12100074 CITY OF CUPERTINO BUILDING PERMIT
RUI LDING ADDRESS: 10592 WHITE FIR CT CONTRACI'OR:FOUR SEASONS ROOFING PERMIT NO: 12100074
OWNER'S NADIE: DAI YUAN.AND KONG XIANGIIUA PO ROX 1668 DATE ISSUED: 10/11/2012
OWNER'S PRONE: 4082721431 SAN JOSE,CA 95109 PRONE NO:(408)278-0330
❑ LICENSED CONIRACII''OOR'SS DECLARATION BUILDING PERMIT INFO: BLDG r ELECT EDPLUMBr_1License Class .-Lie.H % / 91 11_06�
DIECIJ r RESIDENTIAL r COMMERCIAL C
Contractor Dale /
1 hereby affirm that I am licensed to the provisions of Chapter 9 JOB DESCRIPTION:TEAR OF1717NISTING WOOD SI IAKE ROOF.INSTALL NEW
(commencing with Section 7000)of Division 3 of the Business S Professions IR"
Code and that my license is in full force and effect. CDS PLYWOOD AND 30N FELT UNDI7RLAYNI ENT.INSTALL 13
SQ NEW CERTAINTEED PRESIDENTIAL COMPOSITION
1 hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a cer ifica(e of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of(he 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 die work for which this
permit is issued. Sq. Ft Fluor Area: Valuation:$4500
APPLICANTCERTIFICATION
I certify that I have read this application and state that the above information is APN Number;35905128.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances mid state laws relating
to building construction,mid 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 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 Oil
Leith all - pint source regulations er the Cupertino Municipal Code,SectionDAYS LAST CALLED INSPECTION.
9.18.
Signa Date Iss180 G /' ✓ Date:
❑ ONSNER-BUILDER DECLARATION
hereby affirm that I am exempt from the Contractor's License Law for one of RF.-ROOFS:
the following Iwo reasons: All roofs shall be inspected prior to any roofing material will;installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first Olmair'ig ua 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 Code) 104'//7�
I,as owner of the property,am exclusively contracting with licensed contractors Io Signature of Applicant. Uale: �'/
construct the project(Sec.7044,Business&Professions Code). —
1 hereby affirm under penalty of perj nn'one of the following three ALL ROOT'COVERINGS TO BE CLASS"A"OR ISE 1-I'F.R
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's BAZARDOUS M.VI'F"RIAI S IIISCLOSIIRE
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 under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health S Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for theerformance of the work for which this compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health S
F Safety Code.Section 25532(x)should 1 store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certifv that in the performance of die 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 my 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 Cod .Seclions'5M5.25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must
w er or ut :
forthwith comply with such provisions or This permit shall he deemed revoked. horiz a t
APPLICANTCERTIFICATION CONS'I'R11C1'I(IN LENDING AGENCY _
I cenify that I have read this application and state that the above information is
correct I agree to comply with all mad county ordinances and state laws relating I hereby affirm that(here is a contraction 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 save 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 die Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per(he Cupertino Municipal Code,Section ARCI I I'I'F:CI"S DECLARATION9.18.
1 understand my plmis shall be used as public records.
Signature Date
Licensed Professional
1 "
r
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(cbcuoertino.ong
PROJER Z)1 +�Q APS a
O `SAME U / •� I/! )rjj 114 ( E-MAIL
N o.w (/6
AOSEET ADDRESS _ C '.STATE.ZI So/ FAX
CONTRA AMELIC 7o1B/ O LICEN TYPE BUS.LIC.
n� 92=4
COMPAQ E E-MAIL/ FAX
SIRE A 1 IT'. A E. P P
I U RSTAND 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. I also understand that
smoke detectors and carbon mongxide detect are quired to be installed in accordance with Sections R314 and R315 of
the 2010 California Residenti de.
Signature of Applicant/Agent: Date:
ReroofPolicv_?0l l.doc revised 02/16/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 10594 White Fir Ct. DATE: 10/10/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $4,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-FamilDwelling Buildina is PENTAMATION
USE: y g >3 Stories Yes (F) No PERMITTYPE: 1R2R00F
NYORK Tear off existin wood shake roof. Install new 1/2" CDX plywood and 30#felt underla ment. Install
SCOPE new Certainteed Presidential composition shingles. Color: Country Gray.
FEE ID ROOF AREA
s.f.)
1REROOFMRES 1,300
btcch. Plan Check Plumb. Plan Check Dec.. flan Check
blech. Permit Fee: Plumb. Permit Fee: Flec. Permit Fee:
Other dlech.Insp. Other Plumb Insp. Other Elce.Insp. ED
.Ilech.Insp.Fee:- Plumb. hup. Fee: Flee.Insp.Fee:
NOTE: This estimate doer not include fees due to otter Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District, etc). These eev are based on the preliminary information available and are only an estimate Contact lite De t or addn't info.
FEE ITEMS (Fee Resohition 11-053 Eff 7/1/12) FEE QTY/FEE DIISC ITEMS
Plan Check Fee:
Supp/. PC Fee
PI um b.L11ech./F_l ec•
Permit Fee: $195.00
Supp/. Insp Fee
Phmrb.iA,1ech.1E1ec
Phrmh.1Adech.1Elec Permit Fee:
Consnvction Tai':
Administrative Fee:
Work Without Permit? O Yes Q No $0.00
Advanced Planning Pecs:
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
_:SUBTOTALS`: $196.50 $0.00 TOTaLFEE4 $196.50
Revised: 10/01/2012
110
REROOF PERMIT APPLICATION
EQ COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
CUPERTINO I (408)777-3228• FAX(408)777-3333 ' buildingPcupertino.om
PROJECT A RSS� Z APNn 2 �
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STREEI'ADORESSI CIT\'.STATE.ZIP/ FA%
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❑OWNFR ❑ OWNER-RUIIAER ❑ DW'NE0.AGENT Jf CONTRACTOR 11 CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANr
CONTRACTOR NAME LICENSE NUMBER LICENSE T YE BLS.LIC..
Feue SewS.aa�(�Z�'; 2 0 -
COMPANY NAME E-MAIL FAk
SAME
STREET ADDRESS CITY.STATE-ZIP PHONE
Sol a ose C 8-0
ARCHIIECUENGINEER NAME LICENSE NUMBER BUS.LIC n
COMPANYNAME I E-MAIL FAN
STREET ADDRESSI CITY.STATEZIP PHONE
USE OF ❑ SFD or Duplex Ar Multi-Family ROOFAREA: je VALUATION:
STRUCTURE: [ICommercial 3 $ S0
If
EXISTIN'GROOFTYPE: ❑BUILT-CPROOF ❑ASPI[ALT SHINGLES OWOODSHARH$ ❑W'pODSHLNGLEs ❑Ol'HF.R I SPECIFY)
REMOYF.:REPLACE vF5 IF NO. PLYWOOD yr T' ❑ PLY\vD ❑USB PITCHROOF
❑ n0 nL YF.R THICKNESS ❑ i TYPE C x '121AS1 A
PROPOSED ROOF TYPE: ❑BUILT-UPROOF 4SPHALT SHINGLES ❑WOODSHAKES ❑WOOD SHINGLES C3 OTHER IMES REPORT
DESCRIPTION OF WORK;
Mr." ame
T&ood +Len 304 1.4- l�nderl.w,�_�tce+�_F'n�lt� ,_ies�sll
Cer�o„nksed PreSiden+wl conn t4�inwles d
BY my signature below.I cenify to each of the follmving: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information 1 have provided is correct. I have read the Description of Work and verily it is accurate I agree tocomply with all applicable local
ordinances and state laws relating to building cons tion. In onze reprise tiv ofCupenino to enter the above-identified property for inspection purposes.
Signature of ApplicantlAgent: Dam: isto
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USEONLV
If building is associated with a Home Owner's Association.provide letter PLANCHECA TYPE ROUTING SLIP '
ofapproval from HOA. '/JET OYER-THE-COIPTER BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNINGPIAN REVIEW
Provide copy of IManufacturer'S Installation Specifications. Cl 6IANUARD ❑ FtRr.nEPT
Provide signed copy of Cupertino's fear-Off Policy. ❑ OTIIER: '
Nero fApp 2011.doc revised 03/l6/I I