10060208 CITY OF CUPERTINO ]BUILDING PERMIT
BUILDING ADDRESS: 10915 NORTHVIEW SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 10060208
nWNER'S NAME: MOHAMMAD SAATCHI PO BDX 1668 DATE ISSUED:06/30/2010
- ,NER'S PHONE: 6509652917 SAN LOSE,CA 95109 PHONE NO:(408)278-0330
E LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r— ELECT f— PLUMB
License Class ? kic.# MECH r- RESIDENTIAL r— COMMERCIAL
Contractor Date
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING ROOF INSTALL 30LB FELT&A
(commencing with Section 7000)of Division 3 of the Business&Professions
LIFE"'IME COMP CLASS A 12SQ
Code and that my license is in full force and effect.
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 Sq.F t Floor Area: Valuation:$4400
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:31636003.00 Occupancy Type:
APPLICANT CERTIFICATION I
I certify that I have read this application and state that the above information is
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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep ha ess the City of up rtino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and x enses w ch ay accrue ag ins said City in consequence of the 1$0 DAYS FROM LAST CALLED INSPECTION.
granting s permit A ditionally,the ap icant understands and will comply
with al n-point sou a egulations per Cupertino Municipal ode,S tion f�
9.1 r Issued b�'�` Date: l�
Sienatur Date �� ` O
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All r)ofs shall be insp pn r any roof m Tial being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first o inin a inspectio ,I agre to remove all new materials for
the following two reasons: insp ction.
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Appl' ant: Date:CQ
Business&Professions Code) —
1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safi ty Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Ad c it' Wally,should I use equipment or devices which emit hazardous air
comLaa a d fined by a Bay Area Air Quality Management District I will
permit is issued. mai pI an a with t Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Heae C de,Sec o s 25505,25533,an 25534.
not employ any person in any manner so as to become subject to the Worker'sCompensation laws of California. If,after making this certificate of exemption,I Ow ed �O C O
become subject to the Worker's Compensation provisions of the Labor Code,I must 4Z—
forthwith
Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I he-eby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for vhich this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Ler der's Name
to building construction,and hereby authorize representatives of this city to enter
-n the above mentioned property for inspection purposes.(We)agree to save Ler der's Address
,tnify an eep harmless the City of Cupertino against liabilities,judgments,
cuts,and e e ses w ' may accrue a st said City in consequence of the ARCHITECT'S DECLARATION
granting of ' permit dditionally, a app' ant understands and will comply
with all n point sou r lations er the pertino Municip Code,S tion I ur derstand my plans shall be used as public records.
9.18.
3 /V Licansed Professional
Signature Date
CITY OF CUPERTINO
2 ITEMS OF 10 PERMIT R): CEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: I,ot :
APN 31636003 . 00
DATE ISSUED. . . . . . . : 06/30/2010
RECEIPT #. . . . . . . . . BS000010747
REFERENCE ID # . . . : 10060::08
SITE ADDRESS 10915 NORTHVIEW SQ
SUBDIVISION
CITY . . . . . . . . . . . . . . CUPER-INO
IMPACT AREA . . . . . .
OWNER MOHAM14AD SAATCHI
ADDRESS 10915 NORTHVIEW SQ
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM FOUR SEASONS ROOFIN
CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323
COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING
ADDRESS PO BOK, 1668
CITY/STATE/ZIP . . . : SAN JDSE, CA 95109
TELEPHONE . . . . . . . . : (408) 278-0330
FEE ID UNIT QUANTITY AMOJNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ------
1BCBSC VALUATION 4, 400 . 00 1 . 00 0 .00 1 . 00 0 . 00
1REROOFRES SQ FEET 12 . 00 156 . 00 0 . 00 156 . 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 157 . 00 0 . 00 157. 00 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- -----------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF
CITY OF CU PERTINO
REROOF
CUPERTINO PERMIT APPLICATION
APN# Date: ,1
Building(—,,)Cl(ddress�
1
Owner'sName* Phone # � �<, C%��
HOA: Yes No ❑ If yes, provide letter f rom HOA
Contractor: Phone #:�ce) a-�-L --�
Fax
Cupertino Business License#: Contractor Lice #:
e),
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
Other(Specify) CAL S � r o Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: ( t
Li-L7
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation: 1
i
I Have ead, Und sand and Will mppwith Cupertino's Tear-Off Policy:
S'ipatur
Revised 02/05/09
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95)14-3255
`UPERT1N0
(408) 777-3228 • FAX(408)777-3333 • buildincCa)cupertino.orq
APN H
r PHONE E-MAIL
F lti1 YAC' 'A5C Cc i-C�t I �`�2> `t�� C! lCITY, SIAIE.,41P 7
- — – 1.4.\CN`j Zz9
LICENSE NUMBER LICENS T BUS.Lic.0
CJ/ZJ /I? K iiZZ
�✓ E-NIAIL
z
—_--
CIT' STATE,ZI PHONE�
I UNDERSTAND AND AGRE:- TO THE FOLLOWING:
l l:c rc-root project shall comply with all applicable plovisioris of the 2007 California Building Code.
_. AT, inspection request shall be scheduled the day before the inspection date. Please call (40g)777-
22S b;:tween 7:30 - 3:30pm (Mon-Fri) to schedule tre next day inspection.
the roof is torn off and the nails/fasteners have been removed and all the dry-rotted wood has
b�' a replaced, you must call for a roof inspection. A building inspector will be available with one hour,
:.ire special hours for the service: 7:30 – 10:30 am and 1:00 – 3:30pm (Mon–Thurs);
7:30 – 10:30 am and 1:00 – 2:30pm (Friday).
If plywood is installed, a plywood nailing inspection s required.
\,w roof coverings shall not be applied without first obtaining all inspection and written approvals from
building inspector. Any roofing which is applied without first obtaining an approved inspection will
the removal of all new material down to the s leathing so a proper inspection can be perforrned.
tidal 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:
FI�t rootf
s shall have a minimum o /" per foot of slcpe and demonstrate there is no ponding.
from an approved testing agency shall be Mailable on-site to review at the time of the
�:>st�cction.
c. Proper spark arrestor installation.
NO-17L If you call for a plywood nailing inspection and 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.
Inv signature below, 1 certify to each of the following: I am the property owner or authorized agent to act on
property owner's behalf. I understand and agree to comply with the re-roof policy stated ove.
pplicant'Agent: —Q �' -----_ Date:
ReroofPo1icy_2010.doc revised 04 r;.I
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: *VALUATION: $0
`PERMIT TYPE: Minor Building Permit PLAN C HECK TYPE: Re-roof
PRIMARY TOTAL 600 S.f. APPLICATION
USE: SFD or Duplex ROOF AREA: TYPE:
xW
xa
cc
3 �
FEE ID
1REROOFFRES
71,17
NOTE. These fees are based on the preliminary in ormation available and are on1v an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 09-0j1 Elf' 74,09) FEE QTY/FEE MISC ITEMS
Permit Fee: $78.0(
F771
Work Without Permit? Q Yes (D No $0.00
a
Stron€;Motion Fee: $0.00 Select an Administrative Item
131&,Stds Commission Fee: $0.01)
SUBTOTALS: $78.0) $0.00 TOTAL FEE: $78.00
Revised: 5/27/2010
1ADHealth
.Indoor Air Quality andinishes
1.Use LowMaVOC Paint 1 IAQ/F ealth pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/F lealth pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Rescirce pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6IAQ/Iiealth pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQA iealth pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAQ/I iealth. pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 Resc urce pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAC,Health pts y=yes 0
• 1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring e Resoilrce pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 4 Reso trce pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Reso irce pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/liealth pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Reso irce pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Reso jrce pts y=yes 0
1 1 6
Total Points Available: 140 130 57
Total Points Pr 'Zct Received:1 0 01 0
i
E
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