12070008 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10552 RHD FIR CT CONTRACTOR:FOUR SEASONS R00I7ING PERM IT NO: 12070008
OWNER•SNAME: CLARK EDWARD AND WIPAWEE PO BOX 1668 DATE ISSUED:07/022012
OWNER'S PHONE: 2105663535 SAN JOSE,CA 95109 PDONE NO:(408)2/8-0330
CV LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C- $ 1 Lic.q —17`.ILOf
MECH r RESIDENTIAL r COMMERCIAL r
Contractor FS 2. I fJC • Date
I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROOF,INSTALL 1/2"
(commencing with Section 7000)of Division 3 of the Business&Professions CDX PLYWOOD AND 30W FFLT,INSTALL CERTAINTEED
Code and that my license is in full force and effect. PRESIDENTIAL COMP SHINGLES 13SQFT
1 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,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 Arca: Valuation:$4500
permit is issued
APPIJCANT'CERTIFICATION APN Number:35905004.00 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(he above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnity and keep hamtless 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
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 by. Dater
Signature Date 7'2^/2—
❑ OWNER-0111.DF.R DECLARATION
RE-ROOFS:
1 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,I agree to remove all neo materials for
h 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(Sce.7044,
Business&Professions Code) Signature of Applimm Dale- 7-2- /?_
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOFCOVERXt.YSTO BE CLASS"A"OR BETTER
I hereby affirm under penally of perjury one of the following three
declarations: ILC/CRDOl15 MATF:RI,\I,S DISCLOSURE
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 materials 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. 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 Ileallh&
Section 3700 of the Labor Code,for the performance of the work for which this Safely Code,Section 25532(x)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 die work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
mol employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of Cal ifomia. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,1 must Owner or Ih agent:
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANTCERTIFICATION CONSTRUC'T'ION LENDING AGENCY
1 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 perfommnce of work's
correct- I agree to comply with all city and county ordinances and slate laws relating for which this pemnit 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 hamnless the City of Cupertino against liabilities,judgments, Lender's Address
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 ARCHITECT'S DECLARATION
91. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
REROOF TEAR-OPF'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•buildinD(acuoertino.ora
PROJECT ADDRESS /1 APN0
S C
OWNER NAME O ;/O—S6.G�3SS E-MAIL
ed k
STREETADDRESS CITY, STATE., FAX
/ rr?- QA
CONTRACTOR NAME LICENSE NUMBE LICENS PE BUS.LIC.N
COMPANY NAME .Zbwpl, E-MAIL FAX
rm.rOS
STREET ADDRESS CITY.STAT PHONE
So 1 Z `3$
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 andall.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 plywoodNailing 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'isapplied without first obtaining an approved inspection will
require the removal of all new material d'ownto 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. There-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'aie required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential.Code.
Signature of Applicant/Agent: Date:
00 RerogJPolicv_20I Ldoc reri,ad Ol/l6ll I
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 10552 Red Fir Ct DATE: 07/02/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $4,500
*PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1R2R00F
USE: >3 Stories O Yes 0 No PERMITTYPE:
WORK Tear off existing wood shake roof, install 1/2" CDX plywood and 30# felt install certainteed presidential
SCOPE comp shingles.
FEE ID ROOFAREA
s.f.
1REROOFMRES 1,300
?ld,:h. Plnn ( lbel. Phnnh. flan Cha('6 1_/", N,m CHr,:k
I''er: /'/nmh. /'ennir /4..'.
Ulhrr.l h"h. hisP Odra Plamb Insp. Li I Dile,lila hop.
.14, h. imp_ 1,r: Plrunh_ lnop. 6ec lih, ln,p. /,-:
NOTE: This estimate does not include fees due to other Departments(ie. Planning, Public Works, Fire,Sanitary Sewer District,School
District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or ahln7 info.
FEE ITEMS (l'ce Resolution /1-053 E/T 711111) FEE QTY/FEE MISC ITEMS
Plan ('hod.' i'rc.
Permit Fee: $195.00
Suigrl. llrc� 1 ��:
/'hon b.;'dderll.%/ileo
Phunh.;;blrrleii:'(cc l'ramil 1�ec:
C,ull�/flit Pion Tlo
:I.Gnini,anrufrd l4°r:
Work Without Permit? O Yes (F) No $0.00
,Irh',�nrrd Pl<uulil�� 1 ,:cs:
/amcl llncluurll/nlhm ('ccs:
Stione Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
BU4 Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $196.50 $0.00 TOTAL FEE: $196.50
Revised: 0 7/0112 01 2
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228-FAX(408)777-3333-buildinaCdcuoertino.orO
PROJECT ADDRESS APS= / Q I,
S �
OWNER NAME PHONE EAIAIL
E wa 2✓0-r66-3x3
STREEI'ADDRESS CIT). STATE.ZI 1 FAN
CONTACT NAME. PHONE E-NIAIL
49!2-7_18-0330
STREETADDRESS Sot S CITY.STAI'E. )I P FAY
❑OW.\FR ❑ O-NER.RUILDER ❑ OUTER AGENT Je CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ESGISFFR ❑ DEVELOPER ❑ TESANT
("ONTRACTOR NAME ILICENSE NUMBER LICF.SSET PE_59 BUS.LI('.a
417.1 oa7
COMPANYNAME SAME
E-MAIL FAX
STREET ADDRF.S$Sot CITY.STATE.ZIP PHONE
_ o� ose C -o
ARCHI TECTrENGINEER NA\IE I' LICENSE NUMBER BUS LIC
CO\IPANY NAME E\TAIL FAN
STREET ADDRFSS CITY,STATE.LIP PHONE
USE OF ❑ SFD or Duplex je Multi-Family RGOF AREA: �/ VALUATION: �—
STRUCTURE, L1Commercial
,�PRy/ 13 S' u
bo
EXISTING ROOT TYPE: ❑ P
BUILT-UP ROOF ❑ASPI IALT SHINGLES e"OODSHAAF's ❑WOOD SHINGLES ❑OTHER ISPECIFI"I
RENIOVF.'REPLACE (YF.S IF SO. PLY\1'OODl' 11PLYn'D 13 OSB PII'Clr. ROOF
❑ \'0 -LAYER THI ASE ❑ SB" I'1'PE CDX '12 CLASS A
PROPOSED ROOF TYPE- ❑BLILT-UPROOF 4SPHALT SHINGLES 11W'00DS11AKES ❑\VOODSHINGLES ❑OTHER ICC-ES REPORT.
DESCRIPTION OF\VORAo 1/a��
ame
3f
ee E.,,,. a
By mw signature below.1 cenify touch of the following: 1 am the propcny owner or authorized agent to act on the property owner's behalf. I have read this
application and the information 1 have provided is 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 Palatine to building cons tion. I a orize repres tiv of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicam/Agent: Date: -7/1161612
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated With a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP
Of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to veri ry if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
Provide copy'Of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEvr
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroofApp,-2011.doc revised 03/16/ll