12070121 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21067 RED FIRM' CONI'RACFOR:FOUR SEASONS ROOFING PERMIT NO: 12070121
OWNER'SNAME: MANISH&ASHWINIMAWVAN 1'0 BON 1668 DATE ISSUED:07/172012
OWNE,R'SPBONE: 4088071195 SAN JOSE.CA 95109 1`1[ONE NO:(408)278-0330
LICENSED CONFRACFOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class 39 Lie.# l a 08
r
,nc� q ^l,? I .NIECII RESIDENTIAL r r
COMMERCIAL
Contractor 1'J 1�. N�-• Date
I hereby affirm that I am licensed under the prorisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROOF.INSTALL 12'
(Commencing with Section 7000)of Division 3 of the Business&Professions CDX PLYWOOD THEN 304 FELT UNDERLAYMENT.INSTALL
Code and that niv license is in full force and effect. CERTAINTEED PRESIDENTIAL COMP SHINGLES,COLOR
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 Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided mr by
Section 3700 of the Labor Code,far the performance of the work for which this Sq.Fl Fluor Area: Valuation:$4500
permit is issued.
APPLICANTClIRTI FICATION APN Number:35905020.00 Occupancy Type:
I certify that I have read this application:rad state that the above information is
correct. I agree to comply with all city and county ordinances.rad slate Imes relating
to building c0n5lNclion,and hereby authorize representatives of this city to enter
upon[lie above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabiliticS,judgnlents,
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 applicmu understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
,�_��.
9.18. J
/�Gc � Z Issued by:•.%' - - Date:
Signature 8. / Y��— Dale .. ,
tr
❑ OWNER-RUILDER DECLARATION
RF-ROOFS:
hereby aRmn that I nm exempt from file Contractor's License Law fur one of All roofs shall be inspected prior.to any roofing material berg installed.If a roof is
the following two reasons: installed without first obtaining an inspection,1 agree to remove all new materials for
I,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(Sec.7044,
Business&Professions Code) Signature of Applieanc Date:—7 —/`j —'Z
I,as mvner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COS'ER1 TO BE CLASS"A"OR BETITHE
hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self-insurC for Worker's HAZARDOUS MATERIAI S DISCLOSURE
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
1 have and will maintain Worker's Compensation Insurance,as provided for by compliance with tire Cupertino dl unici pal Cade.Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Sarety Code,Section 25532(a)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminams as defined by the Bar Area Air QualityManagement District I will
I certify that in the performance of the work forwhich this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code.Sections 25505.25533,and 25534.
Compensation Imus of California. 1 f a0er making dais certiticate of exenhption,1
become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or
forthwith comply with such provisions or this permit strait be deemed revoked _ Date•.
APPIACANT CEIRTI FICATION
CONSTRUCTION LENDING AGENCY
1 certify that 1 have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to conhply with all city aid county ordinances and state laws relating for which this permit 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
indemnily and keep harmless the City of Cupeninoagainst liabilities.judgments. Lender's Address
costs,and expenses which may accrue against said City in consequence 01'111C
granting of this permit.Additionally,theapplicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section .\RCIIITECf'S DECLARATION
9.18. 1 understand my plans slmall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
:121 ADDRESS: red fir ct. DATE: 07/1712012 REVIEWED BY: bobs.
.\PN: RP#: / Oc -ZD OL 'VALUATION: $4,500
*PERMIT TYPE: Building Permit PLAN CIIECE"TYPE: Alteration/ Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMITTYPE: lSFDWLROO 4
WORT: tear off wood shake install comp shingles.
SCOPE
Meeh, Plan Check Phunh.Plan Check Elec. Plan Check
Alecto. Permit Fee: Plumb, Peomil Fee: Pie- Permit Fee:
Other Mech.Insp. Other Plumb/mvp. Ll I Other Elec.Imp.
Meeh.hmp. Fee: Plumb. losp.Fre: Flee,Insp.Fee:
NOTE: This estitnute does not includejees due to other Departments(i.e. Planning, Public !Narks, Fire,SanitarySewer District,School
District, etc.). These fees are bused on the prelintinan information available and are only nn estinutte. Contact the De r or tabby?info.
FEE ITEMS (Fee Resolution 11-053 Elf 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1,300 S.f.. Re roof
Suppl. PC Fee: Q Reg. Q OTFO-0-1hrs $0.00 $195.00 IRFROOFRFs
PMH Plan Check: $0.00
Permit Fee: $0.00
Supp]. Insp. Feer Reg. Q OTQO hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tax:
Administrative Fee: 0
Work Without Pennit? O Yes iD No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential E)
Travel DocinnenlaHon Fees: Building or Structure
A
Strong Motion Fee: IBSEISAIICR $0.50 Select an Administrative Item
Bldg Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $1.50 $195.001 TOTAL FEE: $196.50
Revised: 07/01/2012
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•building(dcupertino.org
PROJECT ADDRESS �J C7t, APN#
OWNER NAME4 PHONE E-MAIL
Q�-4fd-?—it
9
STREET ADDRESS CIN.STATE.,}{P '�D � 4� FAX
ge%ef
CONTRACTOR NAME LICENSE NUMBER 8 LICFAS^J BUS.LIC.M C��
COMPANY NAME E-MAIL FAX
Stile iw
STREET ADORESS�Z ^ CITY.STAEW.IP _�, ��j2 PHONOOP-279-033
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 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. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, 1 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 are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date:7- Z
Rero J/PolicP_?01 l.doc revised 0211611!
EMIREROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA'95014-3255
G V PERTI NO (408)777-3228- FAX(408)777-3333• building0cupeFtino.oro
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PROJECT:ADDRESS Zl0 6 Lam.L. AFN
OWNER NAME �/a ; /r�Ge�V({Ai/I `^T'I PROSE Ot-�O,7_ 11 q -V1AIL
STREEI'.AUURESS (7—, O6Z Q / c;, C* 1. ST>TE.ZIP CA 17- F S
CONTACT NAME: /[•e•� /' PHONE E-MAIL
uredo Cw2ArHS l 4 -d sol
STREel'ADDRESS5'07- CITY.ST At ZIP
❑OWNFR ❑ ON;\ER-BUILDE0. ❑ OU'SER>GEM 01101TMCTDR ❑CO]TRACTOR>GENT ❑ ARCHITECT ❑E]GINEF.R ❑ DRVELOPER ❑ TENANT
CONTRACI'ORN4ME LICFNSE.'UNIBER l LICENSE TI'PE l BUS.LIC•
Z Q213
COMPANYNAME SAF4E _j E-NIAIL l FAX
STREET ADDRESS SoZ CITY.STATE.ZIPS... OSe C l PHONE(404R-7--78-0
Z8-0
ARCHI'FECiENGIN'EER NAME LICENSE NUMBER BUS,LIC.
COMPANY NAME l &XIAIL FAX
STREET ADDRESS CITY.STATE.ZIP PHONE
USE Of ❑ SFD or Duplex JC (Multi-Family ROOF AREA; VALUATION:
STRUCTURE: ❑ Commercial 3 S Sao
EXISTING ROOF TYPE: ❑BUILT-UPROOF ❑ASPIIALTSHINGLES ;COODSHAAES ❑"OODSHINGLES ❑OIHERISPECIFYI
RCMOVF.:REPLACE XYES IFNO. PLYWOOD j6z C3PLT'W'D 11OSB PITCH ROOF
❑ NO -LAYER THICKNESS ❑ ',S- TYPE CDS 7112 A S' A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF J4ASPHALT SHINGLES ❑WOOD SIIAKFS ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT:
DESCRIPTION OF\fORKt "A" Cox S
eof -E F!nd�
01 It 44ka se A PC a S I A e 14kk"I comdin a
By my signature below.I certify w each of the tollowing: I am the property owner or authorized agent to 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 work and verify it is accurate. I agree to comply with all applicable local
ordinance and state laws relating to buildin_e cons tion. I aorize r<prese ' tiv sof Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicanl/Agenc Date as 12
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_If building is associated with a Home Ow'ner's Association,provide letter PLaNCHECKTYPE ROUTING SLIP
ofapproval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PWSNING PLAN REVIEW
Provide copy ofManufacturer's Installation Specification. ❑ STANDARD ❑ FIREDEPT
Provide Signed copy of Cuperti no's Tear-Off Policy. ❑ OTHER:
ReroojApp_10i Ldoc revised 03116111