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06030051 (2) CITYOF CUPERTINO 4- .7#: rgrsszrxv�i?�^' yt4x':' BUILDING DIVISION PERMITC®NTRAC�`TURINFQRMATION BUILDING ADDRESS; FOUR SEASONS ROOFING PERMIT NO.06030051 20125 NQRTHWIND SO OWNER'S NAME: PERMIT ISSUE DATE NORTHPOINT HOA 502 HORNING ST - 03/10/2006 NE: SANITARY NO. CONTROL NO. (408) 278-0330 ARCHITECTMNOINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 30o LICENSED CONTRACTOR'S DECLARATION me BuJob Description r0 U 1 thereby affirm W Nat 1 am licensed under provisions of Chapter 9(commencing with Section 7")of Division 3 of dncas and Profeaaions Code,sedan It..0 mP< imm�m naadnff Z REMOVE CAL SHAKE ROOF, INSTALL 30 LB FELT, AND 'z LieaaClaa Lle. GAF GRAND C S�V�,N® ALED POSITION SHINGLES - CLASS A lgt-- Dau used as public ��� 3p ARCHf1ECTSDECLARATI N tau I undcruand my Alarm shall he used u punlic Tacna" 5 G� Licensed Professional OWNER-exempt frDEthe Contractors I brachy a(Su ann 1 am exempt from the fee m.Co License law for the APR — 1006 oO following mason permit 7031.5,Business and Nofesduns Code:Any city ormmy $ whim tits au a pormit re cnr srthe nor,impmsu demolish,m repair any swcture pdormits iuunce,alsu mqulma the applicant for such permit to fjmasigned atsumem < thnheislimnscdpuramnitolhcpmvisions M the Contractees Liccve Law(Chapter 9 Sq.Ft.Fl8jrLpj r% Valuati TI)500 $ (commencing with Section 7")of Oivision7 of Ne Bmincsk end Profuulnm Code)or .. Nat W m exempt therefrom and the huts fm the alleged exemption Any Aultif.of "—r-1 Section 70313 by any applicant for a permit subjects the applicant to a civil penalty of 00th Number Occupancy Type mat came than five hundred dollars(3300L 3163 8 013 . 0 0 Q 1.uowneroftiepmperty,armyempioyeuwiNwaeesudekanlecompe oon, will do dewok,and Nesuucu ,I.not handed reoffered fossam(Se.7044,Busircu Required Inspections and Professions Code:TW GmncmrS Liaise law Onus not apply m e ns an owner of q p property who builds or improver,thereon,and who dans such coat himself ar"rough his awn employees,provided Natsuch improvements me notlmmnded mallard foram.if, however.the building or Improvement is sold within ane year of compledon,Ne owner. builder will hale the burden of proving mal W did not Wild or improve for purpose of sale.). ❑1,as owner of use property am excrosfvely comaacting with licensed cenaacton m construct iW project(Sec.7014,Business and Professional Code:)The Contractees V- cense law data not apply to an owner of property,who Wilda or improv s mem m.and, who connate for such projects with a contncar(s)Imme d pursuant m 1W Contrammes License Law. ❑I am uemm under Sec. .B.4 P C far this reason 0. Dau WORKER'S COMPENSATION DECLARATION 1 hereby aBion trades ponslly of perjury aro of tiro following declarulans: I have and will malnWn a Cenifieam of Consentmself-insu a for WarkehCwnP n station.as provided for by Section 7700 of the labor Code,for the performance of the wart for which this permit Is Issued. ❑I have and will mainum Waken Compensation incomes,a required by Sedan s 77W of the Lab"Code,for the performance offt wok fawhich Nu permit is tuned. My WokeesCm ninaumtce artier ted policy rumba a rt: Grtkr. � paltry No.: /Z-y Z 14 y�� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thtssoulan nod not W completed ifflan Permit is foronc hundred dollars($100) nr lug.) 1 certify cant in the performance of Ne wok for which This permit is intend,l shalt tat employ any person in any manncran as a became subject to tW Warman'Compems0on laws of C.Iffmam.Dam Applicant NOTICE TO APPLICANT:If.after making this Cedificam of Exemption,you should become subject to the Workers Compensation provisions of me labor Code,you must .JO faNwith comply with such provision or this Permit Mall a deemed uvaked. Z Fti CONSTRUCTION TENDING AGENCY. 1 amby affirm that then is a construction lending agency for the performance of Cir the wet fa which this Permit is issued(Sec 3097,Civ.C.) IliQ Landeea Name z Lenders Address U Q 1 certify that I have read this application and sum mal the save information is Ur, correct.T agree to comply with all city and county ordinances and sum laws relating to C) building convection,and hereby authorice representatives of this city to cnmr upon the W ahovemrntioned property for impcedon purposes gy (We)agree to an,indemnify and keep harmless the City of Cupertino against n Ihbilidu,judgmenu,cosu andexpeua which may in anyway a one agamussid City V 7 In consequence of Ne granting of Nu Permit. PPLICA STANDS AND WILL COMPLY WI T'+ AUN I,L N N-POINT Issued by: Date SOUR CU ONS. / Re-roofs Signuum al'AppllcanitConuxmr Dam of Roof HAZARDOUS MATERIALS DISCLOSURE Type Will the applicant a future Wilding aceupantstare mbandle became.material an dcOncd by the Cupertino Municipal Code,Chapter 9.13,and the Health and Safety Cada.Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yu �e Wits the applicant f/alum Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove mIt hayandoua air commmants u donned by the Bay Area Air Quality Management all new materials for inspection. Guam'? ❑Ya AIN. [haw mad me headdm 3mamdam requimmems undcrChspw6,93of Ne Califor- nuKml@SafetYCode,Sedans25303.25333aal23534.1undcmanmuifthe Wilding dean not cmremly MSc a ant.mu it a my responsibility to wiry we acupant of me reyuim' calmWmetpdoranWuanceof'c"`:team cup.y Signature of Applicant Date 3G ow aamamteaa ran Dam All roof coverings to be Class"B"or better CITY OF CUPERTINO 4 of 4 PERMIT RECEIPT OPERATOR: suem COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31638013.00 DATE ISSUED. . . . . . . : 03/10/2006 RECEIPT #. . . . . . . . . : 33514 REFERENCE ID # . . . : 06030051 SITE ADDRESS . . . . . : 20125 NORTHWIND SQ SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : NORTHPOINT HOA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0551 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 WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL ______ _____________ __________ __________ __________ __________ __________ BPERMFEE VALUATION 6, 000.00 126.36 0.00 126.36 0.00 BSEISMICRE VALUATION 61000.00 0.60 0.00 0.60 0.00 __________ __________ __________ ---------- TOTAL PERMIT 126.96 0.00 126.96 0.00 METHOD OF PAYMENT AMOUNT NUMBER _________________ ____________ _________________- CHECK 507.84 005389 TOTAL RECEIPT 507.84 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 aClOF Cupertino CA 95014 Telephone(408) 777-3228 Fax(408)777-3333 *UPEI�TINO Building Department JOB ADDRESS: PERMIT # z,,r- ,Uo. �l�,.� S� . X3065/ OWNER'S NAME: PHONE # GENERAL CONTRACTOR: i Se-Ls, FAX # 2 7 S—037 I am not using any subcontractors: Z 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 Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date Community Development Department Building Division City of Cupertino • 10300 Torre Avenue CITY OF Telephone: (408)777-3228 C U PEI�TI NO 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 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-pr6gress 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: /Vo/ �ellO>t"V Job Site Address: ZS Par4'.-. a Roofing Company Name: f zv✓rS Applicant's Signature: Gn7 ��- Date: • Greg Casteel Building Official Revised 11/2/04 D.:nbd..n OurvnlaA 0emr CITY OF CUPERTINO REROOF . CUPERTINO PERMIT APPLICATION FORM APN # Date' 31 (D - 5�-ta l3 3 co Building Address: e po t ;2 5 k)o(4-�wi J- SO- Owner's QOwner's Name: " Phone#: 0C okaA— O, 111�. C tractor: Phone#: License#: ,-,r 2 a Y0g 22 $ -0330 /0 K Contact: /� hone#: Cupertino Business License #: `i 4j6 lit Z 0.fz� �2) $ `o 3.3 O Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles * Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles jd'- Other(Specify) Ca I 8 kaK-01- ❑ 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 1 With Cu ertino's Te az Off Policy: • Job Description: �� S T�s tY.1 k 3 o G C 1 an G Cir Gw of+ C'n csiklo�+ 61.'n Ics — ss Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning De I. if there are any restrictions: Cost of Project Type of Construction: Occupancy group: Qty. if A licable Fee ID Fee Description Fee Group BPERMFEE 91-d-g Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING •