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BUILDING DIVISION PERMIT
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BUILDINGADDRESS:
FOUR SEASONS ROOFING
PERMIT NO. 06040086
10846 NORTHRTT)CW, RQ
OWNER'S NAME:
PERMIT ISSUE DATE
NORTHPOINT H.C.A.502
HORNING
ONE:
SANITARY NO. CONTROL NO.
(408)278-0330
AACNITECfyENGINEER:
BUILDING PERMIT INFO
DG ELECT PLUMB MECH
15 II Q
LICENSED CONTRACTOR'S DECLARATION
Job Description
p
1 hertby affirm that i an IM.emd under previsions of Chapter 9 (commoneing
with Section70f10) of Division 3 of dro Business and Pmressibn, Code, and my license x
mTull low and If _ Lf a, 40?
REMOVE CALSHAKE ROOF, INSTALL 30LB. FELT, AND
License C, ' LIC.,
umar ltJ
GAF GRAND CANYON COMPOSITION SHINGLES CLASS A
ARCHITECT'S DECLARATION.
I uncommon! my pias shall he used ss public records
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby a17im that 1 am tempt from the Conlracmh License Law for the
rollowing mown. (Suction AD I.5, Business and Professions Cale: Any city or county
which requires a permit worriment. alma Improve, demolish, m repair my umctum
MMEM As
prior n its issuance. also requires the applicant fofsch permit to Hie a signed statement
six Contractor's Liam law(Chyner 9
Sq. K. Floor Area
Valuati$15 5 0 0
tut he k licensed pursuant m the provisions of
(commencing with Section 7000) of Division 3 of the Business And Pnefmions Code) or
teat he ts tempt therefrom mtl the basis far the alleged eamption. Any violation of
APN Number
Occupancy Type
Section 7031.5 by ary applimt for a Permit subjects the applicant n a civil penalty Of
not mom than ftw hundred dollars ISM
31636047.00 MAY -
- 1006
❑ 1, As owner of the property, or my employeh with wages As their sats mmpemdm,
will dethe work and the clunhnot eredrorsam(Sec. 7n a4, Begname, of
Cade: The Connagnes Llam law duh not apply lf an owner of
and he es Lica n;La
tl�y
R
property who Wiprovid repmvhchimpr andwho dassuchware himvJforforage his
who
� Ito
hireemPloKes,progded weeImpmwro for oak.R,
.con
een
�
year of cttmlfttsd
pr withinforowner•
rmprove
however, the Wildingmmpmwmenntson
Orfor
build. will have the burden of proving Nn bo did ret Wim ser improve far purphc of
a did ran
sale.).
� 1, As Owner of the property am exclusively connecting with Barad mnuacmn m
cosiroa use pmjeµ (Sc. 7040, Burins and Profnsims Code:) Mw Communes U.
cem law does not apply man owner of pmpeny who builds or ierpomm thereon, and
wheconmets (brought projects with AcsuactoKel licensed purines to the Conmcmh
Liam law.
❑ I ssn hemµ under See , B d P C for this mason
Owner Dare
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury mm of rte roleming declantionc
I haw and will maintain a CoNOam or Coons to self -Insure foworYeesCompere-
gotten, u provided for by Section 3700 of the Labor Code, fa six µtremens of the
work for which this perm, k issued
thaw and will ..!.We Wbrtees Compmuden Imm�nc, ss required by Session
700 of then later Cock. for the peAOmaam of the wok for which rids Permit is sued
My Workees compensWon Wuru¢e carrier W Polity number are:
Carrier. A. N • A • policy No.: 1 a'I 1'14 4
CERTIFICATE OF EXEMPTION FROM WORKERS'
— COMPENSATION INSURANCE
(This senne need retbo complmW if the permit is foam: hundred dollars ($100)
or lem)
1 aNy, fret in the perfomanec Of rte wok for which this permit k issued, ) WWI not
employ any Kenn in my member an as m become subject to tho Workwo Cmnpesadon
Laws of Califomia Dam
Applicant
NOTICE TO APPUCANM If, afar making this Cminate of Exemption, you should
become subim m the Workees Compensation provlsios of the Uter Code, you sun
.
comply with such previsions a this permit,hall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby &Mm for nem k a construction lending agency for the performance of
the work for which this permit ts issuco (Sec. 3097. Civ, C,)
Narm
lander, Addrow
1 ttnify that I haw mad this application aM sun this the above Information k
comet. I agree m comply with all city and county odininces and sun laws relating m
building convection, and hereby nooria mpmsenmives or this city to enter upon Ne
above-mcodusd property for insµction purposes
(We) agree to an, indemnify and Ivsp hanolm the City of Cupcnino against
liabilities,Judgments. cora And expenses which may in my my acme&&alms said City
in mnsegnena or the grating of this µsok
APPLICANT UNDERSTANDS AND L COMPLY WITH ALL NON -POINT
Issued b Date ,(
y:
SOURCEREGU
Re -roofs
Type of Roof
Signature p t on Dam
HA7on D0US ALSDISCLOSURE
WIII the aPPlimsofm ding occupmtuoemhsodic hauNmr material
As de0acd by rte CupeNno M 1µI Coda Chapter 9.12, and rte Nestle and Safety
Cale. Secuon 2553ua)7
All roofs shall be inspected prior to any roofing material being installed.
❑Yes u
If a roof is installed without first obtaining an inspection, I agree to remove
WIII the applicant or future Wilding occupant m equipment or devices which
emit huArdnus all cownsisnes As defined by the Bay Aro Air Quality Marragcmant
all new materials for inspection.
Dian.. `'
❑Yes b
I ban read Ute w ardoug muerlah requirements under Chalner d.95 of the Cal inr.
nk HglthkSgfety Crede,Scctnm25505,25533m 25534.1undemmd hhatifthe budding
/ •, (�
dors Amt currently have a moans that It u my responsibility n oodfy the occupant of the
_
reyulre khmm soh IpissmmofaCertOammrOcapancy.
Signaureo Applicant Date
y - 7.0
oof coverings to be Class "B" or better
'
Owner oramho a sum Dom
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06m 1 of 5
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 31636047.00
DATE ISSUED.......: 04/17/2006
RECEIPT #.........: 34017
REFERENCE ID # ...: 06040086
SITE ADDRESS .....: 10846 NORTHRIDGE SQ
SUBDIVISION .......
CITY .............: CUPERTINO,
IMPACT'AREA .......
OPERATOR: amyw
COPY # : 2
OWNER ............: NORTHPOINT H.O.A.
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-0526
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
BENERGY PERMIT FEE 126.36
BPERMFEE VALUATION 6,000.00
BUSLIC FLAT RATE 1.00
TOTAL PERMIT :
0
AMOUNT
PD -TO -DT
THIS REC
NEW BAL
----------
60.65
----------
0.00
----------
60.65
----------
0.00
126.36
0.00
126.36
0.00
105.00
0.00
105.00
0.00
----------
292.01
----------
0.00
----------
292.01
----------
0.00
Community Development Department
u`° Building Division
City of Cupertino
i.M# P. 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 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:
Job Site Address:
Roofing Company
Name:
Applicant's Signa r` re' 1 C__ 1(` �... Date:
• Greg Casteel
Building Official
Revised 11/2/04
Printed an Recycled Paper
•
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• ,
CITY OF
UPEkTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Bifilding Department
JOB ADDRESS: ,
O o
PERMIT #
OWNER'S NAME:
PHONE #
GENERAL CONTRACTOR:
FAX #
I am not using any subcontractors:
Signs� ee�� Date
Please check applicable subcontractors and complke.tM following information
r�
weer Contractor Signature
q-/L]�)Q—
Date
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
r�
weer Contractor Signature
q-/L]�)Q—
Date
•
•
0
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION FORM
APN�
Bldg Permit Fees
BUILDING
6U1
Energy
I 0-tw
Building A ress:
Seismic Fee Res
BUILDING
o
Owner's Name:
""
Phone #:
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BUSLIC
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Cractor:
Phone #:
License #:
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Gonna-ct:n /�
hone #:
Cupertino Business License #:
� -C� o lit Z 0.fP-S
�2 7 5- -o 33 O
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
0 Asphalt Shingles
>�, Asphalt Shingles
0 Wood Shakes
❑ Wood'Shakes
❑ Wood Shingles
j2' Other (Specify) _(2q $ kcKQ
❑ Wood Shingles
❑ Other (Specify)
Number of existing coverings /
❑ Provide I.C.B.O. Report k
,�7 To be Removed
❑ Provide Mfgr, Installation Specs.
I Have Read, Understand and Will Com 1
With Cu ertino's Tear Off Policy:
Job Description: �e S5
.1^I .7o t C 1 evt
1' Gr,"d-
O+� (L o9f i'10^� '6w'n lcs l Qtss
Residential 'M Commercial ❑
Fire Zone: Yes ❑ No
Confirmed with Planning De t. if
there are anv restrictions:
Cost of Project Type of Construction: Occupancy group:
Qty. if
A licable
Fee ID
Fee Descri tion
Fee Group
BPERNfFEE
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