12050137 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20308 NORTHWEST SQ CONTRACTOR:FOUR SEASONS PERMIT NO: 12050137
ROOFING
OWNER'S NAME: COSTANDI ROBERTS PO BOX 1668 DATE ISSUED:05/17/2012
OWNER'S PHONE: 4082555624 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIALU COMMERCIAL
License Class C ' 3Q Lie.4 Log(ol RE-ROOF 14 SQ-TEAR OFF EXISTING,CAL SHAKE
�.+ O ROOFING SYSTEM, INSTALL 30k FELT UNDERLAYMENT
F Contractor S Iy Date S^r7 — I Z. &
I hereby affirm that I am licensed under the provisions ofChapter9 INSTALL GAF GRAND CANYON SHINGLES,COLOR
(commencing with Section 7000)of Division 3 of the Business&Professions STONEWOOD
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
1 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 whichthis permit is issued. Sq.FI Floor Area: Valuation:$6500
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for tie performance of the work for which this ,CPN Number:31639040.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep hamilessthe City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply Issued by: V1 L Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RF.-ROOFS:
Signature Dale 5��7�� 7 All roofs shall he inspected prior to any roofing material being installed.If a roof is
- - —� installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicutt: Date
I hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVER S TO BE CLASS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code.Sections 25505.25533,and 25534. [will
1 hereby affirm under penally of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(s)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by The Bay Area Air Quality Management District 1
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2 05, 5533,and 25534.
an
Section 3700 of the Labor Code,for the perfomhce of the work for which this
Owner or authorized agent:
remit is issued.
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person inany manner so as to become subject to the Worker's
Compensation laws of Califamia. If,alter making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
became subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
costs,and expenses which may acerae against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Dale
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(o)cuoertino.org
PROJECT ADDRESS 20308 , I O.-*,We.+
S " APS-
OWNER NAME PHONE
E-MAILV -rCSS+,wc3v5- 5624
STREETADDRESS CITY, STATE,ZIzU�Op
FAx
CA
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.-
Cj 7z/off G-3
COMPANY FAME � E-MAIL. FAA
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CIT .STATE,21P PBONFSTREET ADDRESS SDZ r/O rA1- r� Cc-, %SI
1 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. 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 California Residential Code.
Signature of Applicant/Agent: Date:
Rrraa/Puller ?Ill Ldnr'wuwd 02116111
CITY OF CUPERTINO
3 ITEMS OF 12 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31639040 . 00
DATE ISSUED. . . . . . . : 05/17/2012
RECEIPT #. . . ... . . . . : BS000016846
REFERENCE ID # . . . : 12050137
SITE ADDRESS . . . . . : 20308 NORTHWEST SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : COSTANDI ROBERT S
ADDRESS . . . . . . . . . . : 20308 NORTHWEST SQ
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-0548
RECEIVED FROM . . . . : FOUR SEASONS
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 14 . 00 196. 00 0.00 196 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 197.65 0.00 197 .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
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228.1 •FAX(408)777-3333•I •buildinOCdcuoertino.or0
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❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT gr CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHH= ❑ENGINEER ❑ DEVELOPER ❑ n%AN7
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.nseashJ151 !4,72 10A 0 3 Q3
COMPANY NAME E-MAIL FAX
SIRI'.ET ADDRESS CILIA ZIPPNUNE
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ARCHHECTIENGINTERNAME LICENSE NUMBER HITS LICP
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STREET ADDRESS cn-Y.STATE,ZIP PHONE.
USE OF ❑ SFDor Duplex Multi-Family ROOF AREA: n/ VALUATION'
SIRUCIGRE: O Commercial JVs yy11
EMSTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SIIARcc ❑WOOD SHINGLES err OniER(SPECIFY) A1 S1 L A
REMOVE/REPLACE OYES IF NO. PLYWOOD u>S"- ❑ PLYWD ❑OSB Prl'CFI. 12 ROOF ri•1A
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PHOPOSEDROGFTYPE: ❑BUILT.UPROOF AfASPFA.T"GLES ❑WOOD SHAKES ❑WOOD SHINGLES DOTER I
ICC-FS REPORT•
DFSCRIPDON OF WORK
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Hy my signature below,I certify to each of the fol lowing_ 1 am the property owner or authorized agent to act on the property owner's behal C 1 have read this
application and the information I have provided it correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building con on. orve moves of Cupertino to enter me abovo-identified pmpeny for inspection purposes.
Signature of ApplicmttAgent: Dom: j 1E+ /a
SUPPLEMENTAL INFORMATION REQ1l OFFICE USE ONLY
If building is associated with a Home Owners Association,provide letter MANCeF XTVPR RounscsuP
of approval from I IOA. ❑ OVII ieE-Co1 NTN ❑ BUILDING PUN REVIEW
Provide Planning approval to verify if there any restrictions. I 1 +-3 rE;-'.:n,; •t
❑.EXPRESS - ❑ PLANNING PLAN REVIEW
_ Provide copy of Manufacturer's Installation S ftcations. 1 1 AND
1� .❑..'siANLiJ�¢U- C1 FIRE DEPT
_ Provide signed copy of Cupertino's Tear-OITPolicy. I -j..,I • .a. ❑ OTHER:
Reroojdpp_201/.doc revised 03/16111