12070179 CITY OF CUPERTINO 13UILDINO PERMIT
BUILDING ADDRESS: 21085 RED FIR CT CO\1'RACI'OR:FOUR SEASONS ROOFING PFRMIT NO: 12070179
OWNI:R'S NAME: SAVITIIA AND AMARNATIi SAJAPURAM PO TION 1668 .DA'Z'E ISSUED:07242012
OWNIiR'S PHONE: 4089738251 SAN,TONE.CA 95109 PHONE NO:(408)278-0330
JQ— LICENSIiI)CON-fRACfOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class C^—V Lic.4 I—?2- i 0? r r r
rl �� 12
MECFI - RESIDENTIAL COMMERCIAL
Contractor S J Ili C . Date—+ :L
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXSISTING WOOD SHAKE ROOF.INSTALL I2"
(commencing with Section 11100)of Division 3 of the Bu>incss S professionsCDX PLYWOOD THEN 30N FELT UNDERLxYhIENT.FINALLY,
Code and that my license is in full force and effect. INSTALL CERTAINTEED PRESIDENTIAL COAIP SHINGLES.
hereby affirm under penalty of perjury one of the following two declarations:
1 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 hive and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 ofthe Labor Code,for theperformance of die work for which this Sq.Ft Flour Area: Valuation:$4500
permit is issued.
AI'1'LIC.\N"I'f.IiR'I'IPIC,\"I'1(IN ANN Number:35905028.00 Occupancy Type:
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 ordinmmces and state laws relating
to building construction,mid hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs•and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting ofthispemhil. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulatiats per the Cupertino Municipal Code,Section
9.18.
i /& Issued by: Date:
Signamre Date��
❑ ON'NE,R, LITER DECLARATION
121:ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the follmwing tort reasons: installed without first obtaining an inspection,I agree to remove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business K Professions Code) Signature of Applicant: D111-7—
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business S Professions Code), ALL ROOF COV1: ,'GS TO BE CLASS"A"OR BFTITR
herchc 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 HAZARDOUSMATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performnce of the work for which this permit is issued. California l Iealth S Safety Code.Sections 25505.25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health S
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code.Section 25532(x)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. cornaminants as defined by the tiny Area Air Quality Management District I will
I certify that in the performance of die work furwhich this permit is issued,I shall maintain compliance m%ith the Cupertinu Municipal Code,Chapter 9.12 and the
1101 employ any person in any manner so as to become subject to the Worker's I Ieallh S Safety Code.Sections 25505,25533.and 2.5534.
Compensation laws of California. If,after making this cenificate of exemption,I
become subject to the Worker's Compcnsmion provisions of the Labor Code,I must O s; au ari'rcd a' 11:
forthwith comply with such provisions or this permit shall he deemed revokedONDate I
AI'I'LIC.\\1'CI?If1'IPIG\9'ION CS'TRUCT'ION LENDING AGrNCY
I certify that I have read this application and state that the above infornialion is 1 hereby affirm that there is a construction lending agency for the perfamance of work's
correct.1 agree to comply with all city and county ordinances mid state Imus relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize represrnalives of this city to enter Lender's Name
upon the above mentioned properly for inspection purposes.(\\'e)agree to save
indemnify and keep hamiless the City of Cupertino against liabilities,judgmcnts• Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCII ITECI"S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 21085 Red Fir Ct DATE: 07/24/2012 REVIEWED BY: Sean
:91 APN: BP#: 'VALUATION: $4,500
*PERiNH"rT1'PE: Minor Building Permit PLAN CII ECK TYPE: Re-roof
PENTAMATION
PRIMARY USE: SFD or Duplex PER,�I1T TYPE: 1SFDWLRO0 F
WORK Tear off existing wood shake roofing. Install 1/2" CDX plywood then 30#felt underla ment. Install
SCOPE Certainteed Presidential composition shingles - Country Gray color.
FEEID ROOF AREA
(s.r.
1REROOFFRES 1,300
f
Much. Plan Check Plumb,Plan Check Dec.Plan Check
Alech. Permit Fee: Plumb.Permit Fee: Elcc.Penuit Fee:
Other'llech. Insp. Other Plumb Insp. Other Flee,Insp.
11ech.hisp. Fee: Plumb. htsp. Fee: Flee.Imp.Fee:
NOTE: This eviittmte does not includejeer due to otter Deparunents(i.e. Planning, Public Works, Fire,Sanitafy Sewer District,School
District,etc.). These feLv are baser/on the trcliminarl information availahle and are onh,an estinune. Contact the Deliffor adcln'I info.
FEE ITEMS (Fee Resolution 11-053 E(/ 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Phtmh.lhleuh.lClec
Permit Fee: $195.00
Suppl. hisp Fee
Phanb.lMech./Glee
Plumh.lMech.lClec Pei-wir Fee:
Conso-nction Tax:
Adminisit-ative Fee:
Work Without Permit? O Yes Q No $0.00
Advanced Planting Fees:
Travel Documentation Fees: �
Suone Motion Fee: IBSF1SMICR $0.50 Select an Administrative Item
Bldg,Sids Commission Fee: 1BCBSC $1.00
SUBTOTALS: $196.50 $0.001 TOTAL FEE: $196.50
Revised: 07101/2012
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO. CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•building(d)cupertino.org
PROJECTADDRESS F^ /Org- Aed F// C APN#
OWNERNAME >• ,�pV^ s0. ^4 PHONE
LIO�_ ^1- E-MAIL
STREET ADDRESS r CIT',SJ,jTE ZIP 1^ A FAX
Xe d
CONTRACTOR NAME U LTCENSEh'U�N($,HR VLICr SSE NPE BUS.LIC.•
COMPANY NAMEnn F.-MAIL. C• FAX
e O 4 oT A
STREETADDRFSS CITY,ST ZIP HOSE
SO?- „ SoSe c 8- -0 3o
1 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 Y<” 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$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: 1 am the property owner or authorized agent to act on the
property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. 1 also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Dale: —23-/A
RemofPolicv_201 l.doc reviser/02/16111
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT' BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA'95014-3255
(408)777-3228• FAX(408)777-3333•buildincipcupertino.org -
CUPERTINO
PROJECTAUDRESS (f,2 0$ ^ C ,r C aPx
OWNER NAME ( J ,� rs e j PHONE
Gv a b
STREE'1'ADDRESS TE.ZIP _ FAN
CONTACT NAME PHONE I E-?TAIL
11 e og"2_ -0 301
STREETADDRESS 5"02 CITY.STA I E.ZIP FAR
S �acL�oSe��_4SI L
El O\\:NFR ❑ GUNER-BVILDER ❑ OWNER AGENT COVTRACroR ❑CO?TRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE\UMBER I LICENSE TYPE I BT'S.LW.-
Z
COMPA\Y\'AME C-NIHIL FAX
SAME
STREET ADDRESS CITY.SLATE.ZIP PHONE
502 w o5e C
ARfHl'rECTrENGiNEER NAME LICENSE NUMBER I BLS,LIG R
COMPANY NAME E-NTAIL FAX
STREET ADDRESS CITY-ST,ATEZIP PHONE
JC LSE OF ❑ SFD or Duplex ` MDIti-Familc ROOFAREA; Air
VALUATION. :0 p-'�-�
STRUCTURE. ❑ Commercial ��yy a S u 0
EXISTING ROOF TYPE: 13 I. ❑ASM(ALT SHINGLES pe,00 SHAKES C3 ODD SHINGLES -❑OTHER SPECIFY)
R[.%IO%F.:REPLACE JeYES IF NO. PLY.COOD �l!' ❑ PLMD ❑OSB PITCH: ROOF
❑ S -LAVERS THIfKNE � ❑ T'YP . COY 712 LASS' A
PROPOSED ROOF TYPE' ❑BUILT-L'P ROOF XCiSPHALT SHINGLES 0w000 SI TAKES - ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT.
DESCRIPTION OF WORK: I"S"
rJ rDX
e of
Cec)winkeocl PceS1Aeft+,.t6l n G►
j IFI
By my signature below.I certify to each of the following: 1 am the propem'owner or authorized anent 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
ordinance and sate laws relating to building cons tion, 1 a''orize represe • tiv so Cupertino to enter the above-identified property for inspection purposes.
Signature of ApplicanJAgent'. Date: a a�
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home Owner's.Association,provide letter PLAN CHEC6 TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLANREVIEW
_ Provide Planning approval to verifx if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD_ ❑ FIREDEPT
Provide signed copy of Cupertino s Tear-Off Policy. ❑ OTHER:
Reroojdpp 1011.doc revised 03116111
I