06060215 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMITONT12,`�CT(1R�I1�TFyORMATION
BUILDINGADORESS: , FOUR SEASONS ROOFING PERMIT"x.06060215
20267 NORTHRRQQK RQ
Fit -
PERMIT LESLIE DAM
NORTHBROOK HOA 502 HORNI
PHONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHIT IENGINEER: BUILDING PERMIT INFO
BO EO PLUMB MECH
�oo LICENSED CONTRACTOR'S DECLARATION Job DOSCTIpIIOn
I thereby aRUm Nn 1 an licensed under provisions of Chapter 9(ammencing
z with Section 70M)of Division 3 of do Buaincu and PrafcWuna Code,ledmy licwc is
n infullfaraadcrramL Z� 17 RWMOVE CAL SHAKE, IN r LES
z Lice sa Clyy�5a Lk.a
—Q ON Ll •p to Contrsabr ,
W ARCHITECTS DECLARATION
7t I understand my plane"I be used u public records
JUL %h-2006
Gia Licensed Pmreui...I
5 3 OWNER-BUILDER DECLARATION
Comm ON
I hereby wisso .(firm Net I I.S.exempt from the COmm�ors License Law for the
p o following moon.(Section 7113 1. t,alrc.a and ".demolish,
Code:Any city or county
$ftii which I%issuance.
a permit construct,slur,m into camulW,nr repair any struigned meamem
Rg yl laks%JQ� S5500
—Zi Poo is licensed
a,aim
tantWrequires du applicant for Crow w"mit to Bka Law(uumem
FS C (c mole ilansng ithSecdow70 epuvisi.uOfNeCoowcurYliaucltawsCapc)9 Sq.Ft.Floor Area • .tion
(cam is is exempt Seedw]0nd of Divisiof r th the Busaged exemption.
on.Any violation
of
Inn rte u exempt anrtrrom and the bub for the alleged esemant to AnY l Pennon or
not wars,
7031.3 n airy red doll fm a permit abjecu the applicant m a civil Penalty or Occupancy Type
not wort then Rw hundred a01Isrs 153001.
❑Lieowner of the property,army employee with wages u daft rob compensadon,
will do the work.and thesmmmm brat intended"offered Amanda(Sm 7064.Business Required Inspections
MProfusions Code,The nens Communes LiLaw tinea not apply u an avec,of q P
pmpeny who AIB.ar tmprowa dmcon,ane who ansa Ruch work himulr m duougb his
awacreplayca.provided Nat such Improvements nee nothowalled urofrerad far atlas Ir.
however,the building or Improvement Is said within ons year of completion,the mvrcr.
builder will ban the burden of proving that he did an build or Improve her purpose of
sate.).
❑1,as owner of the property un ucledwly contraming with licensed conuaeusa in
construct the project(Sec.7064,Business and Prufadam Code:)The Contsamor's Li-
ave law date not apply an M owrar of property who bulbs or Improves Ihemon.and.
who conwma for such projects with a wuac,,(,)Removed pursuant to the contractors
License Law.
❑lamescmptunder Sm .BdPCfathisrcuon
Data
Ir WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury oro or tie following daWUWnc
❑I lensed will mdnWnaCcnifiauof Coacnluself-WumfaW~.Compcn-
sadan,as provided for by Section 3700 of the Lather Cade,for the peNmerance of dte
wars for which this permit is issued.
❑1 haw and will maintain Worker's Compenaathn Insurance,u required by Section
3700 of the Isbu Coca,for the performance of the work for which this permit is Issued.
My W sets Compegwlon Insure cattle,and Policy number w:
CER77FlG7E 0•EJ( PTION FROM WORKERS
COMPENSATION INSURANCE
(rustication road nalbucompleted ITIne pewit Is formic hundred dollata(SIM)
or Mss)
1 century that in the performarcc of the work four which this permit Is iaucd,l SWI not
employ any portion in any countries u to Mame subject to dte Worken'Compc m
Laws of California Dans
Appllcont
NOTICE TO APPLICANT.If,after making this O ninua of Exemption,you should
haeme subject an the WarknYs Compensation provisions of the Law Cade,you mat
O forthwith comply with such provision or this permit shall lac domed rooked.
y CONSTRUCTION LENDING AGENCY
j" IMmbyam.that frt ba comuunlen having agency far da pnrrormana of
laftwmk for which this permit Is issued(Sec.3097,Civ.C.)
W�Q Lenders Name
ice. L wilm's Address
U Q 1 certify that 1 ban read this application and auto dust the show Information is
JL4 F canto 1 agree m o comply with all city and county andini ncand sum laws rotating t-
o U building consvuction,and hereby authorise representatives of this city to tour upon the
�N7 show-mentioned property for inspection purposes.
1We)agree to save•indemnify and kap harmless;the City of Cupertino against
rF"y c4 (iebilitia judgments,costs and expenses which may in my coy accrue against said City
U 7 in co sequence of the granting of this permit
;emit
ICA UND NDS AND WILL COMPLY WITH ALL NO,qN-POINT Issuedby: DateRe-roofs
um ser Applr VConuacror DauT of Roof
AZARDOUS MATERIALS OISttOSURE YPDWIIII appll a Iser rutum building accupentnort whandle hreNns material
md by penins Municipal Cade.Chapter 9.13.and Ire Health and Safety
Section 23532(a)7` All roofs shall be inspected prior to any roofing material being installed.
❑Yes NuCBI dun appliaot ser ralam bullaing aavrynt s e egmpment se d m e whishIf a roof is installed without first obtaining an inspection,I agree to remove
fo dna air conumianu u dc0ua by the Bay Area Air Quality Maagcmcol all new materials for inspection.
Diwrii:0
❑Yes Nu
I ban mad the nanrdnes materials mquimmcnis undcrChapterd.95afthe Gllrar
nix Hearst 9SaretyCode,Section 25505.35533 and 25534.1 understand dultifdte building
does amt currently haw a unant,thu It is my responsibility m notify du aoupent or the
I It It =
ancmdfic arOccupancy. Signature of Applicant Date
All roof coverings to be Class "B"or better
Owner or authorizedgent Date
CITY OF CUPERTINO
I 6 of 6 PERMIT RECEIPT OPERATOR: suem
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31639038.00
DATE ISSUED. . . . . . . : 06/26/2006
RECEIPT #. . . . . . . . . : 35013
REFERENCE ID # . . . : 06060215
SITE ADDRESS . . . . . : 20267 NORTHBROOK SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHBROOK HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-0501
RECEIVED FROM . . . . FOUR SEASONS ROOFING )
CONTRACTOR . . . . . . . : DIAZ, ALFRED LICA# .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 SAL
__________ _____________ __________ __________ __________ __________ __________
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
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ -__--_-_____-__-__
CHECK 761.76 005620
TOTAL RECEIPT 761.76
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
✓^ Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
41UPEkTINO
Building Department
JOB ADDRESS:
PERMIT#
WNER'S NAME: PHONE #
GENERAL CONTRACTOR: S.P FAX #
I am not using any subcontractors:
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
er/Contractor Signature Date
• Community Development Department
t. 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.
Homeowner's Name: r
Job Site Address:
Roofing Company Name:
Applicants Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROF
UPE TINO PERMIT APPLICATION FORM
; e'3�-o3� DayE
B 'lO g A�ress: O bC S
Owner's Name: I Phone#:
O. IV.
Ctractor: Phone#: License#:
S-eLscAs Vook, l yos 22 S -0330 /0 $
Contact:nn //�� hone#: Cupertino Business License#:
o (2Q Z a_r415 7 $ -o 33 O Z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )zf, Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
;R'— Other(Specify) Ca(8 kaK- ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O.Report#
To be Removed ❑ Provide Mfgr.Installation Specs.
fill Have Read, Understand and Will Com 1 With Cu ertino's Tear Off Policy:
Job Description: .,c l S 1 30 A UF 0^
C Gr cL Gw oN t?c ovi+loj Sl�'n lcs S
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning D t. if
there are anrestrictions:
Cost of Project Type o o struction: Occupancy group:
o
Ssa — 2
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