12070233 CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADURESS: 21101 RED FIR CT CO\1'RAC`fOR:FOUR SEASONS ROOFING PERMITNO: 12070233
OR'N'F,R'S NAME: BOYER IIANG NGUYET PO ROS 1668 DATE ISSUED:08/012012
OWNER'S PHONE: 4085638694 SAN JOSE.CA 95109 PHONE NO:(408)278-0330
h LICENSED COM'RACI'OR'SI)ECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class t,'3 / Lie.9 "I-? Z(OT
trlECll r RESIDENTIAL(- CO\IAIERCL\L (-
Contractor Dale st 4 l i-z—
hereby affirm than am licensed under the prnwisions of Chapter 9 JOB DESCRIPTION:TEAR OFF WOOD SHAKE&INSTALL 12"CDS
(commencing with Section 70011)of Division 3 of the Business& ProfessionEs 1,Izl OOD,JUH
Code and(hurt my. IN is in full.force and effect. lil.T UNDERLAI'MENI'.INSTALLCLASS A Cf:RTA1NTEED
PRESIDENTIAL COMP SHINGLES(COUNTRY GRAY)I3SQF7
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.
I have and will maintain Worker's Compensation lnsuiance,as provided for by
Section 3700 of the Labor Code,for the performance of One work for which this
permit is issued. Sq.Ft Floor Aren: Valuation:&1500
\I'1'LIG\N'I'Cliltl'IFIG\'flf W
I certify that I have read this application mid state that the above informtion is ARV Number:35905037.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances and 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
indemnifyand keep harmless(he City ol'Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence oflhe
granting of this permit. Additionally,the applicant understumds and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section Igo DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature ��r— Date Issued by: - Dale:
❑ OWNE - BLUER MCLARATION
hereby affirm that I it'll exempt from the Contractor's License Law formic of RE-ROOFS:
the following two 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 com(nnsation, installed without first obtaining an inspection,I agree to remove all nese materials for
will do the work,and the structure is not intended or offered for sale(Scc.7044, inspection.
Business&Professions Code) eL
1,as owner of the property,nm exclusively contracting with licensed contractors to Signature of Applicant, Dat
e�� "�
construct the project(See.7044,Business.&Professions Code).
1 hereby affirm under penalty of perjury tine of the following three ALL ROOF COt'ERINGS TO RE CLASS"A"OR BETTER
declarations:
I have and will maintains a Certificate of Consent to self-insure for Worker's IL\'l.AItDOUS MA'I'1?IOALS 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 Imve 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 Health&Safety Code,Sections 25505.25533.and 25534. 1 will maintain
Section 3700 of the Labor Code,for the performance of the work for which this coagtliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section_553_(a).should I store or handle hazardous material.
pemtit is issued Additionally,should I 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 Buy Area Air QualityManagement 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 laws of California. If,after making this certificate of esemplion,'I Health&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 be deemed revoked (h°rte 1r'auth •iz Win: p
Dole:
I
\I'I'LICA\f CI?It"1'IPICA'I'ION CONSTRUCTION LENDING AGENCY
I cenify that I have read this application Enid state that the above information is
correct.1 agree to comply with all city aid county ordimmces and state haws relating I hereby affirm thin 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 die above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgmena,
costs,and expenses which may accrue against said Cit in consequence of the Lender's Address
graving ofthis permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ,\KCI I I'I'FCI"S DECLARATION9.18.
I understmmd my plans shall be used as public records.
Signature Date
Licensed professional
CITY OF CUPERTINO
It FEE ESTIMATOR - BUILDING DIVISION
ADDRESS• r ( DATE: 07/30/2012 REVIEWED BY: bobs.
7m- APN: BP#: VALUATION: $4,500
*PERMITTYPE:YPE: Building Permit PLAN CIIECK T YPE: Alteration / Repair
PRIMARYPENTANIATION
USE: SFD Or Duplex PERMITTI'PE: 1SFDWLR00
WORK sfd tear off wood shake install new comp shingles.
SCOPE
Much.Plan Check Plumb. Plan Check Elea. Plan Check
d-Iech. Permit Fee: Plumb. Permit Fee: Elec.Permit Fee:
Ocher•,ilech.Insp. Other Plumb Insp. Other Dec.Insp.
Afirch.hmp.Frc.' Plumb. Lisp.Fee: r1ce.Insp. Fee:
A'OTE: This estinntte doer not include jeev due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District. etc). There feev are baser/on the prefintinan•information available and are only an ebtiamte. Contact the Det for aild n'I info.
FEE ITEMS (Fee Itesohaion I1-053 Elf 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1,300 S.f.. Re roof
Supp]. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $195.00 1RER00FRES
PME Plan Check: $0.00
Permit Fee: $0.00
Stipp]. Insp. Fee D Reg. O O"I' 0.0 Ivs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tar:
Administrative Fee:
Work Without Permit? O Yes (D No $0.00
Advanced Plannin, Fee: $0.00 Select a Non-Residential Q
T rave!Doctunentatinn Feces: Building or Structure 0
Strong, Motion Fee: IRSFISHICR $0.50 Select an Administrative Item
Bldg, Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $1.50 $195.001 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(4088)777-3333- building(akupertino.ora
PROJECT ADDRESS Z//O Ge/ F1/ C- APN0
OWNER NAME PHONE E-MAIL
e a -S6 3- 86
STREET ADDRESS OO CITY,ST ZIP FAX
O 4.1 /r C A C
CONTRACTOR NAME LICENSE NUMBER WCENSE TYPE BUS.LIC.0
4-2,2108
C-3
COMPANY NAME. E-MAIL FAX
a r o
STREET ADDRESS�y� CITY.STATEJ`1p ONE
J 0 p
7- o O Woe—
Q - 70 `0.?10
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 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:
RerooJPolicv_2011.r1oc reviser/02116111
120-7 o Z�3
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333• buildingecupertino.org
CUPERTINO
PROJECT ADDRESS O C aPN.
OWNERNAME PHO' O —S _ 8 ?y1
EMAIL
u e O6
STREEI'ADDRESS I CITY. STAT P FAX
V
CONTACT NAME I PHONE IQ 30l E-?JAIL
11
'redo Gawzare& o -
STRE41'ADDRESS5'62 Wnrtiiel,5 S CITY.STATE. ZIP I FAX
❑Ow NF,R ❑ OUNERBOLDER ❑ O.NER{GENT .2601TRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGI.NEF.R ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMELICENSE NUMBER LICENSE
TYPE ( BUS.LIC.=
COMPANY SAME �0. 5 I EAM.AIL 2 O I FAN
STREET ADDRESS CIT\ STATE.ZIP PHONE A
S'07- WacWtCA A ose C
ARCHITECT-ENGINEER NAME LICENSE NUMBER 1.BUS.LIC v
COMPANY NAME I EMAIL FAX
STREET ADDRFSS I CITY.STATE.%IP PHONE
CSE OF ❑ SFD or Duplex r. Multi-Family ROOF AREA: 01 VALUATION AD
yy
STRUCTURE- ❑ Commercial 3 5 Oj
EXISTING ROOF TYPE: ❑BL'ILT.LPROOF ❑ASPII.ALTSHINGLE.S Int\'OODSHAKF.S ❑WOODSHINGLES ❑OIHERISPECIFY)
RBMOCE:REPLACE1'ES � IFSO. PL1'U"DOD �li' ElPLYwD ❑ 050 PITCH: ROOF
❑ N v aYFR HICKCE ❑ 1 YPE CDX '�? A
PROPOSED ROOF TYPE: ❑BCILT-UPROOF XASPHALTSHINGLES ❑\COODSHAKES ❑\vOOD SHINGLES ❑OTHER IMES REPORTa
DESCRIPTIONOF t\'ORH: ,/Z,�
ear a-4 exis+,na wooA s6aV& roof_ SAs�'ll
s 4sd +l,en CDY-
30d* -Pell- Ended alllj-t- inc+All
a s. e e W comm shin jes . G' o.
By my signature below.I certiR.to each of the folio,ing: I am the property owner or authorized agencto act on the property owner's behalf. 1 have read this
application and the information 1 have provided is correct. 1 have read the Description ofµ'ork and verify it is accurate. I.agree to comply with all applicable local
ordinances and state laws relatin=_to building cons'.' tion, 1 a,• orize represe; tiv R of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanUAgenC Date: 610
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
I('building i5 associated with a Home Ov%ner'S Association.provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. ln o R-THE-COUNTER G-1-UILDI,VG PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANA'ISG PLAS REVIEW
_ Provide copy ofManufacturer's Installation Specifications. ❑ STANDARD ❑ FFREDEPT
°Provide signed copy of Cupertino 5 Tear-OfT Policy. ❑ OTHER:
ReroojApp_1011.doe revised 03/16111