12070127 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21071 RED 17IR CI' CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12070127
OWNER'S NAME: RIPPENTROP LOIS 13 AND ROBERT PO ROS 1668 DATE ISSUED:07/17/2012
OWNER'S PHONE: 4088465344 SAN.IOSE.CA 95109 PIIONENO:(408)278-0330
-9— LICENSED CON-TRAM'OR'S DECLARATION
rr ,A��-1 BUILDING PER\IIT INFO: BLDG r ELECT r PLUMB
License Class G-� v
Lic.4 l /�Llot r r r
q -1 PI F.CIi RESIDENTIAL COMMERCIALContractor_FS`-I � I�-1c - Date I -tq -I`2-
herebyaffirm that l am licensed tinder the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF TEAR OFF WOOD SHAKE INSTALL COMP
(Commencing with Section 7000)of Dk ision 3 of the Business S Professions SINGLES
Code and that n1v license is in full force and effect. 13 SQ F1'
hereby affirm under penally of perjury one of the following taro declarations:
I have and willmaintain a certificate of consent In 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 dte work for which this Sq.Ft Floor Area: Valuation:54500
permit is issued.
API'LIC\\I'CFH'I'IPIC,\'I'I(1N APS Number:35905022.00 Occupancy Type:
I certity that I have read this application and state that the above information is
correct.I agree to comply with all city mid county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property l'or inspection purposes. (Wye)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indenaifyandkeepharmlesstheCityofCupertinoagainstliabilities,judgments, WITHIN I4U DAYS OF PERMIT ISSUANCE O12
costs,and expenses-,Which may acerae against said City in consequence of the
graming ofthis permit. Additionally,the applican understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulaticns per the Cupenino Municipal Cade,Section
Issued by: - Date:�J/ ��(
Signature Date7-t7-
Cl
-t7❑ OAAN -R-BUILDER DECLARATION
RE-ROOFS:
1 hereby affirm that I am exempt from Thr Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following ban 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 magesas their sole compensation, inspection.
will do the work,and the structure is not intended or ollcred for sale(Sec.7044,
Business B:Professions Code) Signature of Applicant: Date?-I"7-
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(See.7044,Business R Professions Code), ALL ROOF COVE' NGS'I'O TIE CLASS"A"OR IIE'I-I'F-R
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS 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 S Safely 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 I lealth.4
Section 3700 of the Labor Code,for the performance of the work for which this Safeh Code,Section 25532(n)should I-,lure or handle hazardous material.
Additinailly,should I use equipment or devices which emithazardous air
permit is issued. crmtioninans as defined by Ilse Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is'issued.I shall maintain compliance with the Cupertino Nlunicipal Code,Chapter 9.12 and the
not employ any person in silly manner so as to become sunject to the Worker's Health S Safety Code Sections 25505,25533,and 25534.
Compensation Inas of Calif lmia. If,after making this certificate of exemption,I
become subject to the Workers Compens lion provisions oflhe Labor Code,I nmst O%m a h size went: n
forthwith comply with such provisions or this permit shall he deemed revoked Dale: —7-(
APPLIC\NT CFRTI FICATION 2(NSTRI1C11ON LENDING AGENCY
I certify that I have read this application mid state that the above information is I hereby aCfimtthm there is a construction lending agency for the performance of mork's
correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Cie 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
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 ,\I2C111'1'FCI"S DECLARA'T'ION
with all non-point source regulations per the Cupertino Municipal Cade,Section
9.18. 1 undersand my plans shall be used as public records.
Signature Date Licensed Professional
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•buildinanacuoertino.oril
PROJECTADDRESS Z /07/ APNN
OWNER NAME T PHONE E-MAIL
STREET ADDRESS /, CITY. STAfhZIP FAX
CONTRACTOR NAME (�- LICENSE NUM E og, �LICENSE P-E3 BUS.LIC.a
COMPANY NAME E-MAIL FAX
STREET ADDRESS �Z A CITY.STATEZI! PHONE
`may e Q c tZ o>I;-27 -cU
I UN ERSTAND 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 I/<" 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✓.2
ResorfPolicP_201 Lrlocrevi.ced O2/16/11
CiTY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: red fir ct. DATE: 07/17/2012 REVIEWED BY: bobs.
APN: BP#: 'VALUATION: $4,500
*PERDIIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex PENTAlsIATION 1SFDWLR00F
USE: PERMITTYPE:
e
WORK I tear off wood shake install comp shingles.
SCOPE
Mech. Plan Check Platth. Plan Check Flee:.Plat Check
Mech. Permit Fee: MIMI.Permit Fee: like. Permit Fee:
Other A1ech.In.gt. Otter Minh Insp. Other Flee.insp.
Aloch.lusp.rer: Plumb. faq). Fra: F1ce.Insp. rcc:
NOTF-: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Server District,School
District,etc). These ees are based on the prelitninan in onnation available and are only an estitnate. Contact the De t or adcltt'I info.
FEE ITEMS (Fee Resolution 11-053 E(C 7/1/11) FEE QTY/FEE MIISC ITEMS
Plan Check Fee: $0.00 1500 s.f. Re-roof
Suppl. PC Fee: Q Reg. Q OT 0.0 its $0.00 $195.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tai:
Administrative Fee: Q
Work Without Permit? O Yes 0 No $0.00 G
Advanced Planning Fee: $0.00 Select a Non-Residential G
Thwel Doctunentadou Fede: Building or Structure �
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
131dg Stds Commission Fee: 1BCBSC $1.00
sulirorA�s:: $1.50 $195.00 TOTALIFEE:1 $196.50
Revised: 07/01/2012
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA'95014-3255
(408)777-3228• FAX(408)777-3333•buildino(cDcuoertino.orc
CUPERTINO
PROJECT ADDRESS G(f/ 'A
r C* I {PN
OWNERNAME i PROSE —�� / �r•�'✓\LIJAIL
O b J
STREEI'ADDRESSI CITY.STATE.ZIPFAS
_
Aa
CONTACT NAME PHONE -O Sal 7;8E-MAIL
t
STREEI"ADDRESS 5'02CITY.ST At E. ZIP I x
13OINFR ❑ ONNER-BUILDER El Ow.
NE0.{GEM CONTR{CmR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICF.NSENL'MBER 2 O LICF.SSEEPE I 111.111,
COMPANY?AMB E-MAIL I FAX
STREET ADDRESS CITY.STATE.ZIP PHONE
$oZ I a ase C - g-C
ARCHITECDEN'GINEER NAME LICENSE FONIBER BUS.LIG
CONIPANY NAME E-.NLAIL FAX
STREET ADDRESS CITY,ST,{TE.%IP PHONE
USE OF ❑ SFD or Duples JC Multi-Family ROOF AREA: J9, VALUATION: �
STRUCTURE: El Commercial ��// s S .)/�O
EXISTING ROOF TYPE: C3 BUILT-UP ROOF ❑ASPHALTSHINGLES 0VOODSHAKES ❑w00D SHINGLES ❑OiHER(SPECIFY)
RCSIOVE:REPLACE YES IF NO. PLl"WOOD i,t= ❑ PL1'w'D ❑OSB PITCN ROOF
❑ S I :LA1'F.R 2 A
T ICKM $ ❑ -f- T'1'PE• DY ') d
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF jilfASPHALTSHINGLES ❑w000sHAKES El WOOD SHINGLES ❑OTHER ICC-ES REPORT°
DESCRIPTION OF WORK:
4-a*A PreSlArnlit s6in6l es Color CouAcy Graj
Ry my signature below.I eeriA.to each of the followine: Jam the property owner or authorized agent to act on the property owner's behalf. 1 have read this -
application and the information 1 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 relatine to building cons tion. I a orizc repr u% R of Cupertino to enter the above-identified property for inspection purposes,
Signature of ApplieandAgent'. Date: 6!O
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If buildins is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTIFC SLIP
of approval front HOA. 2-16-VER-THE-COUNTER Q19rLDIIG PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_ Pr/od}de copy ofManufacturer's Installation Specifications. ❑ STANDARD ❑ ETRE DEPT
r/Pmvide Signed copy ofCupenino's Tear-Off Policy. ❑ OTHER:
RemofApp_201 I.doc revised 03/16/11