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12080291 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21079 WHITE FIR Cf CONTRACTOR:FOUR SEASONS ROOFING PF,R\IIT NO: 12080291 OWNER'S NAME,: IIARMS THOMAS R PO BOX 1668 DATE; ISSUED:08129/2012 OWNER'S PIIONE: 4082101811 SAN.IOSF,C\ 95109 PIIOiNF.NO:1408)278-0330 ,a LICENSED CON I'RACI'OR'S DECLARATION BUILDING PERMIT INFO: BLDG C ELECT IJ PLUMB I— License Class C-31 - Lie.H 11-1'72j02k M Fs ECH (- RESIDENTIAL r COMMERCICOMMERCIALr 7s rt Contractor ti, 144 - Date 8'29— 1-L hereby affirm that I am licensed under the provisions of Cho pier 9 JOB DESCRIPTION:TEAR OFF WOOD SHAKEAND INSTALL 13 SQFT CLASS A (commencing with Section 7000)of Division 3 of the Business& Professions COMP SHINGLES Code and that my license is in full force and effect. 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 the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:54500 Section 3700 of the Labor Code,for the performance of die work for which this permit is issued. APN Number:35905069.00 Occupancy Type: APPLICANT CERTIFICATION I certify 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 stale laws relating to building construction,and hereby authorize representatives oflhis city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City inconsequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands tmd will comply with all non-point source regulations per the Cupertino Municipal Code,Section /�G� 9.18• Issued by: ,��7N .—L/1 Date: Signature P— GG 9 - -29-,zea Doe ❑ OWNER-BUILDER DIiCLARATION RE:ROOFS: All roofs shall be inspected prior to any roofing material being installed.If roof is hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the fallowing two reasons: inspection. I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(See.7044. Signature of Appli©nC Date: I<-29•/Z Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sce.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER hereby affirm under penalty of perjury one of the following three declarations: IIA%ARDOIIS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's 1 have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Ilealth&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the llealth& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air Pernik is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall llealth&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws ofCalifomia. If,after making this certificate of exemption,I Owner or a [ sized agent: become subject to the Worker's Compensation provisions of the Labor Code,I must Date: g—'L S'/2 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPI-ICAN'1'CF-R'1'IFIC TION I hereby affirm that there is a construction lending agency for the performance of ssurk's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city arca county ordinances and state Imus relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against Iiabilities,judginents, costs,and expenses which may accme against said City in consequence of the ,\RCIIITECI"S DECLARATION of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS:;/U - I%Vhite fir ct. DATE: 08/27/2012 REVIEWED Bl': bobs, 27APN: BP#: `VALUATION: 1$4,500 *PERMIT TN'PE: Building Permit PLAN CHECK TYPE: Alteration / Repair RIMARY SFD or Duplex PENTAQUATION 1SFDWLROOF USE: PERN11 P7"I'1'PE: WORK tear off wood shake and install comp shingles. SCOPE Aleeh. Plan Check Plumb. Plon Check Flee.Plan Check dfeeh. Permit Fce: Plump.Permit Fee: /,fee. Permit Fee: Othm-Afec•h.Insp. Other Plumb Insp. Other Elco. Insp. ,blech. hisp. Fee: Plumb. htrp.Fee: Flee.Insp.Fee: NOTE: This estimate does not includejeev due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District, etc. . These ees are baser!on the prelinzinan information available and are only an estimate Contact the De ! or addn'l info. FEE ITEMS(Fee Xesohnion 11-053 EfT 71111 1) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1,300 S.f.. Re roof Suppl. PC Fee: (F) Reg. 0 OT FO.0 1 hrs $0.00 $195.00 IREROOFRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consnvction Tar: Administrative Fee: O Work Without Permit? Yes Q No $0.00 E) Advanced Planning, Fee: $0.00 Select a Non-Residential E) Travel Documentation Fees: Building or Structure 0 A Strong Motion Fee: IBSFISh1/CR $0.50 Select an Administrative Item Blde,Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $195.001 TOTAL FEE: 7$196,501 Revised: 07/01/2012 • � v /ave p ��/ REROOF PERMIT APPLICATION COMMUNITY,DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•buildinO(okuperlino.orD PROJECT ADDRESS 7/079 /O �5 U C OWNERNANIE MBA ParAAS I PHONE Z/O_,8 / E-MAIL STREE'I•ADDRESS CI STATE.LIP I FAX 2/07 e r CONTACT NAME PHONE -0 30 E-MAIL STREET ADDRESS Sot CITY,STATE.].IP S ./ FAX ❑OU NFlt ❑ OWNER-GUILDER ❑ 0WNER AGENT J( CONTMCTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NCNIBER LICF.SSE PE .BUS.LIC. opt COMPANY SAMEC-NUAIL 5 FAX STREET ADDRESS CIT\'.STATE.ZIP PHONE S��- a ose C 8-0 ARCHrrEc-r ENGINEER\AMIE LICENSE NUMBER BUS.LIC. COMPANY NAME E-.MAIL FAX STREET ADDRESS CITY,STATE.LIP PHONE USE OF ❑ SFD or Duples Multi-Family ROOFAREA: 0, VALUATION: STRUCTURE. ❑ Commercial 13 $2. iSQ E.NISTINGROOr TYPE: ❑BU'ILT-U'P ROOF ❑ASPIIALTSHINGLES PCOODSHAAES ❑MOODSHINGLE.S ❑Ol'HER(SPECIFY) REMOYE:REPLACE OYES IFNO. I PLYWOOD 11PLYWD 1:1 OSB PITCH; ROOT ❑ N AYF.R 1['SE , 11TYP A 'I� A PROPOSED ROOF TPE: ❑BUILT-UPROOF 4SPHALT SHINGLES 1:1 WOOD SHAKES - ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT DESCRIPTION OF\A'ORK. I�Z l 1 ## e• a By my signature below.)cenify to each of the following: I am the property owner or authorized agent to act on the propem'ouner's behalf. I Its%c read this application and the infortnmion I have provided is correct. I hate read the Description of work and verify it is actuate. I agree to comply with all applicable local - ordinances and state laws relating to building cons lion, I a orize represe tiv of Cupertino to enter the above-identified property for inspection purposes. Signature of ApplicandAgene Rete: z'7 O 12 SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY _ If building is associated\vith a Home Ow'ner's Association,provide letter PLAN CHECK TYPE OUTING SLIP of approval from HOA. a-0-1en-THE-COUNTER Buamye PLAn'REv1Ew _ Provide Planning approval to vcri fj'if there any resin. . n5. ❑ EYppESS ❑ PLAN\ING PLAN'RE\'tEW _ Prov a copy of\tanufaclurer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT rov�gnecl copy of Cupertino's Tear-Off Policy. ❑ OTHER: Reroof.4pp dol)aloe revised 03116111 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•buildina(Tcupertino.ora PROJECT ADDRESS q 64. APNN OWNERNAME L PNO EMAIL OM a�MS — P STREET ADDRESS CIT'. ST E.ZIP FAX eZ o ? C Sp CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.a /J / C-35 O COMPANY NAME ✓/ �CCJOAS /T-OC'Fiw E-.NAIL FAX STREETADDRESS CITN,ST ZIP PHONE fo z S Tose c S' P— 3 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 Y<" 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. 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: Date: 4P-Z7- /Z ReroofPolicv_2011.doc revised 02/16/11