06040134 (2) CITY OF,CUPERTINO '`
BUILDING DIVISION PERMIT �CfS vm.R�.cr'OR11 ORT", `
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BUILDING ADDRESS: FOUR-SEASONS ROOFING Fox...NG.06040134
10833 NORTHOAK SQ
OW
NEWS NAME: PERMIT LSSOE DATE
NORTHPOINT HOA 502 HORNING ST 04 21 2006
IM ONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECDENGMEER: - BUILDING PERMIT INFO
BLDG O PO O
;o0 LICENSED CONTRACTOR'S DECLARATION lob Description
aJ 1 hereby aMm that 1 ma licensed under pruvbion of Chapter 9(commencing
z1 with SectionafDividon0a(timBua,sealidProfrssionCode.and mylkenseb REMOVE CALSHAKE ROOF, INSTALL 30LB FELT AND GAF
Lic y m fall fa Re LouYid enCLL
(qz_ Lisa Cl Ccuro �uRAND CANYON COM � �1'�TN LES CLASS A
D.0 ��l'yy con " $- �D
;�� ARcxrrEcrsDECLAIuno a^moi, �O
1 1 unMnuad my plans shail he wood u public rtcnrdr 0 e
tu
eo� Lkorued Profeuionl
sm� OWNER-BUILDER DECLARATION MAY 'J Q
Z 1 hereby a?rm
that I am comp,pmts Ne Comracice,Licorice LAw for the _ 1006
G O following won.(Section 701.5,Business and Pmpeuions Cade:MY city or county
5$ which acquires a Permit m construct.ober.Improve,demdbh,or repair any structure
-z 12 prior an is imance.abs require the applicant sof such permit m Ole a signedstatement
< that beblicensedPursuantinthepravisionoftheComrseur'sL.im.Law(Chair.9 Sq.Ft. Floors Valliant
[�m (commencing with Section 700y)of Division 5 of the Bud.and Ptofesim Code)or
Nat M u aomp,decompress and the bub for the alleged asomption.My violufon at ap7�tIvi ,�
Senior 7051.5 by any aHelican,for•permit subjects the apphean,an a civil penalty of , s — Occupancy Type
oamart Wo Rve hundred dallare LI 0} 3S`i']19TXTQI) , CCU ane
❑I,u owner of the property or my employen with unto u their sets compaaasdao. ..LL bb''11 777
.M do the wads"the arunum is not intendW sur offered for Woo(Sec.7044.Business
and Profession Code:The C stacmA Liana Law Oman Out apply In an came of Required Inspections
Property who Wilds arimpmws lhama.and whodoessueh work hbmrelfor dough his
awn mployec,provided Ihmauch Improvements m:rot intended aaflered for isle IL
however,the Wilding or Improvement is Gold within one Poor ofnmplanem.the Mons,
builder will have the Wrdn of proving that M did not build a improve far Ponpm of
sale.).
❑1,as anter of the pruperiy,am exclusively contracting with licensed anuMan In
oanuuel the Profen(See.7044.Business an!Profesdon Cade:)The Coouacmh U-
cets LAwdaistatapplyWanownerofpmpmywho Widesurimprove.thereon,md,
who carmam far such Projects,with a canunnar(0 licensed pursual an that Contractor,
License Law.
❑Iamnemptander See .Bl PCrorthbacsmn
Ower Dau
WORKER'S COMPENSATION DECLARATION
1 hereby&Man under pelWty,of perjury am of the fallowing declaabon:
❑I have and will maintain aCantiticau of Comm to self-WumfaWormesCompn-
udn,as provided for by Section 3700 of the Labor Cade,far the parts..or the
work for which this permit Is issued. 1
❑1 haw and will maintain Workers Compensation Imam.u required by Section
7700 of the labor Code.for the performana of the work for which thin permit is leaned.
esCpenansutacarrier and Poliry�umbeam:My Walca ,I
{.y/yi""No.: ?—IleLaq v?
CERTIFICATE O•EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section and Out he compared If The permit Is for one hunNed dollars di 10(p)
or less.)
I anify then,in the pafomana of the.,it for which this permit is based,l mail not
employ any person in soy mmnerm or to become subject in the Worksn Compenmon
Laws of Califomb.Data
Applicant ! .
NOTICE TO APPLICANT.If.after making this Cenincate of Exemption.you about;
became subject an the Workers Compensation provisions of the labor Coda you mast .
OfoMwi,h comply with such Prevision or this permit sbsll W doomed revoked.
z CONSTRUCTION LENDING AGENCY '
[-sem I hereby alum that then b a construction lending agency for the Performance of
C the work for which this permit Is issued(Sec.3097.Civ,C.)
W�Q Lenders Name
.7. z Landee.Addw
U O 1 certify NY i have reed No applicaiem and sue that the above information 4
D,F Coma 1 agree to comply with all city and county ordinances and suis laws relating to
0 U building conametion,and hereby authaam representatives of Nis city to toter upon the
W alrove-mentioned property for inspection purposes
(We)agree in saw,indemnify and kap harmless de City of Cupertino ayint
v<VaJ Iiabllhim judgmenu.cuts and capems which may in any way area again,said City
U',Z in consequence of the granting of this permit.
APPLICANT UNDERST ND ILL COMPLY WITH ALL NON-POINT Issued by: Date _Z(-06
GLATIGN$ ( Ov
�/ Re-roofs
Sin¢urt of App ianV naocur Data ARDOUS MATERIALS DISCLOSURE Type of Roof
WIII the applicant Or future Wilding aceupant r9.1 or handle b Heeds
monad
u deMetl by the Cu no Municipal Code.Chapter 9.11.aM the HWN and Safety
Cade,soman 15531(,)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yrs Na
Will Nm applicant or prelim Wilding Occupant lie continuant or devices which If a roof is installed without first obtaining an inspection,I agree to remove
cmb husdnu air cormlinnta ss de0rcd by the Bay Area Air Quality MMIICYenl all new materials for inspection.
Dwn7 \ —
❑m X61 Na
I have read the haudasmaeriabmquimmew uuYrCleparQ95oftheCtlifa-
dalWlthkSafetyCm@,SmdaY13305.15533aml l undersand du,iflhe Wilding
don rat Cmem1Y haw a mutt,that It b my mp(MUNIity m naify de maupsat of the
mgtecormss which mus be o(a CeryRn=af�cupagplSignature of Applicant Date
own surantho" da e l-.` G`^(Dow All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
aClOF
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
OCUPEf�TINO
Building Department
JOB ADDR SS: I �, PERMIT # D K6 / 3 K
/nb
OWNER'S NAME: p PHONE #
GENERAL CONTRALTO FAX #
I am not using any subcontractors: 4-Z 1 'd C4
S gnature Date
Please check applicable subcontractors anom lete 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
u
Community Development Department
law". Building Division
a City of Cupertino
• w
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
Building Department
Subject: Re-roofing policy for the City of Cupertino 6
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 Raid before another inspection can be scheduled.
IMPORTANT: 0
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 complyllwith the above stated policy on re-roofing.
Homeowner's Name: II `n
Job Site Address: NG t4G kk �� l 'h o 950/q ,
Roofing Company Name: S
Applicant's Signator Date /
• Greg Casteel
Building Official
Revised 11/2/04
Printed an Recycled Paper
CITY OF CUPERTINO
!em 4 of 6 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31641619 . 00
DATE ISSUED. . . . . . . : 04/21/2006
RECEIPT 4 . . . . . . . . . : 34091
REFERENCE ID # . . 06040134
SITE ADDRESS . . . . . : 10833 NORTHOAK SQ
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
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
•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
•
CITY OF CUPERTINO
REROOF
•CUPEkTiNO PERMIT APPLICATION FORM
APN # Date
Building Addr ss:
Owner's Name: � ` 11 Phone#:
p(Y-v. 0k1ai— , O, Vit.
Ctractor: Phone#: License#:
�r e q Voo� l yos Z3 S -0330 /0 $
Contact: �1 hone#: Cup�tinoo3Busi ess License #:
(C4o Z fie- .27 g -o 33 p
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof r❑ Built-Up roof
❑ Asphalt Shingles >�, Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ^ C3Wood Shingles
-OL Other(Specify) (2q 113 kare— ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O. Report#
'91 To be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read, Understand and Will Com 1 With Cu ertino's Tear Off Policy:
obDescription: vZ CAlSI —,L-"stv,Ik yo L. C 1 an
C Gr OA_ CJK) o.,
Residential 12311, Commercial ❑
Fire Zone: Yes ❑ No JzLConfirmed with Planning De t. if
there are any restrictions:
Cost of Project Type o o struction: Occupancy oup:
S_so (D CLr
Qty, if
A licable 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
•