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11060106 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20124 NORTHWIND SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 11060106 OWNER'S NAME: KNOESPEL,INGE PO BOX 1668 DATE ISSUED:06/13/2011 0"""R'S PHONE: 4084460507 SAN JOSE,CA 95109 PHONE NO:(408)278-0330 ❑ LICENSED CONTRACTOR'S DECLARATIONF r BUILDING PERMIT INFO: BLDG ELECT PLUMB License ClassC Lic.# G/ 74 1y MECH RESIDENTIAL COMMERCIAL Contractor 'y Date (� '!L/ I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REROOF,14 SQUARES,REMOVE EXISTING CEMWOOD (commencing with Section 7000)of Division 3 of the Business&Professions ROOF 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 decla s-_ 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:54400 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:31638053.00 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. Signature j / Date t �� Issued by: Date: 6- �l G 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) Signature of Applies: Date: I,as owner of the property,am exclusively contracting with licensed contractors to Gr construct the project(Sec.7044,Business&Professions Code). C - 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain [have and will maintain Worker's Compensation Insurance,as provided for by 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 Own r aut_hotized agent:_� 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, c nd expenses which may accrue against said City in consequence of the Lender's Address gi. jg 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 CITY OF CUPERTINO 3 ITEMS OF 18 PERMIT RECEIPT OPERATOR: TraciC COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31638053 .00 DATE ISSUED. . . . . . . : 06/14/2011 RECEIPT #. . . . . . . . . BS000013753 REFERENCE ID # . . . : 11060106 SITE ADDRESS 20124 NORTHWIND SQ SUBDIVISION . . . . . . . CITY * ' * * * . . . . . . * * : CUPERTINO IMPACT ARE . . . . . . . OWNER KNOESPEL, INGE ADDRESS 20124 NORTHWIND SQ CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-0552 RECEIVED FROM FOUR SEASONS ROOFIN CONTRACTOR DIAZ, ALFRED LIC # 21323 COMPANY FOUR SEASONS ROOFING ADDRESS PO BOX 1668 CITY/STATE/ZIP . . . : SAN JOSE, CA 95109 TELEPHONE (408) 278-0330 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 4,400. 00 1 .00 0 . 00 1 . 00 0 .00 1BSEISMICR VALUATION 4,400. 00 0 .50 0 . 00 0 .50 0 .00 1REROOFRES SQ FEET 14 . 00 182 . 00 0 . 00 182 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 183 .50 0 . 00 183 .50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 1, 101. 00 010968 --------------- TOTAL RECEIPT 1, 101 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO 0(0 FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 20124 Northwind DATE: 06/13/2011 REVIEWED BY: TRACIC APN: 31638053 BP#: 'VALUATION: $4,400 r°PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF USE: 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.f. 1 REROOFFRES 1,400 Ll -I__ NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS(Fee Resolution 09-051 Ejf 711:71)) FEE QTY/FEE MISC ITEMS oo! PC Permit Fee: $182.00 1 a r, _ �af•, F-1 Work Without Permit? © Yes E) No $0.00 Stron,q Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldi Stds Commission Fee: IBCBSC $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 CUPERTINO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 � (408) 777-3228 - FAX(408)777-3333 - building(@cupertino.org PROJECT ADDRESS APN# OWNER NAME PHONE E_MAn„ STREET ADDRESS CITY, STATE,ZIP FAX CONTRACTOR NAME LICENSE NUMBER (/� /Q p LICENSg TYPE BUS.LIC.# G COMPANY NAME [j GE-MAIL J STREET ADDRESS CITY,STATE,ZIP PHONE a Z T11 �.,1-s a21(1 Z 27f G acs 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 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: RerooJPolicy_2011.doc revised 02/16/11 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228 • FAX(408)777-3333•buildinc0cugertino.orcl PROTECT ADDRESS ( � I� t ( �j ^�1 7AFNk -- OWNER NAME —i--1'1 Y '7 D 57D / E MAII. STREET ADDRESS (} _ CITY, STATE,ZIL I � FAX APPLICANT NAME P ONE 3 E-MAIL STREET ADDRESS 50 Z, `OT MtS-T CITY,STATE, F ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT AONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME _ n 2 re LICENSE NUMBER L` O LICENSE TYPE BUS.LIC.# �Cp COMPANY NAME ( 1 E-MAIL F M.�- 75^ 033 _S goo STREET ADDRESS!b � �T C ,STATE ZIP P ONE J -z— ARCHITECT/ENGINEER ARCHTTECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex 1141ult1-Family ROOF AREA. VALUATION: STRUCTURE: ❑ Commercial IYA6O /) EXISTING ROOF TYPE:: / BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES XMTiER(SPECIFY) REMOVE/REPLACE .7th IF NO, PLYWOOD 13w, 11PLYWD Cl PITCH: I Z ROOF A ❑ # ❑ g' ❑ CDX CLASS: PROPOSED ROOF TYPE: ❑BUILT-UP ROOF HALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT M DESCRIPTION OF WORK: (or. 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 ion. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: j Date: SUPPLEMENTAL INFORMATION REQUIRED _If building is associated with a Home Owner's Association,provide letter r= x of approval from HOA. Provide Planning approval to verify if there any restrictions. €" Q t "� ; •'w'-14 �` w' SS1fgz t t RTr►N4'HI IG FLAN R&YIIsRt _Provide copy of Manufacturer's Installation Specifications. t� '� '" � � • _ Provide signed copy of Cupertino's Tear-Off Policy. n ReroofApp_201 Ldoc revised 03/02/11