06060211 ,CITY OF CUPERTINO
BUILI)ING DIVISION PERMITU .
j (��V Y2?i.G` f'�12I1 T`� IA•TIQN` f
_z ) .., :.,+ `kin_Mf.<.a 'f?r' 3+n:$'•S5•Yrt 'xd..T"'.CS'dY rc.'I'a"
BUILDINGADDRESS: ' FOUR SEASONS ROOFING PERMITNO'06060211
202C;7 NORTHRPnnN SO
ER'S NAME: PERMIT ISSUE DATE
NORTHP NT HOA SO HORNING ST
ONE: SANITARY NO. CONTROL NO.
408) 278-0330
ARCHITECTIENGWEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB
MECH
O
Sop LICENSED CONTRACTOR'S DECLARATION Job DPSCrIpCIOn
1 busby aRrm that I am licensed under previsions of Chapter 9(Commencing
with Section 70M)or Olviskm 3afthc Business and ProfessiNs C aadmylicamels
n'1 I.f.Ilfom.sed.ffect REROOF-REMOVE KE/INSTALL 30 LB FELT &
o: % ' —c + AF GRAND CAN ES-CLASS A
g ARCHITECTS DECLARA ON / _
I understand my pluu shall M used u public records ��yy
] U
Licensed Professional
5D� OWNER-BUILDER DECLARATION AN �ssw �ryn,v
Z S 1 hereby Am.Sect drat I em exempt from uact
m the Conal License w for the J tf t!b
i a O 0 fallowing musaa(Section 703 1.3,Business and Prefesdam Code:Any dry w County
S$ which mqulru a PCrall in Cameroon,alms hmprew,dcmalW.at mpair any strwwm
prior m its issuance,aim requires the applicant for such permit m me a signed atstemen Val IBt'
p— c
that he is licensed purmranl re the provision,of the Connector',license Law(Chapter 9 Sq.Ft.FI �5 5 0 0
y�s (commencing with Secdon 7000)of Division 3 of the Business and Professiom Coda)or
Nat he is exempt themfram and the basis for the alleged es"mptmn.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant 10 a civil penalty of APN Number Occupancy Type
not ream than five hundred dollen(.SM. 3163901377 . 00
❑I.u.wnerofthepmpmy,amyemploycawlNwaguutMirmlcmmpenndon,
willds the work,and thestrecmm is mtm¢nded orortered fornm(Sec.7044,Business Required Inspections
and Prefessiow Code 7.Canuacbh LRenas Law does ant apply m m Owner of q p
property who builds.rimproves Nemo,and who doessneh work himselfmmmugh his
awn employees,provided mat such improvements are not intended oroRered fes We.If.
however.the building or Impermanent Is sold within ate year orcompledon.the owner.
Wilder wig haw dm burden of proving dot he did NO build a improve fa purpose of
taleJ.
❑1.As Owner of the property am exclusively Contracting with licensed comractan m
eoestruct tiro project(Sec.7044.Eastman and Rafasiam Cade:)The C°"oacmYs U•
cewe law dao ret apply As As awns of progeny srhe Wilds Or Improves thercon.Axl
who Contracts far such project.,with a eonuacmr(s)gemaed pursuant m the Comanche,
License Law.
❑1 son exempt undo See .B k PC for this mason
er Date-
WORKER'S
amWORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury ate of the following declarations:
❑Iham°nd MilmalnminaCeNOumof Comentmxlf-immmf°rWorimesCanpen-
sadon,As provided fa by Section 3700 of the Labor Cade,for the performance of the
work for which this permit is issued.
❑1 haw and will maintain Worker's Compensation Insurance,As required by Secdon
3700 of the lata Code,for the part..A(the work for which this permit is tuned.
My
GrtWiear 's CampgndCarries and Polity
cy Na.:
n
RexCATE ��
KtoIN
FROM WORKERS
COMPENSATION INSURANCE
(ThLLmedm sad oat he completed If the permit is form hundred Callan($100)
or leu.)
I amity that In the pa alarm race of the work fa which this parch is iumd,I slWl not
employ any penon in any manrmr An as mbWcome subject m tho WoM Compensation
Laws of Caltfomi,Data
Applia"t
NOTICE TO APPLICANT:If,ager making this Certificate of Exanpdon,you shwW
become subject in the Worsees Compensation previsions of the labor Code.you moat
7�O forthwith comply with such provisions or this permit shall M accused mucked.
q CONSTRUCTION LENDING AGENCY -
i--i (hereby am.that Vert 1.a construed."lending agency far the parfurmme.of
iY. due work for which this permit is bound!(Sex.3097,Civ.C.)
�W Q undoes Name
0en
z lder's Address
U O 1 aenify that I have mad thin application and state this the above wormada"I-
D,F correct.l agree to comply with all city and county Ordinances and store laws mlatmg re
OU building construction,and hereby aumhorim mpmsenwives of this city to enter upon the
LU ahave-mentioned property for inspection purposes
f's (We)aft.to saw,indemnify and trap harmless tie City of C.Nni"°aVinat
w Iiabilides,juigmcns.catsmdA.pc.which may in any ray amus against said City
U In cNaeguenee Of the gnndng of this permit.
APPLICANT UNDER D WILL COMPLY WITH ALL NON-POINT Issued by: Date r 2L.�
SOURCE RFAULAII S.
Cl (so Re-roofs
Sign-sum ofA li °"DOUS MATERIALS DISCLOSURE Onto of Roof
Will tic pp tafmue building aeupantstare a Moulin hazardous butterfat
defined by uEIZ Municipal Code.Chapter 9.13.and the Health and Safety
Section 355324) All roofs shall be inspected prior to any roofing material being installed.
❑Ya 11_�j-
Will the app clot or future building Occupant on equipment or devices which If a roof is installed without firs[obtaining an inspection,I agree to remove
ami,hazard..air rnanu u defined by the Bay Ana Air Quality Mamgcmcnl all new materials for inspection.
District?
❑Yes u
I have mad the hazardassmaterials mquhcm ants udder Chapter B95 ofth.Califor.
.in Health Jr SafctyCcde.Secdau25505,25533 sod 35534.i mden and autifthe building
doesoat cormndy hew a ma this It a my msp.mibiiity m notify the°aupmt.f the
M ' which. m res issuance.faardficauVI cU Signature of Applicant Date
�^ v
wner err euthor'zedcnt All roof coverings to be Class"B"or better
ODau'
CITY OF CUPERTINO
I 2 of 6 PERMIT RECEIPT OPERATOR: suem
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31639037.00
DATE ISSUED. . . . . . . : 06/26/2006
RECEIPT #. . . . . . . . . : 35013
REFERENCE ID # . . . : 06060211
SITE ADDRESS . . . . . : 20257 NORTHBROOK SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0501
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
•
FEEID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW- BAL c'
---------- _____________ __________ __________ __________ __________ __________
BPERMFEE VALUATION 6, 000.00 126.36 0..00 126.36 .,,. 0.00 -
BSEISMICRE 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 VOICE ID DESCRIPTION
305 FRAME 307 INSULATION
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
•
Community Development
10300 Torre Avenue
Cupertino A 95014
Telephone(408) 777-3228
cl OF Fax(408)777-3333
qU PEf�TINO
Building Department
JOB�ADDRESS- PERMIT # 0
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR• , ^ FAX #
I am not using any subcontractors: �J \If
Signature Date
Please check applicable subcontractors arcomplete the following information
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
Ej• Tile
ner/Contractor Signature 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 Name: 00
Job Site Address: (Y 1)(9
Roofing Company Name:
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
0 REROOF
$CUPERTINO PERMIT APPLICATION FORM
APN #
31 (�-3�- d Dam pZlo�O�P
ildin Address:
O S!s
Owner's Name: , 11 Phone#:
pC't oin {— O, Ac.
C tractor: Phone#: License#:
e,Xl y0s Z2 S -0330 /0 8'
Contact: nn hone#: Cupertino Business License#:
0 1J�2n(2� a1 57 -0330 Z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )Z�, Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
Other(Specify) (2q 16 kaKe_ ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O.Report#
p To be Removed ❑ Provide Mfgr. Installation Specs.
dhT Have Read, Understand and Will Com 1 With Cu ertino's Tear Off Polic
Job Description: �� l 30 t C an
J= Cor o.� 60,405141cyj SI.'n Its —
Residential I Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning D t. if
there are any restrictions:
Cost of Project Type of truction: OccupanW group:
Qty. if
Applicable Fee ID Fee Description Fee Group
1 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