10050095 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20193 NORTHCOVE SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 10050095
OWNER'S NAME: NORTHPOINT HOA PO BOX 1668 DATE ISSUED:05/10/2010
,'ER'S PHONE: 4089963734 SAN J SSE,CA 95109 PHONE NO:(408)278-0330
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT'F PLUMB
License Class 0 Lic.# / F F_
MECH RESIDENTIAL COMMERCIAL
Contract5;�?� `P Date O v
JOB DESCRIPTION:RE-ROOF RMV EXISTING CEMWOOD ROOF&INSTALL
I hereby affirm that I am licensed under the provisions of Ch pter 9 NEW
(commencing with Section 7000)of Division 3 of the Business&Professions GAF C RAND CANYON ASPHALT COMP 50YR ROOF SYSTEM
Code and that my license is in full force and effect. "STOI`EWOOD"IN COLOR CLASS A 46SQ
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:$14466
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN slumber:31641033.20193/20203/20213/202 Occupancy Type:
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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply `'VITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
-�- "" - O c7
Signature �� Issued by: Date:
Li OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All ro ifs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspe(tion.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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
performance of the work for which this permit is issued. I hav!read the hazardous materials requirements under Chapter 6.95 of the
1 have and will maintain Worker's Compensation Insurance,as provided for by Calif►rose Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
compliance 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(x)should I store or handle hazardous material.
permit is issued. Addi:ionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall conta minants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Heap h&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must
Own-r or authorize nt:
forthwith comply with such provisions or this permit shall be deemed revoked. �- +� - Date:
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I herr by affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
-mnify and keep harmless the City of Cupertino against liabilities,judgments,
.s,and expenses which may accrue against said City in consequence of the Lend er's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signa of r Date_
Licensed Professional
CITY OF CUP&ZTINO
PERMIT RECEIPT OPERATOR: patg
3 ITEMS OF 6 COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 31641033 .20193/20203/20213/202
DATE ISSUED. . . . . . . : 05/10/2010
RECEIPT #. . . . . . . . . BS000010368
REFERENCE ID # 100500S5
SITE ADDRESS 20193 I`ORTHCOVE SQ
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER NORTHPOINT HOA
ADDRESS . 10880 ITORTHPOINT WAY
CITY/STATE/ZIP . . . : CUPERT:'NO CA, CA 95014-0553
RECEIVED FROM • ' JAMED AZS ALFRED LIC # 21323
CONTRACTOR . . . . . .
COMPANY FOUR SEASONS ROOFING
ADDRESS PO BOX 1668
CITY/STATE/ZIP SAN JOSE, CA 95109
TELEPHONE (408) 278-0330
FEE IQ UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
----------
---------- ----------
----
00
1BCBSC VALUATION 14, 466 . 00 1. 00 0 . 00 1 . 00 0 •
1BSEISMICR VALUATION 14, 466 . 00 1. 50 0 . 00 1.50 0 . 00
1REROOFRES SQ FEET 46 .00 598 . 00 0 . 00 598 . 00 -- -- 0 . 00
---------- ---------- ----------
TOTAL PERMIT E00 . 50 0 .00 600 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
-----------------
--------------- -- ------------
CREDIT CARD 1, 201. 00 MIEX
---------------
TOTAL RECEIPT 1, 201 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-----
-- ------------------ -------- -------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF C`� s--
J
CITY OF CUPERTINO
RERGOF
C U P E RT I N O PERMIT APPLICATION
APN # )ate.113Z; •
Building Address:
20 i93- .ZoZ G3 - .200 - zv z�3 /t/a�s" c,,V
Owner's Name: Phone #: ,fag)-zzg
�' per.•¢ � �� <� 4 7
HOA: Yes No ❑ If yes, provide letter from HOA
Contractor: Phone 7 -
Fax
Cupertino Business License #: Contractor License #:
,./,32 -3 y Z/off'
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )( Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles p ❑ Wood Shingles
Other (Specify) eel" ❑ Other (Specify)
umber of existing coverings s ❑ Provide I.C.C.E.S. Report #
P
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
�...d�
Residential Commercial ❑
Green Building: Please complete relevant portion A 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 Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signiture
Revised 02/05/09
CITY OF
CITY OF CUPERTINO
REROOF
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commerc al B 1COMMLROOF
IBCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
IREROOFRES Re-roof Residential B 1SFDWLR00F
IBCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1RER00 MRES Re-roof Multi-Fancily B 1MFDWLROOF
1B C Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1 IBSEISMICRE Seismic Residential B
1BUSLIC Business License B
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
49
B. Site 9. Install H.E. Irrigation, (details/spec)" L-1 2 points
11. Permeable Paving, Note L-1 2 oints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
G. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 'points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
w TOTAL POINTS 40 points
Plan Review Process Work Book Page-12-Revised 3/25/08
U1.IrrriaDr Air Ouality and Finishes
1,Use Lour/No-VOC Paint 1 IAO/I-ealth pts y=yes
2.Use Low VOC,1Yatar-Based\rtlood Finishes 2 IAQII ealth pts y=yes Dt
3.Use LDW/No VOC Adhesives 3 IADJr ealth pts y=yes p
4.Use Salvaoad Materials for Interior Finishes 3 Re5olrce pts y=yes D
5.Use Enoine-�red Sheet Goods with no added Urea
Formaldehyde 61ADJI ealth pis y=yes D
6.Use Extarior Grade Ply\a'ood for Interior Uses 1 IAO/F ealth pts y=yes pt
7.Seal all D D,:)sad,3rbalaboard or MDF 41ADJI as th.
8,Use FSC Certified Materials for Interior Finish 4 Re5olrCe pis y=yes D
Use Finger-Joinied Dr Recycled-Content Trim 1 Ra5olrCe pis y=yes D
D.Install Ihrhol-House Vacuum System 3 IAOJHealth pts y=--yes p
1.4.Flooring
1.Select FSC Certified Wood Flooring 8 ResDu-Ce pts y=yes D
2.Use Rapidly FRaneiftfable Flooring Materials 4 Resou-ce pts y=yes D
Use Recycled Content Ceramic Tiles 4 Resou-ce pts y—yes D
A.Install Natural Linoleum in Place of Vinyl 5 IAQ'Hsalth pts y=yes ri
5.Usa Exposed Concrete as Finished Floor 4 Resou ce pts y=yes D
o.Install Recycled Content Carpet with Low VOCs 4 Resou ce pts y=yes D
1 Total Points Availablej 1401 130 5�
_ ��tsl ��el�ts Pr�'�ct �eceivEd: � �►I
G:data/props/greanbuildinognideiinestremodeledgreanpointsfinal2 l 2.N.prof ecl2d.xls
�NORTHPOINT HOMEOWNERS ASSOCIATION -
10880 Northpoint Way NPHOA.ORG
Cupertino, CA 95014
(408) 996-3734
March 10, 2009
City of CupertinoV�
MAY 10 ZQIO JD
Re: Northpoint Roofs
To the City of Cupertino-,
Please note, the Northpoint Homeowners Association has contracted and approved Four
Seasons Roofing to perform re-roofs of our hornet; replacing the current Cal-Shake roof
system with new GAF Grand Canyon Asphalt Coriposition Shingles. We have selected the
Stonewood color for our roofs.
Sincerely,
6�va
Linda Starnes
On Site Manager
PML MANAGAGEMENT, 655 Mariners Island Blvd. 81JU11301, San Mateo, CA 94404(650) 349-9113
Za 39dd dOH 1NIOdH1dON 9ZZ096680P LS:VO 600Z/aZ/Za
DATE(MMIDDIYY)
CEI,TIFICATE OF WORKERS'COMPENSATION COVERAGE 3/3/2010
master Account THIS CERTIFICATE OF COVERAGE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFER NO
OF.ALTER THE COVERAGE AF ORDED BY THE COVERAGE BELOW.UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES
Mainstay Business Solutions
P.O.Box 1128 ENTITY AFFORDING COVERAGE
Blue Lake,CA 95525
INSURER A:Mainstay 3usiness Solutions(a Self Insured Employer,Certificate#2318)
Staffing Client
Four Seasons Roofing DESCRIPTION OF OPERATIONS/LO CATIONSIVEHICLES/EXCLUSIONS
502 Horning St ADDED BY ENDO RESEMENTISPECIAL PROVISIONS
San Jose, CA 95112 This coverage is afforded only to the employees provided to Four Seasons Roofing by
Fax: 408-278-0333 Mainstay Business SolJtions.This coverage complies with the requirements of the Director
of Industrial Relations inder the Labor Code of the State of Califomialfor consent tsions of to selfions 37 7to 05,inclusive,of the
insure.
COVERAGES ERIOD INDICATED.
THE COVERAGES LISTED BELLOW HAVE BEEN
IS U ED To THE-ENTITY NAMED ABOVE FOR THE P HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIIFICATE MAY BE NT,
ISSUED ORM Y PERTAIN,THE
TERM OR CONDITION OF ANY
S.RTIFICATE OF COVERAGE DESCRIBED HEREIN IS S BJECT TO ALL THE TERM
COVERAGE AFFORDED BY THE CE COVERAGE.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS.EXCLUSIGNS AND CONDITIONS OF SUCH
CLIENT EFFECTIVE CLIENT EXPIRATION LIMITS
COVERAGE CLIENT NUMBER DATE(MMIDDIYY) DATE(MMIDDIYY)
letter TYPES OF COVEACH OCCURRENCE $
GENERAL LIABILITY FIRE DAMAGE Any one fire) $
COMMERICAL GENERAL LIABILITY MED EXP(Any one person) $
CLAIMS MADE F__j OCCUR
PERSONAL&ADV INJURY
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMPIOP AGG $
E] POLICY ❑ JECT ❑ LOC
COMBINED SINGLE LIMIT $
AUTOMOBILE LIABILITY (Ea accident)
ANY AUTO BODILY INJURY $
ALL OWNED AUTOS (Per person)
SCHEDULED AUTOS BODILY INJURY $
HIRED AUTOS ((Per accident)
NON-OWNED AUTOS PROPERTY DAMAGE $
Per accident
AUTO ONLY—EA ACCIDENT $
GARAGE LIABILITY OTHER THAN EA ACC $
8 ANY AUTO AUTO ONLY: AGG
EACH OCCURANCE $
EXCESS LIABILITY AGGREGATE $
OCCUR F__j CLAIMS MAGE
$
DEDUCTIBLE
RETENTION s
2/28/2011
A Workers Compensation MBS-SIP-OOR11- 8/6/2007 WC STATUTORY LIMITS
10
EL DISEASE-EMPLOYEE 7MMM11ILL
-FI_DISEASE—LIMIT
EL EACH ACCIDENT
CANCELLATION
CERTIFICATE HOLDER X
Four Seasons Roofing SHOULD ANY C F THE ABOVE DESCRIBED COVERAGE IL CANCELLED BEFORE THE EXPIRATION DATE
502 Horning St THEROF,THE 1 3SUING ENTITY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE
San Jose, CA 95112 CERTIFICATE h OLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION
OR LIABILITY C F ANY KIND.
AUTHORIZED f;EPRESENTATIVE
State Of California
CONTRACTORS STATE LICENSE BOARD
ACTIVE LICENSE .+
Cumum's
Aar
u.-.. .,b. 472108 CORP
�•�.A�.•» FOUR SEASONS ROOFING INC
�•..b�•.,> C39
E=p,•�°� • 04/30/2009
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
'UPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95C14-3255
(408)777-3228 • FAX(408)777-3333 - building �cupertino.orq
PROJErrAI)DRESs 2U/9 ?UZU3, — 2c�2/ 3_ ,�.cazC3
APN H
OWNER NAAN,i[ l
PyONE y es Z.F —
E-MAIL
Si REE F,\DDt SS i ?�'�2(„; 5 CITY, STATE IP
CON K NA IG Off 7 �� L(CHNSE�ZLICEN�rTY�� BUS.LI�C/�N4�
0AIPrWY'NAME !//E-MAIL G,
STRf I=T UDI,I-Sy CIT' STATE,ZIP z PHONE
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable pro-isions of the 2007 California Building Code.
2. An inspection request shall be scheduled the day before the inspection date. Please call (408)777-
3228
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 b,,-en removed and all the dry-rotted wood has
been replaced, you must call for a roof inspection. A bt ilding inspector will be available with one hour,
There are special hours for the service: 7:30 — 10:30am and 1:00 — 3:30pm (Mon—Thurs);
7:30 — 10:30am and 1:00 —2:30pm (Friday).
4. 1f plywood is installed, a plywood nailing inspection is r--quired.
S. New roof coverings shall not be applied without first obtaining all inspection and written approvals from
the building inspector. Any roofing which is applied without 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/" per foot of slope -ind demonstrate there is no ponding.
b. A listing from an approved testing agency shall be available on-site to review at the time of the
inspection.
c. Proper spark arrestor installation. f
T NOTE: If you call for a plywood nailing inspection and the job is not ready, you will be charged to a rc-
inspection fee of$126.00. The re-inspection fee shall bE paid before another inspection can be
scheduled.
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on
)roperty owner's behalf. I understand and agree to comply'vith the re-roof policy statedbove.
Signature of Applicant/Agent: _tl)/e-)//v
Date:
ReroofPohcy 2010.doc revised 0-1,1_;70
Building Department
City Of Cupertino
LM 10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
4�CONT"44OR/ SUBCONTRACTOR LIST
JOB ADDRESS: 2 PERMIT#
OWNER'S /7e4-r PHONE#
GENERAL CONTRACTOR: BUSINESS LICENSE#
ADDRESS: Sr-ie— CITY/ZIPCODE: f��L
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. :?Z-/oz/0_
1 am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
V 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