06040088 CITY OF CUPERTINO 77�+'�
BUILIIING DIVISION PERMIT
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMTr N°'06040088
10816 NORTHRIDGE SO
OWNER'S NAME: PERNUT ISSUE DATE
NORTHPOINT H.O.A. 502 HORNING ST 04/17/2006
ONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECT(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
.00 LICENSED CONTRACTOR'S DECURA71ON Job Description
u I hereby affirm that I w licensed under pMVWOn$or Chapter 9(mmmeuing
a= niulilf and ff Dividon3afNeBudreaandProfeasiunsCoda.andmyliccneh REMOVE CALSHAKE ROOF, INSTALL 3OLB FELT, AND GA
yv�z Ucenae Class ` ' Lic.g06
;F Date GmnDEC Pse alc:
DEC
ARCHITECTS LARATION
GRAND CANYON COMPOSITION SHINGLES CLASS A
I unduaand my plans Nall he used u public reads
)du
ANLicensed Professional FI ALED
`m3 OWNER-BUILDER DECLARATION '``!{■
ZO 1 hereby storm on 11. exempt from the Comione Co e:Any taw for tie
ZOO following won.($cedars 70313,Business and ow, as Cade:Any city m county
$
which requires a pemir re mires Me fifer.imprnt for
h rmitdemolish,or minor any suunure
qual a itiouaeaalarmw to the applicant the Cor state, 0leuLoedaWemcm MAY 1ODU
E thathehlicensedpurwemmthePmdsionsa(th<CmnuaelorsUttrtselaw(Ch4Pmr9 Sq.Ft. Floor Area Valuati$�500
e� (commencing with Section 7000)of Divblon 3 of the Business and Professions Code)at
W�S Nat he is esempt therefrom aM the basis for the alleged exemption.My violadon of
Section 7031.5 by arty applicant for a permit aubjeco the applkatno a civil penalty of APN Numbe Occupancy Type
Out more Nan flim Wndrtd dollar(M). 316 3 6 04 4
0 1,as owner or Ube property,Or my employees with Orem as their sok eampeasadon, MADING
will do are wart arta the strvetwe is call intended or offered for sale(Sec.7044,Brahma Required Inspections
end Professional Cade:The Con==s License Law des oout apply m a matter C ns Of q P
property who builds w i m proves thereon,and who does such work himself Or though his
awn emplayea,provided thusuch Improvements w not intended waffmed for We.If,
lamevw.Ne building w improvement is Bold within one year of ampledm.Me Owner,
builder will have the burden of proving that he did ret build or Improve for purpose of
ale.).
0 1,u Owner of the property.am eulusively conuacning with licensed cantraclum m
construct Ute project(Sec.7044.Business and Prolix Ons Cade:)The Conuacuses U•
came law does not apply m an owner of property who builds or Improvm derean,and,
who contncte for such project with a emnraccer(d licensed pursuant m the Communes
License Law.
O lsmaaemptunder See ,B&PCfarihhwm
Owner Date
WORKER'S COMPENSATION DECLARATION
41 I hereby arms under porosity of perjury one of the following decimations:
0 1 have and will maintain a CaNOat ofComcnt toself•Insum fm Wmrkr's Compen-
sation,a provided for by Section 3700 of the labor Code,for de performance of Me
work far which this permit is iaucd.
Mhave sed will maintain Woftes Compensation Insurance,u required by Section
®1
of the Lebec Cade.for cite performance of the work for which this permit Is lauctl.
My Workers Compenation ho m um artier and Policy number am:
Cartier. A.I'( •A - Policy No.: I ZM A4 4 LI
CERTIFICATE OF EXEMPnON FROM WORKERS'
COMPENSATION INSURANCE
rlha section wetl notbecompkted BMe permit Is fwawhundmtldo0an(5100)
carless.)
I certify tel in the performance of me work for which this permit is hoed,I shill an,
employ any person in any muter an u in became subject an the WmrieW CompeaWon
Laws Of Califomi&Oeste
Applicant
NOTICE TO APPLICANT:If,safer making this Ccnifiate of Exemption,you should
Income sublon m tie Worker's Compensation provisions of the Law Coda you man
.J O roMwith comply with such provisions w this permit shall be,Mimed mmkd.
?ti CONSIRUCnON LENDING AGENCY
[r I totally arnmt Um Nem h acoraaucUen lending agency for the Performance of
Cl.rte. the work for which this Permit abound(Ser.3097.Civ.C.)
W� L ndn's Name
=Z Lenders Addrw
U O 1 cedfy that 1 hale read this application and sate dta the show information is
U.F coma 1 apo m comply with all dry end county ordlanat ces and sIan misting m
O V bottoms construction,ad hereby authoan mprtsenaMvms Of this city to enter upon rte
[id alevomcauwmd property for inspection purposes
(We)acme to aw.indemnify and lamp harmless Me City of Cupertino against
fa/1 li4biliMq judgmena.core and eapenses which may in any my ueuc agsim,aald City
U Z in consequence of the granting of this permit.
APPLICANT UND AND ND W LL COMPLY WITH All NON-POINT Issued by: Date
APPLICANT
U NS.
0 6 Re-roofs
Signaue of Appll m Dam
HA owl ATERIALS DISCLOSURE Type of Roof
Will thcapplicatorfum bas ingaapentsmmwlundlr:hvallou to aial
u denued by the Cupenina Mrn pal Codc.Chapter 9.13,and the Health and Safety
Code,Section 35533(4)? aA All roofs shall be inspected prior to any roofing material being installed.
0Ya ,I(R4o 41
WIII Me applicant or future building occupant use equipment a devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit krardnua air cor aminsna at dc0ud by the Bay Area Air Quality Management all new materials for inspection.
District?
O Yes XNu
I have mal the hwdow mamdals requirement under Chapfer 6.95 of the Califor. �/
niaHalLh&Safety Cade,Soedons35505,35533.d E534.lunMn dthalftie building % — /7_Q(e
Uaw rel currently haw a want•that it b my msponsibllity to noUl'y the accupont of the
requlrtanc ismer mel pa r on
louatec ofa Codlkam Of Occupaey. Signature 0 pp Icon Date
41,/
^�� 11 roof coverings to be Class"B"or better
Owner IhortmKip,IcDate'
CITY OF CUPERTINO
am 3 of 5 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31636044 . 00
DATE ISSUED. . . . . . . : 04/17/2006
RECEIPT # . . . . . . . . 34017
REFERENCE ID # . . . : 06040088
SITE ADDRESS . . . . . : 10816 NORTHRIDGE SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT H.O.A.
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : SAN JOSE CA, CA 95125
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 BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BENERGY PERMIT FEE 126 . 36 60 . 65 0 . 00 60 . 65 0 . 00
BPERMFEE VALUATION 6, 000 . 00 126. 36 0 . 00 126 . 36 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 187 . 01 0 . 00 187 . 01 0 . 00
•
Community Development Department
c' Building Division
City of Cupertino
• � : � ew 10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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 " 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: TL_ )r4� 0-1r rt ' II ff
lob Site Address: 10$1ly �or t/i� e � tro CA Oi�Uj`(
Roofing Company Name:
Applicant's Signature: Date: OI/
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
Community Development
10300 Torre Avenue
aClOF
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
SCUPEI�TINO
Building Department
JOB ADDRESS: PERMIT#
I(o OAQear vino CA . (-
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors:
Signaft5e4 Date
Please check applicable subcontractors and com le e 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
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO OQ D g D n U
REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN # Date'
k U 34 0 U LA +1 Ll —ou
BuildingAddress:
loto tw So
Owner's Name: Phone #:
C tractor: Phone #: License #:
ML>r ycl 2't S -0330 /0 9-
Contact:
Contact: hone #: Cupertino Business License #:
27 $ -o33O
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
JaL Other(Specify) Ca 8kaK.El ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Com 1 With Cu ertino's Tear Off Policy:
Job Description: -,� p S I $�.1.k 30 G C 1 an
G 2 Gr"X Ge o5 f4!0^r Ow'n le.S' C Ais
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are any restrictions:
Cost of Project Type of Construction: Occupancy group:
SSbO
Qty. if
A ]icable Fee ID Fee Description Fee Group
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
•