13060020 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10927 NORTHRIDGE SQ CONTRACTOR:FOUR SEASONS PERMIT NO:13060020
ROOFING
OWNER'S NAME: RANDOLPH RICHARD A AND ELIZABE PO BOX 1668 DATE ISSUED:06/04/2013
OWNER'S PHONE: 4089963734 SAN JOSE,CA 95109 A.PHONE NO:(408)278-0330
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALE]
License Class
Z� Lic.# !J� RE-ROOF 10 SQ-REMOVE EXISTING ROOF SYSTEM AND
INSTALL NEW GAF GRAND SEQUOIA,CLASS A
Contractor Date
I hereby affirm that I am licensed unde a provisions of Chapter 9
(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. Sq.Ft Floor Area: Valuation:$5500
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 APN Number:31636024.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DA OM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Issued by Date: (� /
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18
� RE-ROOFS:
Si Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspecti n,I agree to remove all new materials for
inspectio
❑ OWNER-BUILDER DECLARATION 6— T
Signatur e:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintai pliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Heal &Sa ty Cod Se ns 25 5, 533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or a agent Date:
permit is issued.
I certify that in the perforinance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 O�
CUPERTINO (408)777-3228-FAX{408}777-3333-buildinq(Qcuoertino.org
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❑owNER ❑ owm,-BUILDER ❑oWNER AGENT YCONTRACTOR ❑CONRtAcToR AGENr ❑ ARCHrrECT ❑emnumt ❑ DEVELOPF1t ❑TENANT
CONTRACT R NAME � L�a g LIC�f3� �ISI
COMPANY NAME 7 T E-MAIL CC FAX
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ARCHITEC MNGWEER NAME LICENSE NUMBER BUS_LIC.#
COMPANY NAME E-MAIL. FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF p SFDorDuplex Multi-Family ,ROOF AREA: �� VALUATION: ?'
STRUCTURE 0 Commercial ,�f S
EXISTING ROOF TYPE: 13BUILT-UPROOF E3
ASPHALT SHINGLES 13 WOOD SHAKES ❑WOOD SHINGLES y[�OTHER(SPECIFY)
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REMOVE/REPLACE YES WNO, PLYWOOD h" 13PLYwD loss P1TCH: �/ .12 ROOF A
N CL
ICC ES REPORT#
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF XASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES [3OTHER
DESCRIPTION OF WORK: I
A6WAWe-
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above!,-,identified for inspection purposes.
Signature of ApphcantlAgent: LA-w'� - Date.
SUPPLEMENTAL INFORMATION REQUIRED
If building is associated with a Home OWnefs Association,provide letter
Of approval from HOA. a> afioN INi3 > Y
—Provide Planning approval to verify ifthere any restrictions.
Provide copy of Manufacturer's Installation Specifications. (Q sT wrmnttD L z �Rt+r
Provide signed copy of Cupertino's Tear-Off Policy. fl r
ReroofApp_201 J.doc revised 03116111
REROOF TEAR-OFF POLICY
• 4
y COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO;CA 95014-3255
(408).777-3- 228 FAX(408)777-3333•building aacupertino.org
PR07ECPADDRESS I��, APNit
PHONE E-MAIL
ST S STATE, P / /, J� FAX
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to one business day before the re nested ins ection date.
Please call (408) 777-3228.from 7:30-3:30pm(Mon-Thurs) or 7:30-2:30pm(Friday)to schedule
inspection: For Tear-Off and Nailing Inspections,you must also call on the day of the inspection only..
after that phase of the work is completed. The building inspector will be available within one hour.
Final Inspections will be given a two hour window.
3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either
completely knocked-down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required.
'5:.- Roofing-shall not be applied without first obtaining all prior 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.
5: A Final fnspection and approval shall be obtained from the building inspector when the re-roofing is
completed. To.receive a final sign-off,the following items will be verified:
a. Flat roofs shall have a minimum of 1/4"per foot of slope and demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre-manufactured products used shall be
available on7site to review at the time of the inspection.
C. Proper spark arrestor installation,vents painted, gutter/downspouts installed, debris removed.
7. , NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete,you will be
charged a re-inspection fee. The re-inspection fee shall be paid before ahother inspection can be
scheduled..
By my signing below,I certify-each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that .
smoke detectors and carbonmonoxi ectors are re u' d o be installed in accordance with Sections 8314 and R3-f5 of
the-2010 California Residential
Signature of Applicant/Agent: Date:
ReroojTolicy 2012.doe revised 1017/12
NORTHPOINT HOMEOWNERS ASSOCIATION
Northpoint Homeowners
Association
10880 Northpoint Way April 23, 2013
Cupertino, CA 950,14
PH:408-996-3734
FX: 408--996-0226
UNG Community City of Cupertino
Management
6840 Via Del Oro
Suite 265
San Jose, CA 95119 Re: Roofs
PH: 408-229-6000
FX: 408-229-6001
To whom it may concern;
Northpoint Homeowners Association has contracted Four Season's
Roofing to, install new GAF Grand Sequoia Roof Shingles on homes
here at Northpoint.
Sincerely,
Linda Starnes
On Site FAanager