12050012 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20343 NORTHCOVE SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 12050012
OWNER'S NAIVE: DENNIS&TATYANA FERRIER PO BOX 1668 DATE ISSUED:05/01/2012
OWNER'S PHONE: 4088737524 SAN JOSE,CA 95109 PHONE NO:(408)VS-0330
.9/ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C-341 Lic.N °17,x[08 r r r
MECH RESIDENTIAL CCOMMERCIAL_
Contractor C• Date S —Z— 12-
1
21 hereby affirm that am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF TEAR-OFF EXISTING CAL-SHAKE ROOFING
(commencing with Section 7000)of Division 3 of the Business&Professions SYSTEM
Code and that m license is in full force and effect. AND INSTALL 30q FELT LES.UNDCOLOR:
STOENT AND INSTALL GAF
y GRAND CANYON SHINGLES.COLOR:STONEWOOD
1 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.
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.171 Floor Area: Valuation:$6500
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:31641069.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances and 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 Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of(his permit. Additionally,the applicant understands and will comply WIADAYM
AYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 LAST CALLED INSPECTION.
9.18Signature Date S2��Z IssbDate:
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of Rh:ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,1 agree to remove all new materials for
will do the work,and the structure is not intended or offered for safe(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERI TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
I have reed the hazardous materiels requirements under Chapter 6.95 of the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Cade,for the performance of the work for which this
Safety Code,Section 25532(a)should 1 store or handle hazardous material.
permit is issued Additionally,should 1 use equipment or devices which emit hazardous air
I certify 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 1 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 California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25531.
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 an tze Z�
Deter
APPLICANT CERTIFICATION 'ONSTRUCI'ION LENDING AGF-NCV
1 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 I hereby aR that 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 Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,due applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Dale
Licensed Professional
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REROOF'TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT.SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
C O P E RT I N O 10300 TORRE-AVENUE-CUPERTINO, CA 95014-3255
(408)777-3228- FAX(408)777-3333-buildinoCdcuoertino.ora
PROJECT ADDRESS APN a
OWNER NAME PHONE _ E-MAIL
Il:• nn I l-erCIP A �S - L 1 S
STREET ADDRESS yCITY,STATE.ZIP FAX
i .i�'(.?• �n. 9 G Cv�u S�. L. /.7 c/ 1 n n �I C61 L/
CONTRACTOR NAME (CENSE N[U�MBE2 ( L, LICENSE TYPE
BUS,LIC./
COMPANY NAME ^ EMAIL FAX
/:
STREET ADDRESS, CITY.STATE.ZIP PHONE _
. -� ` �-� >/ ,+ In ��. �—rP it//z (/ lJ �' z- /l' U '1�C
i
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. 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 1/<" 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 S 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: 1 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. 1 also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections 11314 and R315 of
the 2010 Califomia Residential Code.
Signature of Applicant/Agent: Date:
Reroo/Polict_2011.doc revised 07/1611/
CITY OF CUPERTINO
3 ITEMS OF 24 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN .-. . . . . . . : 31641069.00
DATE ISSUED. . . . . . . : 05/01/2012
RECEIPT #. . . . . . . . . : BS000016675
REFERENCE ID # . . . : 12050012
SITE ADDRESS . . . . . : 20343 NORTHCOVE SQ
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : DENNIS & TATYANA FERRIER
ADDRESS . . . . . . . . . . : 20343 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
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- -------------- ---------- ----
309 EXTERIOR LATH 311 SCRATCH COAT
6.01 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 20343 Northcove Sq. DATE: 05/01/2012 REVIEWED BY: Sean
APN: BP#: VALUATION: $6,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK Tear-off existingcal-shake roofing system and install 30#felt underla ment and install GAF Grand
SCOPE Canyon shingles, color: Stonewood.
FEEID ROOF AREA
s.f.
1REROOFFRES 1,500
l/ech. Plnn Ch,1ck Plunk. Pleur Check Elee. flan Clack
I/eep_ Permit Fee: Plump. PC,mil F,e: bile.. Pei nui Fee:
011w, I/c,h. lnsp, Other Plump Insp. Li I Ocher Eli?(. Ina�p.
.1.1".11. Irr.,p. /Sr: Plumb. pint Fee: tile". lisp. Fce:
NOTE: This estimate does not includejees due to other Departments(ie.Planning,Public Works, Fire,Sanitary Sewer District,School
District,eta). Thesefees are based on the Prelimina information available and are only an estimate Contact the De t or addn7 info.
FEE ITEMS (Fee Resohrlion 11-053 ED: 7/1/11) FEE QTY/FEE MISC ITEMS
Platt Che(k /•tic'
suppl. PC Fee
I'lrrrn b..r;1 lcz:1+.!7:lec
Permit Fee: $210.00
.Cupp/. hicp Fee
I'hnnh.irl-leclr./laei:
Plumb_/,llech./1ilec Purmil Fero:
Consn action Tax.
Acltnini.curnA•e Pec:
Work Without Permit? 0 Yes (F) No $0.00
Advaim-el Phuming Fees.
Trrmed Doctunenlnlinn Fees: A
Strong Motion Fee: IBSEISMICR $0.65 Select an Administrative Item
13lde Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $211.65 $0.00 TOTAL FEE: 1 $211.65
Revised: 04/01/2012
'_ C)
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE CUPERTINO,CA 95014-3255
1
CUPERTINO (408)777-3228,•FAX(408)777-3333•buildina(GdcuoertinD.DrD
PROJECT.ADDRESS
20343 o eo�e- SQ • APNY I ^, (�
OWNER NAME PHONE E-MAIL` lJ�
ms
S'rltEFr,O�1:SS A /1 C ^ATE,11 F:1\
CONTACT NAME ii IT �O ^(,p,�� PHONE
E-MAIL
�Q
STREET ADDRESS CirY,STATE,ZIPS
'. FAX
O 'So co'.. s
❑Ow'NER ❑ OWNER �J-BIRLDER ❑ OWNER AGENT rl CONTRACTOR ❑COMAACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ IENANI'
(ONIIUICIOR NAME LICENSE NU]V[BER LICENSE TYPE BUS LILYF�ujr- GeaseAq 7Q 10A
3 3
COMPANY NAME ' � � &MAB, FAX
SI RLLT ADDRESS CITY,STATE,ZIP PHONE
502-
ARCHITECTIENGINEER NAME h LICENSE NUhfBER
AUS LIC.Y
COMPANI"NAME E-MAIL FAX
STREET ADDRESS
CITY.STATE,ZIP PHONE
��//
USE OF ❑ SFD or Duplex 1� Multi-Family ROOF AREA q/ VALUATION:
,IRLCTURE: ❑ Commercial 5 6 S
EXISTING ROOF TYPE: 13 BUILT-UP ROOF ❑ASPHALT sF@NGLEs ❑WOODSRAKES ❑WOOD SHINCYIIS /s OTHER(SPECIFY)
REMOVE AREPLACE YES IF NO, PLYWOOD 0%- ❑ PLYWD IIQ�OSB PITCH: Y ROOF fT
❑ FO Y 5 ❑ nl" Y �:12 LA A
PROPOSEDRUOFTYPE: ❑BUILT-IIPROOF ASPHALT SHINCa.ES E3 WOOD SHAKES 13 WOOD SHINGLES ❑OTHER ICC-IS REPORTY
DESCRIPHUN OF WORK-
_ w n _
7 n I f 1 1
I� on# ,PCJi tfAd!QEL ,f I t II Ins4ym aAF 6nf 61A C*,A GLA
�n
Coto
By m.signature below,l certify,to each of the following: 1 am the property owner or authorized agent m Won the property owner's behalf. I have read This
application and the information 1 have provided is comm. 1 have read We Description of Wort and verify it is accurate. 1 allm to comply with all applicable local
ordinances and state laws relating to building coon. Urorire wives of Cupertino to enter the abovo-identifiedproperty,for inspection purpose.
Signature of Applicam/Agent Dale S-� 2
SUPPLEMENTAL INFORMATION REQkfED _ - - OFFICE USE ONLY
1
It building is associated with a Home Owners Association,provide letter '' PLAN CHECK TYPE 1 ROUTING SUP
of approval from HOA. - , 1:1! PL,;,
❑ OVER-THE-CO INT R ❑ BUILDING PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions. I`EXPRESS :if::t - ❑ PUNNING P1,.vN Review
_ I'ruvide copy of Mmufuctun:r's Installation Specifications. ❑ sT,uvnAnD� ❑ FlRE DEPT
Provide signed cope of Cupenino's Tear-OTT Policy. ❑
OTlim-
.,.- .
f
Reroc,ftp_201 Ldoc revised 03116111