12100085 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10600 WHITE FIR CT CO\IRACI'OR:FOUR SEASONS ROOFING PER\I IT NO: 12100085
O\\'NER'S NAME: KAWADE$ANJAY P AND RAJASHRI S PO BOX 1668 DA'Z'E ISSUED: 10111/2012
OWNER'S PHONE: 4087725678 SAN JOSE.CA 95109 PRONE NO:(4118)278-0330
❑ LICENSED CO\IR.\CI'OR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT❑ PLUMB
License Class #_ 44 Ir
DIECII r RESIDENTIAL r COMMERCIAL r
Contractor e-�i�f(/1 Date Zi
1 hereby affirm that I am licensed under the prorisions of C aprer 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROORINSTALL NEW
(commencing with Section 7000)of Division 3 of the Business&Professions I2"
Code and that m•license is in full force and effect. CDX PLYWOOD AND 304 FELT UNDERLAYMENT.IN$TALL 13
SO NEW CERTAINTEED PRESIDENTIAL COMPOSITION
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
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Fluor Area: Vulundon:$4500
AI'1'LIC\N'I'CliR'1'IFICAT'ION
I certify that I have read this application and state that the above information is APN Number:35905132.00 Occupaney'fype:
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 the City of Cupertino against liabilities,,judgments, PERMIT EXPIRES IF WORD 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 w ill comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non- t source regulations per the Cupertino Municipal Code.Section 180 DAYS Fa LAST CALLED INSPECTION.
9.18.
ryz
Signature Date Is sued y: Mt Date:
❑ OWNER-BUILDER DECLARATION ,
hereby affirm that I am exempt from the Contractor's License Law for one of RE ROOFS:
thefollowing ton 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 withma f irst of of i an inspection,I agree to remove all,new,materials for
will do the work,and the structure is not intended or offered far sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of ApplimnC S Date:/ J
construct the project(Sec.7044,Business&Professions Code).
hereby affirm under penalty of perjury one of the following three AEI.ROOF COVERINGS TO BE CLASS"A"OR BE ITER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's
IL\%.\RDOl1S MA'1'ERL\I C 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&Safety Code.Sections 25505,25533,and 25534. 1 will maintain
Section 3700 of the Labor Code,for theerformance of the work for which this compliance with the Cupertinn Municipal Code,Chapter 9.12 and the Health&
F 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 I will
not employ any person in my manner so as to become subject to the Worker's ma' tnin compliance with the Cupertino NI unicipal Code.Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Bea h&Safe Code,Section 2550 ,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I mus
fbnlovith comply with such provisions or this permit shall be deemed revoked rner or horiz d
APPLICANT CERTIFICATION CONSTRUCTION'LENDING AGE.NNCYY %
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 same 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 cityto enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned propeny for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
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 ARCII ITECf'S DECLARATION
9.18.
I undemiand my plans shall be used as public records.
Signature Date
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• building(acupertino.oM
PROJECT AD � //� • APN•
NAME' / / PH - E-MAIL
1 ase
-of k12,1t)C1&
STREEFA �/ C '. STATE.ZIP ' FAX t
CON TO AME LICEN 1�1BER / LICEeN BUS.LIC.q
CO�� NAM E-MAIL ! FAX
STRFiQADgR�S IST E JP
1 UNDERSTAND AND AGREE TO THE FOLLOWING-.'
-l. 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 froth 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'/0 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: 1 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 noxi a detector re quired to be installed in accordance with Sections R314 and R315 of
the 2010 California Res' ential ode.
Signature of ApplicandA Date:
Re,oq/Policv_2011.doc revised 02/16/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10600 White Fir CL DATE: 10/10/2012 REVIENVED BY: Sean
9714 APN: BP#: 'VALUATION: 1$4,500
*PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Buildina is PFN I AMA I ION 1 R2ROOF
USE: >3 Stories Yes (D No PFRMITTYPE:
�VORI: Tear off existing wood shake roof. Install new 1/2" CDX plywood and 30#felt underla ment. Install
SCOPE new Certainteed Presidential composition shingles. Color: Country Gray.
FEE ID ROOFAREA
s.f.
1REROOFMRES 1,300
Xlech. Man Check Plumb. Plan Check Elec.Plan Check
,Meeh. Permit Fee: Plumb.Permit)-ee: riec. Permit Fee:
Other Alech. Insp. Outer Plumb Insp. Ll I Other F.lce. /,Is/,.
,Meth. harp.Few: Plumb. blip.Fee: Clec.Insp.Fee:
NOTE: This etinmte does not include fees due to other Departments(i.e. Planning, Public WarA.s, Fire,Sanitary Server District,School
District,etc). These feav are based on the prelintinan information available and are only an estimate. Contact the Dept for atld n7 info.
FEE ITEMS (Fee Resolution 11-053 EB' 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Plumh.hUech./F.lec
Permit Fee: $195.00
Supp/. /lisp Fee
Pht m b./etlech./E1 ec
P/ronhAVIechAlec Permit Pee:
C0113I7'aC1i0n Tax:
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Advanced Planning Fees:
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICR $0.50, Select an'Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $196.50 $0.00 TOTAL FEF,: $196.50
Revised: 10/01/2012
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO I (408)777-3228•FAX(408)777-3333 • buildinop_cupertino.org
PROJECT:wORESjrv,y ' , -O " G APS- 3e/-j"- 0 2--
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STREET ADQRr 5 O J CIT' STdTE.ZIP FAX
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CONTACT NAMEPHONE E-MAIL
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STREEI'ADDRESS 5'62 14arA
, S I CITY.STATF ZIP eolft FAX
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❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT Jf CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONT(ACTORNAME LICENSENUMBER LICENSE PE
r SeaBUS.LIC.-
QIjQZ
sei�s IZmFH-7-LI
COMPANYNAME S 6M.AIL FAX
STREET ADDRESS CITY.STATE ZIP
SoZ � a cse CA.902,
PHONE 8-0
ARCHI rECTIENGINEER NAME LICENSE NUMBER BUS.LIC.R
COMPANY NAME E-MAII. FAX
STREET ADDRESS I CITY.STATE ZIP PHONE
USE OF ❑ SFD or Duplex ACMulti-Family ROOF AREA: VALUATION: `per
STRUCTURE: ❑ COmmeTClal 3 S iS0
EXISTING ROOF TYPE: BUILT-CP ROOF ❑ASPIIALT SHI\GEES PeWOODSHAKIFS ❑N'OODSHWGLES ❑OTHER I SPECIFY)
RCNIOVE/REPLACE Jews IF NO. PLYWOOD jd:P' ❑ PLYWD 1-1 OSB PITCHROOF
❑ NO 'FR THICKNESSl❑ TYPF' COY :12 AS ' A
PROPOSEDROOFTYPE: ❑BUILT-UP ROOF 4SPHALT SHINGLES ❑WOOD SHAKES ❑I100D SHINGLES ❑OTHER ICC-ES REPORT
DESCRIPTION OF WORK: `/Z"
Ook
osd� ben 30# �'e-L+pn�.erluu tire- . FinnI1i
AILAVA-
-jC&f1A;,a1,a*A PreSiden+,sl cam�g{+in O-
By my signature below.1 certify to each of the folloe'ing; I am the property owner or authorized agent to act on the property o"mer'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 accumm. I agree to comply with all applicable local
ordinances and state laws relating to building tons lion. I: prize represe civ of Cupertino m enter the above-identified property for inspection purposes.
Signature of ApplicandAgenC Data: 12012
SUPPLEMENTAL INFORMATION REQUIRED A OFFICE USE ONLY
If building is associated With a Home Owner's Association.provide letter PLANCHECK TYPE ROUTING SLIP '
of approval from HOA. I t OVER-THE-COVNTER y.BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑L PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Speci;¢ations. ❑ STANDARD ❑ "RFOEPr
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER: '
ReroojApp 2011.doc revised 03116111