13070034 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10831 NORTHFORDE DR CONTRACTOR:FOUR SEASONS PERMIT NO:13070034
ROOFING
OWNER'S NAME: RICH MARGARET C PO BOX 1668 DATE ISSUED:07/08/2013
OWNER'S PHONE: 4082559346 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL0
License Class Lic.# TEAR OFF(E)ROOF SYSTEM,INSTALL(N)GRAND
SEQUOIA COMP SHINGLE ROOF SYSTEM OVER(E)
Contractor 92Date PLYWOOD. p
I hereby affirm that I am licensed and 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:$2600
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:31637053.00 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 DAYS FROM LED INSPEZION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,thapplicant understands and will comply Issued b Date:
with all n source regulations e e upert' unicipal Code, ection
9.18.
RE-ROOFS:
Sig Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without firs fining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
l
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of A Dater
the following two reasons: XLL 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. 1 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,s1pq I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as d ne y the Bay Area Air Quality Management District 1
performance of the work for which this permit is issued. will maintain comp' n with the Cupertino Mu ' a de,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safe de,Sectio s ,255 n 34.
op
Section 3700 of the Labor Code,for the performance of the work for which this n
permit is issued. Owner or autho zed g Date: �l l
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
REROOF PERMIT APPLICATION O�
,> COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 �11
CUPERTINt� (408)777-3228•FAX(408)777-3333•buildino aC�cunertino.orcl \47,U
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❑OWNER ❑ OWNER-BUILDER ❑OWNERAGENT YCONIRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
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STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex Multi-Family ROOF AREA::� v TIO 4 AG-D
STRUCTURE: El Commercial
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY)aWw�
REMOVE/REPLACE YES IFNO, PLYWOOD , fAs. E3PLYWD 11OSB PTTCH: ROOF
tNO LAYERS: 3TftCRtQE9S: TYPE: Cox :12 CLASS: A
ICC-ES REPORT#
PROPOSED ROOF TYPE: 11BUILT-UPROOF ASPHALT SHINGLES 11WOOD SHAKES ❑WOOD SHINGLES ❑OTHER
DESCRIPTION OF WORK:
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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. l 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-id entified prop for inspection purposes.
Signature of Applicant/Agent:
1 Date:
SUPPLEMENTAL INFORMATION REQUIRED
If building is associated with a Home Owner's Association,provide letter k i
of approval from HOA.
Provide Planning approval to verify if there any restrictions. " '�;1 �a s 1Mt�.
Provide copy of Manufacturers Installation Specifications.
_Provide signed copy of Cupertino's Tear-Off Policy.provide signed copy of Cupertino's Tear- x�
tea,�'...rt'-ty�� r�f� '�'�' ��+�a�txi._ :r:.3��'x"���,s„7",✓� � ti `
ReroofApp-2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10831 NORTHFORDE DR DATE: 07/08/2013 REVIEWED BY: MELISSA
APN: 316 37 053 BP#: *VALUATION: 1$2,600
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
USE: PERMIT TYPE:
woRK TEAR OFF E ROOF SYSTEM INSTALL N GRAND SEQUOIA COMP SHINGLE ROOF SYSTEM
SCOPE OVER (E) PLYWOOD.
FEE ID ROOF AREA
s.f.)
1 REROOFFRES 1,000
Plumb.1111w Che7 off �SI•i:..�3'<rri�,�r7F;F;if
EIF
ln,< , «: 1'hortAy.,,,s{3..Fe£e; ;'sr`er:. 7,r.>f,. Fee.
NOTE:This estimate does not include fees due to other Departments(Ge.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These ees are based on the prelimina information available and are only an estimate. Contact the Det for addn'l info,
FEE ITEMS (Fee Resolution 11-053 f f.' 711112,) FEE QTY/FEE MISC ITEMS
Permit Fee: $160.00
("onsfruction Tax", F-1
Work Without Permit? 0 Yes (E) No $0.00
1€'c=e'I £1C'td€
Strong Motion Fee: 1BSEISAIICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
OT`ALS $161.50 $0.00 TOTAL;FEE: $161.50
Revised: 07/01/2013
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
CUPEkTINO' (408).777-3228•FAX(408)777-3333•buildingaminertino.org
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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 da before the re nested insl3ection 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-O€f Ins ection is re wired. 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.
re. . - e-the.removal of all new material down to the sheathing so a proper inspection can be performed.
qui5: 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'A" 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'on-!site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed.
.7. NOTE: Ifyou 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 afiother 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 carbon monoxi ecto ;/,-5
rs are requ' dobe installed in accordance with Sections R314 and R3 i 5 of
the.2010 California Residential
Signature of Applicant/Agent: Date:
ReroofPolicy_2012.doc revised 10/7112
NORTHPOINT HOMEOWNERS ASSOCIATION
Northpoint Homeowners
Association Ani 23, 2013
10880 Northpoint Way p
Cupertino,CA 95014
PH: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:408-22"000
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