06030051 CITYOF CUPERTINO 4- .7#: rgrsszrxv�i?�^' yt4x':'
BUILDING DIVISION PERMITC®NTRAC�`TURINFQRMATION
BUILDING ADDRESS; FOUR SEASONS ROOFING PERMIT NO.06030051
20125 NQRTHWIND SO
OWNER'S NAME: PERMIT ISSUE DATE
NORTHPOINT HOA 502 HORNING ST - 03/10/2006
NE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECTMNOINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30o LICENSED CONTRACTOR'S DECLARATION me BuJob Description
r0 U 1 thereby affirm W
Nat 1 am licensed under provisions of Chapter 9(commencing
with Section 7")of Division 3 of dncas and Profeaaions Code,sedan It..0
mP< imm�m naadnff Z REMOVE CAL SHAKE ROOF, INSTALL 30 LB FELT, AND
'z LieaaClaa Lle. GAF GRAND C S�V�,N® ALED
POSITION SHINGLES - CLASS A
lgt-- Dau used as public
���
3p ARCHf1ECTSDECLARATI N
tau I undcruand my Alarm shall he used u punlic Tacna"
5 G� Licensed Professional
OWNER-exempt frDEthe Contractors
I brachy a(Su ann 1 am exempt from the fee m.Co License law for the APR — 1006
oO following mason permit
7031.5,Business and Nofesduns Code:Any city ormmy
$ whim tits au a pormit re cnr srthe nor,impmsu demolish,m repair any swcture
pdormits iuunce,alsu mqulma the applicant for such permit to fjmasigned atsumem
< thnheislimnscdpuramnitolhcpmvisions M the Contractees Liccve Law(Chapter 9 Sq.Ft.Fl8jrLpj r%
Valuati TI)500
$ (commencing with Section 7")of Oivision7 of Ne Bmincsk end Profuulnm Code)or
.. Nat W m exempt therefrom and the huts fm the alleged exemption Any Aultif.of "—r-1
Section 70313 by any applicant for a permit subjects the applicant to a civil penalty of 00th Number Occupancy Type
mat came than five hundred dollars(3300L 3163 8 013 . 0 0
Q 1.uowneroftiepmperty,armyempioyeuwiNwaeesudekanlecompe oon,
will do dewok,and Nesuucu ,I.not handed reoffered fossam(Se.7044,Busircu Required Inspections
and Professions Code:TW GmncmrS Liaise law Onus not apply m e ns an owner of q p
property who builds or improver,thereon,and who dans such coat himself ar"rough his
awn employees,provided Natsuch improvements me notlmmnded mallard foram.if,
however.the building or Improvement is sold within ane year of compledon,Ne owner.
builder will hale the burden of proving mal W did not Wild or improve for purpose of
sale.).
❑1,as owner of use property am excrosfvely comaacting with licensed cenaacton m
construct iW project(Sec.7014,Business and Professional Code:)The Contractees V-
cense law data not apply to an owner of property,who Wilda or improv s mem m.and,
who connate for such projects with a contncar(s)Imme d pursuant m 1W Contrammes
License Law.
❑I am uemm under Sec. .B.4 P C far this reason
0. Dau
WORKER'S COMPENSATION DECLARATION
1 hereby aBion trades ponslly of perjury aro of tiro following declarulans:
I have and will malnWn a Cenifieam of Consentmself-insu a for WarkehCwnP n
station.as provided for by Section 7700 of the labor Code,for the performance of the
wart for which this permit Is Issued.
❑I have and will mainum Waken Compensation incomes,a required by Sedan s
77W of the Lab"Code,for the performance offt wok fawhich Nu permit is tuned.
My WokeesCm ninaumtce artier ted policy rumba a rt:
Grtkr. � paltry No.: /Z-y Z 14 y��
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thtssoulan nod not W completed ifflan Permit is foronc hundred dollars($100)
nr lug.)
1 certify cant in the performance of Ne wok for which This permit is intend,l shalt tat
employ any person in any manncran as a became subject to tW Warman'Compems0on
laws of C.Iffmam.Dam
Applicant
NOTICE TO APPLICANT:If.after making this Cedificam of Exemption,you should
become subject to the Workers Compensation provisions of me labor Code,you must
.JO faNwith comply with such provision or this Permit Mall a deemed uvaked.
Z Fti CONSTRUCTION TENDING AGENCY. 1 amby affirm that then is a construction lending agency for the performance of
Cir the wet fa which this Permit is issued(Sec 3097,Civ.C.)
IliQ Landeea Name
z Lenders Address
U Q 1 certify that I have read this application and sum mal the save information is
Ur, correct.T agree to comply with all city and county ordinances and sum laws relating to
C) building convection,and hereby authorice representatives of this city to cnmr upon the
W ahovemrntioned property for impcedon purposes
gy (We)agree to an,indemnify and keep harmless the City of Cupertino against
n Ihbilidu,judgmenu,cosu andexpeua which may in anyway a one agamussid City
V 7 In consequence of Ne granting of Nu Permit.
PPLICA STANDS AND WILL COMPLY WI
T'+ AUN I,L N N-POINT Issued by: Date
SOUR CU ONS.
/ Re-roofs
Signuum al'AppllcanitConuxmr Dam of Roof
HAZARDOUS MATERIALS DISCLOSURE Type
Will the applicant a future Wilding aceupantstare mbandle became.material
an dcOncd by the Cupertino
Municipal Code,Chapter 9.13,and the Health and Safety
Cada.Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yu �e
Wits the applicant f/alum Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mIt hayandoua air commmants u donned by the Bay Area Air Quality Management all new materials for inspection.
Guam'?
❑Ya AIN.
[haw mad me headdm 3mamdam requimmems undcrChspw6,93of Ne Califor-
nuKml@SafetYCode,Sedans25303.25333aal23534.1undcmanmuifthe Wilding
dean not cmremly MSc a ant.mu it a my responsibility to wiry we acupant of me
reyuim' calmWmetpdoranWuanceof'c"`:team cup.y Signature of Applicant Date
3G
ow aamamteaa ran Dam All roof coverings to be Class"B"or better
CITY OF CUPERTINO
4 of 4 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31638013.00
DATE ISSUED. . . . . . . : 03/10/2006
RECEIPT #. . . . . . . . . : 33514
REFERENCE ID # . . . : 06030051
SITE ADDRESS . . . . . : 20125 NORTHWIND SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0551
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
WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL
______ _____________ __________ __________ __________ __________ __________
BPERMFEE VALUATION 6, 000.00 126.36 0.00 126.36 0.00
BSEISMICRE VALUATION 61000.00 0.60 0.00 0.60 0.00
__________ __________ __________ ----------
TOTAL PERMIT 126.96 0.00 126.96 0.00
METHOD OF PAYMENT AMOUNT NUMBER
_________________ ____________ _________________-
CHECK 507.84 005389
TOTAL RECEIPT 507.84
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
aClOF
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408)777-3333
*UPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
z,,r- ,Uo. �l�,.� S� . X3065/
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: i Se-Ls, FAX # 2 7 S—037
I am not using any subcontractors: Z
Signature Date
Please check applicable subcontractors and complete 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
Tile
Owner/Contractor Signature Date
Community Development Department
Building Division
City of Cupertino
• 10300 Torre Avenue
CITY OF Telephone: (408)777-3228
C U PEI�TI NO 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-pr6gress 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: /Vo/ �ellO>t"V
Job Site Address: ZS Par4'.-. a
Roofing Company Name: f zv✓rS
Applicant's Signature: Gn7 ��- Date:
• Greg Casteel
Building Official
Revised 11/2/04
D.:nbd..n OurvnlaA 0emr
CITY OF CUPERTINO
REROOF
. CUPERTINO PERMIT APPLICATION FORM
APN # Date'
31 (D - 5�-ta l3 3 co
Building Address: e
po t ;2 5 k)o(4-�wi J- SO-
Owner's
QOwner's Name: " Phone#:
0C okaA— O, 111�.
C tractor: Phone#: License#:
,-,r 2 a Y0g 22 $ -0330 /0 K
Contact: /� hone#: Cupertino Business License #:
`i 4j6 lit Z 0.fz� �2) $ `o 3.3 O
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles * Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
jd'- Other(Specify) Ca I 8 kaK-01- ❑ 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 Com 1 With Cu ertino's Te az Off Policy:
• Job Description: �� S T�s tY.1 k 3 o G C 1 an
G Cir Gw of+ C'n csiklo�+ 61.'n Ics — ss
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De I. if
there are any restrictions:
Cost of Project Type of Construction: Occupancy group:
Qty. if
A licable Fee ID Fee Description Fee Group
BPERMFEE 91-d-g Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•