12070069 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21053 RED FIR CT CONTRACTOR:FOUR SEASONS PERMIT NO: 12070069
ROOFING
OWNER'S NAME: AVINASII UMAP PO BOX 1668 DATE ISSUED:07/11/2012
OWNER'S PIIONF-: 4086400384 SAN JOSE,CA 95109 PHONE-NO:(408)278-0330
loLICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL
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License Class C_19 Lie.# 47alo? RE-ROOF 13 SQ-TEAR OFF EXISTING WOOD SHAKE
ROOF,
Contractor Fs�t toje--• Date rZ INSTALL 1/2" CDX PLYWOOD THEN 30# FELT
1 hereby affirm that I am licensed under the provisions of Chapter 9 UNDERLAYM ENT CLASS A
(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 penally of perjury one of the following two declarations:
I have and will maintain a cenificate 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. Sq.FI Floor Area: Valuation:$4500
1 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
APN Number:35905014.00 OccupancyType:
permit is issued.
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct. 1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
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 Perron, Additionally,the applicant understands and will comply Issued by ` Date: '
with all nun-point source regulations per the Cupertino Municipal Code,Section
9.18.
' RE-ROOFS:
Signature �C� Date7d�'/��s�- 2 All roofs shall be inspected prior to anyroofing material being installed If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following Iwo reasons: ALL ROOF COVE: 'CS TO BE:CLASS"A"OR BETTER
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(Sec.7044,
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to ILAZARDOUS MATERIALS DISCLOSURE;
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Ilealth&Safely Code,Sections 25505,25533,and 25534. 1 will
1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safely Code.Section 25532(a)should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District l
performance of the work for which this permit is issued, will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505.25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent:
permit is issued- Dale:
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby allirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked, w'ork's for which this permit is issued(Sec.3097,Civ C-)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and slate 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 ,\RCIIITECT'S DECLARATION
and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point Source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
t
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR, P.E.;C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUP,ERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333. .buildino(a)cuoertino.oro
PROJECT ADDRESS APN 4
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OWNER NAME AV711eala 0^01,$P
PNONE EMAIL
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STREET ADDRESS - CITY, STA IP FAX
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CONTRACTOR NAME LICENSE NUMBER LICENS§TYP BUS.LIC.n
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COMPANY NAMESe I 'F EMAIL FAX
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STREET ADDRESS CITY.STA, P PHONE
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
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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 dowmto 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.ofl'/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 on-site to review at.the,time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed.
i
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: 1 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. 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 Resident ial.Code.
Signature of Applicant/Agent: Date:
Reroq/Policr_2011_dor rewsed 02116111
I
REROOF-PERMIT APPLICATION �CA
j COMMUNITY.DEVELOPMENT DEPARTMENT• BUILDING DIVISIONdD
10300 TORRE AVENUE•CUPERTINO.CA 95014-3255 /�
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CUPERTINO I (408)777-3228• FAX(408)777-3333•building(�cupertino.oro 0
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PROJECT ADDRESS dr3 APN= o
OWNER NAME J- PHONE J VE-MIlL V
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STREET ADDRESS r-:9CITY. STATE,4tP FAX
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CONTACT NAME I PHONE 'O 3c E-NAIL
STREETADDRESS�O� ;� S4-. CITY.SU 1'E. Z.IP FAX
❑ON'NFR ❑ OWNER-RUILDER ❑ OWNERAGENT A CO1TRACTOR ❑COYTRACTOR IGEIT ❑ ARCHITECT ❑EN'GINF.FR ❑ DFYELOPER ❑ TES.AuT
CONTRACI'ORNAME .LICF.NSENLMBER LICENSEPE BUSLIC.-
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COMPANY NAME S E-MAIL FAX
STREET ADDRESS CITY.STATE.ZIP PHONE
02 a "e C 1?-6
ARCHi rECT.ENGINCER NAME LICENSE N1 NIBER BCS.LIC
COMPANY NAME E-MAIL FAX
STREET ADDRESS CIT)'.STATE.].I P PHONE
USE OF Cl SFD Or Duplex _� Multi-Family ROOF AREA: +✓ A'ALLUl10N O
STRUCTURE'. ❑ Commercial ' S
EXISTING ROOPTY'PE, ❑BUILT-CP ROOF ❑ASPHALTSHINGLES r,N'OODSHAKES 1Jw00DSHINGLES ❑01'HER(SPECIFY)
REMOVE,REPLACE XYES IF NO. PLYWOOD JCPLN%%D ❑ OSB PD'CH' ROOF
❑ N eLAYERS - THICKNESS 135S" 1')P CDX '12 C A , A
PROPOSED ROOF TYPE; ❑BLILT-UPROOF - dSPHALT SHINGLES ❑AA'ODD ST AKES ❑\GOOD SHINGLES 13 OTHER ICC-ES REPORT
DESCRIPTION OF WORK, 1/Z t f
taonA s
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By my signature below.I eenif4 to each of the following: I am the propem owner or authorized aeent to act on the propem owner's behalf. I have read this
application and the information I have provided is correct.'I have read the Description of Work and eerily it is accurate, I agree to complg withal]applicable local
ordinances and state laws relating to building cons tion I a onze represe u.vg of Cupertino to enter the above-identified property for inspection purposes,
Signature of ApplicandAgenc06— Date: O
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_If building is associated with a Home Owmer's Association.provide letter PLAN CHECK TYPEounnc suP
Of approval from HOA. � 'ER-THE-COUNTER ❑'BUILDING PLAN REVIEW
Provid Planning approval to verify if there any restrictions. ❑ EXPRESS El PLANNINGPLANREVIEW
_ P vide cop),of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy ofCupertino's Tear-OfFPolicy. ❑ OTHER:
ReroojApp_2011.doc revised 03/16/11