10050202 CITY OF CUPERTINO BUILDING PERMIT
CONTRE.CTOR:FOUR SEASONS ROOFING PERMIT NO: 10050202
BUILDING ADDRESS: 20172 NORTHCOVE SQ DATE ISSUED:05/27/2010
PO BOX 1668
OWNER'S NAME: MARCIA ALBERS C/O UNC MANAGEMENT PHONE NO:(408)278-0330
SAN JOSE,CA 95109
VER'S PHONE: 4082296000
� LICENSED CONTRACTOR'S DECLARATION
BUILD ING PERMIT INFO: BLDG ELECT r PLUMB
� RESIDENTIAL� COMMERCIAL
Lie.# /) MECH
License Class � _
Date -7 L
Contractor JOB D ASCRIPTION:RE-ROOF(20172,20182,20192,20202,20212&20222)
EXISITT G CEMWOOD ROOFJNSTALL NEW GAF GRAND CANYON
I hereby ffirm that I am licensed under the provisions of Chapter 9 ASPHALT COMPOSITION SOYR ROOF SYSTEM,"STONEWOOD"
(commend with Section 7000)of Division 3 of the Business&Professions
Code and that my tcense 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 Valuation:$25887
Section 3700 of the Labor Code,for the performance of the work for which this PAPN
door Area:
permit is issued.
APPLICANT CERTIFICATION umber:31641032.20172.82.92.02.12.22 Occupancy Type:
I certify that I have read this application and state that 7 e 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 against said City in consequence of the 1 S0 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Date
9.18. .-- � Issued by:
Date
Signature
v
OWNER-BUILDER DECLARATION RE-ROOFS: If a roof
I hereby affirm that I am exempt from the Contractor's License Law for one of instal ted shall hout first obtaining anected prior i any
specttio n,I gree to remove all being nw materials tfor
the following two reasons:
or my employees with wages as their sole compensation, inspection.
I,as owner of the property, /
Date:
will do the work,and the sttucture is not intended or offered for sale(Sec.7044, Sign tture of Applicant _
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.70441 Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three gp�ARDOUS 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. 1 will maintain
performance of the work for which this permit is issued, con tpliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Saf-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
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall ma ntain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's He rlth&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I ner or autho ized agent:
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 certify that I have read this application and state that the above information is I t ereby affirm that there is a construction lending agency for the performance of work's
fo which this permit is issu
correct.I agree to comply wied(Sec.3097,Civ C.)
th 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 L,.nder's Address
'-mnify and keep harmless the City of Cupertino against liabilities,judgments,
and expenses which may accrue against said City in consequence of the �tCHITECT'S DECLARATION
Lgn�anting of this permit.Additionally,the applicant understands and will comply all non-point source re ulations�upertino Municipal Code,Section I tnderstand my plans shall be used as public records.
. � Date Licensed Professionaa
CITY OF CUPERTINO
PERMIT RECEIET OPERATOR: patg
3 ITEMS OF 3
COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 31641032 .:?0172 .82 .92 . 02 .12 .22
DATE ISSUED. . . . . . . 05000010530
RECEIPT #. " ' . 10050202
REFERENCE ID # • •
SITE ADDRESS 20172 NOFTHCOVE SQ
SUBDIVISION • • • • . CUPERTINC>
CITY . . . . . . . . . . . .
IMPACT AREA • •
UNC MANAG
OWNER ICr e
NQ7j h1 /
ADDRESS CUPERTIN��, CA 95014
CITY/STATE/ZIP . • •
RECEIVED FROM FOUR SEASONS ROOFIN
CONTRACTOR . . . . . . . DIAZ,
ONTRACTORDIAZ, ALFRED LIC # 21323
COMPANY FOUR SEASONS ROOFING
ADDRESS PO BOX 1668
CITY/STATE/ZIP SAN JOSE , CA 95109
TELEPHONE (408) 27E -0330
UNIT QUANTITY AMOUNPD-TO-DT -THIS-REC-
__NEW-BAL_
FEE ID --- 0 .00
------ ---- - 2 .00
---- ---------- ---------- ;3 . 00 0 .00 0 .00
1BCBSC VALUATION 25, 887 ' 00 60 0 .00 2 .60
25, 887 .00 0 ,00 962 . 00 0 .00
1BSEISMICR VALUATION 74 . 00 962 .00 __-_____--
1REROOFRES SQ FEET ----------
---- 966 .60 0 . 00
966 .60 0 .00
TOTAL PERMIT
AMOUNTFEFERENCE-NUMBER
--
METHOD OF PAYMENT ----
-----------------
966 .60 #0( 9687
CHECK _______
966 .60
TOTAL RECEIPT DESCRIPTION
VOICE ID _______
VOICE ID DESCRIPTION ---------------------
__ --
602 ROOF PLYWOOD NAIL
601 ROOF TEAR OFF
605 FINAL REROOF
604 ROOF IN-PROGRESS
CITY OF
CITY OF CUPERTINO
REROOF
C O P E RT I N O PERMIT APPLICATION
ct
( -7 Date: �, 1
Building Address: ������ �` -E-\ C\j
Phone zz9— C.-�CD
Owner's Nam �— = —
�Q/tel
HOA Yes No ElIf yes, provide letter from HOA
Phone
Contractor: o
Fax#: -2 Fg-
Contractor License #:
FCupertino Business License #: y Z/o8
Type of Roof Covering:
I
Existing:
Proposed:
Built-Up Roof ❑ Built-Up roof
:3 Asphalt Shingles Asphalt Shingles
❑ Wood Shakes
Wood Shakes
i
❑ Wood Shingles
] Wood Shingles
)XOther (Specify) ����o��� ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfg. Installation Specs.
Job Description: do ex�sf�'af ��'""'•�� �vh ,�� yr
Residential Commercial
Green Building: Please complete relevant portio 1 of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the appl.cation or if there are any restrictions: ❑
a livable, include in Ian set & the sheet index.
Valuation:
I Have Read, Understand and Will Comply with C,zpertino's Tear-Off Policy:
Signature
Revised 02/05/09
CITY OF
CITY OF CUPERMNO
REROOF
CUPERTINO FEE SCHERULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residentia B 1SFDWLR00F
I
1BCBSC Cal Bldg Standard.. B ALL PERMIT TYPES
Commission Fee
1 B SEISMICRE Seismic Residentia 1 B
1REROO MRES Re-roof Multi-Fan>ily B 1MFDWLROOF
1B C Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Green Points Rating System for Remodeling Proleds
Due to the diversity of remodeling project types,assigning a"total pointy'value to a project to be considered environmentally friendly is
not feasible.However,25 measures have been highlighted to signify the t every effort should be made to incorporate them into your
Projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be ised as a starting point for"greening"your project.
A.Site
1.�3gg�ds..k36 a _ waste --
4
up,0 4 Resource pts 0
85°�=1 ►5 2 2 iroints,BID° = .points D
2.Satvage Reusable Building Materials 4 Resource pts mas
3.Remodel for Mixed Use,Adaptive Reuse,and D
Historic Preservation 2R
Reso irce pts y=yes
2Re5Diroe pts y=yes 0
4.Protect Native Soil 0
5.Minimize Disruption of Existing Plants&Trees 1 ReSo irce pt y=yes \ D
6.Implement Construction Site Stormwater Practices 2 Resoima pts Y=YeS 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 1 0
3.Dasig�i Resou—ica-Ernciant Landscapes and Gardans 4 Rescurce pts y=yes
9.Reuse Materials/Use Recycled Content Materials 0
for Landscape Areas 2 Resc urce pts y=yes
–ves 0
10,Install High-Efficiency Irrigation Systems 2 Resource pts y–) 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes
B.Foundation
1.Incorporate Recycled Flyash in Concrete
25%Recycled Flyash=2 points;Add 1 point for every 1 D% 0
increase of flyash,up to 5 points up to 5 Resource pts
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 En;rgy pts y=yes 0
C.Structural Frame
1.Substitute–Solid Sahni Lumber with Er4naaed Lumber 3 Rei.oume pts y=yes 0
2.Use FSC Certified Wood for framing 0
(For every 10°0 of FSC lumber used=2 points,up to 1 D) uF to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings 2 Re source pts y=yes 0
4.Use Web Floor Trusses 2 Re>ource pts y=yes
P )
5.Design Energy Heels on Trusses fi"or more 2 Er ergY is Y=ves 0
v 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=)
es
0
7.Use Engineered Studs for Vertical Applications 2 Re source pts y=yes 0
B.Use Recycled Content Steel Studs for Interior Framing 2 Re source pts y=yes
9.Use Structural Insulated Panels(SIPS) D
a.Floors
3 E iergy pts y=yes
D
b.Wall 3 EiergY pts y=Yes
o.Roof 3 Eiergy pts y=yesJ
0
10.Apply Advanced Framing Techniques 4 R source pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 R:source pts y=yes 0
i 2-Use OSB
1 R:source pt y=yes 0
a.Svbtloors
b ung 1 R:source pt y=yes 0
1.Windows
1.Install Energy-Efficient Windows 0
1 Ener
a.Double-Paned g!�pt y=)'es
2 Energi pts y=yeS D
b.Low-Emissivity(Low-E) 0
c.Low.ConducMity Frames 2 Energ/pts y=yes
D
2.Install Low Heat Transmission Glazing 1 En erg�pt Y=185
J.heating Ventilation and Air Conditioning n
-� - -- - D
1.Use Duct khasfic on. Du, om - 2 Energy pts--y-)
2.Install Duct�vork within Conditioned Space 3 Energy pts Mes
1 Mkiealth pt y=Yes D
3.Vent Range Hood to the Outside 0
21AQ/Heahh pts y=yes
4.Clean all Ducts Before Occupancy 0
5.Install Solar Attic Fan 2 Enerry pts y=yes
1 Ener jy pt Y=Yes D
6,Install Attic Ventilation Systems 0
7.Install Whole House Fan 4 Enemy pts y=yes
B.Install Sealed Combustion Units 0
a.Furnaces 3 IAQ/lealth pts y=yes
0
b.Water Heaters
3IAQj-lealth pts y=yes.
9.Replace Wall-Mounted Electric and Gas Heaters with as 0
Through-the-Wall Heat Pumps 3 Ene gy pts )--y
0
10.Install 13 SEER1 EER or higher AC with a TXV 3 Ene-gy pts y=yeS 0
11
11.Install AC with Non-HCFC Refrigerants 2 Res�)ume pts y=yes
12,Install 9D%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 EnE rgy pts y=yes
0
13.Retrofit Wood Burning Fireplaces 0
a.Install EPA certified wood stoveslnseris 1 IAC/Health pt y=yes
1 EnE:rgy pt Y=Yes 0
b. Install/Replace Dampers 0
c,Install Airtight Doors 1 En:rgy pt y=Yes
3 En:rgy pts Y=Yes 0
14.Install Zoned,Hydropic Radiant Heating 0
41A(1/Health pts y=yes
15.Install High Efficiency Filter p
16.Install Heat Recovery Ventilation Unit(HRV) 5 IA01Health pts y=yes
31A1/Health is =yes
0
17.Install Separate Garage Exhaust Fan P Y � � 0
K.Renewable Energy and Roofing
4 Er ergy pts y=yes D
1.Pre-Plumb for Solar Water Heating 0
2.Install Solar(Nater Heating System 10 Energy pts y=yes
0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes
4.Install Photovoltaic(PV)System 0
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=1 B points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing materials 1 Re Source pt y=yes 0
7.Install Radiant Barrier 3 Eiergy pts y=yes
L.Natural beating and Cooling 0
1.Incorporate Passive Solar Heating 5 Er ergy pts y=yes
p - es 0
2.Install Overhangs or Awnings over South Facing Windows 3 Er er9Y is )-Y 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes
M.Indoor Air Quality and Finishes
1.Use LoytMo-VOC Paint 1 IAQ/lisalth pts y=yes 0
2.Use Low VOC,Watar-Based Wood Finishes 2 IADAiealth pts y=yes 0
3.Use Lovv No VOC Adhesives 3 lAQ/I'lealth pts y--yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts Y--Yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 5IAQ/ealth pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IM-lealth pts y=yes 0
7.Seal ag Exposed Parddebcard or MDF 4 IM-lealth -Pts y_les 0
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Res)urce pts y=yes 0
10.Install Whole House Vacuum System 3[AG/Health pts y--yes 0
1 6 1
N.Flooring
1.Select FSC Certified Wood Flooring B Resoirce pts y=yes 0
2.Use f3apidly;enewaale Flooring Materials 4 Resolrce pts Y--yes 0
3.Use Recycled Content Ceramic Tiles 4 Rescurce pts y=yes 0
4,Install Natural Linoleum in Place of Vinyl 5 IAQ/dean pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Rescurce pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resc urce pts y=yes 0
1 1 6
Total Points Available: 1 1401 1301 57
Total Points Project Received: 01 0 0
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