12100145 CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS: 10576 WHITE FIR CT CONTRAC'MR:FOUR SEASONS ROOFING PERMIT NO: 12100145
OWNER'S NAME: YEUNG PETER CHUN-NGOK AND SANDRA CH PO ROX 1668 DATE ISSUED: 10119/2012
OWNER'S PHONE: 4082784521 SAN JOSE,CA 95109 PHONE NO:1408)178-0330
/❑1 LICENSED CO\TRACT'OR'S DECLARATION' BUILDING PERMIT INFO: BLDG r rt
ELECT(J PLUMB
License Class ' / / Lie.q q71a40 r rl C
i\•IECII RESIDENTIAL — COMMERCIAL
Contactor t Dale
hereby affirm that I am licensed un a �e provisions of hapicr 9 •JOB DESCRIPTION: RT:-ROOF,REhtOVli SI3AKE @INSTALL PLYWOOD AND
COMP
(commencing with Section 7000)of Division 3 of the Business S Professions SHIN
Code and that my license is in full force and effect. SHINGLES 13 SQ CLASS A
I 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,as provided for by Section 3700 of the Labor Code,for the
performance of 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, Sy.FI Floor Area: Valuation:54500
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is ANN Number:35905120.00 Occupancy"Type:
correct.I agree to comply with all city and county ordinances and state Imus 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 ofthis permit. Additionally,the applicant understands and will comply WITHIN 0 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulation;per the Cupertino Municipal Code,Section I$Q DAY M LAST CALLED INSPECTION.
9.
Date Issue b •[ Date:
/U
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RF:ROOFS:
the following two reasons: All roofs shall be inspected prior many 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(Sec.7044, mspe -
Business&Professions Code) /J/ a
I,as owner of the property,ono exclusively contracting with licensed contractors to
S'g R7� t Dae�a/% /�—
construct the project(Sec.7044,Business d Professions Code).
1 hereby affirm under penalty of perjury one of the following three ALI.ROOF COVERINGS TO BF,CLASS"A"OR BE FI'F,R
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I IAZARDOUS MATERIALS 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 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 Safety Code,Sections 25505,25533,and 25534. 1 will maintain
compliance with the Cupertino;Municipal Code,Chapter 9.12 and the I Ieallh S
Section 3700 of the Labor Code,for the performance of the work for which this Safely Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment ur devices which emit hazardous air
I certify that in the performanceof the work forwhich this permit is issued,1 shall contaminants as defined by the Bay Area Air Quality Management Districts 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 3 Safety Code,Sections 25505,25533,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. w' er or a o ized ent:
i
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY -
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 Imes relining I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,mid 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 Leader's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Sectio ,ARCII I"1'F:CI':S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
x '2_1 y�
CITY OF CUPERTINO
FEE ESTINIAT R — BUILDING DIVISION
ADDRESS: D J DATE: 10/18/2012 REVIEWED BY: jsg
APN: BP#: -VALUATION: 1$4,500
*PER1111T TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR0OF
USE: PER111T TYPE:
WORK Reroof, remove shake instal plywood and comp shingles
SCOPE
FEE ID ROOF AREA
1REROOFFRES 1,300
Meeh.Ilan Check Plumb. Plan Check Flee.Plan Check
Meeh. Permit Fee: Plumb. Pernoir Fee: F.lac.Permit Fee:
Other M c•h.Insp. Other Plumb Insp. Other Flee.Insp.
-le.ch.insp.Fee: Plumb. Lisp. Fee. Elec.btsp.Fee:
NOTE.,This estinmte does not ineludejees due to other Departments(i.e. Planning, Public IVorks, Fire,Sanitary Sem,er District,School
District,etc.). These feev are based on the preflininary information available and are onh,an ertinrate. Contact the De 7 for addn 7 info.
FEE ITEMS (Fee Resolution 11-053 FfL ZL 121 FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Pl ant b.I.Hech./F.l ec
Permit Fee: $195.00
Suppl. Insp Fee
Pl n to b./A4ecl t./Fl ec
Plurnh./.dlech./Flec Permit Fee
Construction Tar:
Administrative Fee:
Work Without Permit? O Yes (j) No $0.00
Advanced Planting Fees:
Trcivel Documentation Fees:
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.001 1
F = SUBTOTALS-!1, $196.50 $0.00 i TOTAL FF-E`:! $196.50
Revised: 10/01/2012
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
GLIPERFINO (408)777-3228-FAX(40B)777-333s • bulldiU tie inG.O
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OWN: /��^ PhIDNFOta ��. P-,MAIL
CIT STAT1.%;P M FA%
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e S� L_�o8-218-a33.Q
STREh-r AODRESSS . CITY.gFATe zIPSg��O-SeYC.a FAX
C1 DWNFA ❑ O-NER-GUILDER EIOWN'ER'AGENT .21/fOYTMCTOR ❑CONTRACTOR AGENT ❑ ARCHFTECT ❑E, :Nrrll ❑ O: 21LOPIR ❑ TENANT
CON'TRAMORNAME � [a LICENSENUNIBER LICENSE' 's
Bu's.I 1C.n
COMPANY N'A.WE E-MAIL FA.N
A
STREET ADDRESS CITY.STATE].Ir PHONE
�7. G1 O$e l^i 80
AR('HITECTIENGINIIER NAME LICENSE NUNIDER BUS.IAC.
COMPANY NAME 'SII f;.unl6 FAX
STREETADDRESS I CITY,STATi,%11' PItONF.
usE of ❑ SFD or Duplex Je Multi-Family RMF ARen; V.LLVATION:
STRUCTURE. ❑ Corrh-rlerclal 3 5aSD
EXISTING ROOP TYPE; 11FlUILT.UP RMF ❑ASPIIALTMIINGtri rPWOODSHAKFS ❑W'OODSHI.NGLES ❑OTHE?ISPEOFY)
REMOVF.AEPLACG Jews I TFNO. T ❑ PLYwD 0Ose PITCH 0.00F
❑ Nn c c r .roc .R' s T CD 1 RS A
• FROK)SEDRUUFTYPE: ❑BUILT-OPRMr 9UPHALTSHINOLES ❑WOODSH.AIFs ❑WOODSHINUR$ 0OTHER ICC-ES REPORTN
DESCRIPTION OF WORN:
/lbeii.r 1 �'S ��o cmcL&�iw}L�._r�.o���ns-k.l l 'A" C,D
G'-,e.c{o,;�n�s�d_Presi���pl Gan�O S��nw�les...—G'oler : cru+o�r_�Gr�ay_
By rry signature below,I cenlfy to each of the 1•ollon•ing; Ian the Xopeny owner or authorized agent to net on the property o.vner's behalf. I have rood this
applielloon and the information I have provided is correcl. I hove read the DeScriptlon of Work mild verify it is accurate. I Ogom to comply Keith all applicable local
ordinances and Stitt Ems elating to building Mn, .lion. I' nriurepro ^tie o.'C,uperino to emu the above-Identi(led property for lmllcotion purposes.
SignEvirc of A ppllcanVAgeni: _ Date: I a_
SUPPLEMENTAL WFORMATION REQUIRED OFFICH USE ONLY
_ If building is associated With a Home Owner's Association,provide letter SPLAN CH F.M TYPE _ RoUnce SLIP
of approval from FIOA. OVER.T7TGcouNTER ❑ RGILDIRG M N REVIEW
Frovidc Plannina approval to verify if there any resiric-ions- ❑ EXPREss J PLANN'IN'G PLAN REVIEW
_ Providc copy of Manufacturer's Installation Specifications. ❑ aTANnnno ❑ rrnr.nerr
.Provide signr-d copy ol'Cupertino's TcerhOff Policy. ❑ ()TIER:
RernofApp„2011.doc revised 013/16/17
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-buildingOicunertino.org
PROIF,CT f]R�S. �J/ AM'n
STREETAOORESS CI STAMZIP0 / FAX Aliz
CONTACT 1E (� LICENS 'VMPF.R D LICEN P. RVC LI �� ��
CO) . NA. E �{.,�-'� E-MAIL PAX
STREET {K{S C TAT , P P N
lJ NDERSTAND 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 perfonned.
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%" per foot of slope and demonstrate there is no ponding.
b. Listings from approved testing agencies for all pic-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.
S. 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 cenify 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 c nply with the rc-roof policy stated above. I also understand that
smoke detectors and carbon mo idc detceto ar •quired to he installed in accordance with Sections 8314 and R315 of
the 2010 Cal ifomia Residen ' C de.
Signature of Applicant/Agent. Date:
Remn(Pnhcv_?0/1.dn<revised 02/1G/11