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10050094 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10870 NORTHOAK SQ CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 10050094 OWNER'S NAME: NORTHPOINT HOA PO BOX 1668 DATE ISSUED:05/10/2010 NER'S PHONE: 4082296000 SAN JOSE,CA 95109 PHONE NO:(408)278-0330 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB F License Class Lic.# 071 ep— _ � I MECH r— r—r— r COMMERCIAL Contractor �� G--�"—� Dat /v � JOB )ESCRIPTION:RE-ROOF BLDG,UNITS 10870,10860,10850,10840 RMV I hereby affirm that I am licensed under the provisions of Chapter 9 EXISTING CEMWOOD ROOF.INSTALL NEW GAF GRAND CANYON (commencing with Section 7000)of Division 3 of the Business&Professions ASPFhkLT COMP 50YR ROOF SYSTEM,"STONEWOOD"IN COLOR 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 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 APN Plumber:31641008.10870/10860/10850/108 Occupancy Type: 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 upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the `VITHIN J89 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 1,30 DA OM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. '> Signature �, ate Issued Date: by: �l�`��/ V OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: instalbA without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspec:ion. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: /v Date: I,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 declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by 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(a)should I store or handle hazardous material. 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 maint tin 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 Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must Owne•or authorized agen / forthwith comply with such provisions or this permit shall be deemed revoked ` Date: � J II D revoked. APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that 1 have read this application and state that the above information is I heret y affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save 'emnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address As,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I unde stand my plans shall be used as public records. Signat -.-Date G �� Licen!ed Professional CITY OF CUPEPTINO 3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lo':: APN 31641003 . 10870/10860/10850/108 DATE ISSUED. . . . . . . : 05/10/2 )10 RECEIPT # . . . . . . . . . BS00001)368 REFERENCE ID # . . . : 10050091 SITE ADDRESS 10870 NDRTHOAK SQ SUBDIVISION . . . . . . . CITY CUPERTIVO IMPACT AREA . . . . . . OWNER NORTHPOINT HOA ADDRESS . . . . . . . . : 10880 NORTHPOINT WAY CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0553 RECEIVED FROM JAMES CALDERON 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 AMOUrT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ------ ---- ------ 1BCBSC VALUATION 14,466 . 00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 14,466 . 00 1. 50 0 .00 1 . 50 0 . 00 1REROOFRES SQ FEET 46 .00 558 . 00 0 . 00 598 . 000. 00 ------ ---- ---------- ------ --- ---------- TOTAL PERMIT 600 . 50 0 . 00 600 . 50 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 / �-) U C�l CITY OF CUPERTINO REROG CUPERTINO PERMIT APPLICATION APN # , „ `� Date: ? I a I o Building Address: Lwo�c� Owner's Name: — �c�,. Phone 4: CJjVG � HOA: Yes No ❑ If yes, provide letter from HOA �, ' Phone #: Contractor: �� s ops '=-7 Fax#: 7g " s 75 Cupertino Business License #: Contractor License #: /.�2 3 Y7 z l o8 — Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof u Built-Up roof ❑ Asphalt Shingles f Asphalt Shingles ❑ Wood Shakes u Wood Shakes ❑ Wood Shingles u Wood Shingles Other (Specify) ��k-'��5 i� Other (Specify) umber of existing coverings :1 Provide I.C.C.E.S. Report # Provide Mfgr. Installation Specs. ❑ To be Removed Job Description: ex/sf'izf ;p4 Residential Residential Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with-Planning Dept. 111 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 Cuperdno's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CITY OF CUPERTINO "ROOF CUPERTINO FEE SCHEDULE Fee Description Fee Permit Type Number of Fee ID Group Squares _ 1COMMLROOF 1REROOFCOM Re-roof Commercia_ B _ 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee _ 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLROOF 1BCBSC Cal Bldg StandardsB ALL PERMIT TYPES Commission Fee — 1BSEISMICRE Seismic Residentic'Il B 1REROO HIRES Re-roof Multi-Far-lily B 1MFDWLROOF y� 113 C Cal Bldg Standards B ALL PERMIT TYPES 1 Commission Fee 1 B SEISMICRE Seismic Resident'al B I Business License B _I 1BUSLIC ____ M. Wi.lr)daor Air Duality and Finishes 1.Use Lovrdl Io-VOC Paint 1 IAO/llealth pis ygas l e r Finishes 21AMlealth pis y=yes ?,Lisa Low VOD,Itratter-3as�d Wood Fin , 3.Use Low/Wo VOC Adhesives 3 IAD/l lealth pts ygas D ^.Use Salvaged Matarlals for Interior Finishes 3 Rescurca pts y=yes 0 5.Usa Engineered Sheet Goods with no added Urea Formaldehyde 6 Mal iealth pis y=yes ?I h.Use E7aerior Grade PlythIood for Interior Uses 1 IAQ/-lealth pts y=yes , 7.Seal all E;oosad Par iclaboard or MDF 41A halhpts I= as � B.Use FSC Certified hfiaterials for Interior Finish 4 Resource pts y=yes t P.Use Fincyar-Joinied or Recycled-Content Trim 1 Res)urce pis y=yes 0 ` n� 0.Insall 1'rrhol House\vacuum System 3 IACIHealth pts y=yes ISI,Flooring � 1.Select FSC Certified Wood Flooring B Rescurce pts y=yes 0 �I 2.Us,--Rapidly Renewable Flooring.Matarials 4 Resc urce pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resc urce pis Mies 0 Vinyl 5 IACD,Health is y-"es Install Natural Linoleum in Place of V inyl P )-) 5,Usa Exposed Concrete as Finished Floor 4 Resclurce. pts y=yes 0 o.Install Recycled Content Carpet with Low VOCs 4 Resclurce pts y=yes 0 Total Points P��raila@�le: c'' ��® Total Points Project Received: G:data/progslgmanbuild ngguidelineslremodelarslgreanp6intsfmal2.12.D4proteoled.xls r L S �NORTHPOINT HOMEOWNERS ASSOCIATION 10880 Northpoint Way NPHOA.ORG Cupertino, CA 95014 (408) 9963734 March 10, 2009 City of Cupertino RECEIVED MAY 10 2010 Re: Northpoint Roofs $Y: To the City of Cupertino, Please note, the Northpoint Homeowners Association has contracted and approved Four Seasons Roofing to perform re-roofs of our homes replacing the current Cal-Shake roof system with new GAF Grand Canyon Asphalt Gom)osition Shingles. We have selected the Stonewood color for our roofs. Sincerely, Linda Starnes On Site Manager PML MANAGAGEMENT, 655 Mariners Island 61vd. Suit„301, San Mateo, CA 94404 (650) 349-9113 G0 39vd dOH iNIOdHidON 9ZZ096680b L5:tb0 600Z/0Z/Z0 FCEIZ TIFICA TE OF WORKERS'COMPENSATION COVERAGE DATE(MM/DD/YY) 3/3/2010 Master Account THIS CERTIFICATE:OF COVERAGE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Mainstay Business Solutions CONFERS NO RIC HTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT P.O. Box 1128 AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE COVERAGE BELOW. Blue Lake,CA 95525 ENTITY AFFORDING COVERAGE Staffing Client INSURER A:Mainstay Business Solutions(a Self Insured Employer,Certificate#2318) Four Seasons Roofing 502 Horning St DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS San Jose, CA 95112 ADDED BY ENDORESEMENT/SPECIAL PROVISIONS Fax: 408-278-0333 This coverage is afforded only to the employees provided to Four Seasons Roofing by Mainstay Business 1volutions.This coverage complies with the requirements of the Director of Industrial Relatiors under the provisions of Sections 3700 to 3705,inclusive,of the Labor Code of the Sate of California for consent to self-insure. COVERAGES THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE-ENTITY NAMED ABOVE FOR THE PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 10 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE COVERAGE AFFORDED BY THE CERTIFICATE OF COVERAGE DESCRIBED HEREIN IS:;UBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH COVERAGE.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. letter TYPES OF COVERAGE CLIENT NUMBER CLIENT EFFECTIV= CLIENT EXPIRATION LIMITS DATE(MM/DDIYY DATE(MM/DD/YY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERICAL GENERAL LIABILITY CLAIMS MADE a OCCUR FIRE DAMAGE(Any one fire) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ POLICY PRO- LOC $ ❑ JECT PRODUCTS-COMP/OP AGG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY $ ((Per accident) PROPERTY DAMAGE $ Per accident GARAGE LIABILITY 8 ANY AUTO AUTO ONLY—EA ACCIDENT $ OTHER THAN EA ACC $ EXCESS LIABILITY AUTO ONLY: AGG EACH OCCURANCE $ OCCUR Q CLAIMS MADE AGGREGATE $ 8 DEDUCTIBLE $ RETENTION s $ A Workers Compensation MBS-SIP-OOR11- 8/6/2007 2/28/2011 10 WC STATUTORY LIMITS EL DISEASE-EMPLOYEE $1 MIL EL DISEASE-LIMIT $1 MIL EL EACH ACCIDENT $1 MIL CERTIFICATE HOLDER X CANCELLATION Four Seasons Roofing 502 Horning St SHOULD ANY OF TH=ABOVE DESCRIBED COVERAGE BE CANCELLED BEFORE THE EXPIRATION DATE San Jose, CA 95112 THEROF,THE ISSUIIIG ENTITY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF AN'KIND. AUTHORIZED REPRE SENTATIVE State Of California CONTRACTORS STATE LICENSE 30ARD ---^• ACTIVE LICENSE .. Consumer Affairs 472108 CORP FOUR SEASONS ROOFING INC C39 ► 04/30/2009 1�.d REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT• E-UILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 9501-3255 JPERTINO (408)777-3228 • FAX(408)777-3333 - buildin c:upertino.orq 11ROJECi:,i>URL'SS fG CD - yU Al N N 0\4'NER NAmG PHONE 7a J E-MAIL X11•/,SLI : hD//tL'ySS �Fr-2li 5 CITY, STATE IP CONTR.:ai iOI2NA IL' LICESE NUNBER LIC6�VTYPE BUS.LICi,NFAX .�^Z Z� COMPAM NAME E-MAIL 3 5 — PI(ONE CIT STATE,ZI s,a�D��IZEs�,, S/f2 Gi3C� I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions 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)7773278 between 7:30 - 3:30pm (Mon-Fri) to schedule the rext day inspection. 3. After the roof is torn off and the nails/fasteners have bf:en 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. 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. If'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 ite_n will be verified: a. Flat roofs shall have a minimum of/" per foot of slope and 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. 7. NOTE: 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. my signature below, I certify to each of the following: I am the property owner or authorized agent to act on ( ,e property owner's behalf. I understand and agree to comply with the re-roof policy stated above. Signature of Applicant/Agent: Date: — — ---- - ReroofPolicy_2010.doc revised 04/14, Building Department Lai City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTJZACT R LIST JOB ADDRESS: PERMIT# ZXS OWNER'S PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: 5'c-r- CITY/ZIPCODE: -57 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSF ECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I 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