12050015CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20313 NORT14COVE SQ I CONTRACTOR: FOUR SEASONS ROOFING I PERMIT NO: 12050015
OWNER'S NAME: MAO ROGER A
PO BOX 1668 1 DATE; ISSUED: 05/01/2012
OWNER'S PHONE: I SAN JOSE, CA 95109 I PHONE. NO: (408)278-0330 I
LICENSED CON'TRACTOR'S DECLARATION
License Class{', -S 1 Lic.q 41A(ap
Contractor 1^_J- F ,Nc- Date S -Z- I11Z_'
I hereby affirm That 1 am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penally 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
perfomnance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, its provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
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
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 hamtless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting ollhis permit. Additionally, the applicant understands and will comply.
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Dale 5'2•/2
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the properly, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044.
Business & Professions Code)
I, as owner ollhe properly, am exclusively contracting with licensed contractors to
construct the project (Sec 7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
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.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, t'or the performance of the work for which this
penult Is issued.
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
Compensation laws of California. If, after making this certificate of exemption. I
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.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. 1 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) agree to save
indemnify and keep hamnless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this pennil. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Date
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: RE -ROOF TEAR -OFF EXISTING CAI: SHAKE ROOFING
SYSTEM
AND INSTALL 30R FELT UNFRLAYME13NT AND INSTALL GAF
GRAND CANYON SHINGLES, COLOR: STONEWOOD CLASS A 15
Sq. Ft Floor Area: I Valuation: $6500
APN Number: 31641066.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS LAST CALLED INSPECTION.
r
Iss a Date:
RF. -ROOFS:
All roofs shall be inspected prior to any roofing material being installed If a roof is
installed without first obtaining an inspection. 1 agree to remove all new materials for
Inspection /��/�J
Signature of ApplicanU�i �f , Date
ALL ROOF COVERINGS TO BE CLASS "A" OR BEITER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California llcallh & Safety Code. Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the llealth &
Safety Code, Section 25532(x) should 1 store or handle hazardous material.
Additionally, should 1 use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
llealth & Safety Code. Sections 25505, 25533, and 25534.
CONSTRUCTION LENDING AGENCY
I hereby affimn that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C)
Lender's Name
Lender's
ARCIIITTF.CT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
3 ITEMS OF 24
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Elk: Lot:
APN ........: 31641066.00
DATE ISSUED.......: 05/01/2012
RECEIPT #.........: BS000016675
REFERENCE ID # ...: 12050015
SITE ADDRESS .....: 20313 NORTHCOVE SQ
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA ......
OPERATOR: patg
COPY # : 1
METHOD,OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT :
AMOUNT
---------------
1,693.20
---------------
1,693.20
VOICE ID DESCRIPTION
-------- ----------------------------
309 EXTERIOR LATH
601 ROOF PEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
AMEX
VOICE ID DESCRIPTION
-------- ----------------------------
311- SCRATCH COAT
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
OWNER ............: MAO ROGER A
ADDRESS ..........: 20313 NORTHCOVE
SQ
CITY/STATE/ZIP ...: CUPERTINO, CA
95014-0507
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 BAL
----------
----------
1BCBSC
-------------------------------------------
VALUATION 6,500.00 1.00
----------
0.00
1.00
0.00
1BSEISMICR
VALUATION 6,500.00 0.65
0.00
0.65
0.00
1REROOFRES
SQ FEET 15.00 210.00
0.00
210.00
0.00
----------
---------- ----------
TOTAL PERMIT 211.65
----------
0.00
211.65
0.00
METHOD,OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT :
AMOUNT
---------------
1,693.20
---------------
1,693.20
VOICE ID DESCRIPTION
-------- ----------------------------
309 EXTERIOR LATH
601 ROOF PEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
AMEX
VOICE ID DESCRIPTION
-------- ----------------------------
311- SCRATCH COAT
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O.. BUILDING OFFICIAL
u C: P RTIL10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO
(408) 777-3228 •FAX (408) 777-3333 • building(dcuoertino.org
PROJECT ADDRESS
APN a
OWNER NAME P
PHONE _
-).2
E-MAIL
oGnr e•o
O1•L/Le-
STREETADDRESSI ))
CITY. STATE,ZI
(FAX
CONTRACTOR NAME LICENSE B�^ LICENSC.. Y!E�
/T
BUS. LIC.b
COMPANYNAME
So,r,
EMAIL
FAX
.J,Jr
_
STREET ADDRESS
-oZ I
CITY, STATE. ZIP {- `
�r IUT.P �.a. 7 IIZ
PHONE 7
I UNDERSTAND AND AGREE TO THE FOLLOWING:
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.
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.
Proeress 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 I/<" 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, 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 carbonmonoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code. _/ _
Signature of ADolicanUAeent: // -- - Date:
Remo(Policv_201 I.doc revised 02116111
_,:18 4085 960226
q
NORTHPOINT;
0 a[ ovin UQUIMI
Nb
J
ity:df Cupertino
J.;
N-11-thpoint R 9 j6ct
a City of Cupertino . P.
-i-ase nose that the Itorth int iiomeowiiersAssociatia"-.
ontracted and apprd ed Ur Season's Roofing to p6rfQrrn re-
v
Do6g of our homes. Th M11 replace the current CAL -Shake
cofbystem with nev A rand Canyo9vNsphalt C4n ilio
r
hihbles.. We have lac the StoneQcolor 1,0010Uroc;
Siwe,eiym
J.
Linda Starnes
On Site Manager;
��,����� CITY OF CUPERTINO
I��//JI FEE ESTIMATOR—BUILDING DIVISION
FEE ID ROOFAREA
s.f.
1REROOFFRES 1,500
ADDRESS: 20313 Northcove Sq. DATE: 0510112012REVIEWED
APN: I l 0_ P#:
BV: Sean
VALUATION: $6,500
PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY
USE: SFD or Duplex
lilor, Permit Frc:
PENTAMATION
PERMITTVPE: 1SFDWLR00F
WORK
Tear -off existing cal -shake roofing system and install 30# felt underla ment and install GAF Grand
SCOPE
Canyon shingles, color: Stonewood.
FEE ID ROOFAREA
s.f.
1REROOFFRES 1,500
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc ). These lees are based on the preliminary information available and are only an estimate Contact floe Dept for addn 7 info.
FEE ITEMS (Fee Re.sohoion 11-053 Ef. 711111)
,tlerh. Plan Check
Plumb. Plan Check
!ilea. Plan Chrck
41rr./
,r. Prrnlil Fee:
Plumh. Permit Fre:
lilor, Permit Frc:
(Alror,Verh. ln.q'.
Odrer Plumb Imp.El
Other Else. In. ¢ ID.
,Ihr/r. /n•p. Pyre:
rhumb. lmap. ret:
tree. Inq,. Frye:
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc ). These lees are based on the preliminary information available and are only an estimate Contact floe Dept for addn 7 info.
FEE ITEMS (Fee Re.sohoion 11-053 Ef. 711111)
FEE
QTY/FEE
MISC ITEMS
Plzen Check Feu:
.Sapp/. PC 1-'ve
Phuth.1d1ech.1/i/c u
Permit Fee:
$210.00
.S111)111. 1n.V/) l'et'
P1i nlh.hblech./Elec Pertnit Fee:
Construction Tar:
Admillisfralive Fen:
Work Without Permit? O Yes Q No
$0.00
Advo! ced Planning Peas:
A
7"l—mvl Docunnentalinn Pees:
SI10116 Motion Fee: IBSEISMICR
$0.65
Select an Administrative Item
13lda Slds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$211.65
$0.00 TOTALFEET
$211.65
Revised: 04/01/2012
CUPERTINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building0cuoertino.orD
/2'US ooi:S-
PRO= ADDRESS 0 , V . / a r 4+ J C, s G4
p(�i W y/- U (0`P
OWNEA NAME n V ,a-4- rrn1 CA
PHJ 8-`- Y q _tI
SPREETADDRESSJr..�.s-rQ4+%wJ�
j.r4-{n
P4
AFF
AFF e.t4V Z (L-ecs
O a 7 ?% T ^�� 33v
E -MALL
ADDRESS
�� 1 apt en
CRY, STATE, ZIP
FAX
❑ OWNEA ❑ OWNER -BUILDER ❑ OWNERAGENT ErCONTRACTOR ❑CONTRACTORAGFNr ❑ ARCIVTEcT ❑ Etunmeea Cl OEVEr.OPFR ❑ TENANT
COW
Y RNA1� f�
J�-RSu�S ao'TEn
LICENSE
NUMBER
��
LICENSE TYPE
x'39
BUS. 7ICY
Zf �✓
COMPANY NAME
E-MAIL
FAX
STREET'ADDRESS
a, -e n, n S{-.
a�� STATE,
awn �os.- Q-A 7.5
7S-oag o
ARCHCTECTIENGPIDE2. NAME
LICENSE NUMBER
BUS. LIC Y
COMPANY NAME -
E-MAILFAX
STREET ADDRESS
CITY, STATE ZIP
PHONE
USE OF ❑ SFD or Duplex 'A Multi -Family
ROOF AREA.
VALUATION: '
STRUCTURE: ❑ Commercial
1.%
cy.�/
EMSTING ROOF TYPE: ❑ BUILT-IrP ROOF ❑ ASPHALT SIGN Ec, ❑ WOOD SHAKPS ❑ WOOD sNiNO[FS
REMOVIIAUPLACE YFS
IF NO.
PLYWOOD ❑'A" ❑ _
PLYWD ❑ OSB
PITCH
to
❑ N
a
❑
TYPE: ❑
i / G i : I2.
CI SS. 11
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF .'ASPHALT MiINGL SS ❑ WOOD SHAKES ❑ WOOD SHWCdfS ❑ OTM
ICC -ES REPORT Y
DFSCRIPRON OF u C
3 O �� ! f un �!u'l m eirF V-- i nh4! C C�t4 6?1
ti o�: �ar1e u�►ood
,
By ray signature below. I certify to each of the following I am The property owner or authorimd agent to act on the property owner's behalf. 1 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 laws relating to building construction I authorize representatives of Cupertino to enter the above -identified p=rt, for inspection purposes.
Signature ofAppli=t(AgmC Date:
SUPPLEMENTAL INFORMATION Qt1IRFD
_ Ifbuilding is associated with Home Owner's•Association,.provide letter
of approval from HOA.
_ Provide Planning approval to verify if there my restrictions.+._"
y
��c.ExnRr•±ss�kc�- �:-Q",�i-aTmrc�Pr.AN�asP>zw;-. �-s
Provide copy of Mmmufactmer's Installation Specifications.
signed copy of Cupertino's Tear Policy.
..
_Provide -Off
xt
�
RemcifApp_2011.doc revised 03/07111