12080114 CITY OF CUPERTINO BUILDING PERMIT
RUILDLNG ADDRESS: 21094 RED FIR CT CONTRACTOR:FOUR SEASONS ROOFING PERMITNO: 12080114
OWNER'SNAME: S'I'13VENSONRUIIYI.TRUSTEEI-STA'I'I-OP PO BOX 1668 DA'Z'E ISSIJED:08/132012
OWNER'S PHONE: 8312349188 SAN JOSE.CA 95109 PHONE NO:(+08)378-0330
JM. LICENSED CON'TRACTOR'S DECLARATION
BUILDING PERMITINFO: BLDG - ELECT PLUMB '"
License Class e_39 Lie.q K ) Z 108 r r F-
r nlEctl RESIDENTIALCOMMERCIALContractor (—'SX.I IN r-' Date ?-- 19-12
1 hereby affirm that I am licensed under the provisions of Chaplcr 9 •1013 DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROOF.INSTALL I2"
(commencing with Section 7000)i f Division 3 of the Business&Professions CDX
Code and that my license is in full force and effect. PLYWOOD THEN 30q FELT UNDERLAYMENT.INSTALL 13SQFT
CLASS A CERTAINTEED PRESIDENTIAL COMP SHINGLES.
o
herebyfiru
afm nder penally,of perjure•(,lie of thne
e following n 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 perfomhance of Ute work for which this
permit is issued. Sq. Ft Floor Area: Valuation:$4500
APPLICANT CERTI FICATIO,N
I certify that I have read this application land state that the above humiliation is. A[.N Number:35905047.00 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
indemnify and keep hamilessthe CityorCupertinoagainst 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,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per lire Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature i Date Issued by: ;/��N �r/jG�1 Date:
❑ O\V �I LDER DECLARATION
I hereby affirm[hal I nor exempt from the Contraclur's License Lawfor one of RF.HOCI FS:
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 compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,mid the stmclure is not intended or oflcred for sale(Sec.7044, inspection.
Business S Professions Code)
1,as owner of the property,am exclusively contraction with licensed contractors to Signature of ApplipnC Date:
construct the project(Sec.7044,Business R Professions Cade).
I hereby affirm under penally of perjury one of the following three ALL ROOF COVERT ' '1'0 ISI•:CLASS"A"OR BE ITER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's 11A7.ARDOUS MATERIAI S DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the stork 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,as provided for by California l lealth&Safely Code Sections 25505.25533,and'553.1. 1 will maintain
Section 3700 ofthe Labor Code,for die perl'onnance of the work for%%[rich this compliance with the Cupemino dlunicipal Code.Chapter 9.1_and the Health S
Safety Code.Section_553_(x)should Istore or handle hazardous material.
permit is issued Additional W,should I use equipment or devices which emit hazardous air
1 certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the[lay Area Air Quality Managenmenl District I will
not employ any person in any manner so as to become subject to the Worker's maintain coni pliance with the Cupertino Jl unicipal Code.Chu pier 9.12 and the
Compensation Imes of Cali lomia. II;alter making this certificate ofesemplion,I Ileallh 3 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. Owner u n rifted agent: /J
(late:
APPLICANT CERTIFICATION CO,NSTRIICI'ION LENDING AGENCY
I cenify that I have read this application.rad state that the above information is
correct.I agree to comply with all city mal county ordinances,rad state laws relanin_e I hereby affirm that there is a con9metion lending agency for the performance of work's
to building construction,mid 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 Cin'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 ,\ItClll"fECr'S DI?CL,\I3A'fION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 21094 Red Fir Ct. DATE: 08/08/2012 REVIEWED BY: Sean
APN: BP#: -VALUATION: 1$4,500
*11ERM1T TYPE: Minor Building Permit PLAN CIIECR T)'PE: Re-roof
PRIMARY Multi-FamilyDwelling Buildina is PENTAMATION 1R2R00
USE: g >3 Stories 0 Yes (j) No PERMITTYPE:
WORT:
SCOPE
FEE ID ROOFAREA
(s.f.)
1REROOFMRES 1,300
Mech. Ilan Check Plumb. Phar Check Elec.Plan Check
blech. Permit Fee: Plumb.Permit Fee., Elec.Permit Fee:
Otho•dlech.Insp. Other Plumb lnsp, L-1 I Other Elec.1,
,Neth. hap.Fee: Plumb. host.Fee: Flee.Imp.Fee:
NOTE: This estimate does not include fees elite to other Departments(i.e. Planning, Public Works, Fire,Sanitary Server District,School
District,etc.). These fees are based on the preffininan information available and are onb,an ettinuae. Contact the Dept for aehht7 info.
FEE ITEMS (Fee Resolution 11-0531--fl.' 7/1/11) FEE QTY/FEE MISC ITEMS
Plun Check.Fee:
S11p1iL PC Fee
Plumb./A/ech./F.lec
Permit Fee: $195.00
Suppl. lnsp Fee
Phrmb./A/ech./Flee
Plumh.4fech./Elec Permit Fee:
Consnvclion Tac:
Administrative Fee:
Work Without Permit? 0 Yes (D No $0.00
Advanced Plamring Fees:
Travel Doeunentallon Fees:
Strong Motion Fee: 18SF.ISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Pee: IBCBSC $1.00
SUBTOTALS: $196.50 $0.00 'TOTAL FEE: $196.50
Revised: 07/01/2012
REROOF TEAR-OFF POLICY
is 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(408)777-3333•buildingecuoertino.org
PROJECT ADDRESS r C APN0
OWNER NAME PHONE E-MAIL
u � ev o $31-23H- 918
STREETADDRESS CITY. STATj✓6IP A �� 4 FAX
Q t��
CONTRACTOR NAME LICENSE NU R LIC BUS.BUS.LIC.a
/00 C..� 3
COMPANY NAME E-MAIL FAX
SCas S
STREET ADDRESS CITY,STATE.Z P NF.
5'07— nrA LA � os¢ CA 4SIIZ 68-2'78-6336
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: 1 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: Date:P_i "/Z,
ReroofPoficv_201 Ldoc reviser/02716/11
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO.CA*95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildino(okuoertino.org I �-r
PROIECT:AUORESS210911 Q .A P\0-Ef O l
OWNER u S7Lt.uy�MARIE PHONE i- ;Z34 - 9,
'R23 ` NIAIL
Sw. 3 S
STREET ADDRESS �/ CITY. STAT P 1 FAX
CA iq 14
CONTACT NANIF. PHONE EJIAIL
4 C12-709- of
STREET ADDRESS SG2 CITY.STATE.ZIP
S FAY
❑ eipuriMse'ICA - qv 07
OWNFR ❑ Ou'NER-BUILDER ❑ ON'NERAGENT A CO\'TRACTOR ElCONTRACTOR AGENT ClARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TEKnM
CONTRACTOR N,AAIE LICENSE NL'\IBER OFJ LICENSE TYPE I BUS.LIC• .
COMPANY NAMG E-MAIL5 FAX
STREET ADDRESS CITY.SLATE.ZIPHONESee"
C 8-0
.ARCHrrECT•ENGINEER\ANE LICE\SE NUMBER BUS,LIC..
COMPANY SAME E-%IAIL
fAX
STREET ADDRESS CITY.STATE.'/.IP
PHONE
USE OF ❑ SFD or Duplex Af Multi-Family ROOF AREA: VALL'AIION'
mucruaE. • Cl Commerciala�yA /3i C C—DO
EXISTING ROOF TYPE: 11 BUILT-UP ROOF ❑ASPIIALTSHI\GLES Jr\\'OODSHAAF.S ❑UOODSHIN'GLES ❑01HF.RISPECIFYJ}
RE\IOVF.:REPL: YES IF\0. PLY\\'ODD ❑ PI I' 1 ❑OSB PITCH: U ROOF
❑ N .LAYFRSr A\ESC' (3 51 TYPE 2rcyI 12 APROPOSEDROOF TYPE: ❑BUILT-UP ROOF XISPHALT SHINGLES C)WOOD SHAKES 11 WOOD SHINGLES ❑OTHER ICC-ES REPORT.
DESCRIPTION OF WORK 1
oocf Stn}ro. 1�roa %/ZtI GD
�.d -��,en '30# 1.1- ,,..,1 r�vuM6AT •_F;nwl1��.D_C_��
as reS l de.&+} .l camp o6in jes Ceder ' o G (: Fav
Ay my Signature below'.I CeniA'to each of the following: I am the property 0%,ner or authorized agent to act on the property o%mer's behalf. I have read this
application and the information I have provided is const. I have read the Description of Work and verify it is arcuate. I agree to comply with all applicable local
ordinances and state laves relating to building cons, tion. I a orize repres< tie c of Cupertino to enter the shore-identified property'for inspection purposes.
Signature ni ApplicanUAgenr. Date: 00
0
SUPPLEMEN"FAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated With a Home Owner's Association.provide letter PLANCHEC:TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions.
❑ EXPRESS C3PLA\:\ISG PLAN REVIEW'
_ Provide copyof Manufacturer's Installation Specifications.
❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. - ❑ OTHER:
Reroofdpp_2011.doc revised Od/l6ll I