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11040027 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20282 NORTHCOVE SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 11040027 OWNER'S NAME: CRITZER DAVID E AND MARGARET L PO BOX 1668 DATE ISSUED:04/05/2011 OV INER'S PHONE: 4082780330 SAN JOSE,CA 95109 PHONE NO:(408)278-0330 L JE��CON CTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class c. 0 on l MECH RESIDENTIAL COMMERCIAL� Contractor ate I hereby affir that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING CEMWOOD ROOF& (commencing with Section 7000)of Division 3 of the Business&Professions INSTALL NEW 304 UNDERLAYMENT&GAF GRAND CANYON ASPHALT Code and that my license is in full force and effect. SHINGLES.COLOR,STONEWOOD&HAS EXISTING PLYWOOD I 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 Floor Area: Valuation:$4400 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:31641074.00 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 indemnInon-poi rmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,aich may crue against said City in consequence of the grantinAdditi Ily,the t understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with allce regul ons per a Cup rtino Municipal ode, ection 180 DAYS FROM LAST CALLED INSPECTION. j�(Signatuate " ` Issued by: Date: r OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspeLngan oo g 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 oti n I agree to remove all new ateri s for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) l 1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: J construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS 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 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. I will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& 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 contaminan as defined y the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain co pliance wi the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health& fety Code, ections 25505,25533,and 7534 . become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Ow or uthJen f Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 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(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 Cupertino against liabilities,judgments, cr and expenses which may accrue against said City in consequence of the Lender's Address i g of this permit.Additionally,the applicant understands and will comply wi...all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: "VALUATION: 1$4,400 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Du lex PENTAMATION 1 SFDWLROOF USE: P PERMIT TYPE: WORK RE-ROOF REMOVE EXISTING CEMWOOD ROOF & INSTALL NEW 30# UNDERLAYMENT& GAF SCOPE GRAND CANYON ASPHALT SHINGLES. COLOR,STONEWOOD & HAS EXISTING PLYWOOD p FEE ID ROOF AREA s.f. 1 REROOFFRES 1,400 F-1 Li NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 09-051 Eff. 7/1'10) FEE QTY/FEE MISC ITEMS Permit Fee: $182.00 F7F Work Without Permit? C Yes No $0.00 i Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $183.50 $0.00 TOTAL FEE $183.50 Revised: 03/01/2011 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(a"�cupertino.org PROJECT ADDRESS APN# OWNER NAME PHONE E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX CONTRACTOR NAME r LICENSE NUMBER U q /Q Q LICENS TYPE BUS.LIC.# COMPA,NY NAME d'y��,/ ZJQI�S E-MAIL \ 2 /) / �C 1 d�J 79-�}�3 r7 l 1 GC�J N CITY,STATE,ZIP C / PHONE 2 79�G STREET ADDRESS l �- -.s 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 shall be scheduled 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. On the day of the inspection, a building inspector will be available within one hour for either a Tear-Off Inspection or Nailing Inspection if you call again on that day between the hours specified. 3. The following inspections are required: a. 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. b. If plywood is installed, a plywood Nailing Inspection is required. c. Progress Inspection is required when approximately 50% of roof covering is installed. 4. New roof coverings shall not be applied without first obtaining all 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. 5. 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 I/4" 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. 6. 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: ReroofPo1icy_2011.doc revised 02/16/11 c) REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX(408)777-3333• buildingPa cupertino.org CUPERTINO PROJECT.ADDRESSNo, C��� APN# �' I 01 �� . OWNER NAME ��. � v`, � ��_ / L PHO .64 �� ✓v�� E-MAIL STREET.ADDRESS M 4e_ �( T CITY, STATE,ZIUP FAX APPLICANT NANDP ONE E-MAII \ re Rza�� G�)S 3—c3 7 STREET.ADDRESS _ CITY,STATE, F �So z tAof�` ` �� `/ co-3 ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS LIC # 2d2© l Z ire c Z l o COMPANY NAMEv� E-MAIL STREET ADORE SS,576 �Qr `� ST. CIT ,STATE ZIP C.Q f // �0 O� ARCHITECTiENGCN'EER NAME / LICENSE NUMBER z BUS LIC ## O COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ;1�2zNlulti-Family ROOF AREA VALUATION: STRUCTURE.. ❑ Commercial I �d /) EXISTING ROOF TYPE: ••❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES El WOOD SHINGLES M : �'QTITER(SPECIFY)/ 'n �w� REMOVE REPLACE NES IF NO, PLYWOOD ❑ 'G ❑ PLYWD ❑ OSB !PITCH: ROOF ❑ NO #LAYERS. THICKNESS ❑ 5/8" TYPE: ❑ CDX 12 CLASS ICC-ES REPORT# PROPOSED ROOF TYPE: ❑BUILT-UP ROOF A<5pHALT SHINGLES 1:1WOOD SHAKES ❑WOOD SHINGLES OTHER DESCRIPTION OF WORK. e p� J _x-�— dJ o v, -u 6 _C— (20 9-,"X ors ►'l 0114 ` By my signature below,I certify to each of the following I am the property owner 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 laws relating to b ding nstruction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of ApplicanUAgent: Date: SUPPLEMENTAL INFORMATION REQUIRED oIITSE Or!t ` If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPEr " � ROUTING SLIP of approval from HOA. ❑ OVER-THE.COUNTER��,�,- ❑ BUILDING PLAN REVIEW Provide Planning approval to Verify if there any restrictions. ❑ EXPRESS ❑ PLANNIIVGPLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD -.❑ "F1REDEPT Provide signed copy of Cupertino's Tear-Off Policy. ❑,OTHER ReroofApp_201 Ldoc revised 03/02/11