12070062 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10538 RED FIR CT CONTRACTOR:FOUR S17ASONS PERMITNO: 12070062
ROOFING
OWNER'S NAME: SF17MANN ANITA G PO BOX 1668 DA'Z'E ISSUED:07/102012
OWNER'S PIIONE: 4085591977 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
1 \_
LICENSED CON'TRACTOR'S DECLARATION JOB DF-SCRIPTION- RESIDENTIAL COMMF-RCIA1.
License Clercs Lic.4 �'�.1 2. ti, O $ RE-ROOF 13 SQ-TEAR OFF EXISTING WOOD SHAKE
I-,+ �1 T, 1 ROOF,
Contractor 1 SpV TtJC' Date D' I'L INSTALL I/2" CDX PLYWOOD THEN 30# FELT
I hereby affirm that I 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.
I 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 Cade,for the
performance ofthe work for which this permit is issued. Sq.Ft Floor Area: Valuation:54500
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 ollhe Labor Code,for die performance of the work for which this
APN Number:35905009.00 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 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 DAY7 LAST CALLED INSPECTION.
indenmity and keep harmless the City of Cupertino against l iabil hies,judgments,
costs,and expenses which may accrue against said City in consequence of the / O - /
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: 7.
with all non-point source regulations per the Cupertino Municipal Code,Scction
9.18.
— /�, /Z RF:ROOFS:
Signature / Date All roofs shall be inspected prior to any roofing material beimg installed Ifa roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUDDER DECLARATION r
Signature of Applicvnl:/ Date,
1 hereby affirm That 1 am exempt from the Contractor's License Law for one of
the following two reasons: ALI.ROOF COVE: IN , TO BE:CLASS"A"OR BETTER
I,as owner of the pmpery,or my crrployees with wages as their sole comfensation,
will do the work,aid the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusvely contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE:
construct the project(Sec 7044,Business&Professions Code). I have read the hazardous materials requirements under Chapler 6.95 of the
California Ilealth&Safely Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the fallowing three maintain compliance with the Cupertino 1lunicipal Code,Chapter 9.12 and the
declarations: Ilealth&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's 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 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 ticallh&Safely Code.Sections 5505,25533,and 25534.
Section 3700 of the Labor Code,for die performance of the work for which this —?
permit is issued Owner or authorized agent: Uale:
I cenily that in the performance of the work for which this permit is issued,I shall
not employ any person manymanner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LE:N DING AGENCY
become subject to die Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the perl'ommance 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. 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 ARCHITECT'S DF.C.I,A R:1'1'ION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accme 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
' 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•buildingCa)cuoertino.org ;
PROJECT ADDRESS APNp
OWNER NAME qq II PHONE _ ' E-MAIL
7.7. _.
STREET ADDRESS CITY, STATE.]IIP FAX
/n 3 CA ( u er A C A 61 TO
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC,Y
(.11 ;LIU� r Jul
COMPANY NAME�- E-MAIL FAX
STREET ADDRESS CITY.STATE.21P T PHONE
iJZ 1- n ni n �..
17 1 17 06' -1G -JS l
1 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/fasteriers 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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: 1 am the property owner or authorized agent to act on the
property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code. �.
Signature of Applicant/Agent: C,// ,'��_�___ Date:
L �
ReroolPulirr_201 Ldor.....oed 02116111
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 _(1�
CUPERTINO (408)777-3228• FAX(408)777-3333•buildinO(0)cupertino.orO ��CPU ?
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PROJECT.\UORESSr-3g dU iP\- 7 O b I
OWNER NA\IE PHONE EAI AIL lJ
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STREEI'AUDRESS CITY. - TE ZIP FAS
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CONTACT \A\" PHONE PHONE 'O 301 EJIAIL
STREETADDRESS Sot S CIT)'.STAIE. ].IP Fa\
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❑OwNFR ❑ 011ERBUILDER ❑ OWNER AGENT Je COXTRAC FOR 13 CONTRACTOR AGENT ❑ ARCHITECT ❑ E\GI\FFR ❑ DEVELOPER ❑ TEIAIT
('ONTRACIORNA\IE LICE.\SEAL'\IBER LICENSE T PE BUS LIC'.=
EA1.1111' 9"r,6111
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COMPANY SAME S E-M NU FAX
STREET ADDRFSS CI TY.STATE.ZIP PHONE
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\RCHI rECTENGINEER NAI$E LICENSE\I:\IBER BUS.LIC.e
COMPAN)'N,WE E MAIL FAX
STREET ADDRESS CIT)',STATE.ZIP PHONE
USE OF ❑ SFD or Duplex j(Multi-Family ROOF AREA. Ae \'+LLAI'IOY
STRUCTURE ❑ Commercial SSZO
EXISTING ROOF TYPE: ❑BUILT-GP ROOF ❑.ASPILALTSHI\OLES aA\OODSHA6F.S ❑`AOODSHINGLE.S ❑OI HER ISPECIF)'1
RCVOyF:REPLACE VIES IFSO. PLN\% �'.e" ❑ "LI" ❑ OSB PIl'CH -1 ROOF
❑ N I . A)'FR THICKNESS C S ❑ S.S" l)'P CD\ '12 cl ASS A
PROPOSED ROOF TYPE: ❑BLUT-UP ROOF XASPHALT SHINGLES ❑GOOD SI IARES ❑\\ODD SHINGLES 13 OTHER ICC-ES REPORT.
DESCRIPTIO]OF)4pR\'.
lA."
Clerkmaill-IragA 'o a6
By in,sienamle W101-I Ce"Ify to each of the following: I am the propem'owner or authorized agent:o act on the property'owner's behalf. I have read this
application and the information I have provided is correct, I have read the Description of\York and<eF f, is is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building cons tion. I a orize represe ti% of Cupertino to enter the above-identi tied prOpen) for inspection purposes.
Signature MApplican✓Agene Date. O
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated\a iLh a Home O\vner s Association,provide letter P N'CHECK TYPE ROUTING SLIP
Of approval front HOA. O\'ER-THE-COUNTER BUILDI\G PLAN REVIEM'
_ Provide Planning approval to verify if there any reS[rlCti005. ❑ EXPRESS ❑ PLAN?'ISG Pux REVIEN'
Pr Ide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Of Policy. ❑ OTHER:
Re,oof4pp._2011.doc revised 03116/11