12060149 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10556 RED FIR CT CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12060149
OWNER'S NAME: MUELITMAN CLARENCE PO BOX 1668 DATE ISSUED:06252012
OWNER'S PHONE.: 4085930037 SAN JOSE,CA 95109 PHONE SO:(408)278-0330
9' LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C-S uc,o l{'?@11019 MECH r RESIDENTIAL r COMMERCIAL r
Contractor Fs 9- Ift)C• Date 6-2S`
I hereby affirm that I nm licensed under the provisions of Chapter 9
JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE,INSTALL COMP
(commencing with Section 7000)of Division 3 of the Business&Professions SHINGLES CLASS A 13 SQFT
Code and that my license is in full force and effect.
1 hereby affirm under penally of perjury one of the following two declarations:
I have and will maintain a cenif icate 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 nuuntain Worker's Compensation Insurance,as provided for by Sq,Ft Floor Area: Valuation:$4500
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:35905006 00 Occupancy Type-.
APPLICANT CERTIFICATION
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 state laws relating
to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the Igo DAYS FROM LAST CALLED INSPECTION.
granting of this permit Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section /� r
91, Issued by - Date: C7" L-3•
Signature Date
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All rooks shall be inspected prior toany roofing material bcug installed If a roof is
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of installed without first obtaining an inspection.I agree to remove all new materials-for
the following two reasons: inspection.
1-as owner of the properly,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, Signature of Applicant: Date:6"Z S- Q.
13usinesS&Professions Code)
I,as owner of the properly-am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALI,ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penally of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's 1 have read The hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the I Iea11h&
I have and will maintain Worker's Compensation Insurance,as provided for by Safely Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Qualify 1llanagement District I will
permit is issued, maintain compliance with the Cupertino Municipal Cade.Chapter 9.12 and the
I certify that in the perfnmmnce of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
not employany'person in wry manner so as to become subject to the Worker's
Compensation laws ofCalif'oria. If,after making this certificate of exemption,I Owner
become subject to the Worker's Compensation provisions of the Labor Code,I must Date:
Forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRIIC'I'ION LF:NDINC.AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I hawc read[his application and state that the above information is for which this permit is issued(Sec.3097,Ciy C.)
correct. I agree to Comply with all city and county ordinances and state laws relating Lender's Name
to building construction,;rad hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
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 ofthis pcmtit.Additionally,the applicant understands and will comply ARCIIITF.CT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Dale
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 10556 red fir ct. DATE: 06/25/2012 REVIEWED BY: bobs.
APN: BP#: 'VALUATION: $4,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY Multi-Family Dwelling Buildino is PENTAMATION 1R2R00F
USE: 3 Stories Yes 0 No PERMITTYPE:
WORK tear off existing wood shake install comp shingles.
SCOPE
1/r,h. N. t./w,A, Phmth. Pluu C7irrA /i/ee. /Y,m('17"k
Ii."J, l'r,n it Fe": I'I,unh. Permit F,"o_ i-il" Pmn,it F:.':
1pp,-r Jlr,h. 1"';' other Plrunh h; Uthrr//"' bz,P_
.1/.'rh_hl'/). /?. l'lumh. [mp. Fe,=: FIs_/nye. P;s:
NOTE: This estimate does not include fees due to other Departments(ie. Planning, Public Works, Fire,Sanitary Sewer District,School
District,etc. . These fees are based on the relimina information available and are only an estimate. Contact the Dept for addn7 info.
FEE ITEMS (Fee Re.sohdion 11-053 E2 71111/) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 NEI s.f. Re roof
Suppl. PC Fee: Q Reg. 0 OT FO.0 hrs $0.00 $182.00 1RER001'MRE
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Feel@ Reg. 0 OT To.oThrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
L„Ir.vnvrtinn 7r1:
A,bninf.rtrntir,r lrr: O
Work Without Permit? 0 Yes 0 No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential (D
7rtmrl DnuntlnounN„n Flus: Building or Structure 0
Strom Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
131de Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $1.50 $182.00 TOTAL FEE: $183.50
Revised: 06/30/2012
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
(408)777-3228- FAX(408)777-3333-buildina(D.cuoertino.orD
PROTECT ADDRESS Orr Fr
sad /` C+. APN•
OWNERNAMEJ PHONE E-MAIL
wrence Mug AAJIL i 96r-S?s-003?
STREET ADDRESS O CITY.IT ZIP FAX
CONTRACTOR NAME - LICENSENUMBER LICENSE TYPE BUS.LIC.— 1412a
C�
COMPANY NAME E-MAIL FAX
1
STREET ADDRESS - CITY.STATE.ZIP PHONE
T6 Z-
0 (-
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. 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 730 - 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 reunited. 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 onsite 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, 1 certify each of the following is true: 1 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. 1 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:
Reroo/Policr 201 I.doc revived 02/16111
REROOF PERMIT, APPLICATION
!VII COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
0RE AVENUE.CUPERTINO, CA'95014-3255
CUPERTINO 228j-.FAX(408)777-3333•builtlinonu cuoert'no oro
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