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13050047 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20071 NORTHWOOD DR CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO:13050047 OWNER'S NAME: SANJAY KANNOJIA PO BOX 1668 DATE ISSUED:05/07/2013 OWNER'S PHONE: 4089963734 SAN JOSE,CA 95109 PHONE NO:(408)278-0330 ❑ LICENSED CONTRACTOR'S DECLARRATION BUILDING PERMIT INFO: BLDG, ELECT r— PLUMB / License Class �4am Lic.# G / MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm thaensed er the provisions of 6apter 9 JOB DESCRIPTION:RE-ROOF 39 SQ,TEAR OFF REPLACE WITH NEW COMP. (commencing with Section 7000)of ivision 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$5000 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 permit is issued. APN Number:31637062.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities;judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-poource regulatio the Cupertino Municipal Code,Section Issued bDater—r__,r?, "/—a 9.18. N -- Signat Date RE-ROOFS: ❑ OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Heal Safety Co4Secs 25505,25533,and 25534. 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 O ner or th ize Compensation laws of California. If,after making this certificate of exemption,I D. become subject to the Worker's Compensation provisions of the Labor Code,I mus 4? forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name 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 Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date R R®OF PERMIT APPLICATION 'JI( COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION d� 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (408)777-3228-FAX(408)777-3333-bui1ding@_cuPg!-tino.org �O CLfPERT'BNO PR D 1APN# 31 3 O COD NA �^ P E-MAIL � (� ! C, STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAME �� i PHONE E-MAIL STPEEDRE ATE P �® ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT CONTRACTOR CONTRACTOR AGENT ❑ ARC=CT ❑ENGINEER ❑ DEVELOPER ❑TENANT 4N: T RNAM Li�SEN LICE�ISJ�EE BtJg.I1 �� COMPANY NAME E-MAIL FAX(� S ADp�tESS C STATE OATE PH !j ►,�� 64 .2.2719 u 3 3 C> ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex Multi-Family TROOF AREA: VAL TION: STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY) s REMOVE/REPLACE YES IFNO, PLYW44 OOD • �/i' ❑ PLYWD ❑ OSB PITCH: ROOF ❑NO #LAYERS: �S: u 5/8" TYPE: CDX '12 CLASS: PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: I/e �.a/.f.�//� �!•✓GYJ� rG°O J c� .� d�BGI a' i�/l ,/ ) tt 4-11101 �` /, 4-5 �� j�.°gd®• Tay �� . By my signature below,I certify to each of the following. I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information have provided is correct. I have read the Description of Work and verify it is accurate. I agre to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-' enti d property for inspection purposes. Signature of Applicant/Agent: ��G�G Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP of approval from HOA. 16 OVER-TH COUNTER ❑ BUILDING PLANREVIEw Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLAMUNG PLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FII2E DEPT Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER: ReroofApp 2011.doc revised 03/16111 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 CUPERTI 0 (408).777-3228•FAX(408)777-3333- building Mcupertino.org APN F O P r PHOi� E-MAIL ' :.' 'I A STREET ADpRESSCITY, STATE,ZIP FAX CO CTO H LSC y f� LI S BUS-LIC. �1,221-3 pT E-MAIL FAX -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 one business day before the requested inspection date. Please call (408) 777-3228.from 7:30-3:30pm (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 only, after that-phase of the work is completed. The building inspector will be available within one hour. 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: 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 goofs shall have a minimum of%4"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. -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 shall be paid before another inspection can be scheduled.. By my signing below,I certify each of the following is true: 1 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 monoxi ectors are requd o be installed in accordance with Sections R314 and R315 of the-2010 California Residential Signature of ApplicanVAgent: Date: ReroofPolicy_2012.doc revised 10/7/12