12070066 CITY OF CUPERTINO BUILDING PERMIT
BUILDING.ADDRESS: 21051 RED FIR CT CONTRACTOR:FOUR SEASONS PERMIT NO: 12070066
ROOFING
OWNER'S NAME: SABABI FARAMARZ AND BARBARA S PO BOX 1668 DA'Z'E ISSUED:07/11/2012
OWNER'S PHONE: 4082780330 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL U COMDIERC[A I.
License ClassC49' Lic.p ]e�.to S RE-ROOF 13 SQ-TEAR OFF EXISTING WOOD SHAKE
,,�,, 7_/0^/2 ROOF,
Contractor "7 �fiG Date INSTALL I/2" CDX PLYWOOD THEN 30# FELT
I hereby affirm that 1 am licensed under the provisions of Chapter 9 UNDERLAYMENT CLASS A
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
hereby affirm under penalty 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. Sq.Ft Floor Area: Valuation:$4500
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 ,APN Number:35905013.00 Occupancy Type:
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. I 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 permit. Additionally,the applicant understands and will comply Issued la Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RF:ROOFS:
Signature Date 7^/O—/Z All roofs shall be inspected prior to any roofing material being installed-If a roof is
installed without first obtnining an inspection,I agree to remove all new materials for
inspection
❑ OAA •:R-BUILDER DECLARATION
7
ate:
1 hereby affirm that 1 em exempt from the Contractor's License Lew for one of Signature of Applicant:
the following two reasons: AL1.ROOF COVERT 'GS O 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)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS S DISCLOSURE
construct the project(See 7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California llcallh&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: Ilealih&Safety Code.Section 25532(a)should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Workers material. Additionally,should I 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
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505.2:- ,and 25534.
Section 3700 of the Labor Codc,for the performance of the work for which this7'1a'A2
permit is issued. Owner or authorized agent: Date:
I certify that in the performance of the work for which this permit is issued.I shall
not employ any person in mty manner so as to become subject to the Worker's
Compensation laws of Cal ifomia. 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 affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work'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 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
upon the above mentioned property for inspection purposes-(We)agree to save ARCHITECT'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 nun-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR. P.E.,C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE CUPERTINO,CA 950143255
CUPERTINO -
(408)777-3228• FAX(408)777-3333•building(.cuoertino.org
PROJECT ADDRESS ZIoS APN4
OWNER NAME F PHONE E-MAIL
a Sa. 02 sus- &31 ti
STREETADDRESS OS CITY. STATF ZIP O FAX
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CONTRACTOR NAME LICENSE NUM ER LICEY TYPE BUS.LIC.a
COMPANY NAME 6 E-MAIL FAX
STREET ADDRESS . CITY,ST P PHONE
S70-4- '
8-
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 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'/<" 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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. 7 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential,Code.
Signature of Applicant/Agent: Date: -7
RerooJPnlicr_11111.dnc revised/12/16/11
REROOF PERMIT APPLICATION Q�
COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014.3255 /1
(408)777-3228•FAX(408)777-3333•building(cDcupertino.ora n p
CUPERTINO
PROJECT ADDRESS 2- IoS APN= ( V,5 V
0\\'NER NAME PHONE -E-\TAIL
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STREE I'ADDRESS CITY. STA'E LIP - - F\Y
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ARCHITECT-ENGINCEN NAME LICENSE NLNISER BLS.LIC
CONIPANY N:\ME E MAIL FAY
STREET ADDRESS CIT\'.STATE./IP PHONE
ESE OF ❑ SFD or Duplex jif Multi-Famfly ROOF AREA. tALLAIION _e9_
STRUCTURE- ❑ CommercialII�� /3 S J Z)o
E\'ISTING ROOF TI'PE. ❑BL'ILT.EP ROOF ElASPHALTSHINGLES r`AOODSHAI:E.S ❑wOODSHINGLES ❑OIHERISPECIFYI
REMO\'F.REPLACE YES IFNO. PLN\c00D jd'.;' ❑ PL1%ND ❑ OSB PITCH ROOF
1-11NO •LAN FRS THICK\ SS 13CS. 1)PE CDY '12 CLAS$ A
PROPOSED ROOF TYPE. ❑BL'ILTUPROOF A(ISPHALTSHINGLES ❑\\OODSI"KES ❑\\OOD SHINGLES ❑OTHER ]CC-ES REPORT•
DESCRIPTION OF\\ORI:'
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!ePresitleiI camp slkia�es . a
Ry my signature below-I certif, to each of the followine: I am the propem'm.ner or authorized aeent to act on the propemowner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and seri:::it is accurate. I aeree to comp]v with ell appbc'able local
ordinances and state laws relating to building cons tion. 1 a orize Teprese tic of Cupertino to enter the abo\'e-identilied propem'for inspection purposes.
Signature of Applicant/Aeent: Date O
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ON'LV
_If building is associated\vith a Home O\cner's Association.provide letter PLAN EH ECJ:TYPE �ROUTING SLIP
Z
o'a] from HOA. f' .ER-THECOUNTER 1'1 BUILDING PLARREVIEW
Planning approval to verif% ifthere an%restrictions. ❑ EXPRESS ❑ PLANN'ING PLAN REVIEW
copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIREDEPT
signed copy of Cupertino's Tear-Off Police. ❑ OTHER:
Reraof.4pp-2011.doc revived 03N6/I I