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12090209 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21072 WHITE FIR CT CON`fRACI'OR:FOUR SEASONS ROOFING PF.RMI'1'NO: 12090209 OWNER'S NAME: OUYANG I TRUSTEE PO BOX 1668 DATE ISSUED:09252012 OWNER'S PHONE: 4082343595 SAN JOSE,CA 95109 PDONE NO:(408)278-0330 At— LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB C License Class C _ 3� Lie.q � p AfECH r RESIDENTIAL(_ COiCOMMERCIALr Contractor FSre-�nl , IA-IC - Date herehy affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHAKE ROORINSTALL I2' (commencing with Section 7000)of Division 3 of the Business X Professions CDX Code and that my license is in full force and effect. PLYWOOD&30N FELT UNDERLAYMENT.INSTALL 13 SQ CLASS A CERTAINTEED PRESIDENTIAL COMP hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a cenificale 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 die performance of Ute work for which this permit is issued. Sq.Ft Floor Aren: Valuation:54500 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is AI'N Number:35905102.00 Occupancy Type: correct.I agree to comply with all city and county ordinances and state Imus 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 6ty 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 xvill 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. �l Signature Date 7 2S�� Issued ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lmy for one of RE:ROOFS: the following tsvo 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&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applipnv Date: construct the project(Sce.7044,Business&Professions Code). hereby affirm under penalty of perjury one of the following three ALL ROOF COVER C.S TO 13F CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to sell=insure for Worker's DA%ARDOUS INLATERI.VS DISCLOSURE 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 read the hazardous materials requirements wader Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California llealth&Safcly Code.Sections 25505,25533,and 25534. 1 will maimain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the llealth& Safetv Code,Section 25532(x)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 pemtit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District 1 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 Cali forma. If,after making this certificate of exemption,I Health S Safety Code,Sections 25505.25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall he deemed revoked. Owne tftn ',.e agent: Date: 7 ,%PPLICAN'1'CER'ru7lCA•TION CONS-RUCTION 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 stave Lender's Name indemnify and keep harmless.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 ARCIIIT-ECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 24 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: B1k: Lot: APN . . . . . . . . : 35905102 . 00 DATE ISSUED. . . . . . . : 09/25/2012 RECEIPT # . . . . . . . . . : 35000018096 REFERENCE ID # . . . : 12090209 SITE ADDRESS . . . . . : 21072 WHITE FIR CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : OUYANG I TRUSTEE ADDRESS . . . . . . . . . . : 21072 WHITE FIR CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 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 SAL ---—----- ----—---—-- -------—- ---------- ---—----- ---------- -- 1BCBSC VALUATION 4 , 500 . 00 1 . 00 0. 00 1 . 00 0. 00 1BSEISMICR .VALUATION 4, 500 . 00 0 . 50 0. 00 0 .50 0. 00 1REROOFRES SQ FEET 13 . 00 195 .00 0. 00 195 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 196 .50 0. 00 196 .50 0 . 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 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•building acupertino.oro CUPERTINO PROJECTADDRESS AP\-✓✓ 1 T — — `' r OWNER NAME i PHONE , _� 51-E-MAIL Ll w I • S STREETADDRESS CITY-STATE.ZIP GAN 2 O Z Gj.4 ,4c, >Cir r,-'-. ( "I,n.ei�:n,+ CA . =1'S0I of CONTACT NAME PHO\E E-MAIL redo G'wzares Olt- -0 30 STREtr ADDRESS S�2 —S+• I CIT'.STATE. ZIP/XI FAX ❑OWNER ❑ OWNER-RUILDER ❑ OWNER AGENT / COYTkACrOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ESGINFF.R ❑ DEVELOPER ❑ TENANT CONTRACTORN:AMEI LICENSENL71BER I LICE.SSET'PE I 2 O BUS.LIC COMPANY NAME SAkE I E-\I:VL I FAA STREET ADDRESS CIT'.STATE.ZIP PHONE Sot in' o5¢ C -2 $-O ARCHTrECTiENGINEER NAME LICENSE NUMBER BCS.LIC.• COMPANYNA.\IE I E.NWL I FAX STREET ADDRESS I CIT'.STATE/.IP I PHONE USE OF ❑ SFD or Duplex JC Multi-Family ROOF AREA: VALUATION: STRUCTURE: Cl Commercial ��..rr EXISTING ROOF TYPE: ❑BUILT-❑PROOF ❑ASPl1ALT SHISOLES ;COODSHAKES ❑WOODSHINGLES ❑OTHERISPECIFY) R[}IOVF. REPLACE t'F.S IF NO. PLY\1'OODl; ❑ PLt'WD ❑OSB PITCH ROOF ❑ N •LAYERS I T ICI:XENS ❑ Ys" 1'Y PE Y 'I2 SS' A PROPOSED ROOF TYPE: ❑BUILT-UPROOF J41SPHALTSHINGLES ❑uO0DS11AKE5 El WOOD SHINGLES ❑OTHER ICC-ES REPORT• DESCRIPTION OF W'ORR g %/ZttrDx _` ..o 36-* -�' 1.4• l nd e r(tta _�.e_e ,—F_/Ackllj_l_/ii II /+ erkP: et Presidea#rwl COMO Snln.Ies 001EX � Co,A inj Gray By my signature below'.I cenify to each of the fol lo,cing: 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. 1 have read the Description of Work and,erify it is actuate. I agree to comply with all applicable local ordinances and State laws relating to building cons r tion. la ,OnZe mprCSCn—tivn of Cupertino to emer the above-identified property for inspection purposes. Signature oe Applicant/Agenl: Date: a0 SUPPLEMENTAL INNFOR:\IATION REQUIRED OFFICE USE ONLY _If building is associated With a Home 0\cner's Association.provide letter PL\N CHECK TYPE ROUTING SLIP Of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW' Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PIAsmsi;PLAN REVIEW' Provide copy of Ibtanufacturer's Installation Specifications. ❑ STANDARD ❑ ETRE DEPT Provide Signed copy of Cupertino's Tear-Off Policy. ❑ OTHER: ReroofApp_2011.doc revised 03/16/11 i CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: O -I Z. DATE: REVIEWED BY: ® APN; BP#; 'VALUATION: $4,500 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF USE: PER111T TYPE: \YORK TEAR OFF EXISTING WOOD SHAKE ROOF.INSTALL 1/2" CDX PLYWOOD& 30# FELT SCOPE UNDERLAYMENT.INSTALL 13 SQFT CLASS A CERTAINTEED PRESIDENTIAL COMP p FEE ID ROOF AREA (s.f. 1REROOFFRES 1,300 Afrrh,Phut Check- Plumb. Plan Check Elec.Plzen Check Mech. Permit Fee: Plumb,Permi;Fee: F-lec. Permit Fee: 0her.ifech.frsl:. 01hu.plumb hup. 01law b7ec. lump. ET ATrh.Insp. Fee: Plumb.Imp.Fee: Fier.Insp. Fee: NOTE: This estinmte does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sekver District,School District,etc.). Thesefees are bayed on the prelininan in onrmtion available and are mdv an estimate. Contact the De t or adda7 into. FEE ITEMS (Fee Resoheimt /1-053 Elf. 7/I/I!) FEE QTY/FEE MISC ITEMS Pleat Check Fee: Supp/.PC Fee Phonh.:Nt:ch_:Elec Permit Fee: $195.00 Suppl. 111sp Fee Phmth_4Llatclt.:Elec.Permit F'ee: Construction Ter: Administrative Fee: Work Without Permit? O Yes Q No $0.00 Advanced Plurtning Fees: Travel Documentation Fees: Strong Motion Fee: IBSFISAfICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCSSC $1.00 SUBTOTALS: $196.50 $0.00 TOTAL FEE:, $196.50 Revised: 07/01/2012 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.org PROJECT ADDRESS Z(p? 2 C - APN M OWNERNAME T u PHONE E-MAIL _3T STREET ADDRESS y y CITY, STA IP � FAX Sn l tE 5D CONTRACTORNAME LICENSENUMBER LICEN�TYP BUS.LIC.a L4 1A D COMPANY NAME E-MAH. FAX STREET ADDRESS )-b? CITY.STA!�ZI ..Tb� CAt3CIIA PHONE Ll OR-^ 9-O O 1 UNDERSTAND AND AGREE TO THE FOLLOWING: eC 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 S 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. 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: RerooJPolicv_201 l.doc revised 02/16/11