Suppl. /dts'p Fee
Plnoth.hldech./1';lec Permit Fee:
Cnn.cnv WW7 T11A.
Aronini.sbruice Fire:
Work Without Permit? 0 Yes 0 No $0.00
;Idrnrrced PlunuigLf Fees:
%'rurcl Docamx:nlulinn Fees:
Strong Motion Fee: IBSEISMICR $0.65 Select an Administrative Item
Bide Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $211.65 $0.00 TOTAL FEE: 1 $211.65
Revised: 04/01/2012
i � S � v I3
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE'•CUPERTINO,CA 95014-3255
/
C1 0 (408)777-3228,•FAX(408)777-3333•buildinaCdcuoertino.orD
PROJECTAOURCSS 20333 &6 "P"b �3 [�p — 4
OWNER NAME PI DONE G-MALL
e
S'IREEI-ADDRESSCITY, STA N FAX
3 AL�ce S6)a . p
CONTACT NAME1T 10 �(� PHONE E'MALL
d -O
S'IRFEIADDRESS CITY,STATE, ZIP CQFAX
LAO SoSQ . S
r �J I
❑UWNER ❑ ONYER-BUILDER 13 OWNER AGEN w CONIRACIOR ❑COMBACIORAGFM ❑ ARCH TDrT ❑ENGMEEK ❑ DEVELOPER ❑n1&%T
CO\TRACTORNAME LICENSE NUMBER LICI3�TYPE BUS.LIC.b leg R3
COMPA.\I"NAVE E-MAIL
FAX
)IREUTADDRJSS CITY,STATE,ZIP - PHONE
Q� S
ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS LIC.b
CUMPANY NAME E-MAIL FAX
S IKEE[ADDRESS CITY STATE,ZIP PHONE
USE OF ❑ SFU or Duplex XMulti-Family ROOF AREA: J VALUATION:
AS
srRLCIVRE ❑ Commercial . 6 S—O0
IXI.TNO ROOF TYPE. 11 BUILT-UP ROOF ❑ASPHALT SHD1CabSl ❑WOOD SIIIRFC ❑WOOD SIUNGIES RR,Ar ,1
/.r OTTIER(SPECIFY)
REMOVE IREPLACE RYES IF NO. PLYWOOD j1'.- ❑ PLYWD 13 osB PrrCll. E ROOF rT Pr
❑ Y u - O CIASq
�:12 A
PRONY'EURWFTYPE, ❑BULLY"1)p ROOF ArISRiA1T SHmCA RA ❑WOOD SHARES ❑WOOD SHINm FC ❑OTFLLR ICY'-ES REPORT,
DESCRIPTION OF WORK'
n _
tAs7y-i,II 3n# gtI{ undv�r...fi t il inSiall GAF craga CO _oII--
1 .I •
0
t r
Hy my signature below,1 certity to each of the following' Earn the property owner or authorized agent to act on the property ovmcr's behalf 1 have read This
application and the information I have provided is coned, I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local
urdirwrces and state laws relating to building cons -On. lhorim resentatives of Cupertino to enter the above-identified property ler inspection purposes,
Signature of Applicant/Agent: Date:
12.
SUPPLEMENTAL,
SUPPLEMENTAL.INFORMATION REQIAKED - - OFFICE USE ONLY
If building is associated With a Home Owners Association,provide letter "PI;AN auaciYPR ROUTING SUP
of approval from HOA.
❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions.
❑ IXPR65B I ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. t I 1 �'`�"
❑'STANDARD-' ❑ FIRE DEPr
_ Provide signed copy of Cuptntino's Tear-Off Policy. � � - ❑ OTDEm
Heroofdpp_201 Ldoc revised Ila/l6/ll
_ 18 4089950220 �'. } NOPTHPDINT�,
o olnt Homeovrn A oclaticn s
a No o i' I
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Y 7,}� Itl' ; ' • h0 , Y
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tty of Cupertino 1
=t,,I�r � 1', . v :p1 ,. , o,., ph ;I>1. +h•L, 4'k. �K,i� ayY
a, h 7, 2012 ,
'borthpoint R I g sect `
F.
y, 9 o City of Cupertino i .
fl
tW lease note that the North Int Homeowners Assccia#o� las
E ;n
fai ontracted and'approyed tar Seasons Roofing to penoi rq rc
[ kk oofirig of our homl�s Th will replace the current CAL Shin,-
Pr Q ♦ r�
�+ I oo5ystem with ne A rand Canyo�y/asphalt CoCnt w *io Itl
L i ;' 1 II11 n 1}I r .^nd : 1--
1 r
ninglzs We have lec the Stonzw. od color for,pur r,ofs.
I Sincerely, .
7 J
Linda Starnes I '
<< Ori SitelManager! �> !: t .
408-9sa-3734' ' I .
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