06040090 (2) CITY OF CUPERTINO �y ''' rasax eg,�.nn �'y�y` �" "s"v'yys
6UILDING-DIVISION PERMIT
a t�s^-�.,..,.„. o-n¢ J{mak al f,..iK+�' P-wl "✓
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT NO.06040090
10806 NORTHRIDGE SO
OWNER'S NAME: PERMIT ISSUE DATE
NORTHPOINT H.O.A. 502 HORNING ST
ONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCH7TECT/ENGINEER: BUILDING PERMIT INFO
DG ELECT 0 PLO
+op LICENSED CONTRACTOR'S DECLARATION
as FF I hucby affirm that 1 an licensed under provisions of Chepier 9(commencing Job Description
�Z`uf with Section 7000)of Division 3 argue Business and Profeaiuns Cade,and my licensee
aw,
n. inmRro-andeIf 3� L g N 11tU� REMOVE CALSHAKE ROOF, INSTALL 30LB FELT, AND GA
jyfLlcenm Clan
Dam v Camranar 9 GRAND CANYON COMPOSITION SHINGLES, CLASS A
nq ARC.,,ra' SDECLARATION
fW I undersand my plans Evill he used as public meords 1�*LED
o Licensed Pmfcsianat
gy 3 Oat I am BUILDER DECLARATION
too I hereby
mand .(Section
11. exempt s an the commofcWom rdLicense: Law for the
0 4 which ng moan.(Seders 7(D sem Business and Professions Cade:Any sty or county 7006
5 9 ti which its aims a Pamir m cnnsouca slur.Improve,h perreNh,or a Pair ed comment
daRkitsccnwd e,atmmquim Novisioexmfof auchpcnni's Lumosigrcdsuumcnt I$S500
< that heelicenxdPunuvnuotMpmvisioerofNorCanuuwrsLicen¢Law(ChaFur9 Sq. Ft. Floor Area Valuat
i�D (commencing with Sudan 7000)of Division 3 of Nor Business and Pofaai"ns Codi)or
$
that he Is exempt tham(rom and tc basis fm the alleged exemption.Any violation of
Sacton 7031.3 by any appllexm for a permit subjects Ne applicant to a civil penalty of APNNumber
romom upancy Type
t Nan Ron, dollars(S5W). 316 3 6G43 . 0
❑1,u owns of W propmy.w my wploym withwtm u gueh sole eompcwgan,
will do th...L and the swnutu a not Intended.offered forced,(Sm.7014,Busiws Required Inspections
and Profealons Code:The Co mucars License law does rot apply an an orrrcr m q P
propmy who builds or Impmws t emem.and who dos much work himuJ r or through he
awn ernployces,provided Nat each Improvements see rot imehhd<d uoa'ered for ale R.
however.the building or hapro derma Is mid within ove year of mmpluiw.Ne owner-
builder will Nve den Widen of proving Nal ad did rot build or improve far purpom of
nle.)
❑1,u owner or due property w exclusively commaing with Burred onommrs as
construct the pmjm(Bee 7044,Business and Pmfexam ns Cade:)The Canumamrs Li-
maxi law doer not apply In an owner of propmy who builds m improves Nem re.and.
who contract,for such pmpois wed a comincmrts)licensed purawnt m t CerroUaners
License law.
❑I am exempt under So .B d P C for this m»oa
Owner Dam
WORKERS COMPENSATION DECLARATION
I hereby affirm under Fondly of perjury no of the following declurutions:
❑Ihimandw0lmainuinaCo RomofComnuoulfdnsumforWorkersCUmpen-
snian,m provided for by Section 3700 of the Labor Code.for the performance of had
work for which Nis pemdt is issued.
r�9 have and will maintain WaMrS CompemNon Imuran•as required by Semon
9960 of Ne labor Cade,for Ne performance ofthe work for which the Formed is issued
My Warkees compensation Insurance carrier and Policy number are:
Cartier. A •o . A , Policy No.: I1 at 1k4 4
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
v
(ILeamsim mail not be completed If the permit Is farad hundred delan($109)
or leu)
1 certify that In the performance of Ne work far which this permit is eased.I shall not
employ any person In my manrcr m as In became subject m to Warken'Comperuaton
Laws of Califamla.Data
Applicant
NOTICE TO APPLICANT:If,spur mutant this CcniRexte of Exemption•you should
became subjem m the Waa a s Compensation provisions of the Lada Code-you must
OZ forthwith comply with such provisional W Ne permit shall W domed revoked.
z^ CONSTRUCTION LENDING AGENCY
[+ I hemby ailm Nat them Is a mumctim lending agency for the lerformanoaf
�i the war for which lids pemtit amount(Sore.3097.Civ,Q
GA Landers Name
z Lenders Address
U0 I ccr lfy Nat I have mad this application and sue that the above information is
D. F cancer.I agme m comply with all city and county ordnance,analauk laws misting in
0 building conswction,and hereby authotim representatives of Nis city to cnmruPin the
W above-mentioned pmperty,for inspection purposes.
LL (We)agree to ave•indemnify and keep hsmeca the City of Cupertino againsl
vy r4 liabilities,judgmem4 casts and expenses which may in my way acme agaWt said City
U Z in conseieercc of the granting of the permit. G�/�
'-" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date G'
SOURCERE ATIONS
Re-roofs
signuum pp uCoal Dior a Of Roof
AZA MATERIALS DISCLOSURE Type
Will Nor spPlieant Tut hiding aoupantsmm or handle havmous material
u deRned by tel Cupenh nuipd Code.Chapter 9.11,and the H.IN and Safety
Code. 25s32(e)!
oys, s
All roofs shall be inspected prior to any roofing material being installed.
❑Yes
Will the applicant or forum building arzuWnt use eyuipmmt or devim which If a roof is installed without first obtaining an inspection,I agree to remove
emit hoard".sir comm insets u&fund by the Bay Am Air Quality Management all new materials for inspection.
District!
❑Y. �Qa
I havercad the l anmager materiae requimments underChipmr6.95 of the Caller.
rte HealdkSafoy Cade,Seetaru 25505,25533 And 25534.1 undersand rhnifthe Wilding Y-77-0&
dm n�'21
tly how a e my maponsihilltY m mmifY gm aceupsnt of true
myulmleh t rmianwNeafacuGrkmetWome mcySignature of Ic t Date
own i she eg nt ,m G All roof coverings to be Class"B"or better
CITY OF CUPERTINO
•em 5 of 5 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31636043 . 00
DATE ISSUED. . . . . . . : 04/17/2006
RECEIPT # . . . . . . . . . : 34017
REFERENCE ID # . . . : 06040090
SITE ADDRESS . . . . . : 10806 NORTHRIDGE SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT H.O.A.
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : SUNNYVALE CA, CA 94086
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
---------- ------------- ---------- --- ------ ---------- ---------- ----------
BENERGY PERMIT FEE 126 . 36 60 . 65 0 . 00 60 . 65 0 . 00
BPERMFEE VALUATION 6, 000 . 00 126 . 36 0 . 00 126 . 36 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 187 . 01 0 . 00 187 . 01 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 1040 . 05 005461
TOTAL RECEIPT 1040 . 05
r Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
/o I
OWNER'S NAME: IPHONE #
GENERAL CONTRACTO „ S , FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete a 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
Owner/Contractor Signature Date
Community Development Department
w� Building Division
City of Cupertino
t€t' 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
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 " 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: 0_0
Job Site Address: 10 $O CO I OC�6,A Sc�,�2✓=�'
Roofing Company Name: S
Applicant's Signature: Date:L Z O�
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
0 D o�
CITY OF CUPERTINO
REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# Date
i Lo y- i L4-o
Building Address:
Owner's Name: Phone#:
C tractor: Phone #: License#:
e - � yos Z-1 S -o3 3 /0 8'
Conrrta�-ct: //�� hone#: Cupertino Business License #:
CQ Z xt, �2 7 g -0 $3 0
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )2�,, Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
Other(Specify) Ca(8 kap- ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O.Report#
-' To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Com ly With Cu ertino's Tear Off Policy:
Job Description: o V,_ S 130 C 1 0ACk
Y Gr cL tr�W O^i . 6v �v,4!O �w�n 1tS' c' ass
Residential Dk Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are any restrictions:
Cost of Project Type of Construction: Occupancy group:
SSpp
Qty. if
A licable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDINQ
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING