12080156 CI TY OF ICUPERTINO BUILDING PLI0'I1T
[till Ull.xc AImitESS: 21066 RHD PIR Cf cOS'nocrow 17OUR SEASONS rltR.\n'rso: 12030156
ROOFING
0W1NER1S.,s,x,%w: SUCHITRA RAO PO BOX 1663 )20'11¢ ISSUE[):03/20/2013
OWNEwS ruoxo-:: 4056535555 SANK JOSE. CA 95109 PlIONE No:(408)278-0330
LICE SP.1)CONfRAC1,01CS DrCLARATION r r r
BUILDING P E1011'I'ISI'O: IthUC 1..1.ECII+LtI?III
License oats C^3� 1-k.ft t'{^12 10 Fl r r r
>IECII RF.SIDE.SlI\L COMMERCIAL f N� C • Ualc 6 p'ZO^/'2_
I herelw:dlirnh that I :un licensed under the provisions ul'Chapter 9 •1011 DESCI(11''HOS: 13 SQS'ITAR OFF RSIS'fING WOOD SIIAKI7 ROOF.
INSTALL
(Condo encimp wi lh Scc l ion 711111)of Dit is i un 3 ol'the Itusinrss.0 Prufrasioos 1/2-CDS PLYWOOD T1IEN 304 ITIJ UNDERLAYMENI'.
Code and that n1v license is in Ildl force alol effect. WS'1'AI.I.CI:RTAIN'I1:I:I PRI:SI UIiN'I'L\I.COMI'SIIINGLIiS.
I here[,%affirm under prnallr of peI j I) 0111'ol'Ihe h l l u.ri n„I+ru it l'l'Ia ca l i a tie:
I have laid will maintain it cerci iCllle 0fc0nsenl to self-insure tit Worker's
Congmnsation,as provided for by Section 3700 ofthe Labor Code,for the
peflitnttance 01'111C work Im which this pcnnil is issued. sq. PI 1§uor Area: Valuation:S4500
I have and'a'ill maintain Worker's Compensation Ih15nr1:hICC,its provided Ihr by
Section 3700 or the Labor Code.for the perlorromhce of the work lir Mlieh this
\I'S\umber:3590:061.00 Orcupanr%'I'rpe:
permit is issued.
,\1111LICANT CERTI fICATION
I certify that l have read this application and state that the above inlimtialion is PERNUT EXPIRES IF WORK IS NOT STARTED
correct. l agree to comply with all city and comity ordinances laid state latcs relating WITHIN 18(1 UAY'SO{' I'I;RD'1I•I- ISSIjr\t\CIi OR
building construction,and hereby authorize representatives of this city to enter
upon(lie above mentioned property for inspection purposes. (We)agree to save 1,40 DAY 'ROtNI LAST CALLED INSPECI-ION•
indemnily and keep hmlllICSS file City 01 Cupertino against liahililies.)udgnunls.
costs.and CSpenSCS which Ilmh)',aeClnC aL'ainsl said City in cunsequrnce 01'111V /
grating of this permit. Additionally,the applicant understands:aid+,ill comply Issued by: Date.
wits all non-point source regulations per the Cupertino\Iwhicillal Code,Section
9.18.
^ w:-Boors:
Signature_` Date All root:.shall be inspected prior m any tooling nu]trrial being installed.If a mol'is
installed without first obtaining un Inspection.I agree m rermwe all ne.v uh:uerials lit
inspection.
❑ O\\'SIIR-13III1DIi1( DECLARATION p
Signuuue o(ApplicflnC� — tar.
I hereby al)irm Ina I;..It eu•ngtl from Ihr Con ti'aclurl Lier n>r Lav fur mw ul'
the lidluwing neo n•avnls0 AI,L M H W C( T1 .- '1'O Illi CLASS"A" OIt Iili'1-1'r it
h as owner ollhr propene,or nhy employers wishcages as(heir sok compensation.
will do the work,and the slmclure is nw intended or offered far sale(Sec.70,L1,
Itrsineis& Prolestions Code)
1„u ...tier ohne property.am eschsieely conlraclim_with licensed contractors to IIA'/„\It Dill is?IA'1'F.11 L\I.S DISC:LOSURr
construct the project(See.7(b14.Business-Professions Code). I has read the hazardous nil:t.riids requiremems under Chapter O95 ill*Ihr
Calif orni:I I le:tlh R'Safely Code.Sections 255115.25533.:md 25534. 1 will
I hereby aff]rnh under penally of perjure'one ofthe following three' maintain compliance with the Cuperiijo. \hmicipal Code.Chapler 9.12 and the
tleclal atiolhs: I lydlh&Safely Coc e.Section 25532(a)should I.lure ur ha de hazardous
I have;aid.cill nhaint:tina Cerlilicatcof Consent toself-insure for Worker's Ion(Urial. Addilinnally,should l usecquipluml urdeeices which emir hazardous
Compensation,as provided for by Section 3700 of the Labor Code.for lite air contaminants as defined by tire Bre Area Air Qu:dily Managenu•nt Dittrich
performative oflhe work for.shich this pcnnil is issued. will maintain compliance will] Ihr Cupertino Municipal Codr.Chapn•r.9.12 and
I have:aid will maintain Worker's Compensation Insurance.its provided lilt by Ihr I Ienith\Safely Code.Seelioos?5515.'_5533,and 25534.
Section 3700 of tlhc I.abur Codc.Int the pcnimnnnce of the work liter which this p 20•
IAcner a1':ullhurizcd mgrni: D:nrY
pcnnil is issued.
I certify that in the performance of the work lit which this permit is issued.I shall
mm employ:any person in any manner so as to become subject to the Worker's
Compensation l aws ul'California. 11.alter making this ecrtiliCnlc of cxeinplion,1 CONS'1'It11C1'10N LENDING AGENCY
become subject In the Worker's Compensation provisions 0f the Labor Code.I most I Inereby affirm than there is a construction lending agency lit the perlimnance Ill'
forlhwilh comply with such provisions or this pcnnil slhall be deemed revoked. work's for which this permit is issued(Sec.3097.Cie C.)
Lender's Want•
APPLICANT CIi RT1 FICA HON Lender's Address
I certify that I have read this application and slate Thal the above information is
correct.I agree at comply wilh all city and cooly ordinances and slate hors relating
In building ttmslnhclion.:nhd[,grebe:uuhariu mprc5enlalives ul'Ibis cite m enter
upon the above motioned property by inspection purposes.(We)agree to save
indemnify and keep harmless the City 01'Cuperlinu against liabilities,judgments. ARCI 11'1'ECI”S 1)IC(:I.,\IL\'PION
costs,and expenses which nhay accrue against said City in consequence of the I understand my plans shrill be used as public records.
granting of this permit.Additionally,the applicant utiderslands and.rill comply
with all non-point source regulations per the Cupertino b1unicipal Code,Section Licensed Prolessional
9.1 S,
Signature Dale
REROOF TEAR-OFF POLICY
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•building(akupertino.org
PROJECTADDRESS A /0
4 4 APN>
OWNERNAME ` l• PHONE E-MAIL
u a a o -,6 - X_
STREETADDRFSS CITY,STATE.ZIP FAX
Snr+E
CONTRACTOR NAME LICENSE NUMBER LICENS�TYPn BUS.LIC.a
COMPANY NAME E-MAIL �r J FAX
OV OAQ
STREET ADDRESSClY,STAT IP PHONE
2 ' 4'f112 -0 Q- 30
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/<" 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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date:_-/3-/2
RerooJPolicv_?Ol!sloe revised 02/16/11
REROOF PERMIT APPLICATION
2 COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION
70300 TORRE AVENUE-.CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228-FAX(408)777-3333- building cuoertino.orD
PROJECT ADDRESS
Z10,94 Q ApN. 3O 5
51 Q
OWNER NAME J r e PHONE EMAIL
o - S' - SS
STREEr.ADDRESS CIT(', STAT P ! iA%
Z/o
CONTACT NAME PHONE EMAIL
40-7-18-09S01
STREET ADDRESS Sc?-
CITY.STATE.ZIP
S �/ FAX
❑OM'NFR ❑ OwNER-RUILDER 13OWNERAGE17 J CO1TRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORN;AMELICF.NSENCMSER LICENSE 'PE Bus.CIC,.
4-17.10a 1
COMPANY NAME 1-NIAIL FAX
STREET ADDRESS CITY.STATE.ZISoZ P o oSe ; PHONE
8-p
ARCHITECT,ENGINEER SAME LICENSE NUNIBER BUS.LIC.•
COMPANYNAME I E-MAIL FAX
STREET ADDRESS CIT'.STATE.ZIP
d PHONE
USE OF ❑ SFD Or Duplex y Multi-Familc ROOF AREA: VALUATION: Q
STRUCTURE: ❑ Commercial /3 S Soo
EXISTING ROOF TYPE: ❑BUILT-CPROOF ❑ASPHALT$HINGLPS XWOODSHAI:ES ❑WOODSHINGLES ❑OINFR(SPECIFY)
RENIOA'F.:REPLACE YES IF NO. PLYICODD ❑ PLYWD ❑OSB PITCH: ROOF
❑ N .LAYERSTHICKNESS, ❑ � 1'Yp C :12 rLAqq A
PROPOSED ROOF TYPE: ❑BLILT-UP ROOF 26SPHALTSHI1GLES ❑A1'O0DSII.ARES El WOOD SHINGLES CI OTHER IMES REPORT.
DESCRIPTION OF U'ORH:
"A If
#ti
�! PreslAra+,a a
Ftp my signature below.I certify to each of the following: I am the property owner or authorized agent to anon the property 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 13115 relating to building cons tion. I a• orize repres< U of Cuperuno to enter the above-identified property for inspection purpose.
Signature of ApplicanUAgent: 'Date: N7 Q
SUPPLEMENTAL INFORMATION( REQUIRED OFFICE USE ONLY
_ If building is associated With a Home DINner's Association.provide letter PLANCHECH TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER Cl BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions.
❑ EXPRESS ❑ PLANN'INC PLAS REVIEW
_ Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑
FIRE DEPT
_ Provide signed COPY OFCupenino'S Tear-Off Policy. ❑ OTHER:
Reroof.4pp_2011.doc revised 4311611/
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
:91-4 ADDRESS: 21066 Red Fir Ct DATE: 0811512012 REVIEWED BY: Sean
APN: BP#: *VALUATION: $4,500
*PERIMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Building is PENTADIATION 1R2R00F
USE: 3 Stories O Yes (F) No PERcMITTYPE:
NvORK Tear off existing wood shake roof. Install 1/2" CDX plywood then 30#felt underla ment. Install
SCOPE Certainteed Presidential composition shingles. Color: Country Gray
FEE ID ROOFAREA
(s.f.)
1REROOFMRES 1,300
Mech.Plan Check Plumb.Phut Check Elec.Plan Check
Herh. Permit Fee: Phunh. Permit r": Elm.Permit Fee:
Ddtcr dlech.lrzip. 01her Plomb 1, Other Elec.Insp, El
Mach. Insp. Fee: Phanb. lasp. Fee: Elec.. hap. Fee..
NOTE: This esliatare does not include jeer due to other Departments(i.e. Planting, Public Works. Fire.Sanitan•Sewer District.School
District,etc.). These fees are hared on the prelitninarl information available and are onh,an estimate. Contact the Dept for adds I in o.
FEE ITEMS (Fee Resolution /1-053 EIl 7/1/11) FEE QT)'/FEE NIISC ITED'IS
Plan Check Fee:
Supp1. PC Feu
Pl um h.::Ayecl t.lEl ec
Permit Fee: $195.00
Suppl. hisp Fee17-
Plumb.:llech✓Elec
Plumb.:Afech.!Elee Permil Fee:
Conswitetion Tux:
Administrative Fee:
Work Without Permit? 0 Yes Q No $0.00
Advanced Phrnniltg Fee..:
Travel Doannenialion Fees:
StromMotion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bld¢ Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $196.50 $0.001 TOTAL FEE: $196.50
Revised: 07/0112012
CITY OF CUPERTINO BUILDING PERAUT
13011.1)ING AUUItESS: 21064 RED PIR CT Com It,\Cful4: POUR SEASONS PI9t>Irr NO: 12080155
ROOFING
OwMF14'SNA.Nw: ESTllFR YOU' 110 BOX 1668 arrR 1SSUe1):08/20/2012
OWNKIVS rIIONI;: 6262329811 SAN JOSF. CA 95109 PHONE:NO:(.108)278-0330
LIC ESSED C:ONTRACrolt'S DrC:LAHA'FION r r r
q (� IMILDINC ITR?11'1'INFO: 1 AIL; E.I.F.CI' 1'1,lbnli
License Class C"3 ! hien tl W?2( O g r r r
n ?IF.CII It IiSIUF C'I'L\I. CO.\I.NWRCtAL
Contractor \��,A.)C. Date �^20^/�Z—
.IOIt IIIiSCltll''I'I(1\': 13 SORS-'1'IiAR OPI'li\IS'I'I,\IG WOOD SIIARI3 ROOI�.
I hereby al'IL'm Ilial 1 am life axed outlet the provisions ol'Cha Flet'9 WSTAI.I.
(t•omnu•ncilg,fish Secniun 7111111)OI'Division 3 of the Itusiuess& Profession., IC"CDS PL1'WOOD'I'III:\30N 17171.1'UN DI:RI.A 11\11:N1.'I'III:N
Cinlr and that uqlicense is in I'ulf force and rlTrcl. INSTA I.I.CEICI'A IN'11:Ii1)PR IN UEHN'I'IAL CONE It Sl I WGI.GS.
I hereby slit rot under penally of perjury One ole he Il lh...ing two declarations:
I have and will maintain a ecnilfcate()]'Consent h,self-insure lin Worker's
Compensation,as provided for by Section 3700 ol'ihe Labor Code,for the
performance of the weak for which this permit is issued. ;it.Ft Floor Arca: Valuation:S4500
I hive laid will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,lilt the performance of the work for which th
permit is issued. is
,U'\Number:35905062.00 Occup:nc) Type:
APPLICANT CFIt'fIFICAA ION
I certiIC that l have tend this application and state that lhcabove infonmmioo is 1'lilt\'III IiXPII(IiS Ili \YORK IS NOT STA RTE D
correct.l agree to comply with all city and coumyotdinanccs and state laws relatin_e
« WITHIN IRO DAYS OF PIiR�911• ISSl1ANCE OR
,building construction,and hereby:mthorize represent ekes of this cite to enter
upon the above mcmioncd tarot lint inspection puq,oscs. (\Yc)agree to salt IRU DAL IS 'I(OD'1 LAS 1 CA LL.I:U 11NS ECTION.
indennit'and keep hannlns the City ol'Cupertino against linbilities.judgntcnu. _ /
I
coils.and expenses which may accrue against said City in consequence ofthe o// Z
granting of this permit. Additionally,the applicant understands and will comply Issued be.: Ze Uate:
with all non-point source regulations per the Cupertino Municipal Code.Section
9.18.
^Zo_ h:Roo PS:
Si nature f��'C s�^' Date � �Z All tools shall be inspectedprior to ann y tooling material being-installed.11 a mol'is
installed without first obtaining:in inspection.I agree to remove all new materials lot
inspection.
11\\'NF.It-14111I,Uh;H IWCLARATION
Signnuuc nl•ApplicanP
I hrrrbyntlirm than I all r\rngn from Ihr Con t'arlur s License Law for unr ul'
the following two reasons: I
ALL IMOF CO\'lilt 4. 1'O lir—a ASS"A"OR IIETIT14
L as owner of the property.or my employees%vitt wages as their stile compensmilm.
will do the work.;aid the structure is not intended or a0ired for sale(Sec.7044,
Business& Professions Code)
I,as ownerot the Property,Lou excluskely contracting with licensed contractors to HAZARD(Il1S,\L\'I'FItIA LS DIS(:LOSIiIt F.
construct lite project(Sec.7044,Rosiness S Pn11'C•5)IUlls Code.). I have read the hazardous materials I equiremcos under Chapter 695 ul'tile
California I lealth& Sal'etr Curie.Sections 25505.25533,and 25534. I o'ill
I hereby affirm under penally of perjure mo-OI the fallowing Ilu'ee ami main cum pl in oce wink the Cop ed inn.\I un icipaI Curie.Chaplet'9.12 and the
theta rat tions: II ;11111&Safely Cod,,Sec non'_5532(:1)should I snore ar r
handle hazadous
1 It ave;aid will not iantiit a Certificate of Cun%eiII to se I Ginsure fix Worker's material. Ad,]1:tiunally.shauld I nue eq uip men or derives which emit ha'a'dOns
Corapensalion.as provided tint by Section 3700 of Ilse[,:,hot Code,Rn Ilse air con land till at,as defined by.the Bay.Area,%it'Qualile.,\I:magemrnl Di.lrirn I
performance of the work till which this permit is issued. will main Win compliance with the Cuperlinn Municipal Curie.Chapter 9.12 urud
I have and will maintain Worker's Compensation Insurance,Its provided for by the I ledth&Sa1'etr Cid,•Sermons 255115,25533,:,all 25534.
Section 3700 of the Lubar Code.'lar the penlim ianCC OfIlIC work Ino which this �• 1�
permit is issued Owner ur anthurized allot; Date:F
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject in the Worker's
Connpcnsation rows of Calilirrtliu, II'.:tier making this cenincane of exemption.I CONSTIMC-110N LI'7NDIN(1 AGIiNCY
become subject to the Worker's Compensation provisions of lite Labor Code.I must I hereby affirm that there is It construction lending agency for Elie performance ill'
forthwith comply with such provisions tit this permit shall be deemed revoked work's for which this permit is issued(Sec.3097.Civ C.)
Lenders Nam,
APPLICANT(ailt'I'114CATIOS Lender's Address
I certify that I have read this application:aid state than the above inl'orntation is
correct.I agree to comply with all city and count)•ordinances and state laws relating
to building construction,and hereby authorize representntives ol'this city to enter
upon the above mentioned property fix inspection purposes.(We)Clove to save
indannil)'and keep harmless.the City of Copenino against linhilities.,ludgments. .\HCI I ITr(.'I'S 1117CLA lzA'Il0\
crisis,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
graining tit this permit.Additionally.the;q,plicau understands and will comply
with all tion-point source regulations per the Cupertino,Municipal Code Section Licensed Professional
9.18.
Signature Dae
REROOF TEAR-OFF POLICY
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•building(Dcupertino.orcl
PROTECT ADDRESS /O(f/ OC d ,/ ' APN4
OWNERNAME /G PHONE /Z� 23Z - 8 E-.MAIL
W H
STREET ADDRESS CITY,STATE,ZIP FAX
SA Hf
CONTRACTOR NAME LICENSE NUMBF. LICENSETYPE BUS.LIC.0
O
COMPANY NAME Cn/� EMAIL FAX
OU Jt4I0Ar 4
STREET ADDRESS CITY.STATE.ZIP PHONE
SUZ oinin SAA ToSa �+t QS//2 -2
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 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: I 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:
RerooJPolicv_?0/Ldoc I-evise�1021/6/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 21064 Red Fir Ct DATE: 08/15/2012 REVIEWED BY: Sean
1:2 APN: BP#: �,�Q�U�.S *VALUATION: $as00
*PERDIIT TYPE: Minor Building Permit PLAN CIIECK'T']'PE: Re-roof
PRIMARY Multi-Family Dwelling Buildina is PENTAi\'IATION 1R2ROOF
USE: 3 Stories 0 Yes (] No I PERMITTYPE:
WORK Tear off existing wood shake roof. Install 1/2" CDX plywood then 30#felt underla ment. Install
SCOPE Certainteed Presidential composition shingles. Color: Country Gray
FEE ID ROOFAREA
(s.f.)
1REROOFMRES 1,300
Afech.Phat Check Plwnb.Plan Check Elec.Phut Choxk
1 tech.Permit Fee., Plrtmh. Permit)-ee: Elec.Permit Fre:
Other 31ecn.imlt Other Phtmh his'p. Other Ele .Insp.
Her:h. lnsp. Fee: Plumb.hrsp.Fee: E1er.. harp.Fee:
NOTE: This estimate does not include fees due to otter Departments(Le. Planning, Public Works. Fire,Sanitary Sewer District.School
District,etc.). These fees are hased on the prelitninarn information available and are only an estimate. Contact the De t or addn 7 info.
FEE ITE.-NIS (Fee Resolution 11-053 ER 7/1/11) FEE QTl'/FEE D11SC ITED1S
Plan peek Fee:
.Snppl. PC Fee
Plumb.:'afech.:Elec
Pennit Fee: $195.00
Suppl. hisp Fee
Plumb.Alech.iElec
Phnnb.:Afech...Flee Permil Fee:
Construction Tax:
Administrative Fee:
Work Without Pennit? 0 Yes No $0.00
_ tIvauced Planning Fees:
Trarel Ducutnentalion Fees: A
Strone Motion Fee: IBSEISAIICR $0.50 Select an Administrative Itern
Bldiz Stds Commission Fee: IBCBSC $1.001 1
SUBTOTALS: $196.501 $0.001 TO'T'AL FEE: $196.50
Revised: 07/01/2012
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO•CA-95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333• buildinD(dcuoeriino.orD
PROJECT.ADDRESS G APN. �.J� _0 C• ` O
OWNER NAME PHONE • E-MAIL
26-Z3 -
STREE'rADDRESS CITY. STAT P i FAX
CONTACT NAME. PHONE E-V.AJL
.� 1.
STREET ADDRESS Sot CITY.STATE.ZIP
S FAX
❑ON'NF.R ❑ Ou'NER-RVILDER ❑ OWNER AGENT Je CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENAVT
CONTRACTOR NAME LICE SENUMBER LICF.NSET'PE I BUS.CIC..
Z213Q A
COMPANY SAME SAkE NJ E-MAIL FAX
STREET ADDRESS CITY,SLATE.ZIP PHONE
S'07- A oS¢ C 8-0
ARCHI FECT•EFGINEER NAME LICENSE NUMBER BUS.LIC.
CWIPA NY NAME E-MAIL
FAX
STREET ADDRESS CITY,STATE.ZIP PHONE
USE of ❑•SFD or Duplex it Multi-Family ROOF kithk VALUATION:
iTRucTURe, ❑ Commercial �3 S 5-00
EXISTING ROOT TYPE: 13 BUILT-UP ROOF ❑ASPHALTSHISGLES ;VIVOODSHAkFS 0u'000 SHINGLES ❑DINER(SPECIFY)
RCN10YE:REPLACE YES I IF N'0. PLY\1'OOD ❑ PLYN'D ❑O58 PITCH; .)2 0.00E
❑ S YFR 1 'xE ❑ 'p .
PROPOSED ROOF TY PE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑%%ODD SHAKES ❑WOODSHINGLES ❑OTHER ICC-CS REPORT.
DESCRIPTIONOF\c ORF:
1211
.. �,-
a
Hy my signature below.I ceniN to each of the followine: I am the property owneror authorized agent to act on the propertyowner'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 to building cons lion, I a' orize repreSe Iiv <Of Cupenino 10 enter the above-identified property for inspection purposes.
Signature of ApplicanUAgenr. Date: -3O
SUPPLEMENTAL INFORMATION REQUIRED nFFicE USE ONLY
_ )(building is associated with a Home Owner's Association.provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. ❑ OYER-THE-COUNTER ❑ BUILDING PLAN REVIEW-
Provide Planning approval to Verify if there any restrictions. ❑ EYraFss ❑ PW N:NINC PWS REv'IEN'
Provide copy or Manufacturer's Installation Specifications.
• ❑ STANDARD ❑ FlRE DEPT
_Provide signed copy of Cupenino's Tear-Off Policy. ❑ OTHER:
ReroofApp ?011.doc revised 0311611)