10060202 CITY OF CUPERTINO BUILDING PERMIT
BU'4LDING ADDRESS: 10925 NORTHVIEW SQ CON'rRACTOR:FOUR SEASONS ROOFING PERMIT NO: 10060202
OWNER'S NAME: CRAIG ROURKE PO BOX 1668 DATE ISSUED:06/30/2010
NER'S PHONE: 4089967432 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
�j' LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG I— ELECT r— PLUMB
Liceel�s ;Lic.# 48 MECH r RESIDENTIAL r— COMMERCIAL
Contrac Date
I hereby, rm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEAR OFF EXISTING ROOF INSTALL 30LB FELT&A
LIFE—IME COMP CLASS A 12SQ
(commencing with Section 7000)of Division 3 of the Business&Professions
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.I 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:31636002.00 Occupancy Type:
APPLICANT CERTIFICATION L�'
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 harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue a ' t said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of ' ermit. dditionally,t e app icant understands and will comply
with all non- nt sourc regulations p r the upertino Municipal Code,Section
9.18. Issued�:"l—� --�- Date:
Signat �= Date
C Q �
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All i Hofs shall be inspect prior to any roo g material being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one of inste lied without first obta hing specti n,I agree to remove all new materials or
the following two reasons: insp x;tion.
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, Sigrature of Applica . Date:
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 Cal:fornia Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. con-pliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safvty Code,Section 25532(a)should I store or handle hazardous material.
Ad(.itionally,should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this con:aminants defined by the Bay Area Air Quality Management District I will
permit is issued. mai am com lance 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 Hef t &Safe ode,Sec ons 5505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I 9P er or a o ized agent: 30 O
become subject to the Worker's Compensation provisions of the Labor Code,I must — Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby 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 Nhich this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Leader's Address
mify and keep harmless the City of Cupertino against liabilities,judgments,
and expgases which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of thi permit ditiona applicant understands and will comply
with all no int sou a egulati ns pe the Cupertino Municipal Co e,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Sign re 1 Date 6
CITY OF CUE ERTINO
2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Iot:
APN 31636( 02 .00
DATE ISSUED. . . . . . . : 06/302010
RECEIPT #. . . . . . . . . BS000010747
REFERENCE ID # . . . : 10060:02
SITE ADDRESS 10925 NORTHVIEW SQ
SUBDIVISION . . . . . .
CITY CUPER"INO
IMPACT AREA . . . . . .
OWNER CRAIG ROURKE
ADDRESS 10925 NORTHVIEW SQ
CITY/STATE/ZIP . . . : CUPER"INO, CA 95014
RECEIVED FROM . . . . : FOUR :SEASONS ROOFIN
CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323
COMPANY FOUR ;SEASONS ROOFING
ADDRESS PO BOX 1668
CITY/STATE/ZIP . . . : SAN JOSE, CA 95109
TELEPHONE (408) 278-0330
FEE ID UNIT QUANTITY AMO'JNT 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 CUPERTINO
REROIDF
CUPERTINO PERMIT APPLICATION
Date: 0
0 ;2 \
Building Address:
Owner's Name: , Phone c616 .- �(-I -? 2
HOA: Yes No ❑ If es, provide letter from HOA
Contractor: Phone #: ?�?
Fax#`�L' :
Cupertino Business License #: Contractor License #:
2 `z- �
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) �AC_ S ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Descriptio T_ � Aj C5 [/\�(pA(.
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:
I Have Re , Under aid and Wil Comply with l�ertino's Tear-Off Policy:
Signatue-
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 95014-3255
CUPERTINO
(408) 777-3228 • FAX(408)777-3333 • building�Dcupertino.orq
APN P
PHUNE E-MAIL
Crn, s,.
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LICENSE�N % LICEI TY3PE BUS.LIC.N
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E-MAIL I'A'X r-� 3 S 3
CIT' STATE,ZI PHONE
I UNDERSTAND AND AGREE; TO THE FOLLOWING:
r--
'fl:c ;c-ruof project shall comply with all applicable provisions of the 2007 California Building COLIC.
P inspection request shall be scheduled the day before the inspection date, Please call (408)777-
�22> between 7:30 - 3:30pm (Mon-Fri) to schedule the next day inspection.
:ter the roof is torn off and the nails/fasteners have been removed and all the dry-rotted wood has
bc:°n replaced, you must call for a roof inspection. A building inspector will be available with one hour.
Ti�cr are special hours for the service: 7:30 — 10:30,,tm and 1:00 — 3:30pm (Mon—Thurs);
7:30 — 10:30um and 1:00 — 2:30pm (Friday).
If ni�wuod is installed, a plywood nailing inspection is required.
X,� roof coverings shall not be applied without first obtaining all inspection and written approvals frorn
tic building inspector. Any roofing which is applied without first obtaining an approved inspection will
re�luire the removal of all new material down to the sheathing so a proper inspection can be performed.
final inspection and approval shall be obtained frorl the building inspector when the re-roofing is
�nipletcd. To receive a final sign-off, the following item will be verified:
Fiat roofs shall have a minimum of 1/4" per foot of slope and demonstrate there is no ponding.
b. listing from an approved testing agency shall be available on-site to review at the time of the
inspection.
! r,�p�r spark arrestor installation.
'\�O"1 L: if you call for a plywood nailing inspection and the job is not ready, you will be charged to a re-
inspcction tee of$126.00. The re-inspection fee shall be paid before another inspection can be
scheduled.
- my signature below, I 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 corrply with the re-roof policy stated bove.
Q -- Date: ��
Sin r�r of ApplicantlAgent: �. --- --— --
ReroofPolicy_ZOIO.doc rewse,,l O.,';; h,
CITY OF CU PERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: I DATE: REVIEWED BY:
APN: BP#: *VALUATION: $0
R,PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex TOTAL 1,200 S.f. APPLICATION
USE: ROOF AREA: TYPE:
xw
as
00
3 �
FEE IE
1REROOFFRES
r7l
NOTE: Theseees are based on the preliminaryin ormation available and are onlyan estimate. Contact the Det or addn'l info.
FEE ITEMS (Fee Resolution 0.9-051 Eff 7.1`09) FEE QTY/FEE MISC ITEMS
i w r f
,r� t
Permit Fee: $156.00
F-1
Work Without Permit? Q Yes 0 No $0.0(1
Strong Motion Fee: $0.00 Select an Administrative Item
Bldg Stds Commission Fee: $0.00 T__
SUBTOTALS; $156.00 $0.00 TOTAL FEE; $156.00
Revised: 5/27/2010
M.Indoor Air Quality and Finishes
1.Use Low/ND-VOC Paint 1 IA(LHealth pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ,Health pts y=yes 0
3.Use Low/No VOC Adhesives 3 IA(I Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Res)urce pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6 IAQ Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ'Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAQ'Health. pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger Jointed or Recycled Content Trim 1 Res ource pts y=yes 0
10.Install Whole House Vacuum System 3 IAOJHealth pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
i 1 i
Total Points Available: 1 140 130 57
Total Points Project Received: p� 0 0 0
D4 rotected.xls
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