12090207 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21070 WHITE FIR CT CONT'RACT'OR:FOUR SEASONS ROOFING PERMITNO: 12090207
OWNER'S NAME: NAM JOONWOO AND Cl IU UNKYUNG PO BOX 1668 DA'Z'E ISSUED:09252012
OWNER'S PHONE: 4087252917 SAN JOSE.CA 95109 PHONE NO:(408)278-0330
. r LICENSED CONTRACTOR'S DECLARATION
C�� �gC�, II tt (� BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r-7
License Class_ Lie.4 '�1-) a ro0-
c� p1ECH r RESIDENTIAL r COMMERCIAL rContractor
Contractor FS R-f 1 N C- • Date_ /- 2-r - I Z
I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROOP.INSI'ALL 112"
(commencing with Section 7000)of Division 3 of the Business&Professions CDX
Code and that my license is in full force and effect. PLYWOOD&304 FELT UNDERLAYh1ENT.INSTALL 13 SQ CLASS
A CERTAINTEED PRESIDENTIAL COMP
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[his 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 die work for which this
permit is issued. Sq.Ft Floor Area: Valuation:54500
API'LICANI'CERTIPIC,\TION
1 certify that I have read this application and state that[he above information is APN Number:35905103.00 Occupancy Type:
coffee(.I agree to comply with all city and county ordinances mid 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 the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may acerae against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN Igo 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 }-2'S - Issued by: ���ate: �f�v
❑ OWNER-BUILDER DECLARATION
hereby affirm that I am exempt from the Contractor's License Law for 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[he property,or my employeesmith 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.1044, inspection.
Business&Professions Code) 4
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant, Date:
concoct the project(Sec.7044,Business'&Professions Code).
I.hereby affirm under penalty of perjury one of the following three ALL ROOF COVE NCS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATFRIAIS DISCLOSURE
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 rend the hazardous materials requirements under Chapter 6.95 or the
I have and will maintain Worker's Compensation Insurance,as provided for by California Ilcalth&Safely Code,Sections 25505.25533.and 25534. I will maintain
Section 3700 ofthe Labor Code,for the performance of the work for which This compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ilcalth&
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 die work for which[his permit is issued,I shall contaminants as defined by the Bay Arca Air.Quality Management District 1 will
not employ tiny 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 Califoria. If,ager making this certificate ofexemption,I Health&Safety Code.Sections 25505,2.5533.and 25534.
become subject to the Worker's Compensation provisions of the Labor Cade,I must
forthwith comply with such provisions or this permit shall be deemed revoked Owner or 4 author' ag2nl:
Date•
APPLICANTCERTIFICAT'IONCONSI'RUC`I'ION LENDING AGENCY
I certify that I have read this application avid state that the above information is
correct. I agree to comply with all city and county ordinances and state Imus relating I hereby affirm that there is a cons[raction lending agency for the performance of swrk's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupenino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regula[icns per the Cupertino Municipal Code,Section
9.18. ARCAI'I'FCI"S DECLARATION
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
REROOF PERMIT APPLICATION
EM COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
(408)777-3228- FAX(408)777-3333•building(acupertino.ora
CUPERTINO 1
PROIECT ADDRESS -7 /,A;
- 1 T C 1 I AP?- �`L5q_ O-3 — 1 I .�
OWNER NAME 5 I PHONE E-?:dtL o w� 1
STREEI'aDDRESS IO O CITY-STATE.ZIP FAS
Ca z:;rS7oiq
CONTACT NAME PHONE E-MAIL
t � � �0 30
STREE.1'ADDRESSTani.%i S4-. CIT\'.STATE.].IP/� FAX
./ ``JJ �CA.4SL1�2
❑ OWNER ❑ OWNER-BUILDER ❑ OW NER AGENT JW CONTRACTOR El CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER L TENINT
CON'TRACI OR SAME I LICENSESL:NIBER Z LICESSET'PE I BUS,LIC.-
COMPANY NAME S I E-MAIL I FAX
STREET ADDRESS SO?- "TY.SLVE."` Q ose 4••r^ I PHONE -7 �_O
ARCHITECT,ENGiNEERNAME LICENSE NLNIBER I BUS,LIC
COMPANYNAME I E-.MAIL FAX
STREET ADDRFSS I CITY.STATL ZIP I PHONE
CSE OF ❑ SFD or Duplex r Multi-Family' ROOF AREA: VALUATION:
❑ Commercial LZ jU(�sTaucruge: Q.
EXISTING ROOF TYPE: 13 BUILT-UP ROOF ❑ASPILALTSHINGLES r`VOODSHAKES ❑"OODSHINGLES ❑OT HER I SPECIFY)
REN10%RHIEPLACE JKES IFNO. PLYw OOD jieii ❑ PL1'W'D ❑OSB PITCH: ROOF
❑ N a a\'F.R � THICKNESS J S3" TYPE• S -I2 USS A
PROPOSED ROOF TYPE: 1:1 BUILT-UP ROOF ASPHALT SHINGLES C3"GOO SHAKES 11WOOD SHINGLES ❑OTHER ICC-ES REPORT:
DESCRIPTIO\'OF WORE:
inn wacA
woodl,en 30# ' Ik �nde�lw, e_n '.—F_l.eall IAS
seA Preslilp_ti+,vl comf s6in n.
Bp my signature below.I certify touch of the iollo\cing: 1 am the proper.owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information I have provided is correct. I have read[he Desciption of Work and Verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building cons*• tion. 1 a orize represe�• [iV of Cupenino to enter the above-identified property for inspection purposes.
Signature of ApplicanUAgent; Date: a0 12
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_If building is associated with a Home Owner's Association.provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDIN'G PUN REVIEW'
Provide Planning approval tO Peri F'if there any reSirlC[IOnS. ❑ EXPRESS ElPLAN'NINC PLAN REVIEW'
Provide cop),of Manufacturer''s Installation Specification. ❑ STANDARD ❑ FIREDEPT
Provide signed copy of Cupenino's Tear-Off Policy. ❑ OTHER:
Rerooj.9pp_2011.doc revised 03/16/11
I Zvi
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 2[U__� O _( I DATE: REVIEIYED BY:
APN: BP#: *VALUATION: $4,500
*PERMITTYPE: Minor Building Permit PLAN CIIECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: I I PERMIT TYPE:
WORKTEAR OFF EXISTING WOOD SHAKE ROOF.INSTALL 1/2" CDX PLYWOOD& 30# FELT
SCOPE UNDERLAYMENT.INSTALL 13 SQFT CLASS A CERTAINTEED PRESIDENTIAL COMP p
FEE ID ROOFAREA
(SX.)
1REROOFFRES 1,300
,Veer. Plan Check Month. Plan Check Flee..Plan Check
blech. Permit Fee: Plunrh.Pei mir Fee: Flee.Pernrit Fee:
Olher.11cch.hnp% Other Phaab hup. other EIse.Imp. Li
Heels.Inv). Fee: Plunrh. Insp.Fee: Flee.InsP. Fee:
NOTE: This estitrmte does not include fees Clue m other Departments(i.e. Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc). These fees are baser/on the prelininan in ornmtion available and are onl/,an ectinune. Contact the Dept for adt/n'I info.
FEE ITEMS (Fee Resohaion 11-053 ETf 711///7 FEE QTY/FEE MISC ITEMS
Plan Check Fen:
Supp/.PC Fee
Fhnnb.hl9ech.;'F,kc
Permit Fee: $195.00
SuppL hasp Fee
Plumb✓Mcch.IElec
J'lumh.tAlech.:Elec Permit Fee:
Cbrtstruction Tax:
Administrative Fee:
Work Without Permit? C) Yes e) No $0.00
Advanced Planning Fees:
Travel Documentation Fees:
Strong_Motion Fee: IBSF.ISNICR $0.50 Select an Administrative Item
Blda Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $196.501 $0.001 TOTAL FEE: 1 $196.50
Revised: 07/01/2012
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(Dcuoertino.org
PROJECT ADDRESS APN M
z b O G
OWNER NAME PHONE E-MAIL
G IA of'- 7a s-
STREErADDRESS CITY.S ZIP C FAX
E
SA 1-4 ' o
CONTRACTOR NAME LICENSENUNOER LICENSE TYPE BUS.LIC.0
11
C-3
COMPANY NAME rte''' n E-MAIL FAX
STREET ADDRESS CITY.STATE, PHONE
S d I�1 A S4- �/aw D CA S_I S-O
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. 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 atm 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:
RemoJPolicl_2011.doc revised 02/1&11