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12070238 CITY OF CU13ERTINO BUILDING PERMIT BUILDING ADDRISSS: 21103 RED FIR CT CONTRACf012:FOUR SEASONS ROOFING PERMIT NO: 12070238 OWNER'SNAME: KOJERRY PO BOX 1068 DA'Z'E ISSUED:08/012012 OW'NER'S 1'l1ONE: 4087771299 SAN JOSE.CA 95109 M10NE NO:(408)278-0330 LICFNNS` 1 ED CONI'RAC-I'OR'S DECLARATIONr BUILDING PERMIT INFO: BLDG r ELECT PLUMB r License Class �S (L� ( FJ C-' DatcC— '� 1 Lie.N Ll -? ( Cis' hI t' - ( ,Z ECH r RESIDENTIAL r COD161ERCLU, Contractor r hereby affirm that I am licensed under the prmisions of Chapter 9 JOB DESCRIPTION:TEAR OFF WOOD SHAKE&INSTALL 12"CDS (coil] reneing with Section 7000)of Division 3 of the Business&Professions PLYWOOD,30# Code and that niv license is in full force and effect. PELT UNDERLAYMENT.INSTALL CLASS A CERTAINTEED - PRESIDENTIAL COMP SHINGLES(COUNTRY GRAY)13SQFT hereby affirm under penally orf perjury one of the fulloeing Mo declamations: I have and will maintain a certificate of consent to self insure lire 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 perfomhance of the work for which this permit is issued. Sq.Ft Flour Area: Valuation:54500 A I'I'LIC,AN'I'CFI2'I'1 FICA'I'IIIN I certily that I have read this application and state that the above information is APN Number:35905038.00 Occupancy'fype: correct.I agree to comply with all city and county ordinances mrd 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 save indemnify and keep hannlessthe City ofCupeninoagainst liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,theapplicmn understands and will comply WITI'IIN IHO DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Secticar 180 DAYS FROM LAST CALLED INSPECTION. 9.18, Signature \ .— Date g�� 2 Issued by: _7 ElOWNER-RUILDI.R DECLARATION `� 1 hereby affirm that I am exempt from the Contractor's License Law for one of Rt;ROOFS: the follo.%ing nvo reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1,as owner of the property,or my employees with wages as their sole comp:nsation, 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 ot7ered for sale(Sec.7044, inspection. Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicmnl: Dale: construct the project(Sec.7044,Business&Professions Code). hereby affirm under penaltyof perjury one of the follow ing three ALL ROOF COVERINGS TO BE CLASS"A"OR BMTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's IIA-/.ARDOUS 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, 1 have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Ilcalth&Safety Code,Seid6us 25505,25533,and 25534. 1 will maintain Section 3700 ol'thc Labor Code,for the performance ol'Ihe work for which this compliance with the Cupertino Munieipal Code.Chapter 9.12 and the Ilcalth& F Safety Code.Section 25532(x)should 1 store or handle hazardous material. permit is issued Additionally,should 1 use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I 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 Imes of Califomia. If,after making this certificate of exemption,I Bealth&Safety Code.Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall he deemed revoked Owner o tl/r ager. /_1Z nuc: API'LIC.\N'I'CI•;KlIFIC.\'19fLN ,'S'I'RUC101ON LENDING AGENCY I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances mid scale laws relating I hereby affnmh 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 C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the City of Cupertino against Iiabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section - .UtCI I1'1'FCI"S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional I ) CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: U 7 r6� DATE: 0 713 0/2 01 2 REVIEWED BY: bobs. \ APN: BP#: 'VALUATION: S4,500 °PERMITT)TE: Building Permit PLAN CIIE CK I'1'PE: Alteration Repair PRIMARY SFD or Duplex 1 EN L\QUXI ION 1SFDWlROOF USE: I'ER� I'I"1'1'I'E: WORK sfd tear off wood shake install new comp shingles. SCOPE "1..... . Y' 'hr1'1 Far, AWE: This estiuutte does not inc•/ude fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District, eta). These fees are hosed on the rrelbnhurry information available and are-onh'an estimate. C..auct the Dept for addn'l info. FEE ITEMS (Fes/larulntion //-U -i E17: i.N%I 11 FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 1,300 s.F. Re-roof Suppl. PC Fee: Q Reg. tJ O'I' OA hrs $0.00 S195.00 IREROOFRES i PME Plan Check: $0.00 Permit Fee: SO.00 SupPI. Insp. Fcc:Q Reg. Q OT0,0 111-s SO.00 PML' Unit Fee: $0.00 PM6 Permit Fee: $0.00 nt . . .•r Jf. ! O Work Without Permit? O lyes Q No 50.00 0 Advanced 11Iannina Pee: $0.00 Select a Non-Residential Q a , i h.: t+.tn4l:Ufirr'; /'n Building or Structure I Strome Motion Fee: IRSEISMICR $0.50 Select an Administrative Item 131de Stds Commission Fee: IRCRSC 51.00 SUBTOTALS: $1.50 $195.00 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 CUPERTINO 10300 TORRE AVENUE • CUPERTINO. CA 95014-3255 (408)777-3228• FAX(408)777-3333•building(a)cupertino.ora PROTECT ADDRESS e' A-0, -` C.a-. APNa OWNER NAME /I PHONE E-MAIL TC- OII E O O8" STREET ADDRESSZ//03 Red C/r c4. CITY. TE.nP _ Q� FAXCONTRACTOR NAME T LIC ENSENU E LICltTy BUS.LIC.0 b C. S COMPANY NAMEE-MAIL FAX a.r r STREET ADDRESS J SZ CITY.ST ZIP T 1JVNEe 27?,al0 I UNDERSTAND AND AGREE TO THE FOLLOWING: i 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 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: RerooJPo1icr_201 Ldoc revised 02116/11 1 Zc�7o Z� REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO•CA 95014-3255 EQ 1 (408)777-3228• FAX(408)777-3333 •buildina(�cupertino.ora CUPERTINO n PROJECT:WORE55Z/<C3 • APN= .� O OWNER NAME I Se - " ePHONE I E-MAIL J v J re o"' t o - MEE I'ADDRESS CITY. STAT IP FAX Z/!03 ,Ptd Fri Cf . „j2qAt,4tb C '? ,r014 CONTACT Nadi F. PHONE EMAIL e zwre$ I o - -O %0 STREET ADDRESS 5,02 S CITY.STATE. ].IP CA FAX ❑OWNER ❑ OWNER-BUILDER ❑ Ou NER AGENT 11601TRACIOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TEeANr COPTRACI'ORNAME I LICENSE NUMBERZ. O LICENS6T'-E BUS.LIC'.= ;213eL^-A COMPANY NAME SAkE %j 11-MAIL I FAN STREET ADDRESS . .wacdLOA CITY.STATE.21P PHONE Sota oSe C -7-718-0 ARCHI'rECTIENGIYEER NAME LICE'SENUNIBER BAs.LIC.- CO\IPA.NYNAME E-NIAIL I FAX STREET ADDRESS ,/ I CITY.STATE/.IP I PHONE Y LSE OF ❑ SFD or Duplex Multi-Family ROOF AREA: r� VALUATION QQ J STRUCTURE: ❑ Commercial 3 S EXISTING ROOF TYPE: 0'BUILT-L9 ROOF ❑ASPIIALTSHINGLES ;4VOODSHAKES ❑o:OODSHINGLES ❑OTHER IsPECIFYI RCNIOPE:REPLACE YES IFNO. PLY\PODD ❑ PLYWD 11 OSB PITCH' ROOF 13 NO I •LAYFR IBNES$ ❑ - TPP CDS :12 A A PROPOSED ROOF TYPE: ❑BUILT-CP 0.00E ASPHALT SHINGLES ❑WGot)SI IAIEES 11 WOOD SHINGLES ❑OTHER ICC-ES REPORT- DESCRIPTION OF U ORp 1/Z�1 S CDX _�to9d -�l,e n 3 O# �-e' .1-t•�-n�_e r(a�e Ole o: s. e e sol con�F 54�in _ G'ele� CnuAcy Gray By my signature below.1 cerintouch of the tollowing: I am the property aener or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of`A ork and eerie'It is accurate. I agree to comply with all applicable local ordinances and state lags relating to building can tion. I a lorize represe AU, �of Cupenino to enter the above-identiFied property for inspection purposes. Signature of Applicant/Agent: _ � Date: 30 ao .2__ SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY _If building is associated With a Home OWner'S Association.provide letter PLA,NCHECATYPE ,,ROUTING SLIP ofapproval from HOA. DYER-THE-COU]7ER L'! BUILDI.VGPLANREVIEW Provide Planning approval to verify if there any restrictionS. ❑ EXPRESS ❑ PLANSING PLA?REVIEW Pr/ov)'de copy oh Manufacturer's Installation Specifications. El STANDARD ElFIREDEPT `Provide signed copy of Cupenino's Tear-OT Policy. ❑ OTHER: . RerwfApp_1011.doc revised 03/16/71