12070231 CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS: 21117REDFIRCT CONT'RACf(IR:FOUR SEASONS ROOFING PERMITNO: 12070231
OW'NER'SNAAIE: TIANXIZIIANG PO BOX 1668 DATE ISSUED:08/082012
OW'NER'S PHONE: 4082521524 SAN JOSE,CA 95109 PHONENO:(408)278-0330
LICENSED C0NfRA(7F0R'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class Lie.9 4,77-1 00 r [ r
� \ p pIECFI RESIDENTIAL COCOMMERCIALContractor � f /NL Date . -O{Y- I'L
I hereby affirm that 1 ant licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING WOOD SHARE ROOF. 13 SQS
from nrenci ng with Section 7000)of Division 3 of the Business\ Professions INSTALL
Cade and that nq'license is in full force and effect. l2"CDS PLYWOOD,30H FELT UNDERLA SHINGLES,
INSTALL
CERTAINTLED PRBSIDE•NTL\L COMP SHINGLES,COLOR
hereby affirm under penalty of perjury one of the following Iwo declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,is 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,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued Sq. Ft Floin-Area: Valuation:S4500
A1'I'LICM\N'I'CItRI'IPICA'I'I(IN
I certify that I have read this application and state that the above inform tion is MIN Number:35905045.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances rand stale 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 harmless the City of Cupenino against liabilities,judgments' PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may acerae against said City in consequence of the
granting ofthis permit. Additionally,the applicant understands mid will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. l /
Signature G�/�� Date C �2' Issued by: JCA/✓ /719 7z�l Date: v -6.1,?
i
❑ O\V'NIi1�ILDER DECLARATION `
hereby affirm than 1 ant exempt from the Conlractur's License Laofor one of RI ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material beiig installed If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining at inspection,I agree to remove all line materials for
will do the work,laid the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code) p �7
I,as owner ofthe property,am exclusively contracting with licensed contractors to Signature ofApplicane Date: 8 p L
construct the project(Sec.7044,Business R Professions Code).
I hereby affirm under penally of perj or) one of Ilie following three ALL ROOF COVMERIN TO . LASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IL\%ARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
perfomtnnce 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 Sudety Code,Sections 25505,25533,and,5534. 1 will maintain
Section 3700 of the Labor Code,for the performance ofthe work for which this compliance with the Cupertino Municipal Code.Chapter 9.1_and the HealthSafely Code.Section_5532(a)should I store or handle hazardous material.
permit is issued Additionally-should I use equipment or devices which emit hazardous air
I certily that in the performance of the 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 any 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 Califomia. If,after making this certificate of exemption,I Health S Safely Code,Sections 25505,2.5533.and 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. Owner o .or a 4n�ent: ¢ r. /�
I'
Dale: (! jf
A 111'LICANCI.RTI FI CATION ONS'I'RIICTION LENDING AGENCY
I certify that I have read this application and state that the above informmfon is
correct. I agree to comply with all city and county ordinances and state haws relating I hereby affmn•tam there is a construction 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 None
indemnify and keep harmless beCity of Cupenino against liabilities,judgmenls,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
graving of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section AItCI I I'I'IiCI"S DECLARATION9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CU13EIlTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS:g/I .,1� 6 >P71— Lj� DATE,: 07/30/2012 REVIEWED BY: bobs.
M-s APN: BV#: oZ •VALUATION: $4,500
`PERMITTYPE: Building Permit PLAN CIIECK TN'I'E: Alteration / Repair
PItIM,UtN' SFD or Duplex I L•.\I ADtAI ION 1SFOWLROOF
USI>: PERMIT TYPE:
WORK sfd tear off wood shake install new comp shingles.
SCOPE.
b"i 1.-.
NOT/:: This wiaNte Anes tint includejees Clue u,other Departutews(i.e. Planning. Public Works, Fire,Sanimq'Seu•er District,School
District, etc./. These fees are haset/on the rrelimittan'in nnnntinn tit i1ahle and are only an eatinium Ca,,Y jct the De a/nr tit/tht'l in(i,.
FEF ITEiNIS (Fee Resulnrinn 11-053 FEB: ,/1:lll FEF QTY/EFF MISC ITE11S
Plan Check Fee: 50.00 1,300 s.F. Re-roof
Suppl. PC Fee: (D Reg. Q OT Fo.0 ills $0.00 5195.00 /REROOFRES
PME Plan Check: SO.00
Permit Fee: $0.00
Suppl. Insp. Fee:Q Reg. Q OT0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
„l•.l+t l!"',, l u
Lr r „n.rA. 1 O
Work Without Permit? O Yes 0 No $0.00 1 O
Advancccl Plannine FCC: $0.00 Select a Non-Residential 0
Building or Structure
. d n••n• n :7trrt v. i . �
Surma iNlolion Fcc: IBSE/SAUCR $0.50 Select an Administrative Item
111( e SRIs Commission Fee: IBCBSC S1.00
SUBTOTALS: $1.50 $195.00 TOTAL FEE: $196.50
Revised: 07/01/2012
2 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• buildimA)cuoertino.ora
PROJECT ADDRESS [ APNs
.115
OWNER NAME P110NE E-MAIL
"an x; M as-zsz-/szy
STREETADDRESS - CIT',jF¢uE ZIP a ^ FAX
A qnl4
CONTRACTOR NAME LICENSE rgjEEQR CIS
l-•LICE7j;E=SE BUS.LIC.01-21311a
COMPANY NAME nn E-MAIL lr S FAX /✓
Gci✓e Y`r,
STREET ADDRESSCITY.ST ZIP P1Wp E
S c,Te. CA 93'112 1Y�-278—d
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/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.
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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, 1 certify each of the following is true: I am the property owner or authnrized agent to act on the
property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date:
RerooJPolin,?011.rloe revised 02/1611 l
REROOF PERMIT APPLICATION
Eal COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•building((Dcupertino.oro /�0
CUPERTINO /'
PROTECT ADDRESS Xe -r,;-'
C7t. �1,`�N OS 757
OWNER NAME ^ Z I PH NE _ s EJtA1L
STREET ADDRESS C+ CITY.CUE.ZIP _ FAX
P A C
CONTACT NAME PHONE I E-NIAIL
sTREET ADDRESSFAN I
5,02— CITI'.5T{1'F_Z.IP`TO^� So$e. - 4s1 I -
:\
❑OWNER ❑ OuER-aWLDER 13 OWNER AGENT �COITRACTOR ❑CONTRACTOR AGENT 13 ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMEI LICENSE NCNIBER I LICENSE TYPE I BUS.LIC._ I ^
Z O e[
COMPANY NAME S E-MAIL �I FAx
AME
STREET ADDRESS CIT1'.STATE.ZIP I PHONE II�O
S'07- a case C II
ARM rECTrENGI]EER NAAIE LICENSE NUMBER BUS.LIC=
COMPANY NAME I E-{TAIL I FAX
STREET ADDRFSS I CITY.STATE ZIP I PHONE
USE OF ❑ SFD or Duplex r, IMuld-Family ROOF AREA: .rte VALUATION. O
STRUCTURE: ❑ Commercial S Sad
EXISTING ROOF TYPE: ❑BL9LT-CPROOF ❑ASPHALTSHINGLES $WOODSHAKES ❑W'OODSHINGLES ❑OTHERISPECIFY7
R@NIOYF.:REPLdCE YES I FNO. PLY%\O0D '.' ❑ PLYW'D 13 OSB PITCH, ROOF
❑ NO AYFR , THICKNESS' ❑ <' " FUN"". DX :12 LASSA
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑11000 SHAKES El WOOD SHINGLES OTHER ICC-ES REPORT
DFSCRIPTION OF WORK:
"AIeGDX
._Ei ACA(I 1
e e •o din a
By my signature below.I certify to each of the following: I am the property other or authorized agent to act on the propem'owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and rerilj'it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building cons' tion. ]a- orize represe • tiv s of Cupenino to enter the above-identified propertyfor inspection purposes.
Signature of ApplicanUAgent: Darer '301 ao12--
SUPPLEMENTAL INFORIAIATION REQUIRED OFFICE USE ONLY
_ If buildins is associated with a Home OWher's Association.provide letter PUN CHECK TYPE �� ROUTING SLIP
of approval from HOA. 01ETHE-COUNQTER BUILDENG PWN REVIEW
Provide Planning approval to eerif%if there any restrictions. ❑ LNpRE55 ❑ PLANNINGPLAN REVIEW
Provide copy of A1anufacturer's Installation Specification. ❑ STANDARD ❑ FIRE DEPT
Lprz ide si_sned copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroojApp_261 Ldoc revised n3116111