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06060163 CITY OF CUPERTINOr-+'+'r'tk?'va'�%kvuL�'x. BUILDING DIVISION PERMIT CONTRA®TOR IN>{'URMATIQN �?P' S Sign 5 fTb^ '. r! Bu1LDINGADDRESS: FOUR SEASONS ROOFING PERMITNO.06060163 20268 NW S OWNER'S NAME: PERMITLSSUEDATE NORTHPOINT HOA 502 HORNING 07 06/19/2006 HE SANITARY NO. CONTROL NO. (408) 278-0330 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDGO ELECTO MECH O l� uoo LICENSED CONTRACTOR'S DECLARATION Job DaSCrI Description "r1 1 W.by affirm dot 1 Sm licensed der provisions of Chapter 9(cemmeacing P �x with Section 7")ai'Divlsion 3 of the Business tab Professions Coda.and my licwc is infullfmcesndeDect. EMOVE CALSHAKE ROOF, INSTALL 30LB FELT, AND GA ^�� LD�e ac 1 rsD ND CANYON �> � CLASS A Fp J�JGanlrKb ?�I`,i� As shall use DEC cr ON U I undenunJ my phos shall W used u public records �C Limemd Professional OWNER-BUILDER DECLARATION isJ(1(y(s ^ i hereby alarm that I am exempt from db Connectors license Taw for the JUL is,! 2006 2 a o fallowing mason.(Section 7031.5.Business and Professions Code:Any city or county 12 which requires a permit b cco mrucL alter.Wpmve,demolish,Or MPdr any suoctum -zy prior At its issuance,also requires the applicant for such pcsmit in Ok a signed statement Valuatyy6500 that W is liccmcd pursuant b the provisions of the Contractor's License Law(Chapter 9 3q.Ft.FIo RILP' $es (commencing with Section 700M of Division 3 of the Business And Professions Com)or �.. that W is attempt thmofrom and the bash for Ne alleged eatmption.My violialon of - section 7031.5 by any applicant(m a permit subjectsthe applicant to A civil Penalty of AypN Number Occupancy Type .at mare Nan five hundred dollars(5500). 31639044 . 00 1,u awoer of Hct property,a my esepbyen wW m{n u Nev tole mmpewdoa, will do lac wore,And Ne rwclsrc Is rummurded oraifered foruk(Sm.7044,Business Required Inspections and Professions Cade The Contractors Lica.Law does not apply b An owms of q P property who builds m im prawn thmson.and who does each Anal,himul(Or through his awn employees,provided Nat such Imprmemenu Am set mantled OraRered formic.B. however,Ne building or impmwment is mid within can car o(coropledon,the Owner. bell&'will have W burden of pmving Nn Im did not build ar Improve for purpose of ask.). ❑1,An Owner of the property,am exclusively contracting with licensed cenuactors to constmm the project(See.7044,Business and Professions Code:)The Contractors Li. cense law docs sot apply in an Owner of property who Wilds ar Improves Hereon.and, who contracts fat such projects;with a cenuutor(s)licensed purmant b the Conuanues License law. ❑I sen exempt under See .B d P C for Lida resson Owner Data WORKER'S COMPENSATION DECLARATION 1 hereby Larm under penalty a(pedury^m of the following declarmans: I have and will maintain aCeNOcam of Comem to self-lasum far Workers Compen, utlon,As provided for by Sect an 37M of the Labor Code,for He performance of the work for which this permit is issued. ❑1 have and will maintain Workers CompemWon laaursom,As required by Section 3700of the labor Cade.for the performance of the wank for which His Permit is IssmQ My We SCompegFWonias mcarrierod Policynnnn,m'MA:: Cartier. Polky Na.1 -7 14 q� CERTIFICATE F mEmmobt FROM WORKERS' COMPENSATION INSURANCE CThisuction mcd not W completed if the Permit 4Imam hundredd^Oan(1100) nr less.) 1 celsfy that in the performance or th0 work for which this permit is issued.l shall Out employ any person in any massacres As in becoma subject to the Workers'Compens n on laws of Califoma.Date Applicant NOTICE TO APPLICANT:IL after making this Certificate of Esempilm.you Abreast become subject in the Worker.CornNnsadon provisiam of to,Labor Cade.You mon .J O fOMwide comply with such pmvidons or Nis permit awl he domed rt+vked. z ti CONSTRUCTION LENDING AGENCY [-t IWreby.M.land them is•cemmtmma lending agency for Ne performurmof lx 7 the work for which this permit is iumd(Sec.3097.Civ.C.) W�0 Lender's Name ,7 z Lenders Add. U O I mNfy that 1 have read this application sod sum Nn the above information is IL 6~- correct.I qme to comply with all city and county ordinances and Sam laws misting b OU building construction,and hereby authorise representatives of Nis city to enter upon lac W ahove.memiu^ed propeny fm inspection purposes. I We)gree b save,indemnify and keep harmless lire City of Cupertinoatoms ti y Ihbilitin.JW{menrs.eau andtapemu which mayldany nYamue agdnstsaid City UZ incomeqummof Negrantin Sp mi ^' APPLICANT UNDE0.57A Dg A WI COMPLY WITH ALL NON.POINf Issued by: Date ULAT70N5 Re-roofs Z� Signals.of Applimu br Dam HAz DOUS MATERIALS DISCLOSURE Type of Roof Will the appOcam o forum building occupantame orhendk hazer lour material As defined by the Cb2CW&Municipal Cade.Chapter 9.11.and Ne Health and Safety Cade.Encu.25532(x)7 All roofs shall be inspected prior to any roofing material being installed. Yes o Will the applicants or future Wilding Occupant use stalemate,of devices which If a roof is installed without first obtaining an inspection,I agree to remove mit baveism.air aonummams as denned by the Bay Area Air Quality MAA{Cment all new materials for inspection. District? ❑Yq I hoc mad the haardnns mamrisls.quimmenu under ChAPmr6.95 of the Cehfor. nh Health Ir SafctyCode,Sxtions 27505,25533 md25534.I understand thall ik building does not 1 hoc• t, 1 my mspomihllity b notify He occuPIOL of Ne A. na muss metpi 'sumeofaCerti�ofOyapan .ol Signature of Applicant Date owner Or ammirrsd a nt 17 'e'�J Dam. 'll All roof coverings to be Class "B"or better CITY OF CUPERTINO �m 3 of 4 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 31639044 . 00 DATE ISSUED. . . . . . . : 06/19/2006 RECEIPT # . . . . . . . . . : 34921 REFERENCE ID # . . . : 06060163 SITE ADDRESS . . . . . : 20268 NW SQ SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : NORTHPOINT HOA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , 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 *EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 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 • ti Community Development 10300 Torre Avenue /- Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 GJUPEkTINO Building De artment JOB AD 6 O DR S: PERMIT# / O l �� OWNER'S NAME. Q . PHONE # (' GENERAL CONTRACTOR!V-->. 5 , K FAX # // ' I am not using any subcontractors: Carl e C* ignature Date Please check applicable subcontractors m fete the followinginformation: 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 er/Contrac c Signature Date Id 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. 1,. ._ ._ _ .__ . _ . Homeowner's Name: !.JDrilrN PD i r, Job Site Address: D Y)O Roofing Company Name: ApplicanPs Signature: Date: ^ b Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO REROOF • CUPEkTINO PERMIT APPLICATION FORM APN # Date- S1 cnr ro 4&2_0(v Building Address: O � Owner's Name: Phone#: 0 O, IN C tractor: /�1 Phone#: License#: vT 2 t �00� qbg 22 S -0330 /0 $' Contact:�1 ��11 hone#: Cupertino Business License #: o lA 2 xe— �2) -0 .o O Z Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles '9, Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ^ ❑ Wood Shingles Other(Specify) l:q 16 kaK2 ❑ Other(Specify) Number of existing coverings / ❑ Provide I.C.B.O.Report# p To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will CoTRly With Cu ertino's Tear Off Policy: Job Description: ZZ.0,0UL/ Cal S 1 TN s .l 3 0 1 L 1 an Y Gr"X c1K) O+✓ G0 c9f C>,, Residential ;-111-1 Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning De t. if there are any restrictions: Cost of Project Type o onstruction: Occupancygroup: Ssao Qty. if Applicable 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 {