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12070237
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21105 RED FIR CT CONTRACI.OR:FOUR SEASONS ROOFING PERMITNO: 12070237 OWNER'SNAM E: CI'IEN CI'IORNG S ANDTWIGGY I' PO BOX 1668 DA'Z'E ISSUED:08/012012 OWN'ER'S PHONE: 4082349188 SAN JOSE,CA 95109 PHONE NO:(408)278-0330 Ilk— LICEINSED CON' RACFOR'S DECLARATION BUILDING PERMIT INFO: BLDG F- ELECT F- PLUNIB License Class C-3CF Lic.N 'l 7 X(Ue, MECtI r RESIDENTIAL r CODIMERCL\L r Contractor F-S C I i-)C— Date x—I — 1 Z hereby affirm that I am licensed it other the provisions of Cha pier 9 JOB DESCRIPTION:TEAR OFF WOOD SHARE&INSTALL IQ'CDS (commencing with Section 7000)of Division 3 of the liusine9,s& Professions PLYWOOD,30N Code and than my license is in full force and effect. FECI'UNDERLAYM ENT.INSTALL CLASS A CERTAINTEED PRESIDENTIAL COMP SHINGLES(COUNTRY GRAY)13SQFT hereby affirm under penalty of perjury one of the following two 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. 1 have and will maintain Worker's Compensation Insurance,as provided COT by Section 3700 of the Labor Code,for the pedormanee of time work for which this Permit is issued Sq. Ft Floor Area: Valuation:$4500 nrrLla\N•r a:R'ru�locrloN I certify that I have read this application and state that the above information is ANN Number:35905039.00 Occupancy Type: correct, I agree to comply with all city and county ordinances mid state laws relating io building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnity and keep harmless the City of Cupertinoagainstliabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,anii eofthisper it.Addch ayaccmeagapplist an unt cnconsandwilo(im WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant undcrslands and will comply with allnon-point source regulanims per the Cupertino Municipal Code,Secllal 180 DAYS FROM LAST CALLED INSPECTION. 9.18. �^ Signature �Date —/— /2— Issued b4 Date:r_N�L ❑ OWNTER-BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Law for one of RF:ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material beiig installed.If a roof is I,as owner of the property,or my employees with wages as their sole comlansation, installed without first obtaining an inspection,I agree to remove all new materials for will do.the work,and the structure is not intended or offered for sale(Sce.7044, inspection. Business C Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Appli© Dam '/-/'L, construct the project(Sec.7044,Business K Professions Code). hereby affirm under penalty of perjury one of die following three ALL ROOF CO\ 'RINGS TO RE CLASS"A"OR BE 17EIR 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 performance of the work for which this permit is issued I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,is provided for by California Ilealth&Safeq Code Sections 25505.25533.and 25534. 1 will maintain Section 3700 of the Labor Code,for die performance of the work for which this compliance wah the Cupertino Ml unicipal Code.Chapter 9.1_zand the Ilealth S Sa fen)'Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Addiniunally,should I use equipment or devices which emit hazardous air I certify that in the performance of die work for which this permit is issued I shall contaminants as defined by the Boy Aren Air QualityManagement District 1 will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health S Safety Code.Sections 25505,25533,and 25534. become subject no the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked Owner on rho 'zed•ge4111: e: APPLIC.\N'I'CI?R"fIFICA'1'IfINCONSTRUCl'ION LENDING AGENCY I certify than I have read this application and sate that the above information is correct.I agree to comply With all city mid county ordinances and sate laws relating I hereby affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ Q upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may acere against said City in consequence of the Lender's Address granting of this permit.Additionally,the applican understands and will comply with all non-point source regulatiais per the Cupertino Municipal Code,Sectiam ARCHITECI"S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Date ,L Licensed Professional I�fl� CITIr OF CU13ERTINO FEE ESTIMATOR - 13UILDING DIVISION ADDRESS: ;rQ L) X-Ir (-. DATE: 0 713 0/2 01 2 REVIEIVEDBY: bobs. \ AM: BPH: •VALUATION: $4,500 PERMIT TYPE: Building Permit PLAN CIII:CF"1'1'1'1:: Alteration / Repair PRIMARY SFD or Duplex PEN'I-,1MATION 1SFDWLROOF USE: 11E101rr TN,PE: WORT: sfd tear off wood shake install new comp shingles. SCOPE =ih, ww ... NOTE This eVinude rhea ma include jecc due it,other Departments(i.e. Planning, Public Works. Fire,Sanitary Sewer District.School District, etc.). These fees ore based oo the rrelintinan•inforamtiou at', Hable and are onb'tar ectinoae. C..ana the Dept/br atldn'l info. FEE ITEMS (/cev Re.rulufinn 11-053 E(f 7:1.!111 [111) 1', QTY/FEE MISC ITEMS Plan Check Fee: 50.00 Uj0fl s.f. Re-roof Suppl. PC Fee: Q) Reg. 0 01- 0.0 hrs 50.00 S195.00 /REROOrRES I Id PiJME Plan Check: 50.00 Permit Fee: 50.00 Suppi. Insp. Fmo Reg. O 0T 1 0.0 1 hrs $0.00 PNIF Unit Fee: $0.00 PMO Permit Fee: $0.00 r rr, fon 1.1.1. / O Work Without Permit? O Yes (D No 50.00 G Advanced Plannine Pee: $0.00 Select a Non-Residential Q .. 1 1 trn ran Watla•rr P'. . Building or Structure Q Stroma Motion Fee: 18SEISMICR $0.50 Select an Administrative Item Bide Suds Commission Fee' IRCRSC S1.00 SUBTOTALS: $1.50 $195.00 TOTAL FEE: $196.50 Revised: 07101/2012 IsREROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (4408)x777-32288• FAX(408)777-3333• building(D)cupertino.oM PROJECT ADDRESS 2/for /foi �(.l� r-// C�. APN d OWNER\AME IPHO.'E E-MAIL �1 or ` �.' - 3 /p STREET ADDRESS CITY TATE ZIP FAX CONTRACTORNAME LIC SEWMAR 100 LICLNIE TXEE BUS.LIC.0 COMPANYNAME EMAIL K (-; FAX D STREET ADDRESSS6Z S Cin',ST ,ZIP PHONE o c Ora o -27P-o3so 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 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. 1 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 Cod Signature of Applicant/Agent: Date: 7--'0- /2 Reroq/Polrev_201 Ldoc revised 02116/11 j �o-7 3-] REROOF PERMIT APPLICATION EM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO,CA'95014-3255 (408)777-3228• FAX(408)777-3333-buifcino(a)cupertino.ora CUPERTINO /J PRUIECT,\UDRESS //a eel C,"- C� I aP� _ 0 OWNER NAME n ,(2 S S I PHONE I E-\tA1LJ J (� 4f CLe STREE'I'ADDRESS ,Or ^�, I CITY.STAT LIP _ - FAX - C+. a S-ajq CONTACT NAMF. IfPHONE E-MAIL 1��_Cgz�s -M4_027 -0 3oI . STREETAODRESS X02 I CITY.ST.AI'E.ZIP FAS an Sose CA. 4S1 ON'NFR ❑ OWNER-BUILDER ❑ OUNER AGENT larCD\TRACTOR El CO\TRACTOR AGENT ❑ ARCHITECT 11 ENGINF.F.R ❑ DEN ELOPER G TENANT CONTRACT"ORNAME I LICENSE NUMBER2I LICENSETYPE BUS.LIC.- � COMPANY\AFIE 5 E-NLAIL I FAX STREET ADDRESS CITY'.SLATE.ZIP PHONE Sot w o5e C I ARCH[TECLENGINEER SAVE LICE\SE\ONIBER BUS.LIC. COMPANY NAME I EMAIL I FAX STREET ADDRESS CITI'-STATE'%IP PHONE AC CSE OF ❑ SFD or Duplex ` Multl-Fam IIC ROOFAREA: +>✓ VALUATION. QQ STRUCTURE: ❑ Commercial 3 S J y0 EXISTING ROOF TYPE: DBUILT-L'PROOF C]ASP[[ALT SHINGLES _jX%OODSHAKES 0ti00DSHINGLES ❑OI HER(SPECIFY) RENIOVF.:REPLACE YES IF NO. PLYWOOD - ❑ PLYwD ❑OSB PITCH ROOF 13 NO -LAYF.RS- THIfA\ESS I T1'PF- CDX PROPOSEDROOF TYPE: ❑BUILT-UPROOF ASPHALT SHINGLES ❑WOODSHAKES ❑\ROOD SHINGLES 13 OTHER ICC-ES REPORT pF.SC0.1PTi0N OF WOftN: g ��y<< _P�►�-s�sQ9d +lLen 30� �i-l- �nds_clo.�te��'._-F_i.Ball q' se e e 4.in a. By my signature below.I ennily to each of the following: I am the property owner or authorized agent to acL on the propern'owner's behalf. 1 have read this application and the infom-ation I have provided is correct. 1 have read the Description of work and verify it is accurate. I agree to comph.with all applicable local ordinances and state laws relating to building cons' tion. I a lorize represe iv c of Cupertino to enter the above-ideatilled property for inspection purposes. Signatureof Applieznl/Agenr. Date: 1-301 a0 SUPPLEMEN'rAL INFORMATION REQUIRED OFFICE USE ONLY _ If building is associated with a Home Owner's Association.provide letter PLAN CHEM TYPE �� ROUTING SLIP of aG�- pproval from HOA. THE-COUNTER LT BUILDING PLAN REVIEW Provide Planning,approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLA?REVIEW _ Provide copy ofManufacturer's Installation Specification. ❑ STANDARD ❑ RREDISK _UeOvide signed copy of Cupenino's Tear-Off Policy. ❑ OTHER: Rero f4pp_2011.doc revised 03//6/11