12070128 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21075 RED FIR CT CO,NTRACI'OR:FOUR SEASONS ROOFING PERMIT NO: 12070128
OWNER'S NAME: I1UI ZIIENG'&WILLIAM Cl ICY 1'0 ROS 1668 DATE ISSUED:07/178012
OWNIiR'S PHONE: 4087381702 SAN JOSE,C\ 95109 PHONENO:(408)278-0330
IJCENSE,D CO�IRAC`fOR'S-rDECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r.—
License Class C^) IE' Lic.N / 2� Ob
DIECH r RESIDENTIAL r COPIAIERCLU.r
Contractor FSS N C - Date
herehy affirm that I join licensed under the provisions of Chapter 9 •JOB DESCRIPTION: RE-ROOF 13 SQ-TEAR OFF WOOD SHAKE INSTALL COMP
(Co nunetic I ng with Section 7000)of Division 3 of the Bust ness&Professions SHINGLE
Code and that my license is in FOR force and effect.
herehy affirm under penally of perjury une of the following two declarations:
I haveand will maintain a certificate ofconsent to self-insure for Worker's
Compensation,as provided for by Scction 3700 of the I.abor Code,for the
perfomnanee of the work for which this Perini(is issued.
1 have and will maintain Worker's Compensation Insurance.as provided for by Sq.F1 Floor Area: Valuation:$4500
Section 3700 of the Labor Code,for the performance of die work for which this
permit is issued.
APN Number:35905024.00 Occupancy Type:
APPLICAN I'CERTIFICATION
I certify that I have read this application and state(hal the above infor ation is
correct.I agree m comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter PERMIT EMPIRES IF WORK ISNOT STARTED
upon the above mentioned property for inspection Purposes. (We)agree to save
indemni(yandkeepharmlesstheCityofCupeninoagainstliabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which mayaccruc against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will connldy
with all non-point source regulations per the Cupertino Municipal Code,Sectioa
9.18. Issued h • Date:
Signature Date
❑ OWN: -BIJILDE.R DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material bene installed.If a roof is
hereby affirm that I am exempt from the Conln¢1nr's License Lay for one of installed without first obtaining an inspection,1 agree to remove all new materials for
the following two reasons: inspection.
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, Signature of Applicant. Date: ('1 —( r2—
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business l Professions Code). ALL ROOF COVE. N ;'1'O Ilii CLASS"A"OR Rfa"1'ER
I hereby affirm under penally of perjury one of the following three
declarations: IIAZARDOUS\IATFRIALS DISCLOSURE
I hawc and will maintain a Certificate of Consent to self insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code.Section 25532(a)should I store or handle hazardous material.
Seclion 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cuperlino Dlunicipal Code,Chapter 9.1_and the
I certify that in the performance of die work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the p'orker's
Compensation laws ofcnlifornia. If,after making this certificate of exemption,I Owner thori' d ag7_11"
r - /7—
become subject to the Worker's Compensation provisions of the Labor Code,1 nos( I are:
forthwith comply with such provisions or this permit shall be deemed revoked.
'1211C1'ION LENDING AGENCY
A I'I'I,IC\N'I'CI?IfI'I PIC,\'I'IUN I hereby affirm than ere is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and corny ordinances mid state laws relating Leader's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities,judgments.
costs,and expenses which may accrue against said City in consequence of the
gaming of this permit.Additionally,(he applicant understands and will comply ARC111TECI"S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
:01 ADDRESS: p red fir ct. DATE: 07/17/2012 REVIEWED BY: bobs.
APN: BP#: 'VALUATION: $4,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRI�IARY PENTAD1ATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLROO
WORK tear off wood shake install comp shingles.
SCOPE
i
Mech. Plan Chuck Plumb.Pum Check Elee. Plan Check
Nleelr. Permit Fee: Plumb. Pcawtit Fee Ele.c. Pennit Fee:
Other Aleeh. Imp, Other Plumh Insp. Other Fier.Imp, Ll I
Ater./I.hup.Fee: Plumb. bray. Fee: rice.Insp.Fee:
NOTE: This estinuue does not include fees clue to other Departments(i.e. Planning, Public IVorks, Fire,Sanitary Sewer District,School
District, etc). These ees are based on the relinnina information available and are only an estimate. Contact the Dept for addn'I info.
FEE ITEMS(Fee Resohrtion 11-053 Elf. 7/1/111 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1,300 s.f. Re-roof
Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $195.00 IREROOFRFS
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee:Q Reg. Q OT 0,0 -its-
$0.00
PME Unit Fee: $0.00
PME Pennit Fee: $0.00
Caturlw ion Tax
Administrative/'etc Q p
Work Without Permit? 0 Yes Q No $0.00
Advanced Planning Fee: $0.00 Select Non-Residential (F)
Building or Structure O
1.
Thwel Documentation Fees: A
Strong Motion Fee: 11ISF,ISHICR $0.50 Select an Administrative Item
131dg Stds Commission Fee: IBCESC $1.00
`. SUBTOTALS: $1.50 $195.00 TATALiFEE:, $196.50
Revised: 07/0112012
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE •CUPERTINO. CA 95014-3255
(408)777-3228• FAX(408)777-3333•building(okuoertino.ong
PROJECTADDRESS APN0
OWNERNAME // PBO.'E E-MAIL
_730
STREET ADDRFSSCI '.S�iy.ZIP FAX
o7T
i L nJ
CONTRACTORNAME LICENSENUMBER LICENSETYPEn/. BUS.LIC:b
COMPANY NAME E-MAIL ` 217 FAX
SG p '^
STREETADDRESS TZ . CIT7'.ST(RE.ZIP TDp �+. 4� IZ POQ� p�M.ri,J
J v 1 UNDERSTAND AND AGREE TO THE FOLLOWING: W
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, 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. I 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: Date:10
ReroofPolig_2011.doc revised 02116/1/
J ' oo
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO.CA'95014-3255 -
CUPERTfNO (408)777-3228• FAX(408)777-3333•building(@cupertino.oro
PROIE(T:AUDRESSZ/4*?S- APV*
OWNER NAME • r �" PHOS EMAIL
e - o
STREE)'.AUORESS Z t� el r I(�jr'. C'I 1'. STATE.ZIP ' FAN
.v ` e
CONTACT NAME PHONE E-NLAIL
-22 -0 30
STREETADDRESS 5,07- CITY.STAI'E LIP FAX
❑OUNER ❑ OUNER-RUILDER ❑ OUNER AGENT 1C01TRACTOR ❑C017RACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TES.mT
CONTRACTOR NAME LICENSE NC?IBER I LICENSE TYPEI BUS.LIC.
2 0 _ 69
COMPAN'YNAMC E-MAIL I FAX
STREET ADDRESS CITY.STATE.ZIP
Set I a o5e C PHONE ^2 8-O
.ARCHrrECTIENGINEER NAME LICENSE NUMBER BUS.LIC.:
CO?IPANYNANIE EAIAIL I FAX
STREET ADDRESS CITY.STATE.ZI P PHONE
usE OF ❑ SFD or Duplex Jr Multi-Family ROOF AREA: VALUATION.
STRUCTURE: ❑ Commercial �3 s S�a
EXISTING ROOT TYPE- ❑BUILLCFROOF ❑ASPIIALTSHINGLES $v OODSHAKF.S ❑w'OODSHINOLES ❑OTHER ISPECIFY)
REMOVE:REPLACE YFS IF NO. PLY1100D Eli ❑ PLYO'D ❑OSB PITCH. ROOF
❑ S-S :LAYER THICKNESS Cl _ T'PE COX '(� LASS'
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑1OOD SHARES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT d
DESCRIPTIONOF WORK: 1/Z f
Lai
S
WOOA +�eA 304 -0614- uLdE-rAAtmeAL e
ae a 'o bin a
BV my signature below.1 certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information I have provided is correct. I hate read the Description of Work and,crify it is actuate. I agree to comply with all applicable local
ordinances and sate laws relatine_to buildine cons tion. I a• oriu represe tiv c of Cupertino to enter the above-identified propertyfor inspection purposes.
Signature of ApplicanUAgent: -=tet Date: a�
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home Owner's Association.provide letter PUN CHECK TT PE ROUTING SLIP
ofapproval from HOA. WOA'ER-THE-COUNTER BUILOINGPLANFEVIEW
_ Provide Planning approval to verify if there any restrictions. ❑ FNPRFSS ❑ PLANNING PLAN REVIEW
_ Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Ovide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroojApp 20ll.doc revised 03/16/11