12050010 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20363 NORTHCOVE SQ CONTRACTOR:17OUR SEASONS ROOFING PERMIT NO: 12050010
OWNER'S NAME: GOOD FSTER V TRUSTEE PO BOX 1668 DATE. ISSUED:05/01/2012
OWNER'S PHONE: 4082573807 SANJOSE,CA 95109 PIIONF NO:(408)278-0330
IF LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class G SI Lie,h (4-72-10 r r r
• r� MECH RESIDENTIAL COMMERCIAL
Contractor FS F=11
Date .��Z' �2
hereby affirm that 1 am licensed under the provisions of Chapter JOB DESCRIPTION: RE-BOOP TEAR-OF-P E&INSCAL-SI)A6Ii ROOFING
IA
(commencing with Section 7000)of Division 3 of the Business&Professions SYSTEM,INSTALL 30N FELT UNDERLAYMENT NS"TALI.
Code and that my license is in full force and effect. 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 the Labor Code,for the performance of the work for which this Sq.Ft Fluor Area: Valualinn:$6500
permit is issued.
APPLIC.ANTCERTIFICATION APN Number:31641071.00 Occupancy'Type:
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 stale laws relating
to building construction,mrd 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 DAYS19M LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
s' Z•/Z Issued Date:
Signature Date 2
❑ OWNER-11111.DER DECLARATION
RF.-ROOFS:
1 hereby affirm Thal I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material beug 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 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 Appli - Date
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code).
AL1.ROOF CO INGS TO RE CL,\SS"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 U•\L•\RDOIIS MATERIALS DISCLOSURE
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 I leallh&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 Ilcalth&
Safety Code.Section 25532(a)should I store or handle hazardous material.
Section 3700 ol'thc Labor Code,for the performance of the work for which this
Additionally.should I use equipment or devices which emit hazardous air
pemtit is issued. contaminants as defined by the Bay Area Air Qualily Management District I will
I ccoifj that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Cade,Chapter 9.12 and the
not employ any person in any inanner so as to become subject To the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,alter making this cenifncate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must Owner a r riz ent:
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
Zhamithere
NSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify thin I have read this application and stale that the above information is I hereby at is a construction lending agency for the performance of work's
correct.I agree to complywith 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 ofthis 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
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
COPE RTINO 10300 TORRE AVENUE -CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333-buildinDCdcuoertino.ora
PROJECT ADDRESS 7 7 // So APNn
OWNER NAME - ( PHONE E-MAIL
STREET ADDRESS _ G ^ , qq CITY. STATE,ZIP. FAX
CONTRACTOR NAME LfCENSE NUMBER r ^LICFASETYPE BUS,LICA
�2 /J { r - �9
COMPANY NAME (' ^ - EMAIL FAX xn
STREET ADDRESSCITY,STATE,ZIP T �- PHONEr 7
-S-F. / S-/ /z. iq;lt'" L7� -U �SCi
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/<" 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 CDde. �J
Signature of Applicant/Agent: / Date:
/ - Remo/Poliel'_2011.dnereri.ced02/16/11
CITY OF CUPERTINO
3 ITEMS OF 24 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31641071 . 00
DATE ISSUED. . . . . . . : 05/01/2012
RECEIPT # . . . . . . . . . : BS000016675
REFERENCE ID # . . . : 12050010
SITE ADDRESS . . . . . : 20363 NORTHCOVE SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : GOOD ESTER V TRUSTEE
ADDRESS . . . . . . . . . . : .20363 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
r .
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
I
GUPERTINO (408)777-3228.'•FAX(408)I, 777-3333•building0cuoertino.orD
PROJECT ADDRESS 'Z 0363 p �V� APN0 L 7
7
ORNLR NA.SIE PHONS-O O Z 3 S E-MAIL
O A�
STREEF ADDRESS CITY.STATE,ZIP FA%
2-0,3462 e S
CONTACT NAME k QC fir^ n PHONE EMAIL
cN �Q
S IREE'r ADDRESS CT'.STATE,ZIP FAN
4 Sose Cw. q6jjj
❑ UU NER ❑ OR'NLR-BUILDER ❑ OWNER AGfM, "Ir CONIMCFOR ❑CONTRACTOR ADEM ❑ ARCHITECT ❑INGINELR ❑ DEVELOPER ❑TLNANT
CONTRACTOR NAME 'LICENSE NUMBER LICENSE TYPE BUS.LIC.a
9 113
CONIPANY cA]IE I E-MAIL FAX
AREEFADDRESS CITY,STA ZIP PI'ONE
02
ARCI UTF.(T,ENGINEER NAME LICENSE NUMBER BUS.LIC.N "
CONIPANY NA%IE E-MALL FAX
S-IREET ADDRESS �,/ CITY,STATE.ZIP PHONE
USE OF ❑ SFD or Duplex Ig MIdd-Family ROOF AREA VALUATION Sy��
SIRUCI URL' (3 Commercial • ` ' •1 5 00
EXISTING ROOF TYPE 11 BUILT-UP ROOF ❑ASPHALTSNWGLFS- ,❑ 1111WOOD SHAKES ❑WOODSHINGLES feI OTHER ISPECO\) AL SI♦A
RENIUVE iKEPLACE IDYES IF NO. PLYWOOD ,Q K" ❑ PLYWD ❑OSD PfICH: . I ROOF fT
r❑- N NLA :R F [J. " E. �' �:12 I. A
PROIVSEUROOF TYPE C1 BUILT-UP ROOF A(ASPIIALT SIONIBFS 13 WOOD SHAKES 11 WOOD SHINGLES ❑OTHER I
ICC-ES REPORT N
DESCRIPHON OF WORK:
_ n w _
111 A el 4z .061# 1 ' } S kQ I I G
AE 6rosel CoA DA
w Co or S40ma"w;%A
Hy my signature below,l certify W each 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 have provided is correct. 1 have read the Description of Work and verify it is accumk. 1 agree tO comply with all applicable local
ordinances and state laws relating To building conon.' thor' tativw of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanUAgen1: Date: S--I.-12
SUPPLEMENTAL INFORMATION RE D OFFICE USE ONLY
_ I f building is associated With a Home Owners Association,provide letter "MAN CHECK TYPE- - ROUTINGSUP
ol'approval from HOA. - I.."..1' "' .
❑ OVEII-THE{;OUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. "
_ ❑-LDITRFS$ ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ Si TANDARD ❑ FIBEDEPT
Provide signed copy of Cupertino's Tear-OTT Policy. - ') '"'gip ❑
orxeR:
Rerog6App_1011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20363 Northcove Sq. DATE: 05/01/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $6,500
*PERMIT TYPE: Minor Building,Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR0OF
USE: I 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.l.
1REROOFFRES 1,500
.11 h. Ploa Check Plmoh. Plait Check E/Ve. Plan(:heck
bleed. l'ermil Ere: Phmlh. Pe"nit Fec: like. Ponnil Pet:
Orbrr,lle<h. /n.ep. Ocher Plumb Insp. Other filer.Insp.
.Llcch,he,p. Pec: Plruub. Insp.Pre: Elcr.Insp. Pec:
NOTE: This estimate does not includejees due to other Departments(Le Planning, Public Works,Fire,Sanitary Sewer District,School
District,eta). These fees are based on the prelimina information available and are only an estimate Contact the De t or addn 7 info.
FEE ITEMS (Pee Resolulion 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS
Plan C/ruck l•toc
.Supp/. PC Fre
!'lun+h.hllecle/!ilc c
Permit Fee: $210.00
Supp/. lisp Fee
Plunr h.6hleeh.//i/cz:
/'llrrnh.hl•/eeh./lilac Peruul Fee:
Cunsnvl N0n Tau..
ildininisinnive Pelf:
Work Without Permit? O Yes Q No $0.00
:Idrnuc•ed Phlruring Pecs:
Treece/Unlaurrenlatinn Fee.+•:
Strong Motion Fee: IBSEISMICR $0.65 Select an Administrative Item
131de,Stds Commission Fee: IBCBSC 1 $1.00
SUBTOTALS: , .$211.65 $0.00 TOTAL FEE: $211.65
Revised: 04/01/2012