06040133 (2) CITY OFCUPERTINO
BUILDING DIVISION PERMIT .cONT.RAGTR1VF0-, , TIO ,
BUILDING ADDRESS: SONS ROOFING PE1eMITNO'06040133
10841 NORTHOAK SQ
OWNER'S NAME: PERMIT ISSUE DAIS
( NORTHPOINT HOA 502 HORNING ST 04/21/2006
ONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHI'fECT2NGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
t l� 0 0
�ap LICENSED CONTRACTORS DECLARATION - lob Description
1 bunchy affirm that I w Vowed under provisions of Chapter 9(comm nminS P
IN Section]WN Of Division Sof the Buz.and Professions Code,and my license u
1.fallfmcamulefract. REMOVE CALSHAKE ROOF, INSTALL 30LB FELT AND GAF
? De¢ lm ,�-cSaw t�GRAND CANYON COMPOSITION SHINGLES CLASS A
ggg RCHrfECI'S DELLA A 10 K0 I n C
1 I understand my plane shall be used u public records J
says Licensed Pmfcssional
1 3 OWNER-exempt RDE DECLARATION
2<� 1 mason.
.Rte Not 11. exempt(sem the Contractor'so :Ary c Lew for nm
O o which Ing mason.(Section]nc LS,Business and improve.
da a Coda:My coy or county
3 9ry which requites•permit re conceder aper,improv,demWkh,(1 repair any tauctum
-Z Y dour m its IEYNM,a1W m nllw the applle of tar suchCon permit b ce se Law(Clap tell
pp < Numeceenectl pumant mom of Division
of theContractor'sNandlaw(Chapter9 Sq.Ft. Floor Area Valuati IS5()0
go (commencing with Section 7000)of Division7af me Business and Rofruiav Ctdu)or
$ Nn he is exempt Nemf m and the basis for Ne allryed eaempdon.My violation of ppb Nq �e
Section 7031.5 by any applicant fm a permit subjects the Applicant m a civil penalty of 316 41 bml 8 0 0 Occupancy Type
Amtor
more them rim ve hundred dollars(SSW).
❑I,u owner of site pmpmy,sur my employes with myea u Nep mlecompc=uon.
will do the work.and Ne umcture is not intended or offered forsam(See.7044,Boniness Required Inspections
AdProfession Cade The Consumes License Law does not apply m an owner of 9 P
property who build,or im proves mernan,end who does such work himself or through he
own employees,provided thatsuch improvements am not Intended oroneread tweak.if.
however.the building or improvement is said within ase your of completion,fee mvnery
builder will haw the hunden of proving Nat he did not build or improve for purpose of
Asia.).
0 I,u Owner of the property.w exclusively contracting wife Banned comrmlors or
consaset the project(Sac.7044.times.aed Professions Code:)The Comracmrs Li-
cense Law does not apply As an owner of property who Wilds or tmpwwa thereon,and.
who canmw for such projece NN a conuacmr(O lkertmd p..1 m Ih Cants m1m1;
Lkewe law.
0 lam exempt under Sec. ,B k P C fns this meson
Owner Dam
WORKERS COMPENSATION DECLARATION
I hereby afam under penalty of perjury sem at Ne following dwlanflons:
0[ham and will maintain a CertiOcom ofConsem to self-Iwum for Wo tan's Compen.
eulon,As provided for by Section 3100 of me Labor Code,for fee wrimmeave of fee
wap for which this Permit is issued.
0 1 haw and will maintain Workers Compenfuion Insurance,As retrWred by Section _
3700of me Labor Code,for the pulomanceof me work for which fest,permit is issued
MyW sComPeend but awrier and Policy nummbbar are:'I�y
Cartier. &cy No.:�G"1 ZYc�fc�l
CERTIFICATE OF MEM ON FROM WORKERS'
COMPENSATION INSURANCE
r
CITIs secflme need notbecompleted if Ih permit Is forams hundred dollars(SIM)
or less.)
1 certify that In the performance of me,work for which this Permit is issued,l shall not
employ any Perm.in my meancrso As in beeoma subject to the Wwkcrf Compewmion
Laws or califomh.Data
Applicant
NOTICE TO APPLICANT:If.after making this Ceninam of Exemption,you should
hKwne subjm An NC Workers Compensation provisions of the labor Code;you most
.J O formwim comply with each Provisions or this Permit Nell h dauried mvmkad.
Z cobtsmUCfION LENDING AGENCY
[--t lhmbyaMm NasdemeaconevuNnn',ndingapncyfwtheperformeneeaf
C' Nu wash fur which Nie permit a issued(Sec.3M7.Civ.Q
W Q Lenders Name
Larches Add.
U Q 1 curtly Nat I have mad this application and sum that Ne above information Is
LI,H come,.I agree an comply with all city and county Ordinances and sum laws miming to
0 U buildingconstruction.and hereby aorharim mpammtives of this city to enter upon Ne
W a Ww-mentlunc l property for inspection purposes.
(We)agree to taw.indemnify and keep harmine de City of Cupertino against
rr y Iiabilltimjudgments.case and expewa which may in Any way acme affairs,said City
U in consequence of the gnnflng of the permit. Cr- �(
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date % S�y yr—0 4
5 T ON
Re-roofs
Signamm of App' unemr Dam
ALSRDOUS MATERIALS DISCLOSURE Type of Roof
Will the pllantarto.Wilding computation,or hand',huardow material
As dc0ned by the Cupertino Municipal Cade.Chapter 9.11,and the Hea1N and Safety
41 Cade.Seed..3SS72rxr—_. All roofs shall be inspected prior to any roofing material being installed.
Oyu mNa
Will me applicant or future Wilding arupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit humdaw air tent�mmanu u de0wd by nm Bay Area Air Quality Management all new materials for inspection.
District? \
Oyu
Ddu
I haw mad the huxudousmmeriaerequirements um',rClupmr6.95ofde Califar.
Wes Health k SarnyCah.Seetiuw 25505.35533andb534.l understand muifNe Wiming
does tet cummly hue•mwre Nat It is my rwpowibilit,m notify Ne Occupant or f
requirements which Mo. sem tmceaf.Ccg1 'nyKy.� Signature of Applicant Date
Ow ranwha'.cd. m e'` Voam 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
WUPEI�TINO
Building De artment
JOB ADDRESS , PERMIT #
o .,0 9 6o r6-113
OWNER'S NAME: �,�4p&6�t 'jj,Q. ,4 PHONE #
GENERAL CONTRACTOR. S FAX #
I am not using any subcontractors:
Sjgnature Date
Please check applicable subcontractors and 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
er/Contractor Signature Date
Community Development Department
o Building Division
16
City of Cupertino
K 10300 Torre Avenue
• �
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPERTINO
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 Dcor-h_
ply with the above stated/policy on re-roofing.
Homeowner's Name: // I/% �A C,
Job Site Address: l O�y/ AOrT�, nc k Cz, lJ D C4Jrnu
Roofing Company Name:
Applicant's Signa re: Date:
• Greg Casteel
Building Official
Revised 11/2/04
Prinfed on Recycled Paper
CITY OF CUPERTINO
am 3 of 6 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31641618 . 00
DATE ISSUED. . . . . . . : 04/21/2006
RECEIPT # . . . . . . . . . : 34091
REFERENCE ID # . . . : 06040133
SITE ADDRESS . . . . . : 10841 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 Du 040153
N%' REROOF
OFUPERTiNO PERMIT APPLICATION FORM
APN
3 # 1 � � DLe
0_0
Building Address:
to 1 So
Owner's Name: Phone#:
O, Ac.
Contractor: Phone #: License#:
�r t t Yb: 2_1 S ro 33o 4 /0 8
Con�rta"-ct:n nn hone#: Cupertino Business License #:
Ci o CAA 0--rz,5 2 7 g -o 33 o S2-'
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ,'9, Asphalt Shingles
❑ Wood Shakes ❑ Wood Shikes
❑ Wood Shingles ❑ Wood Shingles
Other(Specify) Ca(6 kcK4?— ❑ 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 ly With Cu ertino's Tear Off Policy:
rob Description: v�L S I T�sta.l k 30 G C--t- an
C Ger J- Cwv o o9r+lcr+ 61�'n lcs — C c
Residential A-1 Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are anv restrictions:
Cost of Project Type of Construction: Occupancy group:
$7 S-o o — .tet
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
•