12070125 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21079 RED PIR CT CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12070125
OWNER'S NAME: FONTES NANCY A ET AL PO BOX 1668 DATE ISSUED:07/172012
OWNER'S PlIONE: 4082109741 SAN JOSE,CA 95109 PIIONE NO:(408)278-0330
Fay LACIINNSSED Ct NTRAC1'Of I
R''�SDECLARtA�'T'ION BUILDING PERMIT INFO: BLDG r ELECT'C PLUDIR r
Liccncc Class C _- L
( Lie. 1 / 2( 08
D1EC11 r RESIDENTIAL r COMMERCIAL r
Contractor PS i?, Ina G' Date :7 ('7'� 2_
r JOB DESCRIPTION: RE-ROOF TEAR OFF WOOD SHARE INSTALL COMP
1 hereby affirm that I am license(]under the pnrrisiuns of Chapter 9 SHINGLES
(commencing with Section 7000)of Division 3 of the Business S Professions 13 5017
Code and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the following tno 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 for by
Section 3700 of the Labor Code,for the performance of Ole work for which this Sq.Ft Flour Arca: \'aluntion:$4500
permit is issued.
API'LICA NI'CFItTIFICATIf1,N MIN Number:35905026.00 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 mid 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
indemnify and keep harmless the City of Cupertino against liabilities,judgments. WITHIN IRO DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the
gramingofthispermit. Additionally•,the applicant understands acid will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
(,_IrZ Issued by: ��Date:
Signature Date
❑ OWNF. /nII.DER DECLARATION
RF:ROOFS:
hereby affirm than am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the fullm%ing t%yo reasons: installed without first obtaining an inspection,I 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,.rad the structure is not intended or offered for sale(Sce.7044.
-2-1Business R Professions Code) Signature of Applicant: Date.7_0 1-2-
1,
,as owner of the property,am exclusively contracting%k fill licensed contractors to
construct the project(Sec.7044,13usiness&Professions Code). ALL ROOF CO\', INGS TO 1315 CI.ASS"A"OR REl-I'ER
hereby affirm under penalty of perjury one of the following three
declarations:
I hive and will maintain a Ccnifaare of Consent to self insure for Worker's HAZARDOUS\L%TFRIAI.S DISCLOSURE
Compensation,as provided for by Section 3700 Ofthe Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of file
pcdonnance of the work for which this permit is issued. California Ilea kh S Safety Code.Sections 25505,2.5533,and 25534. I will main Win
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ilealth 3
Section 3700 of the Labor Code,for the performance of the work for which[his Safety Code.Section 25532(x)should I store or handle hazbrdous material.
Addifionaliv.should 1 use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Jlanagement District I will
I certify that in the performance of One 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 I Iealth S Safety Code,Sections 25505,'_5533,and 25534.
Compensation laws of California. If,after making this certificate of esenmption,I
become subject to the Worker's Compensation provisions ofthe Labor Code,I must
forthwith comply%yith such provisions or this permit shall be deemed revoked. air: �Z
A PPLI C\NTCERTI FICTION N'S'IRUM IONLENDING,\GF.NCY
I certify that I 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 fork's
correct.I agree to comply with all city mil county ordinances had 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.(Wc)agree to save
indemnify and keep harmless the City of Cupertino 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 understandsand will comply ,\RCI I I'I'ECI"S DECLARATION
all non-point source regulations per the Cupertino Municipal Code,Section
9.l 8. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
1:21 ADDRESS: l) red fir ct. DATE: 07/17/2012 REVIEWED BY: bobs.
APN: BP#: 'VALUATION: $4,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLROOF
i
WORK tear off wood shake install comp shingles.
SCOPE
Meeh. Plan Check Plu nb. Plan CheVA Flee. Plan Check
hiech. Permit F(,r: Plumb.Permit rec: Elec. Permit Fre:
Other Afeeh. Imp. Odmr Plumh Insp. Other riev.huP.
Mcch.Imp.Fre: Phnah, hist). Fee: Elec.hup.Fee:
NOTE: This estimate.docs not include fees due to other Departments(i.e. Planning, Public I Porks, Fire,Sanitary Scnner District,School
District, etc.). There ees are based on the preliminar3v information available and are adv at estiamte. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-093 EfC 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1,300 s.f. Re-roof
Suppl. PC Fee: (j) Reg. O OT] 0.0 [its $0.00 $195.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Feer Reg. O OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Crnrclruction Tax
Administrative Fee:: Q
Work Without Pennit? O Yes Q No $0.00 G
Advanced Planning Fee: $0.00 Select a Non-Residential G
T rrmel Doc umentatinn I,eesr Building or Structure
11
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $1.50 $195.00j'% , TOTAL:FIE:; $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•buildinoCa)cuoertino.orct
PROJECT ADDRESS Z/o7y `,a APN0
OWNERNAME ONE E-MAIL
0.A w e PHd
STREETADDRESS Z tor7 , al
r f''1' • CITY.ST�7i ZIP �1 O CA FAX
CONTRACTOR NAME ` LICENSE N M7aO LICE7JSf�TYPF�,� BUS,LIC.0
COMPANY NAME E-MAIL ��,f FAX
STREETADDRESS ` // f IA S CITY.STNS Z" -O Se CA 9X- 11- PNONE ff-O
Jo r'fn 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/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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections 11314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date:
RerooJPolicv_2011.doc revised 02/16111
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA'95014-3255
(408)777-3228• FAX(408)777-3333 •building6DOupertino.oro
CUPERTINO
PROJECT ADDRESS /0
7 t!5'4
I APN 3� 0
J I V I�tip
OWNERNA\IE PHONE E-MAIL
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STREE'I'dUDRESS 7-/0,79 p , F' G11. CITY.SIP u P e glmt C4A FAN
CONTACT N'AMF PHONE E-NI.AIILL V
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STREEF ADDRESS CITI'.STATE.ZIP FAX
X02 �n;n� S- / I San SoSe C�A_QS
Cl 0.1-FA13OWNER-BUILDER ❑ OUNER AGENT 1 COITRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TEN A17
CON. RACTORN:A\IE I LICE NSENUSIBER Z I LICENSET'PE.59
I BU'S.LIC.+
COMPANY NAME SAkE EQIAIL I FAX
STREET ADDRESS CITY.SLATE.ZPHONE
502 IP w oSe C -2 B-o
ARCHI'rEC-DENGINEERNAME LICENSE Nt'MBER - BLS.LIC.•
CONIPANYN'.AME I E-MAIL I FAX
STREET ADDRESS CITY,ST ATE ZIP PHONE
/
LSE OF ❑ SFD or Duplex F Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial aayy 3 S 7 Soo
EXISTING ROOF TYPE: ❑BUILT-CPROOF ❑ASP[[ALT SHINGLES ��$vOODSHAKES ❑u'OODSHINGLES ❑OTHFRISPECIFYJ
REMOVF.:REPLACE YES IF xO. PLYWOOD /lt;- ❑ PLY'WD ❑ OSB PITCH ROOF
❑ N AYFR T I[I:NESS ❑ TYPE COS '1 2 GSS A
PROPOSED ROOF TYPE: ❑BCILT-UP ROOFASPHALT SHINGLES ❑WOOD SIIAI:E$ ElOOD SHINGLES 11 OTHER ICC-ES REPORT:
DF.SCRIPiION OF WORN: `/Z t�
S
F 11 LA3 0 0A +l en 30# 41+ end-rAu- en+ Flnwllj
a '" 'l,%i n a
Ry my signature below.I cenify to each of the following: I am the property owner or authorized agent to an on the property owner's behalf. I have read chis
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 state laws relating to building cons tion. I a prize repreit ' tis of Cupertino to enter the above-identified property'for inspection purposes.
Signature of.ApplicandAgtnr. Date: a�
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home O\t'ner's Association.provide letter PLAN CHECI:TYPE ROUTING SLIP
of approval from HOA. ❑ OYER-THE.COUNTER ❑ BUILDING PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ P",NNINC PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIREDEPT
Provide signed copy of Cupenino s Tear-Off Policy. ❑ OTHER:
Reroof4pp 1011.doC revised 03116111