12070119 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21069 RED PIR CT CONTRACTOR:FOUR SEASONS ROOFING PERNII'1'NO: 12070119
OWNER'S NANF,: KARANAM ANANTA P AND AMDADASUGARI N 1'0 BON 1668 DATE ISSUED:07/172012
OWNER'S I'IIONE: 4084461853 SAN JOSE,CA 95109 PHONE NO:(408)278-0130
LICrE�NSSED CON`TRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C.> I Lie.# O r r
NIECII RESIDENTIALCODtI\IERCL\L
Contractor F5(I 1 N C, Date `7- 17 — 12
hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF TEAR OFF WOOD SHAKE INSTALL COMP
(commencing with Section 7000)of Division 3 of the Business S Professions SHINGLES
Code and that ors'license is in full force and effect. CLASS A 13 SQFT
hereby affirm under penally of perjury one of the following two declarations:
1 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
pertrat nance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided I'or by
Section 3700 of the Labor Code,for the performance of the work for which this Sq.FI Floor Area: Valuation:$1500
permit is issued.
A 1'I'LIC,\\I'CIiRT'IPIG\T'ION APN Number:35905021.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnity and keep hamdess the City of Cupertino against liabilities,judgments,
costs,and expenses whichmay accrue against said City in consequence ofthe WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting orchis permit. Additionally,the applicant understands tad will contl'ly 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
—(7-12 Issued bv: ate:��
Signature Date
f/
❑ OWNER-BUILDER DECLARATION
RE:ROOFS:
1 hereby affirm that 1 am exempt from the Contractor's License Law formic of All roofs shall be inspected prior to any roofing material being installed.Ira roof is
the fallowing 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 stmeture is not intended or offered for Sale(Sec,7044,
Business K Professions Code) Signature of Applicant: Date: 7- h—(.rL
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business S Professions Code). AL1,ROOF COVERINGS' O s CLASS"A"OR RE ITER
hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Cenif icate of Consent to self-insure for Worker's I]AZAR DOHS MATERIA IS 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
perlmonance of the work for which this permit is issued. California Ilealth S Safety Code.Sections 25505.25533.and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code Chapter 9.12 and the Health S
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(n)should I store or handle hnznrdous material.
Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued, contaminants as defined by the Bay Area Air Quality Management District 1 will
I certify that in the performance of dm work forvhich this permit is issued,I shall maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
It()(cnlploy any person in any manner so as to become subject lO the Worker's I Ieallh S Safetw Code,Sections 25505,25533,and 25534.
Compensation laws of California 11'.after making this certificate of exemption,I
become subject to the Worker's Contpenswion provisions of the Labor Code,I trust Owner •ottlorize gra:
forthwith comply with such provisions or this permit shall be deemed revoked. Date'
\I'I'I,IC,\\I'CIiR'I'IFIG\T,ION CONSTRIICI'ION LENDING AGENCY
I certify that I have read this application and state that the above information is I hereby of iron that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and slate Imes relining for which this pem)it is issued(Sec.3097,Civ C.
to building construction,and hereby authorize representatives of this cit to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupenino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply AltClll'I'ECI"S DECLARATION
all non-point source regulalirns per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 2A U (o red fir ct. DATE: 07/1712012 REVIEWED BY: bobs.
APN: BP#: 'VALUATION: 1$4,500
*PER,111T TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex PENTADIATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK tear off wood shake install comp shingles.
SCOPE
t
Alwin. Plan Check Plumb. Plan Cheek Flec. limn Check
b/cch. Penuit To,,: Phanb.Peonit)--ce. Islas•. Permit Fee:
Other Afech. Insp. Other Plumb Imp. 01her Fler•.Inst.
Mcch. htsp.Fre: Phnuh. hap. Fee: liter.Insp.Fee:
NOTF_: This estimate does not include fees due to other Departments(i.e. Planning, Public I Porks, Fire,Sanitary Sewer District,School
District,etc.). These ees are based on the relintinary information mailable and are aptly an estimate. Contact the Dept for addn'I into.
FEE ITEMS (Fee Resolution 11-053 Ent 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 OT 0.0 hrs $0.00 $195.00 IRFROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. FeeQ Reg. Q O'f 0,0 its $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Consirucrion Tar:
Administrative Fee: Q
Work Without Permit? O Yes 0 No $0.00 1 G
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
Thwel Doctnnenlation Fus: A
Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
�.
SUBTOTALS: $1.50 $195.00 '. 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
10300 TORRE AVENUE • CUPERTINO. CA 95014-3255
CUPERTINO
(408)777-3228• FAX(408)777-3333•buildinaC�cuoertino.ore
PROIECr ADDRESS �lO! APN0
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OWNER NAME PHONE pp E-MAIL
4,0k A
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STREET ADDRESSCITY•STAT I� FAX
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CONTRACTORNAME LICENSE,-"-RF.R4— fO LICENSE PE, BUS.LIC.0
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COMPANYNAMBn ♦ E-MAIL l,r FAX
STREET ADDRESS �Z CITY.STATE,ZI!!-.TO Q S'lIZ 'VE
I UNDERSTAND AND AGREE TO THE FOLLOWING: rt I
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 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:
RerooJPo1icv_201 I.doc revised 02116111
I ZcD1
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA'95014-3255
(408)777-3228• FAX(408)777-3333•building0cupertino.org
CUPERTINO
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OWNER NAME PHONE PHONE `/ E?tAU.
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CONTACT N'AiIE �i I PHO\E ENAIL
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OWNER ❑ ONER-RUILDER _iwl;❑101WNEE/RAGEG1ENTT 400 TR>CrOR 000STRAC700R AGENT ❑ ARCHITECT�(❑j`ENGISF.F.R ❑ DEVELOPEA ❑ TENANT
CONTRACI'ORNAME I LICF.NSEN01EIER I LICE\SEE BUS,LIC..
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COMPANY NANIC C-NIAIL FAX
STREET ADDRESS T'.SLUE.21P PHONE -
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ARCHIFECDENGINEERNAME LICENSE WSIBER I BUS.LIG•
COMPANY NAME E-.\t AIL I FAX
STREET ADDRESS CIT'.STATE.ZIP PHONE
LSE OF ❑ SFD or Duplex jif Multi-Family ROOF ARCA: VALUATION: �-r�
STRUCTURE: C] S VCommercial � ^J 0
OF
TYPE:ROOF PE: ❑BUILT-CP ROOF ❑ C
ASPHALTSHI\GLES �L, OODSHAKF:S ❑UEl OTHER(SPECIFY)
RCMOVE:REPLACE YFS ENO. PLYKOOD ji t ❑ PLY'w'D ❑OSB PITCH- ROOF
❑ NO I .LAYER THC I:\ESS ❑ 4 T\'PE CDX )Z
PROPOSED ROOF TYPE'. ❑BUILT-U �/P ROOF �45PHALT SHINGLES 111AOOD SHAKES ❑x'OOD SHI\GEES ❑OTHER ICC-ES REPORT a
DF.SfRIPT10\Oi UORR:
s 4�kll IIA It CD)
FIj 00A +�en
ae e w bin d
Ry my signature below.I certify touch of the following: I am the propem'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
ordinances and Stara laws relating to buildine cons ;ion. 1 a''orize rcprese civ of Cupertino to enter the aboveidentil fm'ed propefor inspection purposes.
Signature of Applicant/Agen[ Date: a0 12
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home O\mer'S Association.provide letter PLAN CHE"TYPE ROUTIROSLIP
of approval from HOA. Go _T E COUNTER ❑ ILDINC PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_Provide copy ol'ManufaCturer's Installation Specifications. 1:1 STANDARD ElFIREDEPT
vide sighed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
RerooJApp ZOU.doc revised 43/16/11