The URL can be used to link to this page

10080040 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10980 NORTHSKY SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 10080040 PO B(1X 1668 DATE ISSUED:08/05/2010 OWNER'S NAME: RICHARD HSU SAN JOSE,CA 95109 PHONE NO:(408)278-0330 VER'S PHONE: 4089961833 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT r— PLUMB License Class 63 1 Lic.# � �Z/..()� MECH r— RESIDENTIAL F COMMERCIAL F Contractor V154 Date j pS C A JOB DESCRIPTION:RE-ROOF RMV EXISTING CEMWOOD ROOF&INSTALL I hereby affirm that I am licensed under the provisions of Chapter 9 NEW (commencing with Section 7000)of Division 3 of the Business&Professions GAF(;RAND CANYON ASPHALT COMP 50YR ROOF SYSTEM, Code and that my license is in full force and effect. STON EWOOD IN COLOR 14SQ CLASS A I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Sq Ft Floor Area: Valuation:$5200 permit is issued. APPLICANT CERTIFICATION ane Occu Type: I certify that I have read this application and state that the above information is APN Number:31640062.00 occupancy yp correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, 13ERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Date (f Isst ed by: Date: Signature LJ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All oofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, instilled without first obtaining an inspection,I agree to remove all new materials or will do the work,and the structure is not intended or offered for sale(Sec.7044, insl ection. � Business&Professions Code) Sig iature of Applicant: 0Date: 1,as owner of the property,am exclusively contracting with licensed contractors to — construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by co npliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. A(Aitionally,should I use equipment or devices which emit hazardous air I 1 certify that in the performance of the work for which this permit is issued, shall co itaminants as defined by the Bay Area Air Quality Management District I will 1113intain compliance with the Cupertino not employ any person in any manner so as to become subject to the Worker's H-!alth&Safety Code,Sections 25505,25533,rCode,icipal Chapter 9.12 and the and 2 534 Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must OV ner r or' agent: f� /� forthwith comply with such provisions or this permit shall be deemed revoked. Date: C� l APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I 1 iereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating fc r which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save unify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address ,and expenses which may accrue against said City in consequence of the g.;,.nting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 9/5//U I understand my plans shall be used as public records. Signature _v Date Licensed Professional CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 3 ITEMS OF 18 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lct: APN 31640062 .00 DATE ISSUED. • • • • • • : 08000070098 10 RECEIPT #• • • • • . . . . : 1008004 0 REFERENCE ID # • • SITE ADDRESS 10980 ITORTHSKY SQ SUBDIVISION • • • . . CUPERTINO CITY . . . . . . . . . . . . IMPACT AREA . . . . . . . OWNER RICHARD HSU ADDRESS 10980 VORTHSKY SQ CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : FOUR SEASONS ROOFIN CONTRACTOR DIAZ, ALFRED LIC # 21323 COMPANY FOUR SEASONS ROOFING ADDRESS PO BOA. 1668 CITY/STATE/ZIP SAN JOSE, CA 95109 TELEPHONE (408) ::78-0330 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ---------- ___ ---- '- 0 .00 ---------- 1. 00 - ------------- 5, 200 . 00 1.00 0 . 00 0 .00 1BCBSC VALUATION 0 .60 0 . 00 0 .60 1BSEISMICR VALUATION 5, 200 . 00 0 .00 14 . 00 182 .00 0 .00 182 . 00 1REROOFRES SQ FEET ____ ___ --------- ---------- 0 .00 183 .60 0 .00 183 .60 TOTAL PERMIT : AMOUNT----- REFERENCE NUMBER METHOD OF PAYMENT ----- ------------- -- CHECK -------1, 101_60 X009903 TOTAL RECEIPT 1, 101.60 - VOICE ID DESCRIPTION VOICE ID DESCRIPTION ------------------- __ -- __ --------- ------------ 602 ROOF PLYWOOD NAIL 601 ROOF TEAR OFF 604 ROOF IN-PROGRESS 605 FINAL REROOF CiTY OF o C CITY OF CU_?ERT11N0 RLEROOF ON* CUPERTINO PERMIT APPILICATI Date: _2 - --- ---------- Address: o Phone #: Name: C) Yes No El if yes, provide letter from HOA Phone Fax#: (2upertino Business License #: Contractor License 2/� -3 Type of Roof Covering: p Fisting: Proposed: BUilt-Up Roof u Built-Up roof 'Ll Asphalt Shingles Asphalt Shingles u, Wood Shakes ,j Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ! NOther (Specify)' Other (Specify) umber of existing coverings u Provide I.C.C.E.S. Report# j To be Removed L3 Provide Mfgr. Installation Specs. 1 Job Descripticn: 4 1 Aa Commercial ❑ Grecu Building: Please complete relevant portionof the Confirmed with Planning Dept. if 6 Grecu Building Checklist & attach it to the application or if there are any restrictions: ❑ _qjpficable, include in plan set & the sheet index. _VLIL,1ation: ' 'lave tZead, Understand and Will Comply with Cupertino's Tear-Off Policy: S1_411,LLUre Revised 02/05/09 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT- 3UILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OF=FICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 -,PERTINO (408) 777-3228 • FAX(408)777-3333 • buildingacupertino.orq !'ROJECIADDRESS 10T& PN# l O C ((� OGVNF.RNA��IL7 L(�Hsu PHONEQI'.�//' 1J,3 E-MAIL *�7.�� J_�(_ (� jj,J Sll<EGT ADDRESS 4S )n _. p CITY, STATE,ZIP FAX CONTRACPORNAME '1'�� LICENSE NUMBER LIC S-E TYPE BUS•�0/ 3 •� {� Fre C 2are� v 3 er E-MAIL FAX CITY,STATE,ZIP PHONE STREET;�DDRESs Z ?� I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. An inspection request shall be scheduled the day before the inspection date. Please call (408)777- 3228 between 7:30 - 3:30pm (Mon-Fri) to schedule the next day inspection. 3. After the roof is torn off and the nails/fasteners have keen removed and all the dry-rotted wood has )een replaced, you must call for a roof inspection. A building inspector will be available with one hour. There are special hours for the service: 7:30 — 10:30ar:i and 1:00 —3:30pm (Mon—Thurs); 7:30 — 10:30arn and 1:00 —2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. New roof coverings shall not be applied without first obtaining all inspection and written approvals from the building inspector. Any roofing which is applied A ithout first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. To receive a final sign-off, the following item will be verified: a. Flat roofs shall have a minimum of 1/4" per foot of slop- and demonstrate there is no ponding. b. A listing from an approved testing agency shall be ava:lable on-site to review at the time of the inspection. c. Proper spark arrestor installation. 7. NOTE: If you call for a plywood nailing inspection ar.d the job is not ready, you will be charged to a re- inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. P iy signature below, I certify to each of the following: I im the property owner or authorized agent to act on th,, property owner's behalf. I understanA and agree to comply with the re-roof policy stated above. Signature of Applicant/Agent: AK Date: — ReroofPolicy_2010.doe revised 04/14/10 i Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CUPERTINO CONTRACTOR/ SUBC ONTRACTOR LIST j JOB ADDRESS: PERMIT# OWNERS NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. j IL THE NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UpERTINO GENERAL CONTRACTOR AND ALL SUBC NTRAC'CORS HAVE OBTAINED A CITY OF BUSINESS LICENSE. I am not using any subcontractors: Ile Signature Date Please check applicable subcontractors and complete -:he 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 Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date