06030049 CITY OF CUPERTINO .� ti ; ,.�, �, 7777-7
BUILDING DIVISION PERMIT CUNTRAGTUR�°TNP'URMATIO ¢
BUILDING ADDRESS: FOUR SEASONS GARDENING PERMIT NO.
06030049
10145 NORTHWTND 90
OWNER'S NAME: PERMIT ISSUE DATE
NORTHPOINT H.O.A. 2429 LAST OAK DR rl111o17.o06
NE: SANITARY NO. CONTROL NO.
(408) 358-8003
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT
IPLUMB MECH
I� C� [�
3o j LICENSED CONTRACTOR'S DECLARATION Job Description
ee I hereby affirm Nat I em licensed under pmviuona of Chapter 9(commencing '
ZZ with S=tion 7glU)ufDivlaton3of the Buunwud Pr usiou Codc.efum Iicense1.
n= in full forceaedertec 7 p� REROOF-REMO STALL 30 LB FELT AND
j n Z Lkenw Class
Lk.p
' Dam Contractor GAF GRAND P GLES-CLASS A
ARCHTIELTS DFOLARATIO
i understand my plans shall he used u public rtcnr0 '
k4 Licensed Professional
ho OWNER-BUILDER DECLARATION APR 2006
I hereby of ton that I am exempt from the Conuenofs License Law for the
D O following moon.(Section 7013,Business and Profession Code:My city or county
$ which requires a permit fo construct.alter.impmen.dcmNuh.or cartel,any structure
zi prior to its issuance,also requires the applicant for such permit to file a signed statement
dmhe is licensed pursumuo the provisions,of the Contactor"dame Law(chapter 9 Sq.Ft. Valuatil6500
� (commencing with Section 7000)of Division 3 of the Business and Professions Cada)or MLUIN Air
e r3 a that he I.eumpt therefrom and the basis for the alleged exemption.Any chelation of
Section 70713 by terry applicant for a permit subjects the applicant to•civil penalty of APN Number Occupancy Type
not more than five hundred dollars(gsOm. .. 31638011 . 00
D I,u Owner of the property,or my employaa with wages as their sole compensation,
will do the work and thealmmum Is=intended or oRertd fon W.(Sec.7044,Business Required Inspections
and Professions Code:The Communes Licetue Law does not apply m e an Owner of q P
property who builds or i mprovu Iberton,and who does such work himsel f or through his
own employees,provided that such Mprowments see nolintended oroReted fuaak.IL
however,the building Or improvement Is sold within one year of completion,the owner.
Wilder will have the burden of proving that he did tot build or improve for purpose of
sale,).
D 1.as owner of the property am exclusively conuuskg with licensed cenlanoa In
construct the Project(Sec.70N,Business and Profession Code)M Conuaeto't L6
teat Law does Out apply m.owner of properfy.wM bulks or hoped.chances,and
who conduct,for such pmkcts with a contrumr(s)handed pursuant to the Committees
Liceve Law.
D lamexemptundc Sec. ,B&PCfarlAtamusem
Gwnu Due
WORKERS COMPENSATION DECLARATION
I hereby in.under penalty of perjury arc of the following dectaratioas: -
I haroand will maintain a Cert fiumof Coruent mself-imum fon WorecesCompen-
lon,u provided for by Seetian 7700 of the labor Code,for the reviews.of the
work for which this permit Is issued.
D 1 have and will maintain Workch Compensation Imuran,u requited by Section
37M of the labor Code,for the peRarmuceof the work for which this permit is Wood.
My Worker's ompensation insurance carrier and Policy number w: [.
Carrier, `9L policy No.:
2 2 T
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
ClhisuNon need not Wcwnplewd time pmer it isforow Worked deltas($100)
or lass.)
1 o"t,that In the performance of doe work for which this permit u issued.I shall net
employ any pmmn In any mummer an ts to become subject to the Workcn'Compewtion
Lawns of Califomia,Dam
Applicant
NOTICE TO APPLICANT.IL after making this Certificate of Sammons.you should
become subject in the WOrkees Compensation provisions of the labor Code,you most
0 Q forthwith comply with such provide.or this permit shall be doomed ervaked.
„z,i 4CONSTRUCTION LENDING AGENCY
F+ 1Manby.M.thatcoca Is acoutmction lending agony for Je pOmpartanceof
ai 7 the work for which this permit It issued(Ste.IDSL Civ.C.)
QUndere Name
Lcocke.Address r
V Q 1 certify that I haw rad this application and sum that the above information Is
L417. correct.l agme to comply with all city and county ordinances and suite laws relating m
pU building construction.and hembysothnrice mprmenutins of this city in color upon the
W ahovcrnemioned propcny,for Inspection purposes.
f5. (We)agme in sew,indemnify and keep harmless the City of Cupertino aNimt
ti
in liabilities,judgments.costs and expenses which may in my way am=al lfw mid City
V 7 in consequence of the{ranting of this permit. G G
Fl APPLICANT DESR$TANDS AND WILL COMPLY WITH ALL NON-POINT Isiued by:9 Date
SOUR LLDONS. O/IO�Cj SO
Si/gnalmtca of�Applitm—VColn-•mac—I—u •7 Date Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the appliesm or future Wilding occupant more a handle huardoa material
u defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code.S=tiom 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
Dy. rEP06- '`
Will the applicut=future building=.pent tau equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
t haurdnua air contaminants ss defined by the Bay Area Air Quality Management all new materials for inspection.
mk1T
❑Ycs fTu .
I haw mad the hazardous materials requirements Order Chapter 6.95 ort the Califor-
nia Healthk Safety Code,Sections 25505,25577 and=34.I understand Unit lime building
does not cum fly ha a tenam that it is my responshobty in madly the decupanl or the
myulmmen k ti; nmLpfiartaiasaan=enccdma oofooccc clx, Signature of Applicant Date
�'l `�
Owner wauthomeda emDelo All roof coverings to be Class "B"or better
' �
CITY OF CUPERTINO
2 of 4 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31638011.00
DATE ISSUED. . . . . . . : 03/10/2006
RECEIPT #. . . . . . . . . : 33514
REFERENCE ID # . . . : 06030049
SITE ADDRESS . . . . . : 20145 NORTHWIND SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT H.O.A.
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0551
RECEIVED FROM . . . . : FOUR SEASONS ROOFING
CONTRACTOR . . . . . . . : SCOTT R. JOHNSON LIC # 27258
COMPANY . . . . . . . . . . : FOUR SEASONS GARDENING
ADDRESS . . . . . . . . . . : 2429 LAST OAK DR.
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
TELEPHONE . . . . . . . . : (408)358-8003
lam 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
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
aclF
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
�UPERTINO
Building Department
JOB ADDRESS:
-3— ��w'tro( SPERMIT# /
GS_ (/
OWNER' NAME: PHONE #
GENERAL CONTRACTOR: Seaon FAX # .' -2 r -o 3T
I am not using any subcontractors: I�i 3
ignature Date
Please check applicable subcontractors and complete the following information:
66 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
,Pwnbing
" Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Dat
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
TCITY OF Telephone: (408)777-3228
UPEP,TINO 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/tthe above stated//policy on re-roofing.
Homeowner's Name: /VLA0 Mo ,*.
T
Job Site Address: .20 1 Yr NS I✓(n� Ste•
Roofing Company Name: MV r Set So,,.S 43>0 F tom✓
.Applicant's Signature: Z�;z Date: `~
Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF
CUPERTiNO PERMIT APPLICATION FORM
APN # Dater���g
Building Address:
Owner's Name: Phone #:
oC`1 � vin }— O, Pv.
Ctractor: P ne#: License #:
vT P q �oo� yob 22 S -0 3 30 /D K
Contact: nn hone#: Cupertino Business License #:
F c CQzPrt5 .27 $ -o33o
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ,'Zk Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood ShinglesI I'n ❑ Wood Shingles
;6e- Other(Specify) Ca(5 Mir ❑ Other(Specify)
Number of existing coverings / (3 Provide I.C.B.O.Report#
p' To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comely With Cu ertino's Tear Off Policy:
Job Description: O'L. CAkS I a4F�.1 30 G C+ an
ET-
G4G Gr"X Gw o.� �o osi+lrr� 6lti'n 1e 4 C�4
Residential ;!S� Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are any restrictions:
Cost of Project Type of Construction: Occupancy soup:
S S'C) CD `
Qty. if
A licable Fee M 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