12050226CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS: 20102 NORTIICREST SQ CONTRACTOR: FOUR SEASONS ROOFING PERMIT NO: 12050226
OWNERS NAME: VINCEN'I'C LIN PO BOX 1668 DA'Z'E ISSUED: 05/31/2012
OWNER'S PIIONF.: 4082528842 SAN JOSE. C\ 95109 PIIONF NO: (408)279-0330
Iii;- LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT r PLUMB r
License Clercs GJ -Lic.4 y79/0,10
Contractor IrS4 Date
1 hereby affirm Ihal I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following Mn 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 tabor 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
permit is issued.
APPLICANT CERTIFICATION
1 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
indemnity and keep harmless the 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
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Date S" — J/— /7-
11
2
❑ OWNER -MILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons:
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 (Sce.7044,
Business & Professions Code)
I, as owner of the properly, am exclusively contracting with licensed contractors to
construct the project(Sec.7044. Business & Professions Code).
I hereby affirm under penally of perjury one of the following three
declarations:
I have and will maintain a Cer iBcale 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 limy 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
permit IS Issued.
I certify that in the perfommnce of done work for which this permit is issued, l shall
not employ any person in any manner so as to become subject to the Worker's
Compensation ImvS of California. If, after making this certificate of exemption. I
become subject to the Worker's Compensation provisions of the Labor Code, I must
fortMvith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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 properly for inspection purposes. (We) agree to save
indemnify and keep harmless the 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
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: TEAR OFF EXIS"TING CAI. -Sl IAR 17 ROOFING SYSTEM.
INSTALL 309 FELT UNDERI.AYMENTS ANI) INSTALL GAP
GRAND CANYON SI TINGLES. COLOR'STONEWOOD CLASS A
Sq. Ft Fluor Area: I Valuation: $6500
APN Number: 31637011.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Date: 3I- /--I-
RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed- Ira roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant Date
ALI, ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safely Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code. Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cuperlinu Municipal Code. Chapter 9.12 and the
Ileallh & Safety Code, Sections 25505, 25533, and 25534•
Owner ora horn nl:
Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the pedbmmance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCI IITF.CI"S DF.CLARArill ON
I understand my plans shall be used as public records.
Date I Licensed
CUPERTINO
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 - building(Dcuoertino.orD
PROJECT ADDRESS
O I ^
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APN p
OM'NERNAME
PHONE
E -NAIL
s -
STREET ADDRESS
CITY. STA .ZIP
FAX
e o
CONTRACTOR NAME
LICENSE NUMBER
LICENSE fP �
(,,,
BUS. LIC. n
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
SO2
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CITY.STATE Z.IP
�q.
PIIF.
ON
t{O$-.'t
Nor
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w SI 2
0330
I UNDERSTAND AND AGREE TO THE FOLLOWING:
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.
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.
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 5126.00. 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 8314 and R315 of
the 2010 California Residential Code/ _
Sienature of Aonlicant/Aeent: % Date:
RoonlYolier 201 L.dor rrrised //2/16/11
��������//�� CITY OF CUPERTINO
Iti�l'r`7///I FEE ESTIMATOR - BUILDING DIVISION
FEE ID ROOF AREA
(SX)
1REROOFFRES 1,450
ADDRESS: 20102 Northcrest Sq
DATE: 05/31/2012
REVIEWED BV: Sean
imbi
APN:
BP#:
'VALUATION:
$6,500
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
USE:
Tiler. Insp. Fce
PENTAMATION 1SFDWLR00F
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 ROOF AREA
(SX)
1REROOFFRES 1,450
NOTE: This estimate does not includejees due to other Departments (ie. Planning, Public Works, Fire, Sanitary Sewer District, School
DictrirL err k Thew lees are bated an the nreliminary information available and are on/v an estimate. Contact the Deal for addn 7 info.
FEE ITEMS (roe Resohdion 11-053 Elf 7/1/11)
A loch. /'Inn Check
Phunb, Pleur Cheek
Elec. Plan (.7n'ek
d lrrlr. P•nuil Fee.
Phrnrh. Pond[ Fre:
/ileo. P", mf P,,• :
Orber Mech. In'J"
Olher Plumb Insp.
(Idrer /iter% hrcp.
Hoch. la,p. For:
Phnub. /rr¢. Fee:
Tiler. Insp. Fce
NOTE: This estimate does not includejees due to other Departments (ie. Planning, Public Works, Fire, Sanitary Sewer District, School
DictrirL err k Thew lees are bated an the nreliminary information available and are on/v an estimate. Contact the Deal for addn 7 info.
FEE ITEMS (roe Resohdion 11-053 Elf 7/1/11)
'FEE
QTY/FEE
MISC ITEMS
Plan Check ret:
Suppl. PC Fee
1'h nn 6./d •1c•ch. /ls I cc
Permit Fee:
$210.00
Supp/. hisp tee
1'lunrh.%:Llech.iri ler.
1'lrrnrh./.ddrrh.!llcc Permit ree:
Coiwructiun Tax%
ildministratice Fec:
Work Without Permit? 0 Yes (j) No
$0.00
ddvimced 1,1urv,ing tees:
A
"1 ravel Documen(ntion Fees:
Suone Motion Fee: 1BSEISMICR
$0.65
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$211.65
$0.00
TOTAL FEE:
1 $211.65
Revised: 05/01/2012
3 ITEMS OF 15
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 31637011.00
DATE ISSUED.......: 05/31/2012
RECEIPT #.........: BS000016963
REFERENCE ID # ...: 12050226
SITE ADDRESS .....: 20102 NORTHCREST SQ
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER ............: VINCENT C LIN
ADDRESS ..........: 20102 NORTHCREST SQ
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
OPERATOR: patg
COPY # : 1
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT :
AMOUNT
---------------
1,058.25
---------------
1,058.25
VOICE ID DESCRIPTION
-- ----------------------------
309 EXTERIOR LATH
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
AMEX
VOICE ID DESCRIPTION
---------------------------
311 SCRATCH COAT
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
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
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT :
AMOUNT
---------------
1,058.25
---------------
1,058.25
VOICE ID DESCRIPTION
-- ----------------------------
309 EXTERIOR LATH
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
AMEX
VOICE ID DESCRIPTION
---------------------------
311 SCRATCH COAT
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
o
I REROOF PERMIT APPLICATION 12
C0!-1M.UNI1 Y DEI/ELOPMENT DEPARTMENT' BUILDING DIVISION
10300 TORRE AVENUE '1600IERfNb! CA 65014-3'255
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