12080228 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21062 RFD FIR CT CONIRACI'OR:FOUR SEASONS ROOFING PERMIT NO: 12080228
OWNER'S NAM Ii: LI JIANW171 AND PANG DANIIONG PO BOX 1668 DATE, ISSUEID:08222012
OWNER'S PIIONh:: 6506945042 SAN30SE,CA 95109 PlIONENO:(a08)278-0330
0' L1CI:NSED COh"RACfOR'S DECLARATION C I-. r
q BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class C-3l Lie.9 Lf-7Z. I0S r Rr r
1•IECII F.SIDIiNT1AL COMMERCIAL
Contractor�FS(L, Ior— Date F5,-Z2-r2
1 hereby alTi rm thnI I it licensed tinder the provisions of Cha five 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROORINSTALL I2"
(commencing with Section 7000)of Division 3 of the Business S Professions CDX
Code and that my license is in full force and effect. PLYWOOD THEN 30 PELT UNDERLAYMENT.INSTALL 13 SQ
CERTAINTEED PRESIDENTIAL COMPOSI'T'ION SHINGLES
1 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 Cade,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 performance of Ute work for which this
permit is issued, Sq.FI Floor Area: Valuation:$4500
AI'I'I,ICAN'I'CER'1'IFICA'I'ION
I certify that I have read this application and state that the above infamalion is APN Number:35905063.00 Occupancy T pe:
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
indemnity and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting ofthispermit. Additionally,thcapplicantunderstands 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. q r
Signatures i�� Date Q-ZZ-rZ Issued by: �91N 72-'W Date:
v v
❑ U\\'N I•:It-IfU11.D1•:R DECLARATION
hereby affirm that 1 ant exempt from the Contraclor's License Lav formic of RI:1100PS:
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,laid the structure is not intended or offered for sale(Sec.7044, inspection,
Business S Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applic til: Dale: rQ-$7i 12,
construct the project(Sec.7044,Business S Professions Code).
hereby affirm under penally of perjury one of(lie following three ALL ROOF COVET s S'1'0 BE CLASS"A"OR BIs I-PER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IIA%ARDOUS MATFIRIAIS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued 1 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 J Safety Code,Sections 25505.25533,and 25534. 1 wi11 maintain
Section 3700 of the Labor Code,for the perforative of the work for which this compliance with tin Cupertino Municipal Code.Chapter 9.12 and the Health
Safely Code.Section 25532(a)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 perfomtance of die work for which this permit is issued I shall contaminants as defined by the flay Area Air Qualily 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 Municipal Code.Chapter 9.12 and the
Compensation,laws of California. If,after making this certificate of exemption,1 Health S Safety Code,Sections 25505.25533,and 25534.
become subjecLlo the Worker's Conipensruion provisions of the Labor Code,I must
Forthwith comply with such provisions or this permit shall be deemed revoked. Owner ✓lrWtlrtaed-agent: Z'
ate:
AI'I'LICAN'I'CEIY1'IPICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and sate that the above information is
correct. I agree to comply with all city and county ordinances and state Imes relating I hereby a 2hamt e is a construction lending agency for the performance of work's
to building construction,and hereby authorize rcpresentatiycs 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
indemmnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may acerae 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 AI1CI I I'PFCP'S DECLARATION9.18.
I understand my plans shall be used as public records.
Signature Dale
Licensed Professional
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•buildinD(dcuDertino.org
PROJECT ADDRESS 9i062 1
APN9
OwNERNAME Q G PHONE SM-4 _ SQ I E-MAIL
STREET ADDRESS CITY. ST .ZIP FAX
Z/OG2 ec/ r C4. 14 _014 11,
CONTRACTOR NAME LICENSE NUMBER LICFNSyF^P BUS.LIC.a
COMPANY NAME [� /J E-MAIL FAX
O BASO t(q
STREET ADDRESS CITY.STATE.ZIPHONE
Sat oSe CA qTtl?_
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:
ReroofPa1icv_201 Lrloc reviser!02/16111
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS,.g/,�,G ' Red Fir Ct DATE: 08/21/2012 REVIEWED BY: Sean
` APN: BP#: I -VALUATION: 1$4,500
*PEPMi'rTVPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Building is i PENTAMATION 1R2ROOF
USE: >3 Stories O Yes (E) No I PERMITTYPE:
NVORK Tear off existingwood shake roof. Install 1/2" CDX plywood then 30#felt underla ment. Install
SCOPE Certainteed Presidential Composition shingles (Color: Country Gray).
FEE ID ROOFAREA j
1REROOFMRES 1,300 i
i
Alech.Plan Check Plumb.Plan Chark Elec.Plan Check
Alech. Permit Fee: Plumb. Permit Fre: Elec.Permit Fee:
Otho.Aleck.Imp. Otter Phtmh lisp. � Otter El...Insp.
Afech. Imp.Feer Phunb.Insp.Fee: I Eter.. hasp.Fee.
NOTE: This estimate does not include fees due to atter Departments(i.e. Planning. Public IVorks. Fire,Sanitary Sewer District.School
District,etc.). These fees are hosed on the preffininari•information mailable and are mth•an cclintme. Contact the Dept./or adds'/in(a.
FEE ITEMS (FeeResohuion 11-053 ER" 7/1/11) FEE QTY/FEE I MISC ITED9S
Plan Check Fre:
.Supp!. PC Fee j
Plumh.'Alech./Elec
Permit Fee: $195.00
SupPL lttsp Fce
Plumh.hl4ech.iElec j
i
Phunb.:llech.Xlec Permit Fee:
I
Construction Tca:
I
:I dminis trati ve Fee:
Work Without Permit? O Yes (F) No $0.00
Advanced Planning Fees:
Travel Documentation Fees: I A
Strong Motion Fee: IBSEISAIICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $196.501 $0.001 TOTAL FEE: $196.50
Revised: 07/01/2012
REROOF PERMIT APPLICATION j
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA'95014-3255
C V PE RTINO (408)777-3228- FAX(408)777-3333 • buildinO(G)cuoeriino.oro
PROTECT ADDRESS 06 Z_ Q C AP\" - 0 15- �/
•�
OWNERNa?IE PHONE �`jl EMAIL
�.� c" So-6 -
STREEFAUDRESS�/Olb CITY.STA T P ' FAN
CONTACT NAME PHONE EJIAIL .
.0
STREETADDRESS 5,02 S CITY.STATE.ZIP FAS
❑OWNFR ❑ Ou:cER-RVILDER ❑ OWNER AGENT. . CO1TRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACIOR NAME LICENSE NC.\IBER LICENSE 'PE I BUS.CIC.
COMPANY NAME E-%/.AIL i I FAX
STREET ADDRESS CIT-.STATE.ZIP I PHONE
Sot a oSe C B-o
ARCHIrECT.ENGiNEER SAME LICENSENUNIBER i BUS,LIC.
COMPANYNAME E-.MAIL I FAN
STREET ADDRESS CIT',ST.ATE%IP I PHONE
USE OF ❑ SFD or Duplex i Multi-Family ROOF AREA: VALCATIOi
STRUCTURE- ❑ Commercial 43 S I 5_00
ESISrING ROOF TYPE: ❑BUILT-CPROOF ❑ASPIIALTSHINGLES ;CGODSHAKES ❑w'OOD SHINGLES I 001'HERISPECIFY7
RENIOIF.:REPLACE YE$ IFNO. PLYWOOD .i Cl PLY%VD 1-1 OSB I PITCH, ROOF
❑ N w v'F.R T IC'S ❑ i TYP . '12 ICLA 'a
dd I
PROPOSED ROOF TYPE: ❑BEILT-UP ROOF (/ASPHALT SHINGLES 13 WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT.
DESCRIPTION OF\\'ORA; I Z l F
As4yll
Cox
# erl0.4 Men+ . F1Aallu '
•e ,w 6
I
b,
By my signature below.1 cenify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have mad this
application and the information I have provided is correct. I have read the Description of Wort:and verify it is actuate. I agree to comply With all applicable local
ordinances and state laws relslin¢to building cons tion. I a oriu repmse tiv of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicanl/Agenl: Dam; O
SUPPLEMENTAL INFORMATION REQUIRED'e'- OFFICE USE ONLY
_ If 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, ❑ "PRESS ❑ PLANNING PLAN REVIEW
_ Provide cop}<of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIREDEPT
Provide signed copy of Cupertino's Tear-01T Policy. ❑ OTHER:
I
I
I
Reroof.4pp_201I.doc revised 03/16111