12050230 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20142 NORTHCREST SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12050230
OWNER'S NAME: 'FFNG CHAD-TING T AND HUANG TZU-EN E PO BOX 1668 DATE ISSUED:05/31/2012
OWNER'S PHONE: 4088630179 SAN JOSE,CA 95109 PIIONE NO:(408)278-0330
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C"3q Lic,4 4-77- 0r
(r�c�s Qe 3MECH RESIDENTIAL COMMERCIAL
Contractor rJ Dale T-31 - 1Z I
1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING CAL-SHAKE ROOFING SYSTEMS,
(commencing with Sectimr 7000)of Division 3 of the Business&Professions INSTALL 309 FELT UNDERLAYMENTS AND INSTALL GAP
Code and that my license is in full force and effect. GRAND CANYON SIiINGLF.S,COLOR:STONEWOOD CLASS A
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a cenilicate 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 Floor Area: Valuoina:$6500
permit is issued.
APPLICANT CERTIFICATION APN Number:31637007.00 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 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 1S NOT STARTED
indemnify and keep hamiless 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
grandngof this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point.source regulations per the Cupertino Municipal Code,Section
9.18.
5-31- I? Issued by: Date:
Signature Date
❑ OW'NER-RUILDER DECLARATION
RE-ROOFS:
1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any rooting material being installed If a roof is
the following two reasons: installed without first obtaining an inspection,1 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, �I
Business&Processions Code) Signature of Applicant __ Date:
1,as owner of the property,am exclusively contracting with licensed conlmclors to
construct the project(Sec 7044.Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1 hereby affirm under penally 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 S DISCLOSIIRF:
Compensation,as provided for by Section 3700 of the Labor Code,for the 1 have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work I'or which this permit 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 Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safely Code,Section 25532(a)should 1 store or handle hazardous material.
Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I 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&Safely Code,Sections 25505,25533,and 25534.
Compensation laws of Califomia. If,after making this certificate of exemption,I
become subject h,the Worker's Compensation provisions of the Labor Code,I must Own fRor' S� 3 Z
forthwith comply with such provisions or this permit shall be deemed revoked. Dale:
APPIJCANTCERTTFICATION 001 CONSTRUCTION LENDING AGENCY
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 perfnmtance of work's
correct.1 agree to comply wvith all city and county ordinances and state laws relating for which this permit is issued(Sec.3097•Cie C)
to building construction,mid hereby authorize representatives of this city to enter Lender's Name
Upon the above mentioned property Ior inspection purposes.(We)agree to save
indenmily and keep harmless the City of Cupertino against liabilities.judgments, Lender's Address
casts,and expenses which may accrue against said City in consequence of die
granting of this permit.Additionally.the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCIIII'F.Cf'S DECLARATION
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed PrMessional
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR. P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE -CUPERTINO, CA 95014-3255
(408)777-3228- FAX(408)777-3333•buildina(dcupertino.org
PROJECT ADDRESS Zo 1 4 2 APN a
L. e2 S
OWNERN'AMF. PHO ' o E-MAIL
A 1 -7 � �
STREET ADDRESS ! O,� CITY.S E.ZIP C'a. 9 s0/ FAX
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS,LIE.a
f,
COMPANYNAME E-MAIL FAX
STREET ADDRESS Sot CITY.STATE. PHONE
'��'.. S� CA • �f'sn 2 8-27 -os)
I UND RSTAND 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 I/<" 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 properly 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 8314 and R315 of
the 2010 California Residential Cod J
Signature of Applicant/Agent:_ `�''-- Date:
R.•rnolPalirr 2011.dne revim,(10211611l
CITY OF CUPERTINO
3 ITEMS OF 15 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : .31637007. 00
DATE ISSUED. . . . . . . : 05/31/2012
RECEIPT #. . . . . . . . . : BS000016963
REFERENCE ,ID # • . . : 12050230
SITE ADDRESS . . . . . : 20142 NORTHCREST SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TENG CHAO-TING T AND HUANG TZU
ADDRESS . . . . . . . . . . : 20142NORTHCREST 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
171 ADDRESS:.20142 Northcrest Sq DATE: 05/31/2012 REVIEWED BY: Sean
APN: Ir BP#: 'VALUATION: 1$6,500
*PERMIT TYPE: 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, install 30#felt underla ments and install GAF Grand
SCOPE Canyon Shingles, color: Stonewood.
FEE ID ROOFAREA
s.f.
1REROOFFRES 1,450
,I lech. Plop Che,A Plumb. Plan ChetA Flee. Phm Ch,rcA
ah•rh. Perri it Fee Plunrh. Permit Fee: Elec. P.!,vnie Fev.:
Oche, .1 fm h. Insp. Other Plumb Imp. Li Ocher)-le'. brgP.
kch. b,.,p. (2e: Plumb. Lisp. Fee: I,lec. buy. Fce:
NOTE: This estimate does 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 prefindna information available and are only an estimate. Contact the Dept for addn 7 info.
FEE ITEMS(Fee Resolution 11-053 FIT 711/11) FEE QTY/FEE MISC ITEMS
Phill C'hurk 1'ie
.Supp/. PC Fire
Phiinh./F1ech.%E1ec
Permit Fee: $210.00
.Supp/. blsp Fee
l'lrun b_/,1'!c•cl�.%Flee
!'lumh.i:4lrcb.%llec Permit Fee:
ConsIlion Ta.1-:
A(Jon Wistrative 1-e,!:
Work Without Permit? O Yes (E) No $0.00
Adrnured P/amlir{"Mus:
Travel Uacuutenialiarl Fees:
Strong, Motion Fee: IBSEISMICR $0.65 Select an Administrative Item
131da Slds Commission Fee: 1BCBSC $1.00
SUBTOTALS: 1 $211.65 $0.00 TOTAL FEE: $211.65
Revised: 05/01/2012
i IREROOF PERMIT APPLICATION 120 Z 3
CC'. 6"UN1IY DEVELOPMENT DEPARTMENT BUILDING DIViS ION
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