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11060102 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20084 NORTHWIND SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 11060102 OWNER'S NAME: DENENBERG MICHAEL S AND BERNAD PO BOX 1668 DATE ISSUED:06/13/2011 OW'x'ER'S PHONE: 6509647595 SAN JOSE,CA 95109 PHONE NO:(408)278-0330 ❑ LICENSED CONTRACTOR'S``DECLARATION BUILDING PERMIT INFO: BLDG F ELECT r PLUMB r License Class C ` Lic.# Lt 7,A / OF_MECH RESIDENTIAL COMMERCIAL Contractor - Date G - / `/ v (/ -_ " JOB DESCRIPTION:REROOF,14 SQUARES,REMOVE EXISTING CEMWOOD I hereby lrm�lrat I am licensed under the provisions of Chapter 9 ROOF (commencing with Section 7000)of Division 3 of the Business&Professions AND INSTALL NEW,30#UNDERLAYMENT&GAF GRAND Code and that my license is in full force and effect. CANYON ASPHALT SHINGLES-HAS EXISTING PLYWOOD I hereby affirm under penalty of perjury one of the following two declar 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 th 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 Sq.Ft Floor Area Valuation:$4400 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:31638056.00 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 indemnify 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 of this permit. Additionally,the applicant understands 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. Date L' _/Y -ft Issued b Date: Signature — y� [ 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 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 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.7044, inspection. Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Ap 'c3nt: Date: construct the project(Sec.7044,Business&Professions Code). ---ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three 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 compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this 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 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,I Health&Safety Code,Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or agthorized agent: / L forthwith comply with such provisions or this permit shall be deemed revoked. — 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 inkeep harmless the City of Cupertino against liabilities,judgments, c,11 nd expenses which may accrue against said City in consequence of the Lender's Address demnify and g. g of this permit.Additionally,the applicant understands and will comply with 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 a� CITY OF CUPERTINOU0 \ `O FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 20084 Northwind DATE: 0 5/13/2011 REVIEWED BY: TRACIC APN: 31638056 BP#: *VALUATION: $4,400 PiPERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PETAMATI E: 1 SFDWLROOF USE: SFD or Duplex PERMIT TYPE: WORK reroof, 14 squares, remove existing cemwood roof and install new, 30# underla ment & GAF grand SCOPE canyon asphalt shingles - has existing plywood deck. Color Stonewood. FEE ID ROOF AREA S. 1 REROOFFRES 1,400 E:F-L- NOTE: These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addh7 info. FEE ITEMS(Fee Resohiaion 09-051 f. 7,1,1(h FEE QTYIFEE MISC ITEMS Permit Fee: $182.00 C O•JSii2/C;i` tit"t /fl.`+: Work Without Permit? © Yes No $0.00 3 Strom Motion Fee: 1BSEISNIICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $183.50 $0.00 TOTAL FEE: $183.50 Revised: 04/29/2011 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL C O P E RT I N O 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408)777-3228 - FAX(408)777-3333 - building(a�cugertino.org PROJECT ADDRESS TAPN N OWNER NAME PHONE E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX CONTRACTOR NAME/ LICENSE NUMBER OU( •3. 1�S LICENCTYBUS.LIC.N/ QO PE COMPANY NAME / G�� E-MAIL�( r-� n �2 7 r� `CI �•p Ue o .Z S X33 STREET ADDRESSCITY,STATE,ZIP d �� PHONE 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. Prolzress 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 detecto s are required to be installed in accordance with Sections R314 and R315 of the 2010 Califomia Residential Code. Signature of Applicant/Agent: Date: RerogfPoligy_2011.doc revised 02/16/11 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 GUPERTINO (408)777-3228 - FAX(408)777-3333-building (Wcupertino.orQ PROJECT ADDRESS APN N OWNER NAME Mt� ��K`J PHONE/_5„ O6 4y )S E-MAIL STREET ADDRESS / /��,IC (� CITY, STATEgIP FAX APPLICANT NAME l n n '^r P E jO 1 E-MAIL STREET ADDRESS5O\� `Urt ti �-V CITY,STATE, FA "j, arl -��'g-2_ G6—. zS'</ z Zd' 433 ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT 941oNTR.AcTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME e n 2 CrC LICENSE NUMBER �`O LICENSE TYPE BUS.LIC.N �p (j_ COMPANY NAME ( Se4r. w E-MAIL F kplF)"_7 ^v STREET ADDRESS /' Cr ,STATE ZIP P ONE '�-,J ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.N COM ,&,NY NAME E-MAIL. FAX STREET ADDRESS CrrY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex MUltl-Famlly ROOF AREA: VALUATION: ! srRucruRE: O /Commercial /) EXISTING ROOF TYPE:: /1�1�BUILT-UP ROOF 13ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES R(SPECIFY) RI-MOVE/REPLACE .marts IF NO• PLYWOOD ❑ %i ❑ PLYWD 13 OSB PITCH: I Z ROOF A ❑ N 13 /8" C1 CDX I CLASS PROPOSED ROOF TYPE: ❑BUILT-UP ROOF j2l�SPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT N DESCRIPTION OF WORK: 1>0-- By >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 ing nstruc'on. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED If building is associated with a Home Owner's Association,provide letter of approval from HOA. gKa _Provide Planning approval to verify if there any restrictions. r YCk(�IIIVG PLADI REVIEW _Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doe revised 03/02/11