12090170 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21098 WHITE FIR Cf CON'TRACT'OR:FOUR SEASONS ROOFING PERMIT NO: 12090170
OWNER'SNANIE: WFN%HU RTIAN GUICHANG PO BOX 1668 DATE ISSUED:09/192012
OWNER'S PHONE: 4083353635 SAN JOSE,CA 95109 PHONE NO:(+08)278-630
S
LICENSED CON"I'RACI'OR'S TUI?CLARA'1'ION BUILDING PERMIT INFO: BLOC r ELECT r PLUMB r
License Class C— J'l L '
ic.is �1
b1EC11 r RESIDENTIAL r COMMERCIALr
Contractor RSn f/ 1tJC . Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROOF.INSTALL 13
(commencing with Section 7000)of Division 3 of the Business S Professions SQRS
Code and that my license is in full force and effect. INS AL PLYWOOD,THEN ESI FENTLT UNDERLA COMPOSITION INSTALL CERTAINTIiIiD PRIiSID1iNTIAI COMPOSITION
hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to sell'-insure Tor Worker's
Compensation,m provided for by Section 3700 ol'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
perrnit is issued. Sq.PI Floor Area: Valuation:54500
APPLICANT\NT CERTIFIC\TION
I certify that I have read this application and state that the above infomhation is APN Number:35905089.00 Occupancy'1)pe:
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)agrec 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. �7
Signature 4 �� Issued by Date:
❑ 01ANF.R-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOF'S:
the following loo reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1,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 R Professions Cade
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant,
construct the project(Sec.7044,Business R Professions Code).
hereby affirm under penalty of perjury one of the follmving three ALL ROOF COV.RINGS'TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IIA%ARDOUS MATERIA S DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this pemhit 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 Ilealth S Safety Code,Sections 25505,25533,and 25534. 1 will maintain
compliance with the Cuperlino Municipal Code.Chapter 9.12 and the Health S
Section 3700 of the Labor Code,for the performance of the work for which this
Safety Code.Section_5532(x)should I store or handle hazardous material.
permit is issued. Additionally,should 1 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 S Safety Code,Sections 25505,25533,and 25534.
became subject to the Worker's Compensation provisions of the Labor Code,I must /
forthwith comply with such provisions or this permit shall be deemed revoked. Owner or u ent: Dat
e: Qomrl
Dat
A PPLI CANT CERTI FI C TION CONS'1'RUC`FION LENDING ACENCI'
I certify that I have read this application and state that the above information is
correct..I agrec 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 pernil is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harndess the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARA'T'ION
9.18.
1 understand my plans shall be used as public records.
Signature Eric
Licensed Professional '
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 21098 White Fir Ct DATE: 09/14/2012 REVIEWED BY: Sean
-27 APN: a" C, 05-�6 BP#: 1,20 /70 *VALUATION: $4,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Buildina is PENTAMATION
USE: Multi-Family Dwelling >3 Stories Yes ((!j) No PFRMITTYPE: 1R2ROOF
WORT: Tear off existing wood shake roof. Install 1/2" CDX plywood then 30# felt underla ment. Install
SCOPE Certainteed Presidential Composition shingles. Color: Country Gray.
FEE ID ROOFAREA
s.f.
1REROOFMRES 1,300
,llech.Plan Check Plumb. Plan Check Flea flan Check
blech. Perwil Fee: Plumb. Permit Fee: Elec.Permit Fee:
Oaten Mech.Insp. Other Plumb Insp. Other Elce.It ED
Hach. Imp. Fee: 11lu nh beep. Fee: Flee.Insp.Fee:
A'OTF: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District, etc. . These ees are based on the prelindnan information available and are only an estimate. Contact the De t or addn7 info.
FEE ITEMS (Fee Resolwion 11-0FIT 71111/1 FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Stppl. PC Fee
Plumb./,14ech./Elec
Permit Fee: $195.00
Suppl. Insp Fee
Phtmb.AtledUElec
Phinb,/Mech./Elec Permit Fee:
Consn•uction Tax:
Administrative Fee:
Work Without Permit? Q Yes Q No $0.00
Advanced Planning Pecs:
Travel Documentation Fees: �
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission I'ee: IBCBSC $1.00
SUBTOTALS: 1 $196.50 $0.00 TOTAL FEE: $196.50
Revised: 07101/2012
REROOF PERMIT APPLICATION
2 COMMUNITY IDEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORREAVENUE •CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildina(dcupertino.oro
/ DJD/7d
PROJECTADDRESS Z1098 AlLis
• APN•
OWNER NAME V' � l PHONE 64,6 0 3 3S'-363.p `fA1L
STREEr'ADDREss Z(o^� w G CI STATE,ZIP M FAX 11�
CONTACT NAME 7 PHONE J`+E-\LUL
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STREETADDRESS ./ CITY.STATE. ZIP FAX j
- 14nming S+.
eoq ToSe CA 411110-
❑OWNER ❑ OWNER--BUILDER ❑ ONNERAOENT Je CON RACTOR ❑CONTRACTOR AGENT Cl ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
I
CONTRACTOR NAME LICENSE NUMBER LICENSE 'PE BVS.LIC.
COMPANY NAME E-NIAIL FAX
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STREET'ADDRF.SS CITY.STATE.at PHONE
oZ a O C -o
ARCHITECLENG1.11.1 E LICENSE NUMBER BUS.LIC
COMPANY NAME E-NL>IL FAX
STREET ADDRFSS CITY,STATE.ZIP PHONE
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USE OF; C) SFD Or DupleN j( Multi-Family ROOF AREA: jar VALUATION' mpg_
'STRUCTURE: ❑ Commercial SQ. S'O
EXISTING ROOF TYPE: ❑BUILT-LP ROOF ❑ASP(IALT SHINGLES PAVOODSHAAES ❑N'OODSHIN'GLES ❑OTHER(SPECIFY)
REMOVF.:REPLACE YES IFNO. PLY\s'OOD ,F' ❑ PL
T'N'D ❑ OSB PITCH: ROOF
1:1N -LAN'F.R 1 'NE s' ❑ I" T' X 112 A A
PROPOSEDROOFT'PE: ❑BLILT-UPROOF XASPHALT SHINGLES ❑N'OODSHAAES ❑\sOpD SHINGLES 13 OTHER ICC-ES REPORT
DFSCRIPTIONOF\\'ORA: yyyy ,/Zt1
if •
Clerle:ioikef 0.
By my signature below.)certify to each of the following: I am the property owner or authorized agent to act on the propem 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 IaWs relating to building com tion. I a orize rcpresSawuv2 of Cupertino to enter the above-identil red property for inspection purposes.
Signature of ApplicandAgenc Date: lz�41O IQ
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
If building is associated with a Home Owner's Association.provide letter PLAN CHECK TYPE ROUTING SLIP
ofapproval from HOA. OVER.THE-COUNTERBWLDING PLAN REVIEW
_ Provide Planning approval to verify inhere any restrictions. esrRFss PWNN'LNC PWA'REVIEW
Provide Copy Of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIREDEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroojApp 2011.doc revised 03/16/11
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
CUPERTINO
(408)777-3228• FAX(408)777-3333•building(a)cupertino.oro
PROJECT ADDRF)SAPNa OJ G O
re,
OWNERNAME PHOS E-MAIL J U
STREET ADDRFS Ce.STA yll"JO s / FAX
CONTRACTOR NAME LIC ENSEN MBER /O LICENSEE BUS.LIC.a q l
COMPAN'.AME E-MAIL (/ FAX
aS
STREETrADDRESS5
OZ ST CI ',STATE ZI n �//'Z P ONE ok (6-ono
Ug
1 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 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.
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. Progress
and 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. Progress Inspection is required when approximately 50% of roof covering is installed.
7. 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, vents painted, gutter/downspouts installed, debris removed.
8. 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, 1 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. 1 also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date: 9—/N—/2
RerooJPolicv_2011.doc reviserlOJ16/11