12100203 (2) CITY OF CUPERTINO BUILDING PERMIT
RUI LD INC.ADDRESS: 10568 W'IIfTE FIR CF CON1'RACfOR:FOUR SEASONS ROOFING PERMITNO: 12100203
OWNER'S NAME: SIIINTA TED T 1'O BOX 1668 DATE ISSUED: IOR9R012
OWNER'S PRONE: 4082558854 SAN JOSE,CA 95109 PDONE NO:(408)278-0330
❑ LICENSED)CONI'RACfOR'S DECLARA'T'ION r G r
�J] BUILDING PERMIT INFO: BLDG ELECT PLUMB --
License Clan Lic.H tog
p1ECII r RESIDENTIAL(_ COMMERCIAL r
Contactor Date
hereby affirm that I am licensed under the provisions or Chapter 9 JOB DESCRIPTION: BLDG Il-TEAR OFF EXISTING WOOD SRAKE
(commencing with Section 7000)of Division 3 of the Business l Professions ROOF.INSTALL
Code and that my'license is in full force and effect. IQ"CDN PLYWOODTIIEN 30H FELT
UNDERLAYMFNT.INSTALL 13 SOFT CERTAINTEED
hereby affirm under penalty of perjury one of the following too declarationsr
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
perl'omnance 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 perfomnance of the work for which this
permit is issued. Sq.Ft ploitr Area: Valuation:&1500
,O'1'I,ICANI'CER'1'IFICA'1'ION
I certify that I have read this application and state that the above information is AI;N Number:35905116.00 Occupancy Type:
cored.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 City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may acertre against said City in consequence of the
granting of this permit. Additionally,the applicant understands mid will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with a -point s urce regulati pe Cupertino Municipa Cod ,Section 180 DAYS FROM LAST CALLED INSPECTION.
s -V
(Sip Uty�Pa ?� Issued by: V / `G Date:/10 C7?f
❑ OWNER-BUILDER DECLARATION
I herehy affirm that I am exempt from the Contractor's License Lay for one of REIROOFS:
the fallowing two reasons: All roofs shall be inspected prior to any roofing materi ng installed.If a roof is
L as owner of the property,or my employees with wages is their sole compensation, installed without first obla i a inspection,Itt r n v mate is f r
in
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Q
Business&Professions Code) y ✓Z7l
L as owner of the property,am exclusively contracting with licensed contactors to Signature of ApplSc ate
construct the project(Sec.7044,Business&Professions Code).
hereby affirm under penalty of perjury one of the fallowing three ALL ROOF COVERINGS TO 13E CLASS"A"OR BETFER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IIA7.ARDOUS MATERLUS DISCLOSURE,
Compensation,its 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 Ileallh&Safely Code Sections 25505,25533,and 25534. 1 will maintain
Section 3700 ofthe Labor Code,for theerformance of the work for which this compliance e'ith the Cupertino Municipal Code,Chapter 9.12 and the Health&
p Safety Code,Section 25532(a)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 perfommnce of die work fortivhich this permit is issued,I shall contaminants as defined by the Bay Arca%ir Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain rnmpliance with the Cu cru lunicipn Cpde.Chapter 9.12 and the
Compensation laws of California. If,after making this certificate ofexemption,I licalth-4 Safety .ode tion 5 5 nd 25534,
become 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. O411r
u orized en . �t0 /111v
Date: i 7
API'LIGxN I'CER'fIPIC.VI'ION CONSTRUCHON 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 atfimh that there is a construction lending agency for the performance of wurk'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 liabilitics,judgmenls,
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 ARCIIITECI"S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
REROOF PERMIT APPLICATION
EM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
70300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO I (408)777-3228•FAX(408)777-3333• buildino(kupertino.orD
PROJECT 2"6-
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STREeFADORESS�O� I CITY-STATE LIP T FAX
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❑OWNER ❑ OWNER-RUILOER ❑ OWNF.RAGENr Je CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑TENAW
CONTRACTOR NAME LICENSENUMBER LICF.NSET YE BUS.LIC.
�ur_Sessan.�B�4i
72-108
COMPANY NAME E-MAIL FBF
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STREET ADDRESS CITY.SLATE.ZIP
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6 CA.qS112, PHONE 11'0
ARCHI rECT1ENGINEER NAME. LICENSE NGMBER RUS.LIC a
COMPANY NAME I E-MAII. FAX
STREET ADDRESS CIT1'.STATE ZIP PHONE
USE OF ❑ SFD or Duplex Jllf Multi-Family ROOFAREA: VALUATION:
STRUCTURE- ❑ Commercial �? S 57"0
ESISTINGROOFTYPE: ❑BUILT-UPROOF ❑ASPHALTSHINGLFS OWOODSHARhS ❑W'OODSHINGLEs ❑OtIIF.R(SPECIFY)
RCMO\'F.:REPI-A ❑ ND . l.'F.R �� ❑ PLY%%'D 0 PIT01ROOF
WI TYPE. D
')2 AS - A
PROPOSED ROOF TYPE: ❑BUILT-UPROOF XASPHALTSHINGLES 17WOODSHARES ❑WOODSHINGLES 13 OTHER ICC-ES REPORT.
DFSCRIPiION Oi W'ORR: 1/Z„
rlbk
_44W_Q- +Len 30# 41+ 11nrla`10 a F_1eCLII11 i.[�C .�
Cer)p5n4,a.d Presider+;a1 Comm s6inwles_._ d
By my signature below'.I certify touch of the following: I am the property owner or amhonzcd agent to act on the property owner's behalf. I have read this
application and the information I have provided is coned. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and stare laws relating to building cons tion. I a orize represe tiv of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicam/Agem: Date:
SUPPLEMENTAL INFORMATION REQUIRED'--- OFFICE USE ONLY
Ifbuildingisassociated With aHome Owner's Association.provide letter PLANCHECK TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specification,. ❑ Sl AND.R11 ❑ r1RE DEPT
Provide signed copy of Cupenino's Tear-Off Policy. ❑ OTHER:
NeroofApp_2011.doc revised 03116/11
REROOF TEAR-OFF POLICY
0 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• buildinp(a.cupertino.ora
PROJECTA �5 � APNN
OWN R AME
(�glfON a E-MAIL
c�s
STREET ADDRESS _ CI TATE,ZIP FAx
CON NAS E LIC ENS MBER LIC BUS .�
COM NA E E-MAIL FAX
STREET CI '.S AT .ZIP
I 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. i
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, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors e r quired to be installed in accordance with Sections 8314 and R315 of
the 2010 Califomia Residen ' o
Signature of, Date:
ReroofPolicv_2011.doc revised 02116111
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
2 ADDRESS: WHITE FIR DATE: REVIEWED BY:
APN: BP#: 'VALUATION: 1$4,500
*PERMITTA'PE: Minor Building Permit PLAN CIIFCK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR0OF
USE: PERMIT TYPE:
WORK TEAR OFF EXISTING WOOD SHAKE ROOF.INSTALL 1/2" CDX PLYWOOD THEN 30# FELT
SCOPE LINDERLAYM ENT.INSTALL 13 SQ CERTAINTEED PRESIDENTIAL COMP SHINGLES.COLOR: p
FEEID ROOFAREA
s.f.
1REROOFFRES 1,300
dfeth.Plan Cheek Plumb. Plan Check Elec.Plan Chcck
Met* Permit Fee: Phnnh.Pemth Fee: Flre, Pemtit Fce•
Olher:l feeh.•Ir_sp. Otho-Plumb lnrp. Other Get- hrcp. El
Heeh.Int],. Fee: Plumb.In..•p.Fee: Bice./Ay. Fee:
NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District,etc.). Tlrese ees are based on the prelininan in ornmtion avrdlable and are otdr an estimate. Contact the De» or addn'I into.
FEE ITEMS (Fee Resolution I1-053 E2711112) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
SuppL PC Fee
Phamh.J'.Wech.;'E1ar.
Permit Fee: $195.00
Sttppl. /rtsp Fee
Plurnh.:`Mech./8lac
Plunrh_GLleclr.:Elec Permit Fare:
Construction Tax:
AcIntinishtuive Fee:
Work Without Permit? 0 Yes Q) No $0.00
Aah•mtced Planning Fees:
Travel Doctnneniation.Fees:
i
Strong Motion Fee: IBSEISABCR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $196.501 $0.001 TOTAL FEE: $196.50
Revised: 10/01/2012