12070240 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21097 RED FIR CT CO,YI'RACfOR:FOUR SEASONS ROOFING PERMIT NO: 12070240
O\VNER'S NAME: TAN LIN AND LI LAN PO 13OX 1668 DATE ISSUED:08101/2012
OWNLR'S PIIONE: 4082555093 SAN JOSE,CA 95109 PHONESO:(408)278-0330
.ia_. LICENSED COQ TR,\cFORS DI?CIA Rryn'IIfL\ BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r�
License Class C— 'n Lie.4 LA (0d." NIECIir RESIDENTIAL r_1
COMMERCIALr
Contractor ��f I N C-' Date 0 1 2
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF WOOD SHAKE&INSTALL IR"CDS
(coil]menci ng with Section 7000)of Division 3 of the Business& Professions PLYWOOD,30N
Code and that niv license is in full force and effect. FELT UNDERLAYMENT.INSTALL CLASS A CERTAINTEED
PRESIDENTIAL COMP SIiINGLES(COUNTRY GRAY)13SQFf
1 hereby affirm under penalty of perjury one of the following boo 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,for the performance of die work for which this
permit is issued. Sq.FI Fluor Area: Valuation:$4500
.U'1'1-ICAN"1'CP:12'I'I FIC,\'I'ION
I ceriifv that I have read this application and state that the above information is MIN Number:35905035.00 Occupancy T}'pe:
correct. I agree to comply,with all city and county ordinances and state law's 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 �
indenuify and keep harmless the City ol'Cupertino against liabiutics,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may acerucagainst said City in consequence ofthe WITHIN 180 DAYS-OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature i� / Date U " �'— ( � Issued
❑ OWNER-It ,DF.R DECLARATION'
I.hereby affirm that I not exempt from the Contractor's License Law Formic of •RE-ROOFS:
the following too reasons: All roofs shall be inspected prior to any roofing material beim;installed.If a roof is
1,as owner of the property,or my employees with wages as their sole com(insation, installed withota 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(Sec.7044, inspection.
Business&Professions Code)
I,as ownceof the property,am exclusively contracting with licensed contractors to Signature ofAppliuhne Date: 8 — ( — I Z
construct the project(Sec.7044,Business&Professions Code),
hereby affirm under penalty of perjury one of the following three ALL ROOFLOVIiRINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent Io self-insure for Worker'sI1.\%,\I2DOUS M.\'Il Rh\LS DISCLOSURE,
Compensation,as provided for by Section 3700 of the labor Code,for the
performance of the work for which this pemnit is issued. I have read the ha'zardaus materials requirements under Chapter 6.95 of the
I have mid will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25.505.25533,and'5534. I will maimain
Section 3700 of the Labor Code,for the erformance of the work for which this compliance with the Cupertino Municipal Code.Chapter 9.1_and the Health&
Performance Safety Code,Section 25532(a)should 1 store or handle hazardous material.
permit is issued. Additionally,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 Coll[all]inans az defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to die Worker's maintain-compliance with the Cupertino Municipal Code.Chapter 9.12 and the
Compensation Imus of California. If,after making this certificate of exemption,I Ilcalth&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 pernit shall be deemed revoked. (honer uO ri* d agent: /J
Dater
.\I'I'LICA\1'CER'1'IFIC.A'I'ION CONS'I'I21ICI'ION LENDING ACFNC\'
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 state Imes relating I hereby affirm that there is a construction lending agency for the performance of work's
to building'construclion,land 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 liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicau understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCI ITECI"S DECLARATION
9.18.
I understand my plan 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
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•building(cDcuoertino.oro
PROIECTADDRESS /a /r,, C L APN#
OWNERNAME L
T
L/. ^ G^ ) 1 PHONE EMAIL
I (�4/1 t yob -zss- 09
STREETADDRESS �ld Fig C,f• CIN. STATE - FAX
TT
CONTRACTOR NAME LICENSE NUMBER !C!A
BUS.LIC.a
4 a o
COMPANY NAME E-MAIL FAX
FC.UrS
STREETADDRESS S�Z CITY.STAT PHONE
0 o ?-o3so
1 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`/0 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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, 1 certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. 1 also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: 1Z Date. �-3-0_/2
RerooJPo1icv_2011.doc revised 02716111
REROOF PERMIT APPLICATION
EM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•building(acupenino.ora
CUPERTINO !�
PROIECTADDRES$ APN- _ 0 /'� C7?2?
Z/o9� Ria/ F',� Cf.
OWNER NAME //n 7-44 Leto / , I PHONE yO _Z�_ S"PHONE
STREET ADDRESS {`20 I CITY. ST. " GIP FAX
CONTACT NAME ',redo �.wzares I PHO?E�O�- IQ �OI E-NLNIL
STREETADDRESS So Z CITY,STATE.ZIP5FAS
❑OWNER ❑ ON:NER:RUILDER ❑ OWIER AGEXT larCo\TRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGMF,F.R ❑ DF\'ELOPER ❑ TENANT
('ONTRACTORNA\IE LICENSE\C.\IBERI LICENSE T\'PE I BLS.LIC.+
20
COMPANYNAME SAME E-MAIL I FAX
STREET ADDRESS CITY.SLUE.ZIP C PHONE
Sc7r Q CSQ C 8-a
ARM rECT,ENGINEER NAME LICENSE NUMBER BUS.LIC.
COMPANY NAME - I E-MALL FAX
STREET ADDRFSS I CITY.STATE%IP PHONE
"E OF ❑ SFD or Duplex j Multi-Family ROOFAREA: JA VALUATION O
STRUCTURE: ❑ Commercial y SQ. lf'Tf
EXISTING ROOF TYPE: 0BL71LT-CP ROOF ❑ASPHALTSHINGLES XIOODSHAI:FS ❑WOOD SHINGLES ❑01 HER(SPECIFY)
RGNIOVF.:REPLACE YE$ IF NO. PL\'WOOD ❑ PLY\PD ❑USB Pll'CH 7 ROOF
❑ K =LA\'FR ICRNE S' ❑ ll'P DS ')` CLASS A
PROPOSED ROOF TYPE: ❑BUILT-OP ROOF 91SPHALT SHINGLES ❑WOODSHAKES El 1,00D SHINGLES C)OTHER ICC-ES REPORTd
DF.SCRIPTIONOF WORN: "A
pd -E �,en 30# AI+ Under�wu eA+ F�A91( - I CA'o�11
..cl Pre e 4.ines offer : CnuA�ry A rd
By my signature below.I ceniR-to each of the following: 1 am the property•oe'ner or authorized agent to act on the propert owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating w building cons' tion. I a orize represe • liv <Of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanUAgenE Date: �O
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ I If bui[ding is associated v.itha Home O\vncrs.Association.provide leve: usCHEa:n'PE ROUTINGSLIP
of approval from HOA. O\•ER-THE{OUN7ER BUILDING PLAN REVIEW
_ Provide Planning approval t0 Verify If there any restrl cuonS. ❑ EXPRESS E3 PI N'NING PLAN REVIEW
P Ovide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
Reroojdpp_2011.doc revised 03116111