12070229 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21115 RED FIR CT CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12070229
ON;N ICR'S NADIN: LUNNON MICI IAIil.E AND RI'I'A A 1'O BOX 1668 DATE' ISSUED:08/082012
OWNER'SPIPONE: 6502548332 SAN•IOSE,CA 95109 PIIONENO:(408)27841330
W' LICENSED CONFRACrOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r: PLUNID r
License Class C-3 7 Lie.H LA`Z.Z.
�
,/f p p MIECII r RESIDENTIAL 17COMMERCIALr
Contractor F-�•1L/ I P'F C' Date
1 hereby alfanu that I nu licensed under the provisions of Chapter 9 306 DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROOF. 13 SOS
COMP
(commencing with Section 7000)of Division 3 orlhe Rosiness S Professions INSTALL
Code and that my license is in full force and effeet- 12"CDS PLYWOOD,308 FELT AYMENT INSTALL
CERTAINTEED PRFSIDENTIAI.COMP SHINGLES,COLOR
1 hereby afftmin under penally of perjury one of the folloi,ing 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 oflhe work Ibr which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 orthe Labor Code,for die performance of die work for which this
permit is issued Sq.FI Floor Area: Valuation:54500
A I'I'LIC.\N'I'CEIL'1'1IrIG\'PION
1 certify that I have read(his application mid state than the above information is APS Number:35905044.00 OccupancyType:
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives oflhis city to enter
upon the above mentioned property for inspection purposes. (We)agree(o save
indemnifv and keep liamiless the City ofCupertino against liabilities,judgments. PERMIT EMPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
grantingofdtispermi(. Additionally,the applicant understandsmidmill comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date �' 0 2 Issued by: �Gf//✓ �j>�,jG/T Date: �-E •��
❑ (OWNER- LDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Lan,for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material berg installed If roof is
1,ars owner of the property,or my employees with wages a s their sole compensation, installed without first obtaining rat inspection,1 agree to remove all new materials for
will do the work,and the structure is not intended or olfered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of(he property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business K Professions Code).
I hereby affirm under penalty ofperjury one of the follmving three ALL ROOF COVERI, BE CLASS"A"OR RE PIER
declarations:
I have and will maintain a Certificate of Consent to sel Ginsure for Worker's IIA%Altl)OIIS NIA'Il�R1A1.S DISCLOSIIRF
Compensation,as provided for by Section 3700 of the Labor Code,for the -
perfor mance of the work 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 Ileallh S Safety Cuda Sections 25505.25533.and 25534. I xsill maintain
Section 3700 ofthe Labor Code,for the performance of the work Ibr which this compliance with the Cuperdno Municipal Code.Chapler 9.12 and the I Iealth S
Saret•Code.Section 2553.(x)should I store or handle hazardous material.
permit is issued Additionally,should 1 use equipment or devices which emit hazardous air
I certify that in the performance of the work for%6ich this permit is issued I shall emitaininmw5 as defined by the Bny Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Nl unici pal Code,Chapter 9.12 and the
Compensation laws of California. If,alter making this certificate of exemption,I health S Safety Code.Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I mus(
(orthvyi(h comply with such provisions or this permit shall be deemed revoked. Ownr a viz nt: _ ,2
Uatr:
APPLICANT CI?12'1'1 FICA-110N
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and stale that the above information i5 ZK
correct.I agree to comply with all city and county ordinances mid state laws relating I hereby of irnt that(here is a construction lending agency for the perfomance of ssurk'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 fir inspection purposes.(We)agree to save Lender's Nane
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 Code,Section ARCI I ITIX-I"S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed PrurOA011111
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
/l ;� l) 7'r L
ADDRESS: DA rE: 0 713 012 01 2 REVIEWED 13\': bob s.
\ AI'iN: ISI'#: 7O� � 'VALUATION:
aU 54,500
'PERMITTYPF: Building Permit PLAN CIIECK T)TE: Alteration I Repair
PRIMARY SFD or Duplex PEN"I'.\M.\TION 1SFDWLR00F
USE: I'ElitMIT TYPE:
WORT: sfd tear off wood shake install new comp shingles.
SCOPE
NOTE: This estimate does not includelees due m other Departments(i.e. Planning, Public Works, Circ,SanitarySewer District,Schaul
District, etc•.). These lees are baser/on the rrelimivart•in ornatiom arrrilahle and are onh•an estinuue. Contact dre Dem far ar/rhr'I imfn.
FEE ITEMS (I ce Resolution II-q51 E!!: 711,,V JI FEE Q"I'1'/FI?E IIISC ITEMS
Plan Check Fee: 50.00 1,300 s.f. Re-roof
SuppI. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $195.00 IREROOFRES
PMI- Plan Check: $0.00
Permit Fee: $0.00
SUppl. Insp. Fcc:Q Reg. Q OT0.0 hrs $0.00
PMI- Unit Fee: -Fl $0.00
PME Permit Fee: 50.00
r ar.•r,r ran Les:
I'la wn w.w.-r r l O
Work Without Permit? O Yes (D No $0.00 0
Advanced Plannine Pee: 50.00 Select a Non-Residential (D
Building or Structure O
Strum'_ i\-lotion Fee: 1BSEISd11CR $0.50 Select an Administrative Item
Mde Sids Commission Fee: IBCBSC S1.00
SUBTOTALS: 1 $1.50 S195.00 TOTAL FEE: 1 $196.5011
Revised: 07!01/2012
REROOF TEAR-OFF POLICY
0 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O.. BUILDING OFFICIAL
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
LUPE RTI NO (408)777-3228• FAX(408)777-3333•building a(7.cupertino.orD
paw
PROTECT ADDRESS ^ S G� FI/- C APNa 7;y ,6 OL
OWNERNAME. O` PHONE E.MAIILL
ie 6,2 f- 4un 6So- A� - 83 2
STREET ADDRESS ^ r CITY. STAVy wb FAX
CONTRACTOR NAME O' •] LIC ENSEN MBER LICENS¢7YPFn� BUS.LIC.p /
COMPANY NAME E-MAIL C/_•S FAX
Setir /eco
STREET ADDRESS SeZ r '^ ^ CITY.STriLS Tom{ ^ PH O�-
I UNDERSTAND AND AGREE JTO 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 1/0 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 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. 1 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: Dale:_]
ReroofPolicv-201laloc revised 02/16111
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTNIENT• BUILDING DIVISION
10300 TORRE AVENUE -CUPERTINO•CA 95014-3255
(408)777-3228• FAX(408)777-3333 - buildino(okupertino.ora
CUPERTINO
PROJECT ADDRESS -,(^ / d C APS- js/ f15
OWNER NAME I PHO\ (1,11A1L
M v `fir
;Cl40/. LU -
STREErADORESS ^ /,� C ^ ( CIT\'. 5T � 41P T Fa\
oc.
CONTACT NAME %( el• o -PHONE E-NIIAIILL
� -0 30�
$TREEI'ADORESSSot Q STS I CITY.$T.CTE. ZIP/N I FA%
CA AT11 -
J a``77
❑OWNER ❑ Ow NER-BUILDER ❑ ou6ERAGEST 1C0NTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEN ELOPER ❑ TENANT
CONTRACTOR SAME LICENSE NUMBER LICENSE TI RE A I BUS.LIGe
mor SeAS.4A& 4110LIOR
COMPANY SAME E-SIAIL FAX
SAkE
STREET ADDRESS CIT'.STATE.ZIP PHONE
Sot w o5e C -Z 8-0
ARCHI J ECTrENGINEER NANIE LICENSE NL:NIBER BUS,LIG
COMPANY NAME I E-MAIL FAX
STREET ADDRESS I CIT'.STATE.ZIP PHONE
USE OF ❑ SFD or DupleN 'c'lultl-Family ROOF AREA: VALUATION
STRUCTURE: ❑ Commercial ��// 3
EXISTING ROOF TYPE: ❑BUILT-L'P ROOF 1:1ASPI(ALT SHINGLES 0"OOD5HAKES ❑wOpDSHINGLES ❑OTHER I SPECIFY)
RENIOVEAEPLACE VYES )FSO. PLYWOOD ❑ PLYIVD El OSB PITCH ROOF
El NO .LAYER THICKNESS El5S. TYPE. fD% .12 A A
PROPOSED ft00F TYPE: ❑BCILTI�P ROOF 91SPHATSHL\GEES ❑\COOUSIIAKE$ ❑KOOD SHINGLES C1 OTHER )MES REPORT e
DESCRIPTION OF\l ORK: I/Z 1�
S
e O#
ssA Pre-SlAet4t.1 �%Ines Color ctwAcy Cjkr&y
Ry my signature below.I certify to each of the following: I am the property mvner or authorized agent to act on the property owner's behalf. 1 have read this
application and the infoDnation 1 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 relatine to building consI tion. 1 a- orize represe ' tiv of Cupenino to enter the above-identified property for inspection purposes.
Signature of ApplibanUAgenr. M� Date: .30/ 6101.2
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home Owner's Association.provide letter PLANCHECK TYPE ROUTING SLIP
of approval from HOA. N'ER-THE-COUNTER ❑ BUIL-WN REVIEW
Provide Planning approval t0 verify if there any restrictions. ❑ EXPRESS ❑ PW N:\'ING PLAN REVIEW
_ Provide copy Of Manufactures Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
�de signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
RerwfApp_2011.doc revised O3ll6l11