12080111 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21088 RED FIR CT CONI•RAC'MR:FOUR SEASONS ROOFING PERMIT NO: 12080111
OWNER'S NAME: CHERN JUE I-ISIEN AND FANG PO ROX 1668 DATE ISSUED:08/13/1012
OWNEAVSPHONE: 4089963739 SAN JOSE,CA 95109 PHONENO:(408)i78-0330
LICIT\SITU CC)\I'ItACI�'O1R'S DECLARATIONF-
PERMIT INFO: BLDG r ELECT r r
PLUh113
License Class C— 7 I-ic.N —11 9(0
C- G mec11 r RESIDENTIAL I- COMMERCIALr
Contractor 1"S 2e I r C Date 8 -- 13 - 1 2
herchy affirrn that I arm licensed tinder the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHARE ROOF.INSTALL I2"
(commencing with Section 7000)of Hivision 3 of the Business S Professions CDX
Cade and that me license is in full force and effect. PLYWOOD TI IrN 30H FELT UNDERLAYMENT.FINALLY,
INSTALL 13 SQFf CLASS A CERTAINTEF-D PRFSIDENTIAL
hereby affirm under penalty of perjureone of the following two declarations:
I have and will maintain a cenif icate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
perfomtance 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,I'or the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$4500
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is ANN Number:35905050.00 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. (Wc)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrucagains(said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulation per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date O ��3'�2 Issued by: ��/Vjy �!!`/}�liDale:
❑ O\ •.R-I UILDER DECLARATION
1 hereby affirm Ilial I am exengt from the Contractor's License Law for one of RE-ROOFS:
the following nvo reasons: All roofs shall be inspected prior to any roofing material being installed.Ira roof is
I,as owner of the property,or my ennployees with wages as(heir sole connM1nsmfon, installed without first obtaining tun 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 R Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applimnt: Date: e-15-11Z
construct the project(Sec.7044,13usiness K Professions Code).
I hereby alTrrm under penally of perjure'one of the following three ALL ROOF CO\'1- GS'1'O BE CLASS"A"OR IIE'I-I'FR
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 bare 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 Ile:dth S 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 compliance with the Cupertinu Municipal Code,Chapter 9.12 and the I lealth 3
p Safety Code.Section 25532(x)should [.store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
1 certify that in the perfomtance of die work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management 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 ofCalifomia. If,after making this certificate of exemption,I Health S Safely 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 Osrn r au nzeJ age
Dale:
APPLICANT CERTIFICATION CONSST RUCTION LENDING AGENCY
1 certify that I have read this application mrd stale that the above information is
correct. I agree to comply with all city and county ordinances:rad state laws relating I hereby aff i 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 liabilities,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 Cade,Section ARCI I ITI'ECI"S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 21088 Red Fir CL DATE: 08/08/2012 REVIEWED BY: Sean
MAPN: BP#: 'VALUATION: 1$4,500
*PERiMITTYPE: Minor Building Permit PLAN CIIECKTYPE: Re-roof
PRUNIAR\' Multi-Family Dwelling Buildina is PE NTAQIATI ON 1R2ROOF
USE: >3 Stories 0 Yes (F) No PERIIITT\'PE: �
WORK
SCOPE
FEE 11) ROOF AREA
(s.f.)
1REROOFMRES 1,300
Stech. Plan Check Plumb. Plan Check Elea Plan Check
b4-ch. Permit Fee: Phrmh. Permit Fee: rlec.Permit ree:
Other dlech.Insp. Other Plumb Insp. Other Elce.btsp.
E17-
Hech.Insp. Fee: Phmrb. hisp. ree: F.lcc.InvP.Fre:
A'OTE: This eviinutte does not include fees due to other Departments(i.e. Planning, Public Warks, Fire,Sanitary Sewer District,School
District, etc.). T heve fees are based on the rrelinrinaninformation available and are onll'an evtinmte. Contact the Dept for addn'I info.
FEE ITEMS (/,"cc Resolution I1-051 Lff 771711) FEE QTY/FEE MISC ITEMS
Plan Check ree:
suPe/ PC ree
Plumb./A/ech.&lec
PennitFee: $195.00
Supp/. hrs'p ree
Phttm b.111ec h.7F,l ec
Plumb.7Mech.7Elec Permit ree:
Const tiction Tao:'
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Advanced Planning Fees:
Trtt el Documentation Fees:
A
Strong_Motion Fee: IRSEISMICR $0.50 Select an Administrative Item
Blda Stds Commission Fee: IeCSC $1.00
SUBTOTALS: $196.50 $0.001 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
CUPEHTINO 10300 TORRE AVENUE -CUPERTINO, CA 95014-3255
pCT
(4408)777-3228- FAX(408/)777-3333•building(d)cuoertino.ort
PROJECT ADDRESS ZIDQ , . APN•
OWNERNAME PHONE E-MAIL
i0ore,7!9o - 3 3
STREET ADDRESS CITY.STA IP _ FAX
SAME C,WAeam
CONTRACTOR NAME LIC 6NSEN L BERLICEj�SE BUS.LIC.0
'(08
O L
COMPANY NAME E-MAIL FAX
O 1 n
STREET ADDRESS SOZ CITY.STATE.75, J n32 CA QSIIZ, PHONE
JJ 'r , O
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%4" 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: 1 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:
ReroofPolicv_?01l.doc revised 02/16111
J -- 12.0� vl ( (
REROOF PERMIT APPLICATION
COMMUNITIY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
GUPERTINO (408)777-3228• FAX(408)777-3333•buildinD(a),cuoerlino.oro
PROJECTADDRESS Q T;77 _ 0 ,5 _
O
OWNER NAME a PHONE. -\TAIL
08. 4 6-3
STREE I'ADDRESS 7_/09?
OOa I FAN
O 6 CIT\', STAT p
CONTACT NAME PHONE E-?JAIL
-0 30
STREer ADnREss gAmaq Sot CIT',STATE.ZIP
S+_ .,/ FAX
11 Ot"FR ❑ OWNER-BUILDER ❑ 01'NER AGENT /1 CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEE0. ❑ DEVELOPER ❑ TESnM
CONTRACTOR.\'AME LICENSENL'StBER LICENSE T'PE BUS.LIC.•'
CONIPANY'SAME E-NI.AIL I FAX
5
STREET ADDRESS I CITY.STATE.21P PHONE
Sot w oSe C 8'0
ARCHITECT,ENGINEER NAME LICENSE NUMBER BUS.LIC.
COMPANY NAME E-MAIL
FAN
STREET ADDRFS$
CITY.$TATE.%IP PHONE
USE OF ❑ SFD or Duples ArMulti-F amil.v ROOF AREA: fir
VALUATION:
STRUCTURE: ❑ Commercial ..yy 13 5 SDS
E\ISrING0.00r TYPE: ❑BUILT-L'PROOF ❑ASPHALTSHINGLES r\COODSHAKES ❑WOOD SHINGLES ❑OT'HF.RISPECIFYI
RE\IOVE,REPLACE YESI IFNO. PLYWOOD 1-1PL\'\v0 ❑OSB PITCH' ROOF
❑ N AVFH THICKNESS ❑1 li- I 1'Y'PE. 2rrDX ') CLASS A
PROPOSEDROOFTYPE ❑BUILAUPROOF ASPHALT SHINGLES ❑WOOUSIIAKES ❑\YOODSHINGLES ❑OTHER ICC-ES REPORTi
DESCRIPTION OF M ORK: (/tt
moo# AIk ,nderlw�xe ._F_;eaLL�_�i.ric�w�1
J as __ PreS i den�'o.l coma a�in41 Coffer ' CQUA411ZY G Fav
By my signature below.I cenifY touch of the following: I am the property owner or authorized agent to act on the propem'oWncr's behalf. I have read this
application and the infomation I have provided is correct. I have read the Description o"Work and verify it is accurate. I agree to comply With all applicable local
ordinances and state laws relating to building const tion. I a ONZe represe tiv cot Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicanl/Agent: Date: O
SUPPLEMENTAL INFORMATION REQUIRED OFFICEUSEONLY
Ifhuilding is associated With a Home OMTIcrS Association.provide letter PLANCHECKTYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_ Provide Planning approval to verify if there am'restrictions.
❑ C\'PRE$$ ❑ PLAN:CISC PLU'REl'IEW'
_ Provide copy of Manufacturer's Installation Specifications.
❑ STANDARD ❑ FIRE DEPT
_ Provide signed copy Of Cupetlino's Tear-Off Policy. ❑ OTHER:
Reroof4pp ?Ol l.doc revised 03/l6,l l