16010033 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 8064 PARD VILLA CIR CONTRACTOR:FOUR SEASONS PERMIT NO:16010033
ROOFING
OWNER'S NAME: HELD CARL L TRUSTEE PO BOX 1668 DATE ISSUED:01/06/2016
OWNER'S PHONE: 4085591977 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
t,
LICENSED CONTRACTOR'S DECLARATION. JOB DESCRIPTION:RESIDENTIAL 0 COMMERCIAL
UNITS 8064,8066&8068-TEAR OFF(E)TILE&
LicenVClaFl # � "C INSTALL 40#FELT,(N)CLASS A "S" TILE ROOF
Contratej ' (� / SYSTEM
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing 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
—PAlformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$6405
Wye and will maintain Worker's Compensation Insurance,as provided for by I
Section 3700 of the Labor Code,for the performance of the work for which this APN Number 35610030.00 Occupancy Type:
permit is issued,
APPLICANT CERTIFICATION -
I certify that I have read this application and state that the above information is PERMIT EXPNOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WIT �f0 llAYS O T 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 0 DAYS FR ED INSPEC, O
indemnify and k harmless the City of Cupertino against liabilities,judg
costs,and expe s which ay accrue against said City in consequence o e E7
granting of thi ermit. ditionally,the applicant understands and will comply Is y:
with all non- int sourc regulations r the CupertinA ,o Municip 1 Code Section
9.18.
I (p MD
Signa re` ate-° ' / All roofs shall be inspected pri l being installed.If a roof is
installed'without first obtaini remove all ne mate als for
inspection.
OWNER-BUILDER DECLARATION a //_Signature of Applic :;1ate / [ ie
I hereby affirm that I am exempt from the Contractor's License Law for one of u
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(See.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. I 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(x)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 the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the upertino nicipa ode,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sect' s'25505,2 3,and 534. f
Section 3700 of the Labor Code
,for the performance of the work for which this /' la
permit is issued. Owner or authorized a nt: ' Date:
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
3
REROOF PERMIT APPLICATION
s C{.JMM<IUM:Y DEVELOPMEN l f SPAR 3 IME °B'UILDUNG DIVISION
10
300 IG AVENUE,C UPERTINO,CA 950-14-3255
CU p E Wrj N 0 1411)111-318 FAX(408)I77-3333
-
i'ftfllfiC11t3i3Itt5S , AI:\°;F
�n-,rL.,_AMI
.- S p
� tfvL
CONMACY Nz113ti / .2 PHONE
STftt L"t"AAllfS t irY.S7;111:.ZIP FAX
t3]'INL=P, 01vNM St3ILDER El 0WRIMACENT It lI CONTItACTORAfm- ixwtumcr E ET2Go4m 1 DE FLopER lrl T A<
Ca;IRACTO LICEMOSE
`s NUMBER LICE 1,T1'}? BbS
c 4.
COWA Y-NAME E-WIAIL FnxOVO1 J,)
-- :=-.o
btYtlLi s _ rtaonc%ya� rJ
cool r11L ZIP
ARCHUFF_C-DON rINFERWAMF 1-10a1SL-13UMER BUS.LTC.0
CONIPAMS:NAME E-A-MI. FAX
;3
STRFEET ADDRESS Ci"#'1,STATI ZIP PHONE
USE Of C? Sr-D or Duplex Multi-Family R00FAIzt A t too,
STRUCTURE: Cl Commercial A`
rxtS'f1,,r.R0oF'1'YPF-- U BI1It,1-uP ROOF ASPHALT SBIN-6CES 13 WOOD SHAKES I�WOOD SHi1•Gt.t 031ILR(SPECIFY)7,��
RI? o E-,RU,LACE $ jr-40- PLYWOOD 0'%- ElPLYwD 1 oss PITCH: ROQi
_v v.
f NO #L,1'Ews Tlltci :l ss srs TYLE: CDX �-_;1 Roo]]
_� Icc-EsPotz1 i
vROPt3s1,D ROOFTYPE- Btftt:t=tin ttOOt= CI i1sI-1I,WI'sItINGLEa 1=11�•crott sttlst_s C3 woot>sItImt,ts (rixl:R
33LSI RIP7It3\OF%W0Ri_
i' I3y my signature beloN,I certifi to each of the follo-,vjn& I aur tta properi}p3vlter or authorized agent to act on the prope i of ner`s behalf. I have read Ibis
application and the information i bane provided is correct. I have read the Description of kkrori:and verify it is accurate. I agree to comply with all applicable 10"
ordinances and state lairs relating to building construction. I authorize representatives of Cnperdno to enter thea, �e--di niili�piopet4 for inspet tion pttrposcs
Signature of Applicant/Agent= � C -,.,. >j
SLIPPLFAMENTAL INFORMATION REQUIRED aM gip,-
Ifbuildirtg is associated wills a home Ownces-Association,provide letter PLAN CIrEtCKTYPE tomtit 3
of approval front 1100. .t-t tib cetP.t rrc nt. rt e°
Provide Planning approval to verify ifthere any restrictions_
La t xt>t21s a t'1 11i tzt vt t: i
Provide copy of.Manufacturcr's Installation Specifications_ C1 SI'Am),u t} 0 FWE DEPT
h Provide sighed copy ofCupertinos Tear-Off-Policy. (YmEw
iterntt pp 20JLdoc rMsett 03116111
CITY OF CUPERTINO
FEE ESTIMATOR BUILDING DIVISION
ADDRESS: 8064 PARK VILLAS CIR 7DATE- 01/06/2016 REVIEWED BY: 'MELISSA
APN: 356 10 030 BP#: VALUATION: 1$6,405
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1R2R00F
USE: 3 Stories Q Yes F No PERMIT TYPE:
WORK UNITS 8064 8066 & 8068-TEAR OFF E TILE & INSTALL 40# FELT N CLASS A "S"TILE ROOF
SCOPE SYSTEM
FEE ID ROOF AREA
s.f.
1REROOFMRES 1,600
is°c'kr r'icat f.r ' I vz ,, P"', Check
ck
'. L`I F.Per,d Fee:a " r if far. r�.>:
rr',g. =7-- Is£e;-Ph . Isp. E17- Ins'u
L�j
J .r.fech in, Tee.' t}f'.;€Hb zrn?",Fe"c:
NOTE: This estimate does not includefees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta . These.fees are based on the relimina information available and are onl an estimate. Contact the De t'or addn'l in o..
FEE ITEMS F%'ee Resolution II-053, 7,/1,/13) FEE QTY/FEE MISC ITEMS
(,heck b;1111e:Permit Fee: $272.00
I
A(brlhfi�fraiive Floe:
Work Without Permit? 0 Yes (j) No $0.00
Strong Motion Fee: IBSEISMICR $0.83 Select an Administrative Item
Blda Stds Commission Fee: IBCBSC $1.00
SC7BrOTA:LSc $273.83 $0.04,,-'
0.00 TOTALFE $273.83
Revised: 10/01/2015
iafjfir t REROO ' TEAR-OFF
R 'fir l I'Y
' Il
COMMUNI-1 DEVELO,'i`t EN i DLPAFe I'sVEN I -BUILDING DIVISION
d �}
�- ALGER I SALVADOR, P.-E.,C.U,O., BUILDING OFFICI
10300 T URRE AVENUE=z CUP R3"INO1 CA 9501 -3255
(408) 777-:3228 -F/-V 1408)777-3333 buifdinq C@> i.i vrtillcA�l.e�
I
PROJECT i ADDRESS 60 8 �Y[Rl z 4 I 1/+.S li g/� AIN ii �—
r '- L-MAIL
i/I' `+ . j
i
STR I1 4DDRr SS.._ CIT)"
S1A11 % •.f'
a �H' PAY�r.�w
C OA 112AC1 OR NA
1 YA
: EUS.LC11LIC NSHNUMB t
r f• ,y' r t'"'� 1 :� _$ ,�' of f�_..,a ,
} COMPANY NAME r EMAIL Peax f " f< J
STREET ADDRrS4 f < C qN';STATF,/.,IP",
L� r � f i 'F { .L Y:� '7 ..� f. t� �✓y'.� I'1IO IVC
I UNDERSTAND AND AGREE TO THE FOLLOWING.
L The re-roof project shall comply with call applicable provisions of the 2013 California Codes.
2. An inspection request pan be scheduled dap to one l�>!><sllit�ss��iv.k�e�arl°� tt�le rre �a���edl ilra� e��l�x� rl��e.
Please schedule inspections online or call(408)777-•3228 from 7:30-3:30pin (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 onlyafter that p a se of the work is cornpkted. The building inspector will be
available within one hour. The hours for this service are: `/.'30- 0.30am and 12x30.,3;30(Mon—Thurs)
and `7.-3040.30a'm nd 12.30-2:30 (ll�rrndlay). Final Inspections will be given atwo hour window.
3. `g a ® It us Ufa®r� �� reg CO. Any and all dry-rotted wood shall be replaced prior to this inspection.
t.Jnless new plywood roof sheathing is proposed throughout, aaH the nMIs/fastrennerrs shall be either
complete➢y knocked—down or removed prior to this inspection:.
4. If plywood is installed, a plywood Nn� gry I[unedr, �,rraari� l.
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_inspection and ai r�rr® aal mall �e oP�tta�uringd rom the building inspector when the reroofing is
completed. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have'a minimum of Y,. per foot of slope and demonstrate there is no ponding.
b. Listings frorn approved testing agencies for all pre-manufactured products used shall be
available onsite 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 shaaufl be ipaid before another ins eaten can be
scliledided. a - -
�YBy 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
smote detectors and carbon monoxide detectors are required to be installed in accordance with Sections 8314 and R315 of
the 2013 California Residential Code.
pSignature pf_Applicant;Agent: --"`7:, ��'' � nom`_�..__..—�---�r--- Date:
12er-ogf'olicy__201 l.cloc revised 01/15/11