12070190 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21095 RED FIR CT CONFRACFOR:FOUR SEASONS ROOFING PERMIT'NO: 12070190
OWNER'S NAME: BOWER KEITH D AND IIELVIA B PO BOX 1668 DATE ISSUED:07242012
OWNER'S Pl IONIi: 4082537480 SANJOSE,CA 95109 PHONE NO:(408)278-0330
/ JR'- LICENSED CONMAC7FOR'S1DECLARATION BUILDING PERMIT'INFO: BLDG r ELECT r PLUMB r
License Class C— 3T Lie.N �'SI(�ar.� 09 r r r
p1ECt1 RESIDENTIAL CCOMMERCIALContactor D►Z 11�G- Date '-LI —12—
I
1Z1 hereby affirm that 1 am licensed under the provisions of Chapter 9 3013 DESCRIPTION: 13 SQFf.REROOF TEAR OFF EXISTING WOOD SHAKE
(commencing with Section 7000)of Division 3 of the Business S Professions ROOFINGINSTALL 12"CDX PLYWOOD THEN 304 FELT
Code and that nry license is in full force and effect. UNDERLAYNIENT.INSTALL CERTAINTEED PRESIDENTIAL
1 hereby a0frm under penaltyof perjury one of the fallowing mo 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 oflhe 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 die work for which this Sq.Ft Floor Area: Valuation:$4500
permit is issued.
,U'I'LIC\NI'CEIt'1'IFICA'1'I0N ANN Number:3590503400 Occupancy Type:
I certify that I have read this application and state that the above information is
coffee(. I agree to comply with all city and county ordinances and state Laws relating
to building construction,mid hereby authorize representatives of this city to enter
upon the above mentioned proper for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indenmify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said Cit'in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source re ulatiols per the Cupertino Municipal Code,Section
9.18. �—'y
-7 —Z(1 -12 Issued hy'. Date: /,2yq1-
Signature Date
❑ O\VN•: -BUILDERDECLARATION
RATION
RE-ROOFS:
I hereby afirm that 1 am exempt from the Contractor's License Law for ane of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the follmying 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 Applic nt: Date—ZLI —,2
I,as owner of the property,am exclusively contracting with licensed contractors toCJ
construct the project(Sec. Business fi Professions Code). AL1,ROOF COVERINGS TO Illi CLASS"A"OR BETFER
I hereby affirm under penalty of perjury one of tile following three
declarations:
I nave and will maintain a Certificate of Consent to self-insure for Worker's DAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I lune read the hazardous materials requirements under Chapter 6.95 of the
performance of the stork for which thispermit 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(x)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Jlanagement District I wipe
I certify that in the performance of date 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 the Worker's licalih S Safety Code,Sections 25505,25533,and 25534.
Compensation paws of Cali fomia. 11,alter nmking this certificate ofexennption,1
become subject to the Worker's Compensation provisions of the Labor Code,I must Oa ncry ut .edagent _2L(-
forthwith Comply with such provisions or this pernnit shall be deemed revoked Date: 7
\I'I'LICyNI'CM:R"I'IPICA'1'ION 3ONS"I'RIJC`FI1N LIiNDING AGENCY
I certify that I have read this application and state(hal the above information is I hereby affirm[hill there is a construction lending agency for the performance of%wok's
correct.L agree to comply with all city and county ordinances mid state laws relating for which this permit is issued(Sec.3097,Cir C.)
to building construction,mid 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 Cupertino against liabilities,Judgments, Luhdcr's Address
costs,and expenses which may acerae against said City in consequence of the
granting of this permit.Additionally,the applicat understands and will comply ANCI I ITECI"S DECLARATION
with all non-point source regulatims per the Cupertino Municipal Code,Section
9.18. 1 understand 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•building(a)cugertino.org
PROJECT ADDRESS APN M
a o s-
OWNER NAME PHONE 4 E-MAIL
STREETADDRESS C
CITY.S ZIP /•. FAX
�V 1
CONTRACTOR NAME LICENSE NU45aIo� LICEN Lf BUS.LIC.0
COMPANYNAME E-MAIL (J FAX
STREET ADDRESS S"02 r ',. NE CITY.S ZIP P - 2 Q -0
3 A
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 ail 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 1/<" 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 S 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: 7- Z3-/Z
RerooJPo1icv_2011.dac reviser!02//6/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 21095 Red Fir Ct DATE: 07/24/2012 REVIEWED BY: Sean
A PN: BP#: 'VALUATION: $4,500
*PERMITTYPE: Minor Building Permit PLAN CIIECR TYPE: Re-roof
PRIMARY PENI'ANIATION
USE: SFD or Duplex PERAIrl-TYPE: Al
1SFDWLR00
\VORI: 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.
FEEID ROOF AREA
(s.f.)
1REROOFFRES 1,300
,Llech, Plan Check Plumb. Plom Check Fl,,. Plan Check
blech. Perini/Fee: Plumb. Permit Fee: Ver.Permit Fee:
Other Afech. lap. Other Plumb Insp. Ll I Other Elce.Itw El
,Ifech.bap. Fee: Plumb. beep. Fee: Flec.Insp. Fee:
NOTE: This estinuue does not incline jeer due to other Department'(i.e. Planning, Public Works, Fire,Sanitary Server District,School
District. etc.). These fecv are based on the prelindwn3 information amilohle and are only an esrinmte. Contact the De t or adtbt7 in o.
FEE ITEMS (Fee Resolution 11-053 Elf 71111/) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Phunb.lHech./Elec
Permit Fee: $195.00
Supp/. Insp F'ee
Phunb.111ech./Elec
Phimb.41ech.11,1ec Permit Fee:
Construction Tac:
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Advanced Planning Fees•:
Travel Documentation Fees:
Strong Motion Fee: IBSEISa-OCR $0.50 Select an Administrative Item
131dg Stds Commission Pee: IBCBSC $1.00
SUBTOTALS: 1 $196.501 $0.00 TOTAL FEE: $196.50
Revised: 07/01/2012
l Zv-7 C>( `�(
REROOF PERMIT APPLICATION
Lu, COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE -CUPERTINO,CA 95014-3255
(408)777-3228- FAX(408)777-3333• building(c),cupertino:org
CUPERTINO /-y
PROJECT ADDRESS I .{PN= I/1 D
OWNER NAME I PH NE '" EMAIL
e o ¢ I 0
STREEI'ADDRESS CITY. ST ZIP F.AX
oZI wl S aeA
CONTACT NAME PHONE I E-MAIL
Al-freJoO - -O 301
STREEI'ADDRESS SO2 CITY.ST.ATF..ZIP I FAX
❑ OWNFR ❑ O\PdER-BVILDER ❑ ON FER AGENT CONTRACTOR ❑CO]TRACTOR{GENT ❑ ARCHITECT ❑ENGINF,F.R ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME I LICENSE NUMBER LICENSETYPE I BUS.LIC'.-
2 O
COMPANY NAME SAAE E-MAIL I FAX
STREET ADDRFSS CITY.STATE.ZIP430.4 PHONE
Soto5e C -Z B'C
ARCHITEC,ENGINEER NA%IE LICENSE NUMBER BCS.LIC.
COMPANY NAME I E-MAIL FAX
STREET ADDRESS . CITY.STATE.'ZIP PHONE
F/
USE OF ❑ SFD or Duplex Multi-Family ROOF AREA; ALI:AT10. : 0 -M—
STRUCTURE: ❑ Commercial 3 g41 5-0c)
EXISTING ROOF TYPE: ❑BUILT-L'PROOF ❑ASPHALTSHINGLFS `PCOODSHAKES ❑W'OODSHINGLES ❑OTFIER(SPECIFY)
REMO\'E:REPLACE YES IF NO. PLY%VOOD {r.1i ❑ PL1'W'D ❑ O58 PITCH: 0.00E
❑ N a LAYER THICKNE S ❑ - TVP CD.' 712 ASS
dd
PROPOSED ROOF TYPE: ❑BCILT-UP ROOF i�ASPHALT SHINGLES' ❑ll'p0US11{ICES 13 X% SHINGLES ❑OTHER ICC-ES REPORT n
DESCRIPTION OF\YORK: 1/Z I,
COX
S 1
a^ as a we. MA o
Ry mg signature below%I certify touch of the following: I am the property owner or authorized agent to act on the property owner's behalf. I haveread this
application and the information'l have provided is correct. I have read the Description of Work and%erif)"it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building cons tion. I a orize represe tie of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicandAgem: Date: 3 112O
SUPPLEMENTAL INFORMATION'' REQUIRED OFFICE USE ONLY
_If building is associated with a Home 0%mer'S Association,provide letter PL{NCHECATYPE ROUTING SLIP
of approval from,HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_Provide Planning approval to verif%.if there any restrictions. ❑ EXPRESS ❑ PLAN:\IsC PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FRE DEPT
Provide signed copy of Cupertino's Tear-OT Policy. ❑ OTHER:
Rerwf,4pp_2011.doc revised 03/16/11