10060209 CITY OF CUPERTINO 13UILDING PERMIT
BUILDING ADDRESS: 10935 NORTHVIEW SQ COr TRACTOR:FOUR SEASONS ROOFING PERMIT NO: 10060209
OWNER'S NAME: ERIC STODDARD PO BOX 1668 DATE ISSUED:06/30/2010
.NER'S PHONE: 4089731005 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r- ELECT r- PLUMB
License Class A i .#
MECH RESIDENTIAL COMMERCIAL
Contractor Date
I hereby a that I am license under the provisions of Chapter 9 JOI;DESCRIPTION:TEAR OFF EXISTING ROOF INSTALL 30LB FELT&A
LIFE TIME 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 Zt Floor Area: Valuation:$4400
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APP Number:31636001.00 Occupancy Type:
APPLICANT CERTIFICATION �c
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 harm)As the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and ex uses whic ay accrue amst said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of t permit. itionally, a pplicant understands and will comply
with all non- int source egulations p r e Cupertino Municipal Code,Section
9.18. Isst ed b Date: v'40-lv
Signature Date
❑ OWNER-BUILDER DECLARATION RE-R F
All:oofs shall be insp t prio to any roofr ma rial 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 aining nspection, agr a to remove all newterials for
the following two reasons: inspection.
I,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, Sigi ature of Ap Date: (e �� 0
Business&Professions Code)
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
HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I ha ve 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 forma 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 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 Adi litionally,sh uld I use equipment or devices which emit hazardous air
conrants efrne the Bay Area Air Quality Management District I will
permit is issued. maidta n com i nce h he 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 Hca 1 &Safe Code, a 'ons 25505,25533,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 w n ran to ized ent:
become subject to the Worker's Compensation provisions of the Labor Code,I must Date: ( C)I
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 which this permit is issued(Sec.3097,Civ C.)
correct. I agree to comply with all city and county ordinances and state laws relating Let der'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 Lei der's Address
nriify and a harmless the City o upertino against liabilities,judgments,
and expe s ay ay accrue ga nst said City in consequence of the ARCHITECT'S DECLARATION
granting of thi ermit. d itionally, e a plicant understands and will comply
with all no o nt sou e r gulations er e Cupertino Municip Code,Section I ur derstand my plans shall be used as public records.
9.18.
, ( V Licensed Professional
Signat re Date`�
CITY OF CUE ERTINO
2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Blk: I,ot:
APN 31636001 . 00
DATE ISSUED. . . . . . . : 06/3012010
RECEIPT #. . . . . . . . . BS000010747
REFERENCE ID # . . . : 10060209
SITE ADDRESS 10935 NORTHVIEW SQ
SUBDIVISION . . . . . .
CITY CUPERCINO
IMPACT AREA . . . . . .
OWNER ERIC 3TODDARD
ADDRESS 10935 NORTHVIEW SQ
CITY/STATE/ZIP . . . : CUPERI'INO, 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 AMOUNT 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 i
CITY OF CUPERTINO
REROOF
C U P E RT I N O PERMIT APPLICATION
r�
APN# Date:
Building Address:
C
11
Owner's Name- - — Phone #:
5TOQOA�LC) __�,__/
HOA: Yes No ❑ If yes, provide letter from HOA
Contractor: Phone #:l
Fax#H 08 J-9-
Cupertino Business License #: Contractor Li #:
Lj
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
,;a'I Other (Specify) e '�f ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
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 ad, Undr and and W' 1Co ly with Cu;)ertino's Tear-Off Policy:
Signature!
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 9514-3255
UPERTINO
(408) 777-3228 • FAX(408)777-3333 • buildinc a(�cugertino.orq
APN H
HONE 9 7 3 - -ti L
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CITY, STATE IP ��G \x4
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LICENSE NUMBER LICEN''`T BUS.LIC.
_ CJ �� cc0
E-MAIL FAX
�� CIT' STATE,ZI //z PHONE
I UNDERSTAND AND AGRE.: TO THE FOLLOWING:
project shall comply with all applicable provisions of the 2007 California Building Code.
_.
An inspection request shall be scheduled the day before the inspection date, Please call (408)77-/7-
322"S
404)777-
3??S between 7:30 - 3:30pm (Mon-Fri) to schedule tre next day inspection.
Ater the roof is torn off and the nails/fasteners hav( been removed and all the dry-rotted wood has
been replaced, you must call for a roof inspection. A building inspector will be available with one hour.
-ti-e special hours for the service: 7:30 — 10:301m and 1:00 — 3:30pm (Mon—Thurs);
7:30 — 10:30am and 1:00 — 2:30pm (Friday).
ood is installed, a plywood nailing inspection s required.
roof coverings shall not be applied without first obtaining all inspection and written approvals from
?i building inspector. Any roofing which is applied without first obtaining an approved inspection will
r a lire the removal of all new material down to the s leathing so a proper inspection can be performed.
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:
Flat roofs shall have a minimum of/" per foot of slope and demonstrate there is no ponding.
fisting from an approved testing agency shall be aN ailable on-site to review at the time of the
inspection.
�. Proper spark arrestor installation.
N0T1_: if you call for a plywood nailing inspection and the job is not ready, you will be charged to a re-
i��pection fee 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: 1 am the property owner or authorized agent to act on
propertv owner's behalf. I understand and agree to comply with the re-roof policy stated ove.
ApphcantlAgent. ---_—_-- Date: -- --- — --
ReroofPolicy_2010.rloc revised i) . i�
Enemy !
M.Indoor Air Quality and Finishes
1.Use LowMo-VOC Paint 1 IAC/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAC/Health pts y=yes 0
3.Use LowMo VOC Adhesives 3 IAC/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Re:;ource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6IAC Mealth pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAC/Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAC/Health. pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Re;ource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Re;ource pts y=yes 0
10.Install Whole House Vacuum System 3 IAO]Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 6 Res)urce pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 4 Res wrce pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Res)urce pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAC/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Res)urce pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Res)urce pts y=yes 0
1 1 1
Total Points Available: 1 140 130 57
Total Points Project Received: 01 0 0
G:data/progs/greenbuildi igguideliines/remodelers/greenpointsfinal2.12.04protected.xls
CITY OF CUPERTINO
FEE ESTIMATOR- BIJILDING DIVISION
ADDRESS: I DATE: REVIEWED BY:
APN: BP#: EVALUATION: $0
PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Du lex TOTAL S.f. APPLICATION
USE: P ROOF AREA: 600 TYPE:
xW
xa
00
3 �
FEE IE
1REROOFFRES
=Jl.
NOTE. These fees are based on the preliminary in ormation available and are only an estimate. Contact the Dept for addn7 info.
FEE ITEMS (Fee Resolulion 09-051 F't. 7/1:09) FEE QTY/FEE MISC ITEMS
Permit Fee: $78.00
Work Without Permit? Q Yes (D No $0.00
Strong Motion Fee: $0.00 Select an Administrative Item
131dR Stds Commission Fee: $0.00
SUBTOTALS: $78.00 $0.00 TOTAL FEE: $78.00
Revised: 5/27/2010