06030048 (2) CITY OF CUPERTINO ^r?zx '�` ' "' "''�`" • '
BUILDING DIVISION PERMIT CONT , 'Cif NFURMAT.TON':�
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT NO.06030048
20105 NORTHWIND S
OWNER'S NAME: PERMIT 55UE DATE
NORTHPOINT HOA 502 HORNING ST - 03/10/2006
JE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECf7ENG1NEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MEC"
�0, LICENSED CONTRACrOR'S DECLARATION lb Description
vd IY 1 hemby affirm deal ns at 1 am licensed under prevision of Chapter 9(commeno
cing p
with Section 7OaO)al'Divisan 3 aids.Busincemand Ismica ter.Cotte.ail my licensets
in fullmn<andetm�we,. O REMOVE' CALSHAKE ROOF ALL 30 LB FELT AND GA
i�4 License Clp&i O C nvxemr y3t/0!1
LY D.m fl GRAND CANYON COMPOSI � CLASS A
ARCHfTECPSDECLARATION LL
1 undersand my plans shall be used u public rmnNa
lea. Licensed Pmfcuional j] ��
So OWNER-BUILDER DECLARATION APIR 2006
3g @ 1 hereby Amore that I am exempt form the Conlnctoes License law for the o
p O following reason.(Section 7031.5,Business and Professions Codc:Any city or county
I which requires a permit to enosrrct,that.improve.dermdkh,or occur any nrecturt MAIM Was,
y pow m its issuance.also requires the applicant for such permit m file sm
signed statement
�< Net M is licensed pmtustum the previsions of the Conuacmr's Lmnm Law(Chapter 9 Sq.Ft. Floor Area Fifilwily AKAxIuati$iFD500
,Spy (commencing with Smla 7000)of Division 3 of the Business and Professiaru Code)Or
3 s
that he is exempt Liberatore and to basis fw the dhcged exemption.Any violation of
Section 7031.5 by any applicant far a permit subjects the applicant w a civil pmtslty of APN Number Occupancy Type
oat mart than five hundred dollars($5007. 31638014 . 0 0
❑1,as owner of the property,Or my ctoplayms with wages u deo sale compewdon,
will do de work,tad to struau ,is rot intended warmed for sak(Sm.7044,Estimates Required Inspections
and Professions Code:The Contractor's License law data not apply m e ns an Owner of q p
property who bull&or improve,thmoan,and whadoesauchwwk himtedfw Waugh his
awn employees.provided that such improvements are notinendeel mastered for ad&If.
however,the building or improvement Is sold within am year of completion,the Owner.
builder w10 haw the burden of paving that he did Out Mid ar improve for purpose of
rhe.).
C3 I,as owner of the property.am exclusively contracting with licensed anmctors to
construct the project(Sas.7044.Business ad Prafadons Cade:)The Comramm's Li-
same Law docs not apply to an owner of propeny-who builds or improve Hanson.and,
who contracts cts for such Projects with atom sewr(0liuwsed pursnsnt to W Connor's
License Law.
❑I am exempt under Sac ,B&PC far this renters
Owner Dam
WORKER'S COMPENSATION DECLARATION
I MmbY of tom under penalty of perjury am of fete following declarations:
have and will maintain a CeNftaaof Canumtcaclf-imat a for WaftesCompen-
sadon,as previded for by Section 37W of the Labor Cade.for the performance of the
work for which this permit is lured.
❑1 haw and will maintain WwkW`5 Campemadon Insuran¢,a required by Section
3700 of the labor Carle,far ton performance of the work for which this permit is lased.
My WOdmfe C pemadon Insurance earrim W Polley number tae:
Cartier. gg't� Policy No.: yy -
ERTIFICATE OF EXEMPTION FROM way
COMPENSATION INSURANCE
Tina seNm wood an,bocmnphcted U W permit Isforane hundred dollars($100)
or lesa)
1 unify that In sec performance of the work for which Its permit is isseed.l shill net
employ any person In my manner an as to became subject to th,Worlecn''Compensadon
Laws ofCalifornia.Data
Applmmi
NOTICE TO APPLICANT.If.after making this Certificate of Exemption,you should
become subject to W Worker',Compensation previsions of sec labor Code.you mew
.�.Z forthwith comply with such provisions or Nu permit Mall he deemed revoked.
zO CONSTRUCTION LENDING AGENCY
t'w I hertbY ams.Nu Nen Is a connomtinn kobing agercy fw W perfemana of
CL,7 W work fur which this permit ts issued(Sec.309'1,Civ.Q
0 Lender's Name
a z Untie:Address
U O I Beatify Nat I haw read Oda application and sue Wt W show information it
!! coma I agree to comply with all city and county aNir mos and state laws relating in
p SV" building construction,and hereby authorise Mimumniws of this city to enter upon
,hove-mentioned property for Inspection purposes
(Wt.)agme to saw,indemnify and keep harmless the City of Cupertino against
rA liabilities,judgments.emu ad expenses which may in any my acerae against said City
U 7 in Come moan of Ne grading of this pmmit. r
G APPL ANT DERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date (O— D 61
SO E S..
Re-roofs
ssurt of
HAZARDOUS
Date
HAlA to,=b MATERIALS DISCLOSURE Type of Roof
WIII y t e Cupertino
w forum building occupant owe or handle h Health
a maesid
u defined by the Cupertino Municiryl Cade,Chapter 9.13,and W Ha1N and Safety
Code,Section 35532(a)7 �. All roofs shall be inspected prior to any roofing material being installed.
Yes
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
I haardma dr mntaminsnts as,defined by the Bay Area Air Quality Management all new materials for inspection.
u tt7
❑Yrs .$Ido
I one mad the bazamousmaterlals requirements undcrChapter695of the Califor.
nla HOW&Safety Cad.,Sedans 75515.35533 and 35334.1 undermost ma if Ne building
does set camently bow a unuml Ne it Is my ompauihilhy to noufy W meupant of Ne
rtyulmm.,p0,0chmotapdorretssu ccof.ccr":r Signature of Applicant Date
PIA—
Owner or authorized agent o,a All roof coverings to be Class"B"or better
CITY OF CUPERTINO
7• 1 of 4 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . : 31638014 .00
DATE ISSUED. . . . . . . : 03/10/2006
RECEIPT #. . . . . . . . . : 33514
REFERENCE ID # . . . : 06030048
SITE ADDRESS . . . . . : 20105 NORTHWIND SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . CA
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
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
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
305 FRAME 307 INSULATION
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
Community Development
10300 Torre Avenue
r Cupertino CA 95014
Telephone(408)777-3228
Cl OF Fax(408)777-3333
#PEI�TINO
Building Department
JOB ADDRESS: PERMIT #
02
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: o $ / �— FAX # 2 Z 8
I am not using any subcontractors: �i 2//
Signature Date
Please check applicable subcontractors and complete 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
Z.---Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
Community Development Department
Building Division
/Jl City of Cupertino
• 10300 Torre Avenue
CITY OF Telephone: (408)777-3228
CUPE�T�N� Fax: (408)777-3333.
Building Department
Subject: Re-roofing policy for the City of Cupertino
1— Prior to permit issuance,you must agree to comply with 1997-UBGStandards-
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: nn XJ."-9i,Om //��
Job Site Address: �X �� S ���7Gr,)v
Roofing Company Name: �� SP �^� JC'1'�
Applicant's Signature: Date: Ila 04
• Greg Casteel
Building Official
Revised 11/2/04
Onnln.V nn Onni.nlnr!Oennr
CITY OF CUPERTINO x(00 S(XD"t-b
REROOF
• CUPEkTiNO PERMIT APPLICATION FORM
APN # .21(ig_ 35. 0)t Date' /o "
Building Address: I
a.Olo.S- Noc lQ.w�n,l� Sa�r�
Owner's Name: Phone#:
06L 0 n+- . O. Ih.
C tractor: Phone #: License#:
�e4 yob 2Z 5 -0330 /0 K
Conrrta-ct: r/1� hone #: Cupertino Business License #:
l 4 Z .-rt, .2 7 $ -o 33 O
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles '0, Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles �t ElWood Shingles
Other(Specify) t_q 113 kaK2. ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O. Report#
Y To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Com 1 With Cu ertino's Tear Off Policy:
• Job Description: �L l S ZN 5*� 1 t 3 0 l C an
C Gr"oq- Gw oN CD o9t`d log+ 6l 'n les — (fjl? .5
Residential Commercial
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are anrestrictions:WE
Const oS Project Type of�onstruction: Occupancy gfoup:
t OO
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