12070064 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10542 RED FIR CT CONTRACTOR:FOUR SEASONS PERMIT NO: 12070064
ROOFING
OWNF,R'SNAME: WANG TBNG TSAI PO 13OX 1668 DATE ISSUED:07110/2012
OWNER'S PHONE: 4082101247 SAN JOSE.CA 95109 PHONE:NO:(408)278-0330
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMDIERCIAL
License Class C'31�1 Lic.# L1 72(<:)8 RE-ROOF 13 SQ-TEAR OFF EXISTING WOOD SHAKE
ROOF,
Contractor FSS I NC Date -/6` )�— INSTALL 1/2" CDX PLYWOOD TH EN 30# FELT
1 hereby affirm that I am licensed under the provisions of Chapler9 UNDERLAYMENT CLASS A
(commencing with Section 7000)of Division 3 or 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 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.F-1 Floor Area: Valuation:$4500
I have and will mainmin 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:35905011.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I 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 complywith all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,mid hereby authorize representatives of this city to enter
upon the above mentioned propertyfor inspection purposes. (We)agree to save 180 DAYS F M LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may Date:
accrue against said City in consequence of the 7 �U, j C
granting of this permit. Additionally,the applicant understands and will comply Issued by:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18-
O RE-ROOFS:
Signature �C .� Date 7 ��`�Z All roofs shall be inspected prior to any roofing material beug installed.If a roof is
installed without first obtaining mit inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION —7- �o - �Z
Signature of Applicant. Date:
1 hereby affirm that t am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERT .S TO BE CLASS"A"OR BETTER
1,as owner of the property,or my co1Pl0yces with wages as their sole comirnsation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner ofthe property,am exclusively contracting with licensed contractors to IIA7,ARDOUS MATERIALS DISCLOSURE
construct the project(See 7044,Business&Professions Code). I have read the hazardous malerials 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: Ilealth&Safety 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 1
performance of the work for whichthis 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 Ileallh&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.
I certify that in the performance of tic work far which this permit is issued,I shall
not employ any person inany manner so as to become subject to the Worker's
Compensation laws of Califomia. 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. 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 budding construction,mid hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
ARCHITECT'S DECLARATION
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
REROOF TEAR-OFF POLICY 1
_ COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 1
ALBERT SALVADOR, P.E., C.B.O.. BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO ; t 1
(408)777-3228• FAX(408)777-3333•buildinaCadcuoertino.org
PROJECT ADDRESSAPN 4
12,d 'r C I
OWNER NAME PHONE, EMAIL
!Nun = conn Cca 1J ' ', •-/ -
STREET ADDRESS / `� CITY. STATE.7.IP FAX
/n - 4 a-CA t7.,r C r or ;Ar, ( A :i t
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.9
,- 7
COMPANY NAME-Fr,.
AMF. E-MAIL FAX
Fr,. )r Sec.C.� c '�-O JnG
STREET ADDRESS j(J LCITY,STATE.ZIP PHONE
J
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/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 ttie 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 5126.00. 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,thi 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 are required to be installed in accordance with Sections 8314 and 11315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date:
Ro 11'olir1- 2011_doe rrriei•d 0211//11
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO. CA 95014-3255 �( N
CUPERTINO I� (408)777-3228• FAX(408)777-3333•building(c)-cupertino.oro ��- F/
PROJECT ADDRESS APN C, CS C)
OWNER NAME PHONE E-NLAIL
e 8- 2 0- 2
STREE r ADDRESS CITY. So.ZIP ta\
(�u
CONT:\CT NA\IF PHUNE IO 30 E-IIAIL
STREETADDRESS Sot .S CIT\'_STATE.ZIP gou, Tose. CA, qTt
FAA
❑ DINER ❑ OWNER-RLILDER ❑ OWNER AGENT Je CONTRAC rOR ❑COITRACTOR ACE?T ❑ ARCHITECT ❑EI'G11FER ❑ DFCELOIER ❑ TEI INT
("ON'TR\CTORNAME LICENSE NUMBER LICF,NSET PE BLS LIC.=
Four, 5zqAXr'a0k1 Z p
COMPANV NAME SAAE
E-MAIL FAX
STREET ADDRFSS CIT)'_STATE.ZIP ose PHONE
C S'07-
\RCHI
8-0
rECT ENGINEER NAME LICENSE NI:?IBER BUS LIC.=
COMPANY NAME E-MAIL FAX
STREET ADDRESS ).
CITSTATE./IP PHONE
LSE OF ❑ SFD or Duplex Ar
Multl-Family" ROOF AREA r VALLATION AD
STRUCTURE'. ❑ Commercial 3 s :OQ
If
EXISTING ROOF TI'PE CI BUILT-LP ROOF ❑ASPIIALTSHINGLES ae`AOODSHARh:S ❑MOODSHINGLES ❑01 HER ISPECIFYI
REMOYF.:REPLACE YF.S IFNO. PLY\900D I- ❑ PLI'llD ❑ OSB PIl'CH ROOF
❑ \O AYFR THICI:\' SS ❑ is- l\'PF CDS :12 CLASS 'a
PROPOSED ROOF TYPE. ❑BLILT-L'PROOF ASPHALT SHNGLEs ❑AAOOD SI IASEs ❑A\OOD SHINGLES ❑OTHER ICC-ES REPORT°
DESCRIPTION OF WORK
S /?." Cby-
r1i
se e d6
By my'signature below'.I certify to each of the following: I am the property o. oer or autnorized agent to act on the propeal owner's behalf. I have read this
application and the information I have provided is correct, I have read the Description of Work and eerifc it is accurate I agree to complv with all applicable local
ordinances and state laws relating to building cons tion I a orize represSgPii%.g of Cuperino to enter the aboA'e-identitled property for inspection purposes
Signature OfApplicantlAgene Date O
117—
SUPPLEMEN"rAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home 0\\per's Association.provide letter PLAN CHECK n'PEP
of approval from HOA. ElOVER-THE{OUSTER BUILDING PLAN REVIEW
_ Provide Planning approval to veriF ifthere any restrictions. ❑ RE55 ❑ PLANNING PLAN REVIEW
_ Prov a Copy of iManufacturer s Installation Specifications. STAREARD ❑ FIRE DEPT
,.vide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroofApp_1011-doc revised 03/16111