1511011511
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 8076 PARK VILLA CIR
CONTRACTOR: FOUR SEASONS
PERMIT NO: 15110115
ROOFING
OWNER'S NAME: SMITHWICK RICHARD M AND DONNA
PO BOX 1668
DATE ISSUED: 11/17/2015
OWNER'S PHONE:
SAN JOSE, CA 95109
PHONE NO: (408)278-0330
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
14 � CIE
UNITS #8076, #8078, #80980 - REMOVE (E) ROOF TILES
License Class ic. # , d
AND UNDERLAYMENT, INSTALL 2 LAYERS OF 40# FELT
Contractor Date
AND
(N) BORAL OS CLAY "S" TILE - 16 SQUARE'S
I hereby a m that I am licensed under the provisions of Chapter 9
(commenci g with Section 7000) of Division 3 of 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 maintain a 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: $6405
performance of the work for which this permit is issued.
Zecave and will maintain Worker's Compensation Insurance, as provided for by
tion 3700 of the Labor Code, for the performance of the work for which this
APN Number: 35610024.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this 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 FROM LAST CALLED INSPECTION.
indemnify and k harmless e City of Cupertino against liabilities, judgments,
costs, and expe se which m yv accrue against said City in consequence of the
��
Issued by: Date: 1 I
granting of thi p it. Ad onally, the applicant understands and will comply
with all non- t source r ulations er the Cupertino Municipal Code, Section
RE-ROO
9.18.
Signat re Date (
All roofs shall be inspected rior to y roofin aterial being installed. If a roof is
installed without first obta� ing an spXee to remove all ew ma rials for
inspection.
❑ OWNER -BUILDER DECLARATION
' r
l
Signature of Applic Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROO COVERINGS TO BE CLASS "A" OR BETTER
1, 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 3700 of the Labor Code, for the
air contaminants as defined by he Bay A a Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance wit the Cupe 'no Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, ctions 55 , 2 533, an 5534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorize ent Date: t
permit is 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. If, after 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
9.18.
Signature Date
E OOF PERMIT APPLICATION
C{?tililb'IUNITY DEVELOPMENT DEPAR-MENT . BUILDING DIVISION
10300 T ORRE AVENUE • CUPERTINO, CA 350'14-3255
(408) 777-3228 -FAX (408) 777-3333 - bl ildiiq9b-.C4pPrtinO.o[q
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USE OF fj SFD or Duplex Multi -Family
'ROOF AREA
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FXIS UING ROOF - YPIi: ❑ outLT i 1P RooF ❑ A.CPtiAI.T SNii�GLFS ❑ WOOD SI IAIC F. ❑ %Voon SHIiYGLES UTIILR (SPECIFY)71-_7_-
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DE-SCRIPTION OF WORK-
s _ _
By my signature below, I certify to eac z of the following, I am the propett� owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the inforntation 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 Ims relating to building construction. I authorize representatives of Cupertino to enter the above/ ntified rt�� £or inspection purposes.
Signature of Applicant/Agent: �-"_,�. _ -C'' - Date; —Lill
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SUPPLEME 17AL INFO&MAPION REQUIRED
4 If building is associated with a Home (hvner s Association, provide fetter
of approval from IIOA.
Provide Planning approval to verify if there any restrictions.
_ Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupertino'S Tear -Off Policy.
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OFT -WL USE ONLY
ROU i ING SIdP
BUILDING PLAN REVIENW'
PLANNING PLAN REVIEW
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Remof.4pp_ _201 1. doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 8076 Park Villa i Cir DATE: 11/17/2016 REVIEWED BY: Phuong
APN: 356-10-024 BP#: 'VALUATION: 1$6,405
IPERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof
PRIMARY Multi -Family Dwelling uildina is PENTAMATION 1 R2ROOF
USE: Stories 0 Yes E) No PERMIT TYPE:
WORK UNITS #8076, #8078, #8 C580 - REMOVE (E) ROOF TILES AND UNDERLAYMENT, INSTALL 2
SCOPE LAYERS OF 40# FELT AND (N) BORAL OS CLAY "S" TILE - 16 SQUARE'S
FEE ID ROOF AREA
(S.f.)
1REROOFMRES 17600
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, tire, SanitaryNewer District, lychool
nfr;nf nfn I Th"c" f""v "v,& A"vad n" i1to ;"fnr"siyt;"" 7wz;1,7h1,o imd,7ro n"to "n ovdmizla Ca"tart tho Apnt fnr aild"'I itifn-
FEE ITEMS (1,ee Resolution 11-053 tff.7/LU3
p
QTY/FEE
MISC ITEMS
Nkch. permt bee:
J'erprjii hec?"
1" Perniii I
Oiher.,Wech. h? p.
Oiher blec, Irsp.
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, tire, SanitaryNewer District, lychool
nfr;nf nfn I Th"c" f""v "v,& A"vad n" i1to ;"fnr"siyt;"" 7wz;1,7h1,o imd,7ro n"to "n ovdmizla Ca"tart tho Apnt fnr aild"'I itifn-
FEE ITEMS (1,ee Resolution 11-053 tff.7/LU3
FEE
QTY/FEE
MISC ITEMS
Permit Fee:
$272.00
z ,c
onstruction Tdx':
11. ;'Y'4. Pee.:
Work Without Permit? C) Yes (F) No
$0.00
Fees:
Strong Motion Fee: IBSEISMICR
$0.83
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$273.83
$0.00 TOTAL FEE.-
$273.83
Revised: 10/01/2015
REROOF TEAR -OFF POLICY
COMMUNI-I Y DLVE'LOPMENT DEPARTMENT 13UILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300TORR'E AVENUE - CUPERTINO. CA 950-14-3255
Ll P 1-1-f I N '408) 777-3228 -FAX (408)177-.3333 - Wildin
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PROJ13CTADDRLSS ANN It
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CONTRACTOR NA LICUNSE NUMBER 1% BUS.
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COMPANY NAME, H -MAIL F trX J
PHONE,STREET ADDRE TF
I UNDERSTAND AND AGREE TO THE FOLLOWING-.
1. The re -roof project shall comply with all applicable provisions of the 2013 California Codes.
2. An inspection request' n be scheduled up to one baushRess da, re th re te'.
ca v befo e gues ed inspection date.
Please schedule inspections online or call (408) 777-.3228 from 7-30-3:30pm (Moll --Thugs) or 7:30-
2:30pm (Friday) to schedule inspection. For Tear -.Off and Nall 1no Inspections, you must also call on the
day of the inspection only after that phase of the work is coin npkted. The building inspector will be
available within one hour. The hours for this service are: 7:3040:30ain and 12:30-3:30 (Mon-Mbuirs)
and'7:30-10:30am and 112,:30-2:30 (Friday). Final Inspections will be given a two hour window.
3. Tear--GJjnpe� �-i
9pi
as K�aAny and all dry -rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the be chheir
com1pletely knocked -down or removed prior to this inspection.
4. If plywood is installed, a plywood PN`F4WLitJkt�pccflon -H*sj(q
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 Insfoection and n, roval shall be obtained from the building inspector when the re -roofing is
- R P K 01 S
completed. To receive a final sign -'off, the following items will be verified:
a. Flat roofs shall have a minimum of Vt 71) 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.
7. NOTH: 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 fe.-Inspection fee shall be paid before _another kWcflon can be
schedtfled.
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
smolpr, detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code.
Signature of Applicant/Agent:
Date:
Remof Policy__2014.doc revised 01115114
,