12080096 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21084 RED FIR Cf CONI'RACI'OR:POUR SEASONS ROOFING PERMIT NO: 12080096
OWNER'S NAME: GUPTA PRAMOD K AND SEENIA 1'0 BOX 1668 DATL ISSUED:08/13!_)012
OWNER'S PIIONE: 4088661896 SAN JOSE,CA 95109 PDONE NO:(408127x-0330
A?� LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG 1- ELECT F- 1'LUM13 r
License Class_
Lie.d X
l"12 Lc� n1Ecrl r RESIDENTIAL C COMMERCIAL C
Contractor FS��pJG Date
hereby affirm that I am licensed under the pro%isions of Chapter!) •1013 DESCRIPTION:T14AR 01'1)EXISTING"'OOD SIIAKE ROOF.INSTALL 13
(commencing%rich Section 7000)of Division 3 of the Business K Professions SQIT
Code and than nny license is in full force and effect. IR"CDX PLYWOOD TI'IEN 30N FELT
UNDERLAYMENT.FINALLY,INSTALL CERTAINTEED
hereby afTmn 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 Insurance,as provided for by
Section 3700 of the Labor Code,for the perlbrnanee of tlne work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$4500
A I'I'LIC.\N'1'CI•:R'I'1 FICA'I'll h\
I certify that I have read this application and state that the above information is AI'N Number:35905052.00 Occupancy'fype:
correct.I agree to comply with all city and count%•ordinances and state laws relating
to building construction,and hereby authorize representatives of[his city to enter
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the 6tyofCupertino against liabilities.judgments. PERMIT EXPIRES IF WORK IS NOT .STARTED
costs,and expenses which may accme against said City in consequence of the
granting of this permit. Additionally,theapplicautundcrsumdsandwillcomply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
%with all non-point source regulations per the Cupertino Municip:d Code,Sectio) 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature /� �- Date ?-15 Issued by: J AN fTATG/'i Dnte: ,�i-/3•Ja
el-❑ O\\, 1?It-111IILDER DECLARATION
hereto'alDrin that 1 our c%mnpt from the Contractor's License Laefor one of BE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.Ira roof is
I,as ow'ner.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[he stmc[ure is not intended or offered for sale(Sec.7044, inspection.
Business S Professions Code)
h as owner of the property,an)exclusively contracting with licensed contractors to Signature of Applicim: •tr.
construct the project(Sec.7044.Business R Professions Code).
1 hereby affirm under penalty of perjury one of the fallowing three ALL ROOT'CON'F 'GS'1'O BE CLASS"A"OR li 1.7I"I'ER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IL\'/.ARDOIIS 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 live 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 I Ieulth S Safety Code,Sections 25505,2.5533.and 25.534. 1 will maintain
compliance with the Cupertino Municipal Code,Chapter 9.12 and the l lcallh&
Section 3700 of the Labor Code,for[lie performance of[he work for%which[his .Safety Code.Section 25532(x)should I.store or handle hazardous material.
permit is issued Additionally.should.I[INC equipment or devices which emil hazardous air
I certify that in the performance of the workfor which this permit is issued,I shall cunlaminmus as defined by the Bay Arca Air.Quality Management District I will
not employ tray person in maintain any manner so as to become subject[o the Worker's mainin compli ace with the Cupertino Municipal Code.Chapter 9.12 and the
Compensation laws of California. 11'.after making this certificate of exemption.I llcalth\Safety Code.Section.%25505.25533,and 25534.
become subject to the Worker's Compensmion provisions of the Labor Code,1 must
forthwith comply with such provisions or this permit shall be deemed revoked. Owner or milt ail-'agent:
Date: O
APPLICAN 1'CERTIFICATION CONSTUUCHON LENDING AGENCY
I certify that I have read this application and state that the above information is
correct.1 agree to comply with all city and county ordinances:rad state laws relating Ill 'affirm that thereis 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,Cie C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indenmify 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%%ill comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCII I'1'F.CI"S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
;"�'+v`-.j. J �n-'1PM-h,�r '':-'3'�.-t-�.t,o-, -�. r_ .;wi..,r..�rsr%-••,rv-•vR'T5-_^.Y�.J.�-..J.c/v>�'M�4i-e^T�-1+.....-w.P%-+..:;y;,k,i��
kREROOF TEAR-OFF POLICY I Xboq
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
-.4
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL as'�
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO
(408)777-3228• FAX(408)777-3333•buildinq(a7cugertino.orq
•
PROJECT ADDRESS -7/o e tI iJ(. / F/ ( C�. APN u (4 Ag AO,S I fi-) !l
OWNER NAME t� CII PHONE E-MAIL
•'-( fin n•tu� . - SCFMn u;JiC. LO('' " 8L,L- /%�/�i
STREET ADDRESS / CITU.STATE.ZIP 1 FAX
CONTRACTORNAME LICENSE NUMBER SE
I10g LICW ., BUS.LIC:.%,\
COMPANY NAME r E-MAIL
STREET ADDRESS -� CITY.STATE.ZIP S+ �•�I PHONE
C ToSc ��1 �i��fl � o??G
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 I/<" per foot of slope and demonstrate there is no ponding.
In. 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, ventslpainted, 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
j 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. 1 understand and agree to comply with the re-roof policy stated above. I also understand thatvi
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: fi — P. -/Z
veRerooJPolic —Z011.doc revised 02/16/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 21084 Red Fir CL DA'Z'E: 08/08/2012 REVIEWED BV: Sean
APN: RP#: `VALUATION: $4,500
*PERNtIT TYPE: Minor Building Permit PLAN CIIFCK TYPE: Re-roof
PRIMARY Multi-FamilyDwelling Buildina is PENTAtNIAI'10N
USE: g >3 Stories O Yes (D No PERMIT'I'\'PE:
1R2ROOE;
WORK
SCOPE
FEE ID ROOF AREA
1REROOFMRES 1,300
Alech. Plan Check Plumb. Plan Cheek Dec.flan Chock
Mach.Permit Fee: Plumb.Permit Fee: Elce. Permit Fee:
Other dlech. Insp. Other Plumb Imp. Ll I Other Eler.Ittsp.
.Meeh.Gip.Fee: Plumb. hcsp.Fee: F.lec.Imp.Fee:
NOTE': This cctinmte does not incluc%jeer due to other Departments(i.e. Planning, Public Works. Fire,Sanitary Server District,Schaal
District,etc.). Thesefees are hosed on the treliminnninformation available and are only an estintate. Contact the De t or addtt7 info.
FEE ITEMS (Fee Resolution 11-053 Q 711/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Phanh.lA-lech.lElec
Permit Fee: $195.00
.Supp/. /asp Fee
Pl um h.lA/ecl t.lF,l ec
Phatth.A14ech.lElec Permit Fee.
Conslivetion Tac:
Administrative Fee:
Work Without Permit? O Yes 0 No $0.00
Advanced Plamting 1,ees:
Travel Documentation Fees:
Strome Motion Fee: IBSEIS,t1ICR $0.50 Select an Administrative Item
131cik Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $196.50 $0.00 TOTAL FEE: $196.50
Revised: 07/01/2012
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CI (408)777-3228" FAX(408)777-3333"buildina(a),cuoerlino.oro ..J//��S
PROJECT AUDRESS Z/O rA i♦ e APS• /1 1 - VI
O"'NERN�AME PHP MAIL
a K" I Se4GM^ CL CE IKI 8-
16
STREE'r ADDRESS �/O�� ,I CIT.STAT P i FAN
CONTACT NANIF PHONE E-MAIL
409-1-18-01101
STREET ADDRESS 5,6
2
S CITY.STATE. 7.IP FAR
- warninq
ClO"'NFR ❑ OWNER-RUILDER ❑ OWNER AGENT 1 Jr.�/CONTRACTOR ❑CONTRACTOR AGENT Cl ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
C'ONFFRACTOR NAVE LICENSE NUMBER LICENSE 'PE BUS,LIC.•
COMPANYNAMC SA64E
C-AIAIL FAX
STREET ADDRESS CIT'.STATE.21P PHONE
Sot a ose C 8-0
.ERCHtTECT,ENGINEER NAME LICENSE NUMBER BUS.LIC.
COMPANYNAME I E-MAIL
FAX
STREET ADDRESS CIT'.STATE CIV PHONE
CSE OF ❑ SFD or Duplex JC Multi-FamilyROOF AREA; .I/ VALUATION:
STRUCTURE; ❑ Commercial RRyy 13 s X00
EXISTING ROOF TYPE: 13 BUILT-LP ROOF ❑ASPIIALTSHINGLES PCOODSHAKF.S ❑WOOD SHINGLES ❑OTHER(SPECIFY)
RESIOYE!REPLACE MIYES IF NO. PL\'"'GOD ❑ PLYWD ❑OSB PITCH; ROOF
❑ N . AYFR • I KNES ❑ : ' 'Y .:12 LAS A
i
PROPOSED ROOF TYPE: ❑BUILT-UPRooF ASPHALT SHINGLES ID"ODD SIIAKES CI WOOD SHINGLES ❑OTHER ICC-ES REPORT•
DFSCRIPTION OF A%ORK: 1/Z f f
sCOX
WQQA L-e^_ 30# . ' Id (maer(ILILAerk Ftnoll�_� in
�erkeSn�sea rtS1Aea+'a.1 camp. s6ir% es GC46y
By my signature below.I certify to each of the following: I am the property w
mvner or authorized agent to act on the property oncr's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and v<riiy it is accurate. I agree to comply with all applicable local
ordinances and state la"'s palating w building cons� tion. la orize represe tiY c of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanUAgent: Dale: O
SUPPLEMENTAL INFORMATION REQUIRED op� OFFICE USE ONLY
If building is associated With a Home Owner's;Association.provide letter PLAN CHECW TYPE ROUTING SLIP
of approval from HOA. ❑ OYER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions.
I ❑ EXPRESS ❑ PW SNINC PUNREYIE"'
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cuper(ino's Tear-Off Policy. ❑ OTHER:
Reroojdpp_201 I.doc revised 03/16111