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BUILDING DIVISION PERMIT.
'
BUILDING ADDRESS:
FOUR SEASONS ROOFING
PERMIT 110.06060213
20217 NORTHBROOK SO
ER'S NAME:
PERMIT ISSUE DATE
NORTHPOINT HOA
502 HORNING ST.
nr19.r120Q6
PHONE:
SANITARY NO. CONTROL NO.
(408)278-0330
ARCHITECTYENGINEER: .
BUILDING PERMIT INFO
BLDG ELECT PLUMBD
D D D
LICENSED CONfRACrOR'S DECLARATION
- Job Description
I l meby affirm that I Am limned under pmvWons of Chapter 9 (Commencing
with Section 7037)) of Division 5 o(ihe Business and Prokesimn Code, and my license b
in full and erect. ! g
REROOF-REMOVE CALSHAKE/INSTALL 30 LB FELT &
sefarce
Uzmb �2W.L C�emnctar
, R*F GRAND CANYON COMP SHINGLES -CLASS A
ARCH? l DECLARATION
1 understand my plans &lull he used u public records
Licensed Professional
OWNER -BUILDER DECLARATION
�®
I herehy &ITim the I am exempt from the Contractees license Law for the
-
L
��e
following mason. (section IIDLS, Busimas and Ihafwiaos Code: MY city or roomy
which requires a penult a em9 t. Aller. Improve, demolish, or repair any structure
prior W its issuance, Wa requires the applWat for such peril1001c &signed st,temCot
that he is licensed pursuant W de provisloa of the Contractors UaMA law (Chapter 9
Sq. Ft. Floor Area J�
- b Valuat” 5 0 0
200sv
(commencing with Section 7000) of Division 3 of the Bulnessaral Pro(casiaru Cade) m
that he t, exempt therefrom and the bub for the allrycd emmptiom Any violation of
__TPN Number ey Type
season 7031.5 by any appllesnt for a permit subjects the applicant W a Civil penalty of
not mart Nan Run hundred dollen ($5007.
31639033.0 0
❑ I. u owner ofthe property, or my employees with wages u their Aute compenation.
will do thewark.end Uncommon is notinumadoroffered formic (Sec. 7644• B"...
Re uire 375 CCUOBS
and Professions Cade: The Communes License Law does Inst apply W an oven of
q P
property who builds or i mprowa thereon, and who does such wosk himsel r err trough his
Own employees, provided thetsttch improvement, arc not intended ororered for We. If,
however, the building or improvement b &old within one you ofcompledan. the owecr-
Wilder will have the burden of proving that he did not Wild m Improve for purpose of
SAM.).
❑ 1, a owner of W property am exclusively contracting with licensed Contractors W
Conswct the project (See. 7044. Business and Professions Code:) The Communes Li.
tens law does not apply W a owner of property, who Wilds or impmws theme, and
who conmet, for such pmjmU with a conmacmr(O licensed pursuant m the Contractor's
License Law.
❑ lameaemptunder See ,B&PCfothismaan
Date
WORKERS COMPENSATION DECLARATION
1 hereby grim under penalty of perjury rn of the following dmlaaulans:
❑1hartandwill
raby =Oon37uofComemWse1f-inamforWorkerCompeer-
atio, pmvidhi (pe by Satin 5700 of the LabOc Cade. (os Ute performaae of the
r
work for which this permit is btuN.
❑ 1 haw and will maintain Workers Compensation Insunue, u na7Wred by Section
3700 of the Labor Codc. (a the pirfomace of the work fawhich this permit b lased.
Mywarkees Compeuatin lnwra exmiv AM Policy number am:
-
Cartit Mt t•I, 1 n 7EMMP'licy
FROM WO ERS'
CER71Fl A N FROM WORKER$
ATI I
COMPENSATION INSURANCE
(Thbsectlan coed set ISO catiN ed Ifdu permit b fOcoe hundcddoOAn(8100)
or leas)
I Certify that in the performance of the war for which this peril 6laued, l shall net
employ any person in any manner so u W become Subject to tie Woriren' Compensgden
Laws of California. Dam
Applical
NOnCE TO APPLICANT: If. sfer making this CeNOtale of Exemption. you Arnold
become subject to the Werkces CompnWlin provisions of the Latin, Codc, yen must
forthwith comply with such provisions or this permit shall be deemed mwkcd.
CONSTRUCTION LENDING AGENCY
I hereby affirm Lou Nem Is a comtmctina lending agency for the performance of
the wart for which this permit t, issued (Ser. 5097, Civ. Q
Name
Lcndees Address
I etnify that 1 have mad this application and sue that the &bow Information is
I agree to comply with all city ad county ordinances and state laws mlating W
Wilding consuuclian, and hereby &mhorim¢pracmativu of Nis city to enter upon the
.hove -mentioned progeny for insptm.A pugwse..
(We) agree to Saw, indemnify And Men harmless the City of Cupertino against
liabilities, judgments, costs ebu expenses which may in Any way acne against aid City
of this permit
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
A PLICA T of the UNDERSTANDS
y � n
Issued b Date
EC NS. 1I � (0
b V
Re -roofs
T of Roof
Type
Signuure. IicadcWtme r Date
HAZARDOUS MATERIALS DISCLOSURE
Will the Applicant or future building Occupant sort An handle huardous material
deflmd by the C no Municipal Cade. Chapter 9.13, and the Health ad Safety
e, section 25533(+)7
All roofs shall be inspected prior to any roofing material being installed.
❑Yes Na
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building Occupant use equipment or devices which
emir hexand air Inane u defined by the gay Amo All Quality Maagcme.t
all new materials for inspection.
District7
❑Ya Nu
I have mW the raardo; materials equlmmeus under Chanel 6.95 oftheC IiMr-
nob Heald" Safety Cade, Sued. 25505.25531 SAW 25534. I understand dut ifthc building
does tet curentiymsune dot it b my responsibility W notify the =upset of the
ds muB arWiauateeof. nation of upuey;^
TN
Signature of Applicant Date
IP
All roof coverings to be Class "B" or better
owier er,ethe eda tut
Item 4 of 6
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Elk: Lot:
APN ........: 31639033.00
DATE ISSUED.......: 06/26/2006
RECEIPT #.........: 35013
REFERENCE ID # ...: 06060213
SITE ADDRESS .....: 20217 NORTHBROOK SQ
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER ............: NORTHPOINT HOA
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
OPERATOR: 8uem
COPY # : 2
VOICE ID DESCRIPTION
305 FRAME
601 ROOF TEAR OFF
603 ROOF BATTENS
Ll
VOICE ID DESCRIPTION
307 INSULATION
602 ROOF PLYWOOD NAIL
604 ROOF IN -PROGRESS
RECEIVED FROM ....:
FOUR SEASONS
ROOFING:'..
CONTRACTOR .......:
DIAZ, ALFRED
LIC #:21323
COMPANY ..........:
FOUR SEASONS
ROOFING
ADDRESS ..........:
502 HORNING ST. .. ..,
'
CITY/STATE/ZIP '...:
SAN JOSE, CA'
95112''
TELEPHONE ........:
(408)278-0330
FEE ID
__________
UNIT QUANTITY
_____________
AMOUNT
PD -TO -DT THIS REC
NEW SAL
BPERMFEE
__________
VALUATION 6';000.00
__________ __________
126.36
__________
0.00 126.36•
__________
0.00
13SEISMICRE
VALUATION 6,000.00
0.60
0.00 0.60.
0.00
TOTAL PERMIT
__________ __________
126.96
__________
0.00 126.96
----------
0.00
VOICE ID DESCRIPTION
305 FRAME
601 ROOF TEAR OFF
603 ROOF BATTENS
Ll
VOICE ID DESCRIPTION
307 INSULATION
602 ROOF PLYWOOD NAIL
604 ROOF IN -PROGRESS
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRES
PERMIT # 96 /
O R'S NAME:
PHONE #
GENERAL CONTRACTOR:
FAX #
I am not using any subcontractors:
ignature Date
Please check applicable subcontractors and complete the following information:
60
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
__Owner/( on�tractorSignature
Date
Community Development Department
Building Division
City of Cupertino
• 10300 Torre Avenue
Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
Subject: Re -roofing policy for the City of Cupertino
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re -roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re -roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre -inspection and/or tear off approval.
2) In -progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
• 5. If plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re -inspection fee of $176.18. The re -inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re -roofing.
Homeowner's Name14
Name: AJar�Y� i r \ 0 •r—\
Job Site Address: o a4v, b rnoI( s -
Roofing Company Name:• 5 ��
Applicant's Signature: Date: ��so�
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION FORM
�) �dko o
APN #- �� O
r
Bldg Permit Fees
BUILDING
D to
Building Addr
BUILDING
BSEISMICRE
Seismic Fee Res
D
6 200
S
U
Owner's Name:
Plan Check Fee
BUILDING
Phone #:
o C`I-Lo �, a A--
O, A .
t
Cractor:
Phone #:
License #:
C>r Setses Veokl
lYog
2`t S'0330
/0 $
Contact:n
CQ
hone #:
Cupertino Business License #:
o Z ar'e. g
�2 7
g -o $3 O
Z
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
❑ Asphalt Shingles
)2�, Asphalt Shingles
O Wood Shakes
❑ Wood Shakes
❑ Wood Shingles
Other (Specify) Cg ($ kcrP--
❑ Wood Shingles .
❑ Other (Specify)
Number of existing coverings /
❑ Provide I.C.B.O. Report #
p' To be Removed
❑ Provide Mfgr. Installation Specs.
Have Read, Understand and Will CoTRly With Cu
ertino's Tear Off Policy:
Job Description: 0co�k
S k&W-r-
\. 3 o G (C --t- 1 01
G GC"X
Criv o +
osrflo�+ ^cl�'n ltS
Residential Commercial ❑
Fire Zone: Yes ❑ No
Confirmed with Planning Dept. if
there are any restrictions:
Cost of Project
Ssao —
Type of truction: Occupancy group:
Qty, if
Applicable
Fee ID
Fee Dn-nrintinn
FPP ('.rnnn
BPERMFEE
Bldg Permit Fees
BUILDING
BENERGY
Energy
BUILDING
BSEISMICRE
Seismic Fee Res
BUILDING
BSEISMICOM
Seismic Commercial
BUILDING
BPLANCHK
Plan Check Fee
BUILDING
BUSLIC
Business License
BUILDING