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11060020CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10802 NORTHFIELD SQ OWNER'S NAME: BUSIJA VEDRAN O'-�-N.ER'S PHONE: 4082780330 G LICENSEG�D CONTRACTOR'S DECLARATION License Class ( Lic. # i Contractor Date I hereby ar wnt -that I 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 penalty of perjury one of the following two decla ions: I have and will maintain a certificate of consent to self -insure for Worker' y 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, 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 harmless the City of Cupertino against liabilities, judgments, 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 -point source regulations per the Cupertino Municipal Code, Section 9.18. CONTRACTOR: FOUR SEASONS ROOFING PO BOX 1668 SAN JOSE, CA 95109 BUILDING PERMIT INFO: BLDG PERMIT NO: 11060020 DATE ISSUED: 06/03/2011 PHONE NO: (408)278-0330 ELECT PLUMB r MECH r RESIDENTIAL r COMMERCIAL JOB DESCRIPTION: REROOF, 14 SQUARES, TEAR OFF EXISTING CEMWOOD ROOF AND REPLACE WITH NEW 30# UNDERLAYMENT & GAF GRAND CANYON ASPHALT COMP SHINGLES, COLOR STONEWOOD, HAS Sq. Ft Floor Area: I Valuation: $4400 APN Number: 31637034.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Signature Date �� 5 t Issued by: Date: OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, 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 of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I 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, for the performance of the work for which this permit is issued. 1 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. 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 harmless the City of Cupertino against liabilities, judgments, r and expenses which may accrue against said City in consequence of the ig of this permit. Additionally, the applicant understands and will comply wuu all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date RE -ROOFS: 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 inspection. 11 Signature of Applicant: Date: L� 1 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: 71 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Mork's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 3 ITEMS OF 18 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31637034.00 DATE ISSUED.......: 06/03/2011 RECEIPT #......... BS000013651 REFERENCE ID # 11060020 SITE ADDRESS 10802 NORTHFIELD SQ SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER BUSIJA VEDRAN ADDRESS 10802 NORTHFIELD SQ CITY/STATE/ZIP CUPERTINO, CA 95014 OPERATOR: patg COPY # : 1 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 ---------- 4,400.00 ---------- 1.00 0.00 1.00 0.00 1BSEISMICR VALUATION 4,400.00 0.50 0.00 0.50 0.00 1REROOFRES SQ FEET 14.00 182.00 0.00 ---------- 182.00 ---------- ------0_00 TOTAL PERMIT ---------- 183.50 0.00 183.50 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT AMOUNT --------------- 1,101.00 --------------- 1,101.00 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- #010967 VOICE ID DESCRIPTION -------- ---------------------------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF {1I� V CITY OF CUPERTINO91 l FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10802 northfield sq. DATE: 06/03/2011 REVIEWED BY: bobs. APN: tp 3� 0_&q I BP#: "VALUATION: 1$4,400 '-PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIUSEMARY SFD or Duplex PENTAMATION PERMIT TYPE: 1 SFDWLROOF WORK tear off existingroof replace with new comp. shingles. SCOPE NOTE. These fees are based on the preliminary h FEE ITEMS (Fee Resolutio,7 09 -OSI F Permit Fee: T-1 Work Without Permit? 0 Yes G No Strong Motion Fee: IBSEISMICR Bldg Stds Commission Fee: IBCBSC SUBTOTALS: tion available and are o FEE QTY/FEE $182.00 $0.00 $0.50 $1.00 $183.50 $0.00 an estimate. Contact the Dept for addn 7 MISC ITEMS Select an Administrative Item TOTAL FEE: I $183.50 Revised: 04/29/2011 FEE ID ROOF AREA s.f. 1 REROOFFRES 1,400 NOTE. These fees are based on the preliminary h FEE ITEMS (Fee Resolutio,7 09 -OSI F Permit Fee: T-1 Work Without Permit? 0 Yes G No Strong Motion Fee: IBSEISMICR Bldg Stds Commission Fee: IBCBSC SUBTOTALS: tion available and are o FEE QTY/FEE $182.00 $0.00 $0.50 $1.00 $183.50 $0.00 an estimate. Contact the Dept for addn 7 MISC ITEMS Select an Administrative Item TOTAL FEE: I $183.50 Revised: 04/29/2011 CUPERTINO 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 (408) 777-3228 - FAX (408) 777-3333 - building a(%cupertino.org PROJECT ADDRESS ' 6 g�j L C, S {V� F ('d APN # OWNER `% �l r� V W Ql PHO�I� g �G C% EMAIL -NAME STREET ADDRESS CITY, STATE, ZIP FAX CONTRACTOR NAME OU r LICENSE NUMBER U / O p LICENSF, TYPE BUS. LIC. # COMPANY NAME l 1 EMAIL �p t J (Yes) ,Z 79-(q 3 STREET ADDRESS CITY, STATE, ZZIIPj PHONE 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 shall be scheduled 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. On the day of the inspection, a building inspector will be available within one hour for either a Tear -Off Inspection or Nailing Inspection if you call again on that day between the hours specified. 3. The following inspections are required: a. 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. b. If plywood is installed, a plywood Nailing Inspection is required. c. Progress Inspection is required when approximately 50% of roof covering is installed. 4. New roof coverings shall not be applied without first obtaining all 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. 5. 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/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. Proper spark arrestor installation. 6. 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 $126.00. The re -inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agree to comply with the re -roof policy stated above. I also understand that smoke detectors and carbon monoxide detecto s are required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Code. /f Signature of Applicant/Agent: // Date: ReroofPolicy_2011.doc revised 02/16/11 r REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 Lo (408) 777-3228 • FAX (408) 777-3333 • building cDcupertino.orct CUPERTINO PROTECT ADDRESS (d Ry CI A`) J� a C7 APN # I 01a+ 01a+OWNER NAME % -e(AJ /an 98 v s`_` v i/Q, PHONE ^ 7 Sr —G 3 3 el E-MAIL STREET ADDRESS S CITY, STATE, ZIP FAX APPLICANT NAME ` _ z� PHONE � E-MAIL STREET ADDRESS 5O tAo(Ml X" � ` CrrY, STATE. �L —�v$� cA C�'L/ 07e- 0333 ❑ OWNER ❑ OWNER -BUILDER ❑OWNER AGENT ONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER 13 DEVELOPER 11 TENANT CONTRACTOR NAME e (1 �ZVe �(pE-MAIL LICENSE NUMBER Ll O LICENSE TYPE / BUS. LIC. # COMPANY NAME ( w , n (t F ��? Q33 STREET ADDRESS�6� 170TYLilt �T• C STATE ZIP ^ L ��I —Z— C� =06) OOS)2 / 9'0330 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 ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial IYA GO �- EXISTING ROOF TYPE:: BUILT-UP ROOF ❑ ASPHALT SHINGLES 13 WOOD SHAKES ❑ WOOD SHINGLES �IiIER (SPECIFY) /0� REMOVE /REPLACE 39: cZS IF NO, PLYWOOD ❑ vv,❑ PLYWD ElOSB PITCH: :12 ROOF A ❑ # AYER : THIC ❑ 5/8" TYPE: ❑ CDX CAS: PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF t7245PHALTSHINCILFS ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK: b vMe,,t ,n.. a �C— �r4-"� p �v D Y`S kgj_4_ n �.,•�. 1 S . ion: �.e�� -- � �x�l � � ��-- 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 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 b 'ding nstruc ion. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicanUAgent: Date: (� SUPPLEMENTAL INFORMATION REQUIRED s If building is associated with a Home Owner's Association, provide letter fl RBiT�D¢i; R- 910 " of approval from HOA. _ Provide Planning approval to verify if there any restrictions.I xr �Pi ` z n RrANIINGpiA1�REYfER+s '�' Provide copy of Manufacturer's Installation Specifications. Provide copy of Cupertino's Tear -Off Policy.° _ signed ReroofApp_2011.doc revised 03/02/11