12080225 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21056 RED FIR CT CONTRACTOR:POUR SEASONS ROOFING PEIRMIT NO: 12080225
OWNIi R'S NANIE: XIA DA PO BOX 1668 DATE. ISSUED:082212012
OWNER'S PHONE: 5109711621 SAN JOSE,CA 95109 PIIONII NO:(408)278-0330
LICENSED COKI'RACI'OR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUNIB r
License Class C_3ff Lied r C r
�2 AIECII RESIDENTIAL COMMERCIAL
Contractor . Ri In1C - Date 8-22-12
hereby affirm that I Hill licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHARE ROOEINSTALL I2"
(commencing with Section 701111)of Division 3 of the Business& Professions COX
Code and that my license is in full force and effect. PLYWOOD TIIEN 304 FEUr UNDERLAYMENT.INSTALL 13 SQ
CERTAINTEED PRESIDENTIAL COMPOSITION SHINGLES
hereby affirm 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 tire
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 perfomrance of Ore work far which this
permit is issued. Sq.Ft Floor Arca: Valuation:54500
APPLICANT CERTIFICATION
I certify than have read this application mrd state that the above information is APN Number:35905067.00 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 harmless[lie City ol'Cupertino against liabilities.judgments,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accmc 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 the Cupertino Municipal Code.Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. {
Signature Date y--sl I 2_ Issued by:9/ "I/A/ _�A7GA/ Date: -IF-7 -
❑ OWNF.-I2-IS UILDER DECLARATION
1 hereby affirm that I am exempt front the Contractor's License Laefor one of RF.-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,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,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant Date:
construct the project(Sce.7044,Business& Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COV INGS TO RIE CLASS"A"OR BL I-fER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IIA-/.ARDOUS NIATERLUS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
perfomance 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 Health&Safety Code.Sections 25505,25533.and 25534. 1"ill maintain
Section 3700 of the Labor Code,for theerfor mance of doe work for which this compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ilealth&
p Safety Code.Section 25532(a)should I store or handle hazardous material.
permit is issued Additionally,should I use equipment or devices%which emit hazardous air
I certify that in the performance of the 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 Safety'Code.Sections 25505,'_5533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must
fonlweith comply with such provisions or this pemrit shall be deemed revoked. O%cner r'au riE4d agent:
Date:
APPLICANT CERTIFICATION CONS'I'RUC`1 ION LENDING AG FN CY
I cenify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating_ I hereby affirm 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(See.3097,Civ C.)
upon the above mentioned properly for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against Iiabilities,judgmems,
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 ARCDn*FCr-S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildina(ftuoertino.oro
PROIECT.\UDRES$ Z/O�4 Q APS. 1 ' O V7
OWNER NtAIEI PHONE E-MAIL J V
S Q
STREET ADDRESS�1Di CITY. STAT P FAX
CONTACT NAME PHONE E-MAIL
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STREET ADDRESS�D� S CIT\'.STATE.ZIP FAX
❑Ou'NFR ❑ OWNER-RUILDER ❑ OWNER AGENT A CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSENCNIBER LICENSE 'PE BUSlphnr gepsa 4-1%1 0a _-69 .CIC.
COMPANY\*AMC C-MAIL FAS
STREET ADDRESS CIT'.SLATE.ZIP PHONE
S"07- CITY.
ose C B-o
,ARCHI'rECT,ENGINEER N.ANIE LICENSE NUMBER BUS,I.W.
COMPANY NAME EAAIL FAN
STREET ADDRESS CT'.STATE%IP PHONE
LSE OF ❑ SFD or Duplex (I Multi-Family ROOF AREA: e VALUATION:
STRUCTURE: ❑ Commercial /3 S 5'00
dr
EXISTING ROOF TYPE: ❑BUILT-LPROOF ❑ASPHALT SHINGLES OkVOODSHAKES ❑WOODSHINGLES ❑OTHER(SPECIFY)
REMOYF.:REPLACE 011ES IFNO. PLYWOOD Cl PLYWD ❑OSB PITCH: ROOF
❑ N •LAYER // THICKNESS ❑ TSP X --q-:12 LA A
PROPOSED ROOF TYPE: ❑BUILT-UPROOF XISPHALT SHINGLES ❑A\'ODD SI IAKES ❑WOODSHINGLES 1:1 OTHER ICC-ES REPORT
DFSCRIPnON OF\\'ORI:: `/Z�1
apk
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By my signature below.I certify to each of the following: I am the property cnvner or authorized agent to act on 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 IawS relating to building cons tion. I a orize represe a.vQ of Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanUAgenr, Dace: O
SUPPLEMENTAL INFORMATION' REQUIRED OFFICE USE ONLY
_ If building is associated\vith a Home Owner's Association.provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUN-FER ❑ BUILDING PWN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANININC PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
Reroojdpp_1011.doc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADD RES S:,f���G Red Fir Ct DATE: 08/21/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: 54,500
*PERbIPf TYPE: Minor Building Permit PLAN CHECK Tl'PE: Re-roof
PRIMARY Buildina is PENTAAtATION
USE: Multi-Family Dwelling >3 Stories O Yes (' No PERMITTYPE: 1R2R00F
WORK �Tear off existingwood shake roof. Install 1/2" CDX plywood then 30#felt underla ment. Install
SCOPE ertainteed Presidential Composition shingles (Color: Country Gray).
FEE ID ROOFAREA
1REROOFMRES 1,300
Mach.Plan Check Plumb.Plan Check Dec.Plan C4axk
dlech.Permit Fee: Plumb. Permit Fee: Elea Permit Fee:
Odu:r,t/ech.lase. Other Plumb bOfher Elec./asp.
Alac.h. /nsp. Fac: Phunb.In p.Fee. Mae. leap.fee:
NOTE: This estinmte does not include fees due to other Departments(i.e. Planning, Public I Forks, Fire,SanitarySewer District,School
District,etc). Thesefees are based on the prelindnart information available and are only an estimate. Contact the Det for adds 7 in fn.
FEE FI'EAIS (Fee Resolution 11-053 Eli UU112 FEE QT)'/FEE t111SC ITEMS
Plan Check Fee:
Suppl. PC'Fee
Plumh..'Afech.:Elee
Permit Fee: $195.00
Suppl. hisp Fce
Plumb.:Hech..Elea
Plumb.httech✓Elee Permil Fee:
Cunsnvctiun Tax:
AtIndnisnative Fee,:
Work Without Pennit? O Yes Q No $0.00
.,Wvnnc•e d Planning Fees:
Travel Documentation Pees:
Strong Motion Fee: IBSEIS,VICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $196.501 $0.001 1110'1'AL 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
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•building(a)cuoertino.org
PROJECT ADDRESS APNN
OWNER NAME PHONE E-MAIL
a FAQQ $'/0 - 97/-/62
STREET ADDRESS Z O�6 Red F/r /` I CITY.STA ZIP FAX
CONTRACTOR NAME U �J� LICEVSENUMBER LIC2!E 11 BUS.LIC.N
COMPANYNAME E-MAIL � •' FAX
o Se. �o :.
STREET ADDRESS CITY.STA P P ONE
sae Tase C S Z- 08 78- 033
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/," 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: a-ZO—
ReroofPalicv_20l Ldoc reviser/02/16/I I