12050011 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20353 NORT1ICOVE SQ CONTRACTOR:FOUR S17ASONS ROOFING PERMITNO: 12050011
OWNER'S NAME: GOPALAN JANAKIRAMAN AND PADMANABHAN PO BOX 1668 DATE ISSUED:05/01/2012
OWNER'S PIIONE: 4089967395 SAN JOSE,CA 95109 PI ION NO:(4(18)278-0330
LICENSED CONTRACTOR'S D--E�CLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C—3q Lic.q 4 1 2(o$ r r r
MECH RESIDENTIAL COMMERCIAL
Contractor P5 2. INC. Date
r
I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RI-ROOF TEAR-OFF EXISTING CAI:SI IAKE ROOFING
(commencing with Section 7000)of Division J of the Business&Professions SYSTEM,INSTALL 30q FELT UNDERLAYMENT&INS'fAl.l.
Code and that my license is in full force and effect. GAF GRAND CANYON SHINGLES.COLOR:STONEWOOD
I hereby affirm under penally of perjury one of the following two declarations:
I have and will maintain a cenifica[e 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[his permit is issued.
1 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:$6500
permit is issued.
APPLICANT CERTIFICATION APN Number:3164107000 Occupancy II'ype:
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
indemnifyand keep harmless done City of Cupertino against liabilities,judgments,
costs,and expenses which nmy accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this pennil Additionally,the applicant understands and will comply 180 DAYS M LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
5-2—/2 Issue y: L Date:
Signature Date Z
❑ ON'NP - U 1.DER DECLARATION
RF:ROOFS:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material berg 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 Ore property,or my employees with wages as their sole compensation, inspection.
will do the work,mid the structure is not intended or offered for sale(Sec.7044, :
Business&Professions Code) Signature or Applicmf Date
h as owner of the property.am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOFCOVE GS TO BE CLASS"A"OR BETTER
1 hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation.as provided fur 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 pennil 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 Code,Chapter 9.12 and the llcallh&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)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 1 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 Ilealth&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 ul rze Ill:
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
CONSTRUCTION LENDING AGENCY
APPLICANTCERTIFICATION
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 mwrk's
correct I agree In comply with all city and county ordinances and stale laws relating for which[his 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 hamdess 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 ARCI II'1'EC'F'S DECLARATION
9.18. 1 understand my plans shall be used as public records.
Signature Dale Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 24 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31641070. 00
DATE ISSUED. . . . . . . : 05/01/2012
RECEIPT #. . . . . . . . . : BS000016675
REFERENCE ID # . . . : 12050011
SITE ADDRESS . . . . . : 20353 NORTHCOVE SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : GOPALAN JANAKIRAMAN AND PADMAN
ADDRESS . . . . . . . . . . : 20353 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 0. 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: 20353 Northcove Sq. DATE: 05/01/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $6,500
°PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
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.
FEEID ROOFAREA
s.f.
1REROOFFRES 1,500
,1 ha:h. flan f.'h,rk Plumb. PlaYCheCA- E/va. Plan Ch,r:k
,L1rob. Permit Fee: Mimi_Permil Fee: lilts. Po'mit Fe.r:
Olhrr m h. /n.sp. Other Plumb Insp. Li Other Ela•.hm11
:ble(h. hi,P. Fes: Plumb. bl.rp. Fee: tiler. hisp. Fee:
NOTE: This estimate does not include fees due to other Departments(ie.Planning,Public Works, Fire,Sanitary Sewer District,School
District,eta). Thesefees are based on the prefintina information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Re.sohuion 11-053'F_ll' 7/1/11) FEE QTY/FEE MISC ITEMS
!'lull Chcck /'ec:
.Supp/. PC Fue
Phinih./,1•lech./tiler.
Permit Fee: $210.00
.Supp/, 111sp Pee
Plmn b.ill-lech.iElec
P/unlh.i.F/ec/l.!lflec Pern/il less'
Construction Tax:
ildmini.str Live Fee,
Work Without Permit? O Yes (F) No $0.00
A elvonced Plurnling Fee:.s.
Trovel Dncuulenlaliun Fees:
Shone Motion Fee: IBSEISMICR $0.65 Select an Administrative Item
Blcha Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $211.65 $0.00 TOTAL FEE: $211.65
Revised: 04/01/2012
`.v .� - v ... .-.. ..,`.w.�t%-/-�M...�-�.--.-^w�.-:�-.:--�:.iil'ri,'-\L\�4T+d'-'.VY'„vdrrhYl`t;�"e,.rev✓.:.M1[�v...-w:-\vy-�=.3."-:i'c^'M:."-..
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.oro
PROJECT ADDRESS _ J y/,,1 C\' APN4
OWNER NAME—r /` PHONE EMAIL
STREET ADDRESS CITV, 5T TE ZIP FAX
CONTRACTOR NAME LICENSE NUMBER 9 �. LICENSE TYPE BUS LIC.0
yam!
COMPANY NAME E-MAIL FAX
STREET ADDRESS _ CITY.STATE,ZIP PHONE
✓ b2- FIs/_� ^ C .F - ��. � ., Sc �_. . `/i// Z t/')/' .� iG " O .'J ;•J
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. 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%" 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: I 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 detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: �- . _ Date:
L'J -- Re,oo/Polico_201 Ldoc revised 02/16/I1
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228, FAX(408)777-3333•buildinD(dcuoertino.om
PROJECT ADDRESSZO3 f` APNM - 3� I ( __ 0-7
OWNERr:AME PHONE E-MAIL
A e
STREET ADD0.' CI Y.STATE,ZIP FAX
l0dnrluiap CA QUO 14y
CONTACT NAME 1T 1 �f^ c PHONE -O E-MAIL
dO cJ
STREETADDRISS CRY.STATE,ZIP FAX
O SoSe Ca. 6
I
❑U4'NFR ❑ OWNER-BUILDER ❑ OWNER AGENT 5r CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCH= ❑E OI:EER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME - LICENSE NUMBER LICENSEIYPE BUS.LIC A 3 3
Eaur
CUSIPANYNk%fE1 E-MAB.
IFAX
S BUJ-r ADDRESS CRY,STA ZIP P!'ONE
02 S
ARC'I IITET�E.NGISLER NAME LICENSE NUMBER BUS LIC.a
COMPANY NAME E-MAIL FAX
SHOA71 ADDRESS CRY,STATE,ZIP PHONE
USE Of ❑ SFD or Duplex XMuld-Family ROOF AREA, e, VALUATIONS,
S-IR';L-II1RIi: ❑ Commercial -- S Ttqq A ,L
EXISl1NGROOFTYPE. ❑BUILT-UPROOF ❑ASPHALTSHINGLPS 13 WOOD SHAKES 13 WOOD SHINra FC p OTHER(-SPECIFY) „L GRA
RLSIOI'E'REPLACE OYES a NO. PLYWOOD fl'A ❑ PLYWD ❑OSB PRCH- (2 ROOF f1YIA
THICKNESS LJ sm- YPEAYEKS- D �' fA
. 1
I'ROPUSEURWF'TYI'E, El BUILT-UP ROOF ASPHALT SHINGLES 13 WOOD SHAKES ❑WOOD SIINCLIiS 13 OTHER ICC-13 REPORT.
DESCRIPTION OF WORK:
#
t e s G
• 11 1r ' , 1 oil i
n
(
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf I have read dus
application and the information 1 have provided incorrect. 1 have read the Description of Work and verify it is accurate. 1 agree o comply wish all applicable local
ordinances and stare laws relating to building co on. dbtho= mtimp fCupenirooenfertheabovo-iden6fiedpropertyforinspectionpurposes-
SignatureofApplicanVAgent: Dale:
SUPPLEMENTAL INFORMATION RE D- OFFICE USE ONLY
If building is;usnciatcd with a Home Owner's Association,provide letter ''"PLAN CTreac TYPE ROUTING SLIP
ofapproval from HOA. ❑ OVER-THE-COUNiTER ❑ BUILDING PLAN"EW
Provide Planning approval to verify if there any restrictions. !'':' ''?'�,.I,, '
❑ RISS ❑ PLANNING PLAN RENTIEW
4
Provide copy o(Manufaaurers Installation SpecificWions. STANDARD . ❑ FIRE DEPT
I.I
Provide signed copy Of Cupertino's Tear-OJT Policy. ❑ OTHER
ReroofiApp_101 Woe revised 03116111