06060210 (2) CITY OF CUPERTINO �'.rKxr�� rric �'€ ' �* ��' ` ' �`'`
,BUILDING DIVISION PERMIT011N-
' � ?
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT N°'06060210
20247 NORTHBROOK 90
lerR'S NAME: PERMIT ISSUE DATE
NORTHBROOK HOA 502 HORNING ST
PHONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCRITECT/ENGINEER: BUILDING PERMIT INFO
BLD° E11R PLUMB MECH
0 � 0
app LICENSED CONTRACTOR'S DECLARATION Job Description
u 1 herby affirm that 1 am renewed under provlaioes or Chapter 9(Commencing p
with Section 7000)afDiviaion 3 of the Buunev and Profuekew Cade.and my Risen I.
n kmB(oheaandefrem L4:7 0$a ,REMOVE CAL SHAKE, TE SHINGLES
q z Ikeryyee Chau Lin.R
n'q Dalsb—Z Comrum M Ir\
CW ARCHITECTS DECLARATION
J
i�7 1 understand my plans be used u public roar is JUL qua (�
SyU U zs 2000
;Q�n Licensed Professional
`„h OWNER-BUILDER DECLARATION
a I hereby aRrm that 1 am exempt from me Conuamofs Uccr m law for rte
i on o following Mason.(Section 7031.7.Business and Profasioew Cade:Any city or County
$9 which requires a permit M connsueL shher.improve.demolLm.or rePM MY ammure
_Z prior ro its Issue=.aha require tie applicant forsuch permit mfik a signed sutemem
"s `e that hekliccmeJpromeanttomanprovisionsoftheContracarsLicemetaw(Chapter9 Sq.Ft.Floor Area Valuation
00 (commencing with Section 70W)of Divblon 7oflK Buslntss srW Prafeuioew Cade)ar
r3—
that M b axehnpt therefrom and Lou bub far the Akged exemption.My violation of
Section 7031.5 by any applicant for a permit mblow the apphicsuuo a civil Penalty of 3 Occupancy Type
nab Come than five hundred dollars(5.1007. ,
0 L as awnes of Ne property,m my employees with wags u men sn a eompeasaton,
will do and PmICV10N code:The Cand netrsumfa License Law dma acIs nortimunded"Offered t apply in an Owner 0( Required Inspections
propeny who builds or improves thereon,and who dam such work blm self or through his
awvemplayw,provided that such improvements are notinanded moRemd for ale.If.
however,the Wilding or impmvemmt Ismhd within one yew of mmplcton.the owner-
. builds will have me Wrdcn of proving that M did em Wild or Improve for purpose of
"in I.
0 I.as owner of the property,am uclulvely contracting with[learned comamon m
construct the project(Sec.7044,Business and Profusions Code:)The Conhacar's LI-
came Law dam rat apply m an owner of property who build,or improves thereon.and
who mntram for each projects with a mnuaclor(s)Bunsed personal ro the Conmuto's
Leena Law.
0 lam.mroptunder Sec ,B&PCforthiareamet
r Data
WORKPA5 COMPENSA71ON DECLARATION
1 hereby&M m under penalty of perjury arse of the following dcclamio s:
❑IWvenM will maintain aCeniOcamofCom munself-esurefmWmkarsCompm-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
0 1 hove and will maintain Workers Compensation Insunnm,as required by Section
37M or that Labor Code,for the performance of the work fa which this permit It Issued.
My W ra Compe3wtion Imuran abler ark Policy number
Came % �. cep•No.:
CERTIFICATE OFEC PIONFRO WORKERS'
COMPENSATION INSURANCE
(Dhbxedom reed notbceomPkaA Lima permit is two=hundred dMara(SIM)
m Less)
1 canify that in me performance of Tho wart fm which this permit is issued.l shill trot
employ any permn in any mmnerse as to became subject to me Wmaa s'Compensuia
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this Ceniflate of Exemption.You shmW
become subject in the Worker Compeewadan provistoew of the Labor Code,you am
.,O fonhwim comply with such provisions or this permit shall be domed rooked.
ZrA CONSTRUCTION LENDING AGENCY
[.r I hlarm the them ereby same, b a Construction Lending agency for to perfmmanCo of
gY. me wok fm which this permit is robed(See.3097,CO.C.)
14 (] Undoes Name
a, z Lender's Address
U O 1 certify that I have read this apphkatan and sells than the shove tars..Mmis
Iy F correm I agree to Comply with all city and county ordinances and num laws rebtint m
�U Wilding eomtroction,and hereby amWrim representatives of this city no enter upon me
�f37 mo t-memhUmd property for Inspection p.q..
a (We)agree to ave,indemnify and kap heard.me City of Cupertino agaimt
y liabilities,judgments.cera and K.which may k my way same against said City6azz-
of
U wZin Conuence of the. APPLICANT UNDtn`DS ANDWILLWILL COMPLY WITH ALL NON-POINT Issued by: Date 6"-
DNS.
Re-roofs
Sign umof Apptcan nMotor Data
H
DOUS MATERIALS DISCLOSURE
Type of Roof
Willy me tnoMuni Municipal
Chaptnamor handle Heartland Safety dented by the Cupertino Municipal Cade.Chapter 9.13,and the Halm and Safety
Je.Section 25532f0Y, All roofs shall be inspected prior to any roofing material being installed.
0Yu ZeJ Nu
Will me applicant m future building occupant use equlpment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit huardous air c uminanu u defined by the Bay Arta Air Quality Management all new materials for inspection.
District?
0 Yu u
1 haw mad the hazardous maerlitsmqulmments undcrChapterd.95 o(thecalifor•
me Health&SafmyCado,Sectou 25505,25537 and 25534.1 umkruand thel(thC Wilding
Jau hest nonentity have a L that It is my responsibility m notify the occupant of tre
u m whichmnst dor bm,naofagrdna arpae�O Signature of Applicant Date
Owner or aumori de nl b b Data roof coverings to be Class "B"or better
CITY OF CUPERTINO
It• 1 of 6 PERMIT RECEIPT OPERATOR: suem
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31639036.00
DATE ISSUED. . . . . . . : 06/26/2006
RECEIPT #. . . . . . . . . 35013
REFERENCE ID # . . . : 06060210
SITE ADDRESS . . . . . : 20247 NORTHBROOK SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHBROOK HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-0501
RECEIVED FROM . . . . : FOUR SEASONS ROOFING.' . . i
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
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
`s Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
UPERTINO
Building De artment
JOB ADDRESS: O PERMIT # /
OWNER'S NAME: PHONE # CO
GENERAL CONTRACTOR: ' , 2 FAX #
I am not using any subcontractors: --
t_,—`R L/e o(,
Signature Date
Please check applicable subcontractors an com Tete 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
caner/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 reed-roofing.
%
Homeowner's Name: V OrV\'�k r��_1_i 1T�i �lJ •7 0 /
Job Site Address: DZ r c ✓W(bC7 xl
Roofing Compan Name:
Applicant's Signature: Date42
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROOF
WUPEkTINO PERMIT APPLICATION FORM
APN# D to
3)
Buildin Address:
Owner's Name: Phone#:
o(` L okn 4- O, 14.
Ctractor: Phone #: License#:
t_�r t qsa,%s Vook' Y09 ZZ S -0330 /0 $
Contact: //�I hone#: Cupertino Business License#:
FC So l Q 2,�Cz� 7 g -o 33 O Z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof O Built-Up roof
❑ Asphalt Shingles 2�, Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
;W- Other(Specify) Ca(s kaKe_ ❑ Other(Specify)
Number of existing coverings / O 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 Polic
Job Description: t l S af ��5k-C.1� 3 0 1,05 AV,C I an
C Cir r� o , (n o9r`+log+ sL .'n lcs CSS .
Residential Al Commercial ❑
Fire Zone: Yes ❑ NoIPL Confirmed with Planning De t. if
there are any restrictions:
Cost of Project Type of ction: Occupancy oup:
.ra 0_1
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