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13050003CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10876 NORTHRIDGE SQ CONTRACTOR: FOUR SEASONS PERMIT NO: 13050003 ROOFING OWNER'S NAME: YOGISH KOD19 PO BOX 1668 DATE ISSUED: 05/01/2013 OWNER'S. PHONE:; 4084807881 ' SAN JOSE, CA 95109 PHONE NO: (408)278-0330 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lia Q (1,200 SQ FT) TEAR OFF (E) WOOD SHAKE, INSTALL (N) GAF GRAND SEQUOIA SHINGLE OVER (E) PLY Contracto at, ` I hereby affirm that I am licensed un erthe provisions of Chapter 9 (commencing with) Section'.7000) of Division 3of the Business & Professions Code and that'my license is in full force and effect. I hereby affirm: under'penalty of perjury one of the following two declarations: I have and will in 4 certificate of consent to self-insure for Worker's Compensation, as provided for by Section, 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $5200 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 tabor Code, for the performance of the work for which this APN Number: 31636017.00 Occupancy Type: permit is issued.. APPLICANT CERTIFICATION I certify thatI have read !is application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED : correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building. construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS CALLED INSPECTION. indemnify and keep, harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue, against said City in consequence of the granting 'ofr permit: Additionally, the,applicant understands and will comply by: Date: with all n -p int source regulations per the Cupertino Municipal Code, Section 9.18. Signatu Dates- �- l 3 RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obt ' inspection, I agree to remove all new materials for inspection. " ❑ OWNER-BUILDERDECLARATION_ / Signature of Appl Date; I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business &Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business& Professions Code). I have read the hazardous materials requirements under. Chapter 6.95.of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: ! Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self: insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3.700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance withpe pertino Municipal Code, Chapter 9.12 and 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 the Health & SafetyCode, S tion 5505, 25533, d25 4. Owner or authorized ag Date: % permitis issued• I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. It atter making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep' harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this. permit. Additionally, the applicant understands and will comply with all non point source regulations per the Cupertino Municipal Code, Section Licensed Professional I Signature - Date COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 1O3DOTORREAVENUE ^CUpERTK$B.CAB5O14'3255 � (408)Y7y'3228^FAX (4#08)777-3333° _--_--__—___-�,L__ � -� ReroqfAppj0JLdoc revised 03116111 FSTnRUF,1T�DDrj4,k, STA FAX CONTACT NAME PH E-MAIL 0 OWNEP 0 OWNER -BUILDER 0 OWNERAGENT )(IONTRACTOR 1:1 CONTRACTOR AGENT 13 ArtcHrmcT 0 ENGINEER [3 DEVELOPER 11 TENANT CONTRACTQR NAME LI UB WOO; Linir COWANYNAME E-MAIL FAX STREETADDRESS, CITY, STATE, ZIP PHONE USE OF 0 SFD or Duplex Multi -Family ROOFAREA: VALUATION: STRUCTURE: 0 Commercial OWOOD SHINGLE' )(OTHER (SPECIFY) EXISTING ROOF TYPE- 0 BUILT-UP ROOF 0 ASPHALT SHINGLES 0WOOD S REMOVEIREPLAC �_FNO I A #LAYERS- -liffell-fflm- Q*s/g­ TYPE, JgLcDx CLASS: PROPOSEDROOFTM: OBUILT-UPROOF XASPHALTsmNGLEs 11 WOOD SHAKES 13 WOOD SHINGLES OTHER ICC -ES REPORT # DESCRIPTION OF WORK 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. 1haveread application and the inforniation I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to cornply with all a ca el ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspectio Signature of Applicant/Agent: Date: PLANCHECKTWE YIP RO*G If building is associated with a Home Ownees Association, provide letter 4,0VER-THE-COUNTER BUIOLDING PLAN REVIEW of approval from HOA. Provide Planning approval to verify if there any restrictions. 13 EXPRESS 11 PLANNINGPLAN REVIEW Provide copy of Manufacturees Installation Specifications. 0 STANDARD 0 FM DEPT Provide signed copy of Cupertino's Tear -Off Policy. oTam- ReroqfAppj0JLdoc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR -BUILDING DIVISION .,A,fech. Plan ('heck - erin - itFee: OtherAfech. Insp. Ifech. Imp. Fee: 1REROOFFRES Plumb. Plan Check I I Plumb. Permit Fee: Oflier Plumb Insp. Plumb. Insp. Fee: Elec. Plan (.-hock I I Elec. Permit Fee: Other Dec, Insp. Elec. Insp, Fee: NOTE. This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Pire, Sanitary Sewer District, School District, etc). Thesefees are based on the prelimina information available and are only an estimate Contact the Deptfor addn 71ao. ADDRESS: 10876 NORTHRIDGE SQ DATE: 05/01/2013 REVIEWED BY: MELISSA MISC ITEMS A nXT. '16336 017 BP#: *VALUATION: 1$5,200 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: I PENTAMATION 1SFDWLR00F I PERMIT TYPE: 14 WORK (1,200 SQ FT) TEAR OFF (E) WOOD SHAKE, INSTALL (N) GAF GRAND SEQUOIA SHINGLE OVER SCOPE I (E) PLY .,A,fech. Plan ('heck - erin - itFee: OtherAfech. Insp. Ifech. Imp. Fee: 1REROOFFRES Plumb. Plan Check I I Plumb. Permit Fee: Oflier Plumb Insp. Plumb. Insp. Fee: Elec. Plan (.-hock I I Elec. Permit Fee: Other Dec, Insp. Elec. Insp, Fee: NOTE. This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Pire, Sanitary Sewer District, School District, etc). Thesefees are based on the prelimina information available and are only an estimate Contact the Deptfor addn 71ao. FEE ITEMS, (Fee Resolution 11-053 Eff. 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: 4S111 -71j1. PC Fee Plumb.lAfech.lE lec Permit Fee: $180.00 Suppl, Jim[) Fee Plum b./Mech�. /Elec Plumb.lMech.lElec Permit Fee: Construction Te ix.. Administrative Fee: Work Without Permit? 0 Yes iq No $0.00 Advanced Planning Fees: A Travel Documentation Fees: Strong Motion Fee: lBSEISAffCR $0.52 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 MENEM $1181.52, $0.001 $181.52 Revised: 04/29/2013 CUPERTi3Q 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 (408) 777-3228 • FAX (408) 777-3333 • buildingecupertino.org tl. � % M911 1 RIM LICENSE TYPE � � . • N-2 Wo ,ri 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 can be scheduled up to one business day before the requested inspection date. Please call (408) 777-3228.from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pm (Friday) to schedule 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. 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: A Final In0ectioin and approval shall be obtained from the building inspector when the re-roofmg is completed. Toreceive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of 1/4" 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 ori -site to review at the time of the inspection. c�. , Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed. .7. 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. 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 under and agree to comply with the re -roof policy stated above. 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LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF © SFD Or Duplex Multi -Family ROOF AREA, VALUATION: STRUCTURE: ❑ Commercial ,.. EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑WOO SHAKES ❑ WOOD SHINGL S OTHER (SPECIFY) REMOVE /REPLACE4-YES ffNO, PLYWOOD--/:' ❑ PLYWD ❑OSB PITCH: ' 12 ROOF NO #LAYERS:i1CiS�lS: 5!8" TYPE: CDX CLASS: PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF -ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK: �p /fl♦ 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 behANapplication and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to complordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property Signature of Applicant/Agent:.� Date: 't f3 SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE oN PLAN CHECK TYPE u® G;;u jIf building is associated with a Home Owner's Association, provide letter x�COUNTEx ❑ BUILDIKG PLANREvTEw of approval from HOA.vEx _ Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAIT REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FutE DEPT Provide signed copy of Cupertino's Tear-OffPolicy. ❑ Oma: ReroofApp 2011.doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION Ji. ` ADDRESS: 10886 NORTHRIDGE SQ DATE: 05/01/2013 APN: 316 36 018' BP#: REVIEWED BY: MELISSA *VALUATION: 1$5,200 PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: p PENTAMATION PERMIT TYPE: 1SFD1NLR00 i WORK' 200 SQ FT TEAR OFF E WOOD SHAKE INSTALL N GAF GRAND SEQUOIA SHINGLE OVER SCOPE (E) PLY IV1ec:h. Plan Check Akch. Permit Fee: Other A -tech. Insp. Hech. Insp. Fee: FEE ID ROOF AREA s.f. 1REROOFFRES 1 1,200 Phunb. Plan Check Plumb. Permit l7o—,: Other Plumb Insp. Plumb. Insp. Fee: Elec. Plan Check. Elec. Permit Fee: Other Elec. Insp. Elec. Insp. Fee: NUIE. "Phis estimate does not inctude fees due to other Departments (ie. Planning, Public worKS, Pire, January Jewer District, acnool llictrint om 1- Thorn foo. nro hncod nn tho and nro an/v an octintato Contact tho Dont far addn'1 info_ FEE ITEMS (Fee Resolution 11-053 E . 7/1112) FEE QTY/FEE MISC ITEMS Plan Check Fee: Sztlpl. YC' .C'c c Plumb.111 fech./Etee Permit Fee: $180.00 S`uppl. Imp Fee Plumh.iMech./Elee Plumh,Alfech./Elee Permit l'ec. Construction :Tax: Administrative Fee: Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fees: � Travel Documentation Fees: Strong Motion Fee: 1BSEISAffCR $0.52 Select an Administrative Item Blde Stds Commission Fee: 1BCBSC $1.00 $181.52 $0.00 $181.52 Revised: 04/29/2013 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 (408) 777-3228 - FAX (408) 777-3333 • buildingaftugertino.org PR APN # ow=AME y}/, E MAII. D yGy /e FAX C CTOR L/G"AV LICENSE E LICENVYPE BUS . LIC. # coft E-MAILF; ,2 STIUMT ADD C ST TE IP P v � 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 can be scheduled up to one business day before the requested inspection date. Please call (408) 777-3228. from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pm (Friday) to schedule 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. 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'. A Final tnspection and approval shall be obtained from the building inspector when the re -roofing is completed. Toreceive 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 availableon-site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed. .7. 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. 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 underst d and agree to comply with the re -roof policy stated above. I also understand that . smoke detectors and carbon me de detect e re ed to be installed in accordance with Sections 8314 and R3.5 of the 2010 California Residen ' 1 ode. Signature of Applicant/Agent: Z1.45 ate: ReroofPolicy_2012.doc revised 1017112