08040026 (2) CITY OF CUPERTINOaw
WILDING'DIVISION PERMIT .f:Cd1VTRAC.�TOTi Tl URMAT'It7!N ��'
Bu1T�BI�MORTHWIND SQ FOUR SEASONS ROOFING P�08040026
OWNER'S NAME: PERMIT ISSUE DATE
PML MANAGEMENT P 0 BOX 1210 04/04/2008
ONE: SANITARY NO. CONTROL NO.
CHI ECTrENGINEER: BURRING PERMRINFO
REMOVE & REPLACE EXISTING aO EO mum O
�8 Zp LICENSED CONTRACTORS DECLARATION —IOW DDSCrI UOn
UZ I ion 7 a)Erm that 1 am hive Business
candor provisions of Chapter 9(commencing
n< with Schon 70f10)o(Dlviion7of Ne Buainent and Professions Colo,and my license is
< in full fano an etta�d
Lkense Lle.g
dir
imz Cl� Dem Can
ARCHRECI'SDECLARATION
I embossed my plana Mall he used nt public records
�yU
'iI yQ LleenseJ Profentianal .
OWNE.comDER DECLARATION _
herthy.(Seco Nat I 1 .Bump,from do CCnrrmoro :An,C Law for the —
O o following mown.(Section 7mrso Buaieus and 0ofchmodi Cole:Any city or many
3$ which mquima•polio fond.the alcor.mfar such
tlemmW,or MCA
sig any mromum
_Z i prior b its iensedp Also rryulms tiro applicant for web perm",Lies.Lath statement -
<
dean ac ocingwitpursuanttothe ofDivision
ivision3WConusiness ndPrQlaw(Chapter9 Sq.Ft. Floor Area Valuation
gE s dent(coremein, with Scmran t and of Diub for of Nlleged care and Prafeuy vi Cade)or
[�� W,he V ecomP,Neiefrom and be hofs for the alleged eampJon.Any vlohtion of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not mort Nan five hundred dollars(I50B.
❑I,As Caner Clubs property,or my employes with wages As Neo sale compensation,
will da Newark-and eI'm ComisatesLiam awcomon,apply. Boer of Required Inspections
and ProperPorfcssty
bar Cade:The nathencon,Liam law dura cot appy lf an owner is q p
propertyoho s,pro provided
On,mobim r mdwha dmfauchwdect.r sellar through Ma
Can employees,the Wilding
Nat such improvements are not intended mpledon.red for We.if.
however, bve noturden of proving
cold withinoroyear ofhappe ,for theowner.
of
buedm w10 have W burden of pvving Nn K did net build or Improve far purpose of .
ole.).
❑1,a owner of use property,am exclusively emus ting with littered mnuscmrs in
annswat the project.(Sec.7WC.Business and Prafevsimu Code:)The CmuacmYs U.
cema law does not apply be an owner of property who builds or improw,W ran,And.
who contraeu for such projects with a cnnuacmr(s)licensed pursuant to the C rauwa oes
Liceve law.
0 lameaemprunMSe, .B@PCforthis.
0. Dau
WORKERS COMPENSATION DECLARATION
I hereby of mat under Family of perjury ore of the following dedara urnee
kknsw and will maintain a Certificate of Conant to self--iiuum for Werkefs Compeo-
n.u pmvidcd for by Section 3700 of W Labor Cade.for the performance of Ne
far which this permit is issued.
(]1 have and will maintain Worker's Compensation Insurance,as enquired by Section
3700 offt labar Cade.for W performance of the work for which this permit Is Intend.
My Workefs Passed n saran artier and Polity number
Grtler. Q�iL" to g -Polityclio ��
CERTIFIC OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ThOaeNm hand trot be completed iftie permit is faro a hundraddelant(glao)
or less)
1 country then,in the performance of Use work fm which this Permit is Issued,l shall nm
employ any person In my mmmrco As to become subject to the Workers'Compensadon
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:IL after making this CertiRcam of Eamption,you should
become suem m the WorkrYs Compensation provisions of the labor Code,yen mum
.J 0 foMwiN provisions comply with such provions or permit Nall be deemed rtvoked.
y'-' CONSTRUCTION LENDING AGENCY
[.r.�. 1 hereby afrum W,Nem u a construction lending agency far the Fafarmance of
yW work for which this Permit Is Wood(Sec.3197,Civ,c.)
fg1 Q Lenders Name
z Undoes Addrent
U 0 1 comfy Nat 1 have Man this application arW amu Nat the above Information U
tomcat.I agree to comply with all city and county ordinances and state laws reading in
.0 building construction,and hereby suNarim seprescomiwa of this city to enter open the
W ahme-mendoad property for Inspection purposes.
G (We)agree to an,indemnify and kap harmless the City of Cupertino against
n„t fn liabilities.Judgment.casts and expenses which may in any wayeccoue against avid City
U'z in consequence of the granting of this Pont
'+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date —61 1.y
SOURCE REGULATIONS._
Re-roofs
Sillegure ofAWthondConuaaor Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof /�-
WIR W applicant Cr future Wilding ompe cat start or handle hesarCous material
As de0ad by tic Cupertino Municipal Code.Chapter 9.13,and the Health and Safety
rade.Scnlm 7S533(.)7
❑Yes All roofs shall be inspected prior to any roofing material being installed.
Will Na applicant or rutum building asupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
It hovaNnes air ccmmimmis As Jefincd by W Bay Area Air Quality Management all new materials for inspection.
bR
❑Yu ofI have road the It.. amrlis requirements under Chammr 6.95 ofthe Cslifor.
nice Health A,Sefe,y Code.Scatiarts M00,25533 end 35534.1 undcrm rd Na if Nc building
does not cumently how•wnam,Nu it is my rem omibility m notify Na ma,.,of the
requirements which mum W mel piano issuance of a Candicim of Occupancy. Signature Of Applicant Date
arwmained.gem Date' All roof coverings to be Class'%¢"or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31638059 .00
DATE ISSUED. : . . . . . : 04/04/2008
RECEIPT # . . . . . . . . . : BS000004363
REFERENCE ID # . . . : 08040026
SITE ADDRESS . . . . . : 20004 NORTHWIND SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA
OWNER . . . . . . . . . . . . : PML MANAGEMENT
ADDRESS . . . . . . . . . . : 20004 NORTHWIND SQ
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-0550
RECEIVED FROM . . . . : FOUR SEASONS ROOF
CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323
COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING
ADDRESS . . . . . . . . . . : P 0 BOX 1210
CITY/STATE/ZIP . . . : ALAMO, CA 95407
TELEPHONE . . . . . . . . : (408) 278-0330
FEE ID _---UNIT----- QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 26, 000. 00 2 . 60 0. 00 2 . 60 0. 00
1BUSLIC FLAT RATE 1. 00 110 .00 0. 00 110. 00 0. 00
1REROOFRES SQ FEET 76 . 00 988 . 00 0. 00 988 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 1100 . 60 0 . 00 1100. 60 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- -------------- - --------------------
CREDIT CARD 1, 100 . 60 AMERICAN EXPRESS
---------------
TOTAL RECEIPT 1, 100 60
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
•
03/28/2008 08'.02 FAX 408 777 3333 CITY CUPERTINO Q 001/004
CITY OF CUPERTINO
REROOF
• CUPERTINO PERMIT APPLICATION
Qr7�
APN#3(cp w S-ci- 6V Date: 3/3f,/0:f-
Building
/3f/G�
Building Address: ll
Owner's Name: Phone#{Le S
(( ��
Cho—ntractor: Phone #: i� i 4 �3
Fax #: &Ak ;z 32f- '
Cupertino Business License#: l Contractor License #:
moi' o`�/O Fs
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )k Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles /� �� , ❑ Wood Shingles
• Other(Specify) i 't `S ��►uC ❑ Other(Specify)
umber of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: o' epieeve, rtl7ACG e.<1Z,-1 4 .SJR �r '✓i
Residential Commercial
Fire Zone: Yes No Confirmed with Planning I lept. if
there are any restrictions:
Valuation:
1 Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
• Signature
03/26/2006 08'.02 FAX 408 777 3333 CITY CUPERTINO Q 002/004
CITY OF CUPERTINO
REROOF
CUPER—TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares
Group
1REROOFCOM Re-roof Commercial B ICOMMLROOF
IBSEISMICO Seismic; Commercial B
76 S?r. 1RFROOFRES Re-rool'Residential B ISFDWLROOF
J 1BSEISMICRE Seismic Residengal B
IREROOFMR$S Re-roof Multi-Family B IMFDWLROOF
IBSEISMICRE Seismic Residential B
•
1BUSLIC Business License B
•
03/26/2008 08:02 FAX 408 777 3333 CITY CUPERTINO 003/004
Community Development Departr tent
Building Divi ion
City of Cupei ino
10300 Torre Av ue
• Telephone: (408)TTI- 228
Fax: (408)7774 333
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 fust 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 he 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 1i14"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: C
Job Site Address:
Roofing Company Name: uc dr [OG✓7 5
Applicant's Signature! — �C�-- Date:
Greg Casteel
Building Official
Revi-wd 11/2/04
Community Development
10300 Torre Avenue
N
✓ Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
`UPEkTINO
Building De artment
JOB ADDRESS: Y - `Z3 PERMIT#
OWNER'S NAME: ?uG PHONE # 27,'--033 0
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors:
y/�/dam
Signature Date
Please check applicable subcontractors and complete the followinginformation:
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