12050228 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20122 NORTHCREST SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12050228
OWNER'S NAME: MITCHELL ANNE PO BOX 1668 DATE ISSUED:05/31/2012
OWNER'SPIIONE: 4089968924 SAN JOSE,CA 95109 PHONE NO:J408)279-0330
�ar LICENSED CONTRACTOR'S DECLARATION r r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class C— 39 Lie.a 412, ( 09 r r r
MECH RESIDENTIAL COMMERCIAL
Contractor FS(L Dale 5-3 1-1 St
I hereby affirm that 1 am licensed under the provisions of Chapter JOB DESCRIPTION:TEAR OFF EXISTING CAL-SHAKE ROOFING SYSTEM,
(commencing with Section 7000)of Division 3 of the Business&Professions INSTALL 30N FELT UNDERLAYMENTS AND INSTALL GAF
Code and that my license is in full force and effect. GRAND CANYON SHINGLES,COLOR:STONEWOOD CLASS A
I hereby affirm under penally of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,u 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.FI Floor Area: Valuation:$6500
permit is issued.
APPLICANT CERTIFICATION APN Number:31637009.00 Occupancy Type:
I certify that I have read this application and state that the above information is
correct.1 agree to comply with all city and county ordinances and slate 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 IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may acerae 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 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
Issued byt ��1 Dater 372
Signature Dale �
❑ OWNF. - II I LDF-R DECLARATION
RF--ROOFS:
hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing 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,
Business&Professions Code) Signature of ApplicmC Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVE GS TO BE CLASS"A"OR BETTER
I hereby affirm under penally of perjury one of the following three
declarations: IIA''/.ARDOUS MATERIALS DISCLOSURE.
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 I have read The hazardous materiels requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505.25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for bycompliance with the Cupertino Municipal Cade,Chapter 9.12 and The Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25,532(a)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued, contaminants as defined b Area Air
y the Buy y Quality Management District 1 will
I certify that in the performance of the work for which this permit is issued,l 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 Health&Safety Code,Sections 25505,25533,and 25531.
Compensation laws of Cal ifamia. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must Owner zeds
forthwith comply with such provisions or this permit shall be deemed revoked. 1e' 1Z
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
1 certify that I have read this application and stale that the above information is 1 hereby affirm that there is a construction lending agency for the performance of work's
coffee[.I agree to comply with all city and county ordinances and stale 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 expenseswhich may accrue against said City in consequence of the
granting of this 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
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 20122 Northcrest Sq DATE: 05/31/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $6,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
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.l.
1REROOFFRES 1,450
Alech. Man C'hrrk Phinrb, Plan Check Etc, !Then Check
AIre;h. Permit Fra: I'hmrh. Perini(h,r: E-1w% !'drrrrir hi•, .
Ocher My h. ln.rp. Other Plumb Insp. 011ier lifer.la¢.
Aitch.hip.Frcr Phnuh. by p.Fee: filer. lisp. Fre:
NOTE: This estimate does not includejees due to other Departments(Le. Planning, Public Works, Fire,Sanitaq'Sewer District,School
District,etc. . These fees are based on the prelimina information available and are only an estimate Contact the De t or addn'l info.
FEE ITEMS (Fee Resohnion 11-053 En' 711//1) FEE QTY/FEE MISC ITEMS'
Plan Chuck Fee:
Supp/. PC Fc'e
l'lurnh.i,l-lerlr.!li lec
Permit Fee: $210.00
.Snppl. hup Fec
1'lumh.1,11ech./l lec Permit Fee:
Cunsirucnon Tax:
rl dinini.wruti ve Fee:
Work Without Permit? 0 Yes 0 No $0.00
:Idi•anccd Planning Fees:
Travel Dncmnenlalinn Fees: A
Strong Motion Fcc: IBSEISMICR $0.65 Select an Administrative Item
131de,Stds Commission Fee: IBCBSC $1.00
.i ,` SUBTOTALS: '$211.65 $0.00 TOTAL FEE: $211.65
Revised: 05/01/2012
CITY OF CUPERTINO
3 ITEMS OF 15 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31637009.00
DATE ISSUED. . . . . . . : 05/31/2012
RECEIPT #. . . . . . . . . : BS000016963
REFERENCE ID # . . . : 12050228
SITE ADDRESS . . . . . : 20122 NORTHCREST SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . .
OWNER . . . . . . . . . . . . : MITCHELL ANNE
ADDRESS . . . . . . . . . . : 20122 NORTHCREST
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-0512
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'
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(okuoertino.org
PROJECT ADDRESS APN>
Z o 2.2 e5 S
OWNER NAME 11 PHONE _ ob2 E-MAIL
VMa Y-1
STREET ADDRESS CITY.STAT 21P FAX
20 Z2 e S s
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.a
8
COMPANY NAME. E-MAIL FAX
O S s \/\
[STRIEFT�ADDIHS S62 CITY,STATE,ZIP PNE
I•�orr\i M1 Se..n oSn G' HO - 2?8. 0330
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 Y<" 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 Code
Signature of Applicant/Agent: Date:
Remo Ynlirr ]III/Joc w,i ed 02/16111
I REROOP PERMIT APPLICATION I Z
�• : ,•� CO'.4d UNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE' CUPERTINO, CA 95014-3255 :
C
IJ P ERTI N 0 (406)777 3228.•7PAX �D(406)777-3333• buildinacunertino.ora
1L II
-- - t I1'1'. I' ' hlA
�9t^ wr�S Q o i
. .� .;' E.,l}-.11'.CfF..dIP„
_. .., .,.._.,:.w ❑ U'A'r.I:R.u:E.vl QCO:fI NACI UK ❑C'UMHACIURAUL\r ❑ AM1111:(-I ❑ I'.'.(;InIIi ll ❑ 11M.Aw-rcN ❑
.LICl73ENUAD)FRLICENSE TYPE 1tUS I.IC.e 3 3
.,
IAA
C1l).Si ArE.Z11,
J., _ �, ate .” C. qSjj ,
_ � .-__--_\_•..____—__.—____—_—. LIC'IiN]G NL'11DlJt 1 uU< IJC—.--___—___
EMAIL :Al
------
SFU of Dup!cS \1uI11-Fallll) iWIF AREA'. : �.C� VALUA nu.N
- .. .,-:F-i—_—iI' ❑.UI. ',J SII INCLLS 11 WWI)SI IA%Ei 011WD SIIIN(iLliS /vlL
Id ' :' ':U. PLPb'WU ❑Y, ❑ rIIIPLYWD ❑USB Pn('ll' v Rwr
�_ _. . . ,. . L .�. sT,'uti � nIIrR`Ir.v ❑ yr 1_�� l7 ru\ � 4 - �I'� rl \s< :�
✓ — I(c IUIVNI+
'.I L_FICII:Y H(v'I' {'�ASPII\ITNIII\GI.LS ❑V."Wne11ARE5 UlI
❑H(x)USIIINULbS � ❑ 11iN !j
1 a
3f PX i S7i n Q C0.' - S �5
r 1 I j . i I ! .- I -.'I '!.
112_._ '�.�—ts_�.i' LL�Ylfi4 Ir 3�n�a1.1 GAlZ
.�.�fW.l� -
j
cI ,
i n C=o�3L -
J f I;
c r.: c:L.;j to v_vn UE the wlluAmy I un uu ploll.rty msnu or uDUwl veJagmt lu acl un Ule pmpa p'mvvt\mu!I, I is v I-_v.r.,
i+
j :inI l l.1 I II..:ve pW1 i11,115y H}�n. cl I hucc read the De cripxon of Wolk yid verity N is aw"iatc I ugr w c-I ipl 'I::I II pl icabiy I.:.:.
.-.. sr 1 .1 l�!u b_I'Jwgv11: g1011. ,.holirt' rvsenlmntt of CulwluuowLn4r Jlc alwvc l`c tynvdp n) lar iln;wlloll pl.l po,-,.
__— 5,11111 'F 'I:\I NFORA(ATION RC D•r- "' OMCEUSEusu —_
"3,n1 i
'. 1 :! 'I ;I I Toni. U•:nu o \aiU'i:.Iwn,pruude I'f lCf �" PLAN CIIEOC TVPC �' HUU'IINC SLIP
OVER TRELOIfNTER ❑ DUILUISG Yla!xcvu;W
I �
E pwP ss '', ❑ I'L%N.NI.\G PI-\V REYIF.\1
I I .
:. -- ❑ -I Ia u t Slk' IICL'LIUnS. ❑ STANDARD ❑ f IkE DEPT
_ I .\`: Ill f rl:OII 1 uhLv' 1 ❑ of la a
I