12070187 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21093 RI7D FIR Cf CO\I'RACI'OR:FOUR SEASONS ROOFING PIERMIT NO: 12070187
OWNER'S NAME: SINGH VISIIWAJITIi AND PRASAD SUJATIIA PO BOX 1668 DATE ISSUFD:0724/2012
OWNER'S I-BONE: 4084463385 SAN JOSH,CA 95109 I'RONE NO:(408)278-0130
LICENSED CON1'RACI'OR'SDECLARATION BUILDING PERMIT INFO: BLDG( -. ELECT r PLUMB r
License Class�-� Lie.4 L172-1 c 11EC11 r RESIDENTIAL r COMMERCIAL r
Contractor Ci t IQ G- Dale — 2—'-1 -I2
heretry affirm that l am licensed under the provisions of Chapter 9 JOB DESCRI PTION: 13 SQFT-REROOF TEAR OFF EXISTING WOOD SHAKE
(coil] with Section 7000)of Division 3 of the Business S Professions R00I7ING.INSTALL 12"CDX PLYWOOD TIJEN 304 FELT
Code and that my license is in full force and effect. UNDERLAYMENT.INSTALL CERTAINTEED PRESIDENTIAL
1 lie,eby affirm under penally of perjury one of the following rwo 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,1'or the performance of die work for which this Sq.Ft Floor Arca: Valuation:54500
permit is issued.
A IT LICANT CIiRTI FI CATION Al'NNumber:35905033.00 Occupancy Type:
I certify that I have read this application and stale 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 sae PERMIT EXPIRES IF WORK IS NOT STARTED
iosts,a and
xpend nses which ss the City of Cupertino against once uen eofthents. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the
granting of[his permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
With all non-point Source regulatiams per the Cupertino Man icipal Code.Section
9.18.
7 _2-11 _I� Issued h • Date��Z�11/'1--
Signature Date
❑ OWNEIR-I UILDER DECLARATION
R6;ROOFS:
hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the sticture is not intended or offered for sale(Sec.7044, "�.r-`LI� —l.Z
Business K Professions Code) Signature of Applicant: Date:
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business R Professions Code), ALL ROOp C : INGS TO RE CLASS"A"OR BETFER
I hereby affirm under penalty of perjury one of the folluwing three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker'sIL\%.\RDOLIS d1.\TIiRIALS 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
performnce of the work for which this permit is issued. California l larlth S Safety Code,Sections 25505,25533,and 25534. 1 will maialain
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 ofthe work for which this Safely Code,Section 25532(:)should I store or handle hazardous material.
Additionally.should I use equipment or devices which emit hazardous air
recruit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will
I certify that in the performance of the work for which 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 die Worker's Ileallh S Safety Code.Sections 25505,25533,and 25534.
Compensation laws ofCaliforia. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I trust Ownem 1 .ed agent: �2y
forthwith comply with such provisions or this pemnit shall be deemed revoked. hate: l
,u'r1.1c,\N•r ceanFlc\•r1DN CONSTRUCYION LENDING AGFNC\'
I certify that I have read this application and sone 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 comply with all city ad county ordinances mid 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
indemnity and keep harmless the Cit'of Cupcnino 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 ARCI I ITECI"S DECLARATION
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: 21093 Red Fir Ct DATE: 07/24/2012 REVIEWED Bl': Sean
APN: BP#: 'VALUATION: $4,500
*PERMITTYPE: Minor Building Permit PLAN CII ECKTYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD Or Duplex PERMITTYPE: 1SFDWLR00 i
WORK Tear off existing wood shake roofing. Install 1/2" CDX plywood then 309 felt underla ment. Install
SCOPE Certainteed Presidential composition shingles - Country Gray color.
FEE ID ROOF AREA
(S.L)
1REROOFFRES 1,300
Slect). Plan Check Plumb.Plan Check Flee.Plan Check
Meeh.Permit Fee: Plank.Permit Fee: Flee.Permit Fee:
Other Alech. Insp. Other Plumb Insp. Other Flee.Insp.
.Rech. Insp.Fee: Phmrh. Ityt. Fee: Elec.Insp. Fee.,
A'OTE: This euinutte doer not include jeer cure to other Departments(i.e. Planting, Public Works, Fire,Sanitary Seaver District,School
District.etc). Thesefees are baser/on the preliminan information available and are onb,an estimate. Contact the Dept for tuldn'I in o.
FEE ITEMS (Fee Resolution 11-053 E/T 7/1/11/ FEE QTY/FEE MISC ITEMS
Plan Check Fee.
Supp/. PC Fee
Plumb.lHech./Elec
Permit Fee: $195.00
Suppl. Ins? Fee
Plnmb.lhlech./Elec
Plumh.611ech./Elee Permit Fee:
Construction Tac:
Administrative Fee:
Work Without Permit? 0 Yes (2) No $0.00
Advanced Planning Fees:
Travel Documentation Fees:
Strong Motion Fee: IBSE1SMICR $0.50 Select an Administrative Item
13ldg Stds Commission Fee: IRCRSC $1.00
SUBTOTALS: $196.50 $0.001 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
10300 TORRE AVENUE • CUPERTINO. CA 95014-3255
CUPERTINO
(408)777-3228• FAX(408)777-3333•building ancuoertino.orq
PROIELT ADDRESS ^ 1 013 CL 1 APN•
OWNER NAME � PI10NE E-MAIL
STREET ADDRESS CITY.ST ZIP FAX
a (C398e
CONTRACTOR NAME LICENSENUMBER LICENSE NP BUS.LIC.N
t4r)2_( aR Cr
COMPANY NAME E-.NAIL FAX
Ou Q A
STREETADDRESS �Z T CITY.STsz O�- Q PHONE A 9S119, 1 ,0330
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. 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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date: 7 —Zl—/Z
ReroofPolicr_2011.doc revised 02116111
17U) ��
REROOF PERMIT APPLICATION
Ell COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA'95014-3255
(408)777-3228• FAX(408)777-3333•building(c),cupertino.oro
CUPERTINO
PROJECTADDRESS P.1093 Pir Cl. AP\•
OWNER NAMEj PHONE
• ^ E-MAIL
STREEI'.ADDRFS$ 6W Il"
CITY• 5 TE.ZIP _ FAN
�U o CA Ct n 14
CONTACT NAnIF. ' PHONE I E\JAIL
e
STREEI'.AODRESSSO2 CITI'.STAI'F..].IP
❑ O%INER ❑ (VANER-BUILDER ❑ OWNER AGENT 01101TRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGNF.ER ❑ DEVELOPER ❑ MIA NT
CONTRACTOR NAME LICENSENL'NIBER41 LICENSE T'PE I BCS,LIC'.•
• Z
COMPANY\'AME E-MAIL FAX
SAAE %J
STREET ADDRFS$ CIT):ST,\TE.ZIP PHONE
$02. w o5e C ^2 $'O
ARCHI FECT,EN'GINEER N'ANIG LICENSE NUMBER BCS,LIC.
COMPANY NAME I E.NIAIL FAS
STREET ADDRESS CITY.STATE.ZIP, PHONE
USE OF ❑ SFD or Duplex Ar Multi-Family ROOF AREA: �/ VALUTnOS
STRUCTURE: ❑. Commercial r 3 S
EXISTING ROOF TYPE: ❑BUILT{ �ay
PROOF ❑ASPHALTSHISGLES r%'OODSHAKF.S ❑WOOD SHINGLES ❑OTHER(SPECIFY)
RENIO\'F.:REPLACE \'ES (FSO. PLYWOOD �li' ❑ PLY\VD ❑OSB PITCH: ROOF
❑ N' •LAYFR THICANESS ❑ "' I'YP CDS
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF PeASPHALT SHINGLES 0%'0013$1IAI:ES ❑WOOD SHINGLES ❑OTHER IMES REPORTa
DFSfRIPT10N OF WORK: (+ /Z
S IDS = AS-tM1I l t f
wood +1 eA 30# -P'e' t+ underll;,�"+ ._F_i�l
iller)cw' •f a ,,.t come s6in�
es 00617 CouAMf CAr*-y
By.my signature below.1 certify touch 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,crify it is accurate, I agree to comply with all applicable local
ordinances and state laws relating to building cons lion. I a orize represe civ sof Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanUAgenl: Date: bt0 12
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ I f building is associated with a Home Ottner's Association.provide letter PLANCHECK TN PE ROUTING SLIP
of approval from HOA. ❑ OPER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIREDEPT
Provide signed copy o(Cupenino's 1'ear-Off Policy. ❑ OTHER:
- ReroojApp 1011.doc revised 03116111