12070182 CITY OF CUPERTINO 13UILDING PERMIT
RUILDING ADDRESS: 21089 RED FIR CT CONTRACTOR: FOUR SEASONS ROOFING PERMITNO: 12070182
OWNER'S NAME: MAHURON TERRY 1'0 BOX 1668 DA'Z'E ISSUED:07242012
.OWNER'S PHONE: 4082173695 SAN'JOSE,CA 95109 PIIONE NO:(408)278-0330
!0 LICENSED CO\IRACI'OR'S DECLARATION
�'(� �l p BUILDING PERMITINFO: BLDG r7 �ELECT PLU\113 '
License Class C—� 1 Lie.# 4�/'I OC d t1
n1EC11 C RESIDENTIAL r COMMERCIAL r
Contractor FSrZ I N C • Date —?—2 LI—(2
hereby affirm that lam licensed under life provisions of Chapter 9 .1013 DESCRIPTION: 135QFT-RE-ROOF TEAR OFF EXISTING WOOD SIIAKE
(conunrncing with Section 7000)of Divisian 3 of the ISusiness&Professions ROOFING.IN$TALL I2"CDX PLYWOOD THEN 30#FELT
Code and that my license is in full farce and effect. UNDERLAYMRNT.INSTALL CERTAINTEED PRESIDENTIAL
here[,%affirm under penalty of perjury one of the follmving byo declarations:
I have and will maintain it certificate of consent to self-InSare for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
pertbrmance of the work for which(his 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 One work forahich this Sq.Ft Floor Area: Valuation:54500
permit is issued.
AI'PLIC.\N'I'CF:I3'1'IFIC,\'I'111,N ANN Number:35905031.00 Occupancy Type:
I certify that I have read this application and state that the above infomtation is
correct.I agree to comply with all city and county ordinances and state Imus 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 1S NOT STARTED
indemnify and keep hmmlcss the City of Cupertino against liabilities.judgments,
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,lire applicant understands:md will comply r
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Dale2y _(`L Issued If Date:
— /
❑ O\\ slt-RIIILDISIt UFCLARA'I'ION
RF:ROOFS:
I hereby affirm flint 1 tan exempt from(he Contractor's License Laeformic of All roofs shall be inspected prior to any roofing material beteg installed.If a roof is
the following two 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,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date: �-
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVI-HINGS TO BE CLASS"A"OR BE'I•I'ER
hereby affirm under penally of perjury one of the follmving three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IL\%ARDOUS MATERIA 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 Ifealth&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&
Section 3700 of the Labor Code,for the performance of the Work for which(his Safely Code,Section 25532(x)should 1 store or handle hazardous material.
Additionally,should I use equipment or deices which emit hazardous air
permit is issued. t911taminants ns defined by the Bay Arca Air Qua lity;ll a nagement District I will
I certifv that in the performance of the Work for which this permit is issued,:1 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 Ieafth&Safety Code.Sections 25505,25533,and 25534.
Compensation laws of Cali l'ornia. If atler making this eenilicate ofexcnnption•I
become subject to the Worker's Conipensmion provisions of the Labor Code,I mustO"mer a t .ergenc
forthwith comply with such provisions or this permit shall be deemed revoked. Dale: G--
APPLICANT CERTIFICATION LONS'1'RUC`1 ION LENDING AGENCY
I certify that I have read this application and state that the above imbrolation is I hereby affimr(hat(here is a construction lending agency for the performance of work's
correct. I agree to comply with all city and 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
indemnify and keep harmless the City ofCupenino against liabilities,judgments, Lender's Address
costs,and expenses which may aceme against said City in consequence of the
granting of permit.Additionally,the applicant understands and will comply ,\RCIIITECI"S UF.CL,\ILCI'ION
with all non-point source regulations 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: 21089 Red Fir Ct DATE: 07/24/2012 REVIEWED RY: Sean
APN: BP#: 'VALUATION: $4,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARYPENTAMATION
USE: SFD or Duplex PERMIT I YPE: 1SFDWLR00 i
WORK Tear off existing wood shake roofing. Install 1/2" CDX plywood then 30#felt underla ment. Install
SCOPE Certainteed Presidential composition shingles - Country Gray color.
FEE 11) ROOF AREA
(s.f.)
1REROOFFRES 1,300
blech, Plan Check Plumb. Plan Check Elec.Plan Check
Mech. Permit Fee: Plumb.Permit Fec: Elec.Permit Fee:
Other Hech.Insp. Other Plumb Insp. Other Elec,hasp.
ble.ch. lap. Fee: . Plumb. hasp.Fee: Elec.insp.Fee:
NOTE: This ewintane does not include fees due to otter Departments(i.e. Planning, Public 11'orks, Fire,Sanitary Seaver District,School
District,etc.). These ees are based on the prefindnarr information availahle and are only an estinuae. Contact the De 1 or addn'I into.
FEE ITEMS (FeeResolution ll-053 E/T. 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Sup])/. PC Fee
Plumb./Mech./Slee
Permit Fee: $195.00
Suppl. /nap Fee
Plumb./A/ech./Elec
Plumh./A•lech./Stec Permit Fee:
Conswuction Tax:'
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Advanced Planning Fees:
Travel Docnmewation Fees:
Strong, Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Comnlission.Fee: IBCBSC $1.00
SUBToTALS: 1 $196.501 $0.001 TOTAL FEE: 1 $196.50
Revised: 07/01/2012
REROOF TEAR-OFF POLICY
0 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•building(a),cupertino.org
PROJECT ADDRESS O APN0
O%`NER NAML 7 PHONE E-MAIL
STREET ADDRESS CITY,5 EZIP FAX
CONTRACTOR NAME. I.ICENSENUMBER LICENSCPE BUS.LIC.0
alola
39
COMPANY NAME E-MAIL FAX
_bUr
STREET ADDRESS S-b Z ` I CT'.STATF C HONE r ^P -03
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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with (here-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections 11314 and 11315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date:—7—!::Z 3�Z
Rer'ooJPolicv_?011.doc revised 01//6/11
-&0-7vt �Z
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333• building(@cupertino.org
CUPERTINO
PROJECTAUDRESS O APN
OWNER NAME PHONE ��6 E-NIAIL
STREET ADDRESS I CITY. STATE.ZIP FAN
b e C: C r0
CONTACT NA0.1E. ' PHONE I E-NIAIL
! o C&-Lare-& 402-7-18-OASOI
STREEI'ADDRESSS02' ^^J �� CITY.$TATE.IIP`TOJAn -lose qTI 11Z.\
❑ ON:NFR - 0 Ow:GER-BUILDER ❑ 01'NER AGENr CONTRACrOR 13C017RACTOR AGENT ❑ ARCHITECT ❑ ENGINFF.R ❑ DE4'ELOPER ❑ TENn NT
CONTRACTOR NAME FLICENSEN01BER LICENSE IE 2 O BUS.LIC.
COMPANYNANIE C-.MAIL FAY
SAOAE
STREET ADDRESS CITY.STATE ZIPPHONE
S',07- A -Se-se 11 C 1140Q-2,78-
ARCHITECTrENGINEER NAME LICENSE NUMBER BCS.LIG
COMPANY NAME E-NIAIL FAX
STREET ADDRESS CITY.STATF ZIP I PHONE
USE OF Eld SFD or Duplex F Multi-Family' ROOF AREA: +>✓ 'ALEATION,
STRUCTURE: ❑ Commercial I 3 S y snO
EXISTING ROOF TY PE; ❑BUILT-UP ROOF ❑ASPHALTSHINGLES �;KVOODSHAlF.S ❑N'OODSHINGLES '❑DINER(SPECIFY)
REMOVE:REPLACE ONES IF N0. PLYWOOD {�.li ❑ I PLY\CD ❑ OSB PITCH: ROOF
❑ K I .LAN FRS THICKNESS' ❑ S.8- TYP COX ')2 CLASS'
PROPOSED ROOF TYPE: 13 BUILT-UP ROOF aeSPHALTSHINGLES ❑wOOOSIIAKES El WOOD SHINGLES CI OTHER IMES REPORTa
DESCRIPTION OF W00.6;Tear t14 PxiS+jnq WO-OA
G "A"
11,113"A +6eA 304 P' i+ Ljnde�en+-._F_;
0-eckaI:kAkeea PreSlAeft+,wtlk� d
By my signature below.1 cervi f•to each of the following; I am the property owner or authorized agent to act on the prop"owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and serif'it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building cons tion. I a orize represe civ of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanVAgent: Date: 7 Sl0
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_If building is associated With a Home OWner's Association.provide letter PL ,%CHECK T1 PE ROUTING SLIP
ofapproval from HOA. ❑ OYER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to veri F'if there any restrictions. ❑ EXPRESS ❑ PLANNIYG P1,AN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEFT
Provide signed copy of Cuperiino's Tear-OTPolicy. ❑ OTHER:
ReroofApp 201 Ldoc revised 03/16/11