12070236 It I
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21113 RED FIR CT CONTRACI'OR:FOUR SEASONS ROOFING PERMIT NO: 12070236
OWNER'S NANIE: LIU QUANWEI ET AL PO BOX 1668 DATE ISSUED:08/082012
OWNIi R'S PHONE: 4089676434 SANJOSF.CA 95109 11110NEN0:(408)278-0330
LICENSED CONIRACI'f"M'S DECLARATION r,—_RATION RUILDINC PERMIT INFO: BLDG ELECT r PLUMB r7
License Class C-31 Lic.N n r�I OO
p_ \IECIi r RESIDENTIAL r COMMERCIAL r_—
Contractor FS 12 . N G• Dale g ' I 2
I hereby'affirm Thal 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION:TEAR OFF WOOD SHAKE$INSTALL 12"CDS
(commencing w th Section 7000)of Di%ision 3 of the Business$ Professions PLYWOOD,30M
Code and that nuc license is in full force and effect. FELT'UNDERLAYMEN'I'.INSTALL CI-ASS A CERTAINT'EED
PRESIDENTIAL COMP SHINGLES(COUNTRY GRAY)13SQFT
hereby affirm under penally of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,os provided for by Section 3700 of the Labor Code,for the
performance of the work for which[his 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 due work for which this
permit is issued Sq. Ft Floor Area: Valuation:$4500
,\I'I'I:ICA N'I'CI?It"1'IPIC,\'PION
I certify that I have read this application mid state that the above information is AI',N Number:35905043.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances mid state lays relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save
indenmify and keep harmless the City ol'Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands mid will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with allnon-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature� Date Issued by: Date:
Date. �/ •� ��
❑ OWi ;R-ISIIILDER DECLARATION
hereby affirm that I am exempt from the Contractor's License law fur one of RF-ROOFS:
the following two reasons: All roofs shall be inspected prior to tiny roofing material being installed.If a roof is
1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining_an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sce.7044, inspection.
Business$Professions Code) �^ I
I,as owner of the property,am exclusively contracting with licensed contractors to Signature ofApplieane Dale:
construct the project(Sec.7044,Business$Professions Code).
1 hereby affirm under penalty.of perjury one of the following three ALL ROOF COVERINGS T'O BE CLASS"A"012 BE I-FER
declarations:
I have and will maintain u Certificate of Consent to Self-insure for Worker's IIA%ARDOUS MATERIAI S DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. I hn%e read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,;a provided for by California Health S Safety Code.Sections 25505,25533,and 25534. I will maintain
performance of the work for which this compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ilealth$
Section 3700 of the Labor Code,for the
F Safely Code.Section 25532(x)should I store or handle hazardous material.
permit is issued Additionally,should I use equipment or devices which emit hazardous air
I certify that in the perforniance of Une work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Qualily Nlanagemew District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cuperino Munlclpal Code.Chapter 9.12 and the
Compensation laws ofCalifomia. If,after making this certificate of exemption,I Health$Safely Code.Sections 25505.2.5533,and 25534.
become subject to the Worker's Compensation provisions of the labor Code.I mus[
forthwith comply with such provisions or this permit shall be deemed revoked Oil 11 t4i zed agrnC
Date:
APPLICANT-CERTIFICATION CONST'RUcfION LENDING AGENCY
I certify that I have read[his application and slate that the above information is
correct. I agree to comply with all city and county ordinances mid state laws refiling I hereby affirm 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 CJ
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupenino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ,\I2CI I1'I'BCI"S DECLARATION
9,18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
Z070 Z3cn
REROOF PERMIT APPLICATION
EM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
(408)777-3228- FAX(408)777-3333•building(avlcupertino.org
CUPERTINO
PROJECTAUDRESSI AP\- O O
0\\'NER NAMEt PHONE _ I E-MAIL
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STREET'ADORES; ! I CIT'. . .ZIP C FAN
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CONTACT NAME PHONE E-?i AIL
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STREETADDRESS SCZ I CITY.ST Al E. ZIP ��p FAX
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❑ OwNFR ❑ O\1:NER-BLILDER ❑ OWNER AGENT IVICOITRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINF.F,R ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME LICENSENL'MBER I LICENSE T'PE I BUS.LIC.•
Four SE.O.Se 2 O
COMPANYNAME 5 I C-.MAIL I FAX
STREET ADDRESS IP PHONE
S"07- CITY,STATE.Z
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ARCHI rECLENGIN'EER NAME LICENSE NUMBER BL'S.LIC.
COMPANY.NAME E-MAIL FAS
STREET ADDRESSI CIT-.STATE.LIP PHONE
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ESE OF ❑ SFD or Duplex F Multi-Family ROOF AREA: rVALUATION. 00
jJ/
STRUCTURE: ❑ Commercial 3 S
EXISTING ROOF TPE: ❑BUILT-L'PROOF ❑ASPHALTSHINGLES ;C%OODSHAICES ❑WOODSHINGLES ❑OTHER I SPECIFY)
RENIOVE:REPLACE YES IFSO, PLl'tl'DpD �!: ❑ PLl'\\'D ❑ OSB PITCH ROOF
❑ > e AYFR THIfF\E ❑ T'P CDx :12 A ' A
PROPOSED ROOF TYPE: ❑BUILT-UPROOF x1SPHALTSHINGLES ❑ICOOUSIIAAES ❑%\ODD SHINGLES ❑OTHER [CUES REPORT:
DF.SfRIPTION OF N'GRK:li�ar n4
yin S`1n�2 foo _ Zns�a�l l�2rrCDY
+Ai e n 3 0 �e LST,nd-e r e�,—F_ina
ss a idee.+_ 1 Come sMiri es , �.'oler : Coua�e�_ fav
Rr my signature below.I certify to each of the fol lowing: I am the property oe%ner 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 hart read the Description of Work and verily itis accurate. I agree to comply with all applicable local
ordinances and state laws relating to building const- tion. 1 a orize represr W liv e of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicanl/Agem: rt Date: O $10 12
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home Owner's Association.provide letter PLAN CHECK TYPE ��ROUTING SLIP
of approval from HOA. OVL'3 FR-THE.cousrER BLI UILDING PLAN REVIEW
_ Provide Planning approval to veri F'if there any restrictions. ❑ EXPRESS ❑ PLAN:NINC PLAN REVIEW
_ Provide copy.of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
'Ide Signed copy of Cupenino's fear-Off Policy. ❑ OTHER:
ReroojApp_2011.doc revised 03/16/11
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 a[kuoertino.ora
PROJF.CTADDRESS APN#
OWNER NAME PHONE E-MAIL
t' j a
STREETADDRESS CITY, ZIP FAX
a 3 c
CON' CTOR NAME LICE:SE NUMBER LICFN TYP BUS.LIC.#
L4 02 Q J
COMPANY NAME E-MAIL FAX
STREETADDRESS �Z CITY,STA!! P PHONE
Jc O,ne C
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 VV' 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 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: Date: -2 --TO —/ Z
RerooJPolicv_20l lJoc revised 02/16/11
CITY OF CUPERTINO
PUT,�� ; ?FEE ESTIMATOR — BUILDING DIVISION
ADDRESS. ,,Q�/� �'/— ��C. DATE: 0 713 012 01 2 REVIEWED BY: bobs.
\ APN: VALUA"IION: 1$4,500
�PERMITTYPF: Building Permit PLAN CIIF.CF TYPE: Alteration / Repair
PRIiNLUiY SFD or Duplex I'EN'TAPIATION
USE: p PEI2DIIT'1'1'PIi: 1SFDWLR00
WORK sfd tear off wood shake install new comp shingles.
SCOPE
'7•.t !'•ro 'r . ;•a,:ai7'.,n:.t l�, fbr P •n-.:l..
(•...i l.. lr �� I '' "tort. Iq' t):Lr.. . ��
i•
A'OTE: This estimate does not include fees due br older Departments(i.e. Planning, Public JI'orAs, Fire,Sanitary Server District,School
District, etc). 77eae fees are based on the treUmD,arr•information available and are.onh•tit,estimate. Contact the Den for atdln7 inlr.
FEE ITEMS (Fee Restdrtium 11-UiJ E17: 7:1;1// FEE Q"I.1'/1,1?E MSC ITLNIS
Plan Check Fee: St0.00 1,300 s.f. Re-roof
Suppl. PC Fee: (j) Reg. O OT0.0 hrs $0.00 5195.00 1RF•ROOFRES.
i
PME Plan Check: 50.00
Permit Fee: 50.00
Suppl. Insp. 1=ee:Q Reg. O OI 0,0 1 firs 50.00
PIPIE Unit Fee: 50.00
PNIE Permit Fee: $0.00
'Jamni,Item
l,ia'rsrdr✓:,rl'. r' O
Work Without Permit? O Yes (D No $0.00 G)
Advanced Planninc Fee: 50.00 Select a Non-Residential (D
1 t 4h u.t„'rauuntr h, Building or Structure O
Strome Motion Pee: IUSE13AaCR $0.50 Select an Administrative Item
Inde Stds Commission I7ce: IBCRSC $1.00
SUBTOTALS: $1.50 $195.00 TOTAL FEE: $196.50
Revised: 07/01/2012