12050007 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:20293 NORTHCOVE SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12050007
OWNER'SNAME: HIGGINS JOE PO BOX 1668 DATE ISSUED:05/012012
OWNER'SPHONE: 4082579184 SAN JOSE,CA 95109 PHONE NO:(409)278-0330
LICENSED CONTRACTOR'S DECLARATION r r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class c-vf Lie.9 Ai a l a 8 r r r
T ryry MECH RESIDENTIAL COMMERCIAL
Convector TSI-,Tlx�• . Date-S;L-12
' JOB DESCRIPTION: RE-ROOF TEAR OFF EXISTING CAI:SHAKE ROOFING
1 hereby affirm that l am licensed under the provisions of Chapter 9 SYSTEM
(commencing with Section 7000)of Division 3 of the Business&Professions AND INSTALL 30k FELT UNDERLAYMENT AND INSTALL GAF
Code and that my license is in full force and effect. GRAND CANYON SHINGLES,COLOR:STONEWOOD CLASS A 15
1 hereby affirm under penally of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insurc 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 Workers Compensation Insurance,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:$6500
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:31641064.00 Occupancy Type:
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 City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORT( IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. 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 t T CALLED INSPECTION.
Signature Date S 2-/� Issued by: Date:
5Z lZ
❑
ONNI114 .R-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of RF.-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being 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 Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant Dale:�.Z• �Z.
construct the project(Sec.7044,Business&Professions Code).
1 hereby affirm under penalty of perjury one of the following three ALI,ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS 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. I 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 Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code.Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this pernit is issued,l shall contaminants as defined by the Bay Area Air Quality Management District 1 will
not 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 Cal ifamia If,after making this certificate of exemption,I Health&Safety 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. Owner rite enl: e►
Date. J 7
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I cenify that I have read this application and stale that the above information is
correct.I agree to comply with all cityand county ordinances and state laws relating I 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 properly for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless 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 permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'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 . . . . . . . . : 31641064 . 00
DATE ISSUED. . . . . . . : 05/01/2012
RECEIPT #. . . . . . . . . BS000016675
REFERENCE ID # . . . : 12050007
SITE. ADDRESS . . . . . : 20293 NORTHCOVE SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER HIGGINS JOE J
ADDRESS . . . . . . . . . . : 20293 NORTHCOVE SQ
CITY/STATE/ZIP . . . :. CUPERTINO CA, CA 95014-0507
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
:121 ADDRESS: 20293 Northcove Sq. DATE: 0510112012 REVIEWED BY: Sean
APN: BP#: `VALUATION: $6,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD Or Duplex PENTAMATION 1SFDWLROOF
USE: P PERMITTYPE:
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
Id•,h Ih,rk I'lunrh. Ph...Chnrk Elr,'. l'lm Clnrh
IL•rtli. 1'.•,1111!Fres l'lnmh. 1"!"?w Pru: /iter-. 1',111111/4a;:
rdru".'.Ir.lr. l,np 011u-'Pllunh ln,vp, f/lhrr likr. lri,p.
.Id,r h_lmp. l4r' El
!Tenth, hop. l'i,, !.'ler. ht,p. /."'
NOTE: This estimate floes 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 prelimina information available and are only an estimate Contact the Dept for afldn'I info.
FEE ITEMS (Eec Kc.sohnion 1/-059 E(/.' 71111/) FEE QTY/FEE MISC ITEMS
l'hui Chis l; fir:
Sapp/ VC l:'r•,.
l'ltunh.;':1.1C,:Ir.ilacc
Permit Fee: $210.00
Srq�pl, hip/, f'c c
1'hruth.;�llrc/r.;7ilrc
PhII,Ih,flIck'lr_?lit. fermi/ Fee.
C-mim 11, lion Trcc:
Work Without Permit? Yes Q No $0.00
,irlriuerrrl 1'luruin,� /.�,e,s.
7 fore!Doeluurinalinn f i(e.e.- A
Slronu Motion I cc: /BSEISMICR $0.65 Select an Administrative Item
131de Stds Commission Pec: IBCBSC $1.00
SUBTOTALS: $211.65 $0.00 TOTAL FEE: $211.65
Revised: 04/01/2012
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 1
(408)777-3228• FAX(408)777-3333-building(acuoertino.org
PROJECT ADDRESS 1 ,11 ,4_ APNa
ti
OWNERNAMF. _ -
kill
-I L C PIONF. E-MAIL
71 A C
STREET ADDRESS _ J C CITY, STATE.ZIPi _ FAX
CONTRACTOR NAME LICENSE NUMBER rV LICENSE TYPE^ BUS.LIC.a
COMPANY NAME' r .[7 E-MAIL FAX
STRF.ETADDRESS ' CDCV.STATE.Z.IP PHONE v _
1 UNDERSTAND AND AGREE TO THE FOLLOWING:
/ ,I
I. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
'- 1
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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf I understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections 8314 and R315 of
the 2010 Califomia Residential Code. _
Signature of Applicant/Agent: �— /-- Date:
Hcroo/Pnlicr_2011.d.. rrri.a•d 02116111
i
Inc) 0oc)-7
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
AVENUE 1 .
10300 TORRE AVENCURTINO,CA 95014-3255
1 .
CUPERTINO (408)777-3228,•FAX(408)777-3333•buildinaCdcuoertino.orD
PROJECT ADDRESS Zo2q 3APN a _
NorJ&aoue S� : -
OWNERNAME
71og PHO MAD.
o - S
SKI:Er ADDRESS�OZ `3 C/�• CITY.ST�7,E,ZIP FAX
CA, qtol
t'ONTACr NAME 1� as 2wr'es QTY I PIIIOIC IO E-MAIL
SrREFrADDRCSSCnY,STATE,ZIP FAS
O SOSP- CTA. 5
❑UVNER ❑ OW'NER-BUILDER ❑ OWNr.RAGENr 'IWCONTRA( ❑CONIRAMRAGENr ❑ ARCIOTC`T ❑DRGIN'EE.R ❑ DEVELOPER ❑ TINAVF
CONTRACT00.NAME LICENSENUMBER LICENSETYPE BUS.LIC.0 3 3
COMPANY NAME t E-MAIL FAX
S IRLLF ADURFSS 02 CITY."
ZIP I'I IONE
ARCHITECT,ENCi NFFIt NAME I LICENSE NUMBER BUS LIC.a
COMPANY N'A.NE E-MAIL FAX
STREE r ADDRESS CITY.STATE,ZIP PHONE
USE OF ❑ SFD or Duplex Multi-Family ROOFAREA: VALUATION:
STRUCTURE ❑ Commercial 5 6 ,r C QD
E.XISrINGROOFTYPE: ❑BUILT-UPROOF ❑ASPHALT SItNmEs E3 WOOD SHAKES 11 WOOD SUING.!RS P OnIER(SPECIFY) qL Stye
KF
RE.UOVE rKEPLACE XYFS IF NO. PLYWOOD p`A- ❑ PLYWD ❑OSB Pll'cl r KWF ft
❑ . n 1. - I CKNE$ LJ TYPE x �— 1 2 CLAS.' A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF A(ASPIIALTSHINGLFS 13 WOOD SIWCES ❑WOOD SHINGLES ❑OnIER ICC-IS REI`ORTn
DFSCRIPIION OF WORK'.
_ n _
Jy I 1 3 • s N
co!
By my signature below,l cenify,to each of Ne following: Ism the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information 1 have provided iscorrect. 1 have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local
urdin,mces and stale laws relating to building cc 'on.' tho=_Xrescittefives of Cupermo to enter the above-identified pmperty for inspection purposes
S ignalureof ApplicanOAgent Dale: 57-1 - 12—
SUPPLEMENTAL INFORMATION REQA&D - OMCE USE ONLY
_If building is associated with a Home Owners Association,provide letter "-`-F1_4NCkI1xXTYPK- ROtmxe SUP
ol'approval from HOA. 0 .`� `„' ' '.
OVER-TF I. UNTKR ❑ BUILDING PIAN REVIEW
Provide Planning approval to verify if there any restrictions.-
❑ EKPRESS` • ❑ PLANNING PIAN REVIEW
Provide cop),of ManOIaCIDR`rS IOSIaIlah00 Spl'CIFICid10115. ❑ STANDARD ❑ FIRE DEPT
I'nrviJe signed copy of Cupcnino s Ten-ORPolicy. ,_; ❑ On1ER:
ReroofApp_201 Ldoc revised 03116111