13060079 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:.10845 NORTHVIEW SQ CONTRACTOR:FOUR SEASONS PERMIT NO:13060079
ROOFING
OWNER'S NAME: SUSAN HUBBART PO BOX 1668 DATE ISSUED:06/10/2013
OWNER'S PHONE: 4087259747 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIP'T'ION: RESIDENTIAL❑ COMMERCIAL❑
License Class Lic.# �® RE-ROOF 12 SQ-REMOVE EXISTING COMWOOD ROOF
„ SYSTEM
Contractor Date AND INSTALL NEW GAF GRAND SEQUOIA
I hereby affirm that I ani licensed undirige provisions of Chapter 9 SHINGLEROOF,
(commencing with Section 7000)of Division 3 of the Business&Professions CLASS A
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:$5200
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:31636010.00 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 80 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 F M LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ��t ,+
costs,and expenses which may accrue against said City in consequence of the Issued b `r w ��
granting of this it. Additionally,the applicant understands and will comply y: Date: •
with all n -p0. source re lations per a Cupertino Municipal Code,Section it
9.18.
RE-ROOFS:
Signatur ate r All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed wi t first obtaining an inspection,I ee to remove all new materials for
in pec
❑ OWNER-BUILDER DECLARATION / /,o�
S Date:(J-/
I hereby affirm that I am exempt from theContractor'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 m ' a► compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the ealth Safety ode,S�crions O5, 5 3,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Own ant ized agent: Date
permit is issued.
I certify that in the performance 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
Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
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
0
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIONLa U
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 tt�
(408)777-3228•FAX(408)777-3333•hu ilding(&cuDertino.orcl �V
CUPERTINO
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QWNERNAM f O �-- r(� E-MAIL
STREET ADDRESS "CITY,STATE,ZIP ` FAX
CONTACT NAME PHONE E-MNL
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❑OWNER ❑ oWNER-BUII.DER owmR AGENT COMA(TOR ❑CONTRACTOR AGENT ❑ ARCMT£Cr ❑ENGDMR ❑ DEVELOPER ❑TENANT
CONTRACT R NAME n LICEjNSN O; Li 3r t�rlji
COMPANY NAME /Gs E-MAIL 7 FOAX[/` �
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ARCHiTECTlENGWEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAB. FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex Multi Family jtOOF AREA: 'LUATION:
STRUCTURE: ❑ Commercial /Z PrAggo
EXISTING RooF TYPE: ❑BUQ.T-UP ROOF ❑ASPHALT SHRJGLES ❑WOoDSHAKES ❑WOOD SHINGLES XOTAER(SP my)awAlaow
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REMOVE/REPLACE YES F NO, PLYWOOD ❑ PLV WD ❑OSB PTTCH: .12 ROOF
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ICC ES REPORT#
PROPOSED ROOF TYPE: ❑B rmup ROOF XASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER
DESCRIPTION OF WORK:
G eDf:'t1 ��t 1Gss�- fltd4 s��d'+K�/
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kmy 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 property for inspection purposes.
7
Signature of Applicant/Agent: Date., —>
SUPPLEMENTAL INFORMATION REQUIRIM 1 STit?Q>�ly]'
If building is associated with a Home Owner's Association,provide letter
of approval from HOA. �ptfl+r s
_Provide Planning approval to verify if there any restrictions. ] ] ft WIM <Y rlum-,
Provide copy of Manufacturees Installation Specifications.
Provide signed copy of Cupertiao's Tear-Off Policy.
ReroofApp 2011.doc revised 03116111
r
'REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
CU'Pl:1 v'kO'
(408).777-3228•FAX(408)777-3333•buildin__q@cu e_r_f o.0
FROJE r � APNti ,
OwiV�itI$AMB P � E-MAIL '
STREET AADR S• crrY,STATE,ZIP FAX
CO N LICENSE �, UCENWMQ, BUS. #
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E-MAIL (('�T A FAX
' TATE,
'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 requested inspection 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,
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 xemoval 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 items will be verified:
a. Flat roofs shall have a minimum of%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 ori-site 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 afthe following is true: I am the property owner or authorized agent to act on the
properly owner's behalf. 1undeptffdvnd.agree to comply with the re-roof policy stated above. I also understand that .
smoke detectors and carbon no 'd detecto re r ' ed to ed in accordance with Section 8314 and R3 iS of
the 2010 CaliforniaResiden al Co
Signature of Applicant/Agent Date:
RerogfPolicy 2012.doc revised 1017/12
NORTHPOTNT HOMEOWNERS ASSOCIATION
Northpoint Homeowners
Association
10880 Northpoint way April 23, 2013
Cupertino, CA 95014
P H: 408-996-3734
FX:408.996-0226
UNC 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 Manager