06040087 (2) CITY OF CUPERTINO o'.aad�, at ^-•' ` ""`'�'" " '$ °i` '
BdILDING DIVISION PERMIT �N�'R�• n ,Y a „: ,`'Tt
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMITN0.06040087
10826 NORTHRIDGE SO
OWNER'S NAME: PERMITISSUEDATE
NORTHPOINT H.O.A. 502 HORNING ST n4/i7/2oo6
ONE: SANITARY NO. CONTROL NO.
(4 08) 278-033 0
ARCHITECTYENGINEER: BUILDING PERMIT I ThIFICI
EIECr
PLUMS
MECH
.00 LICENSED CONTRACTOR'S DECLARATION Job Description
m 1 Weby stats thus I am licensed under Provisional of Chslam 9(commencingp
Mwith Section of Division 3 afdre Business and prolamines Code.arul MY license is
hes failferce and moa REMOVE CALSHAKE ROOF, INSTALL 30LB FELT, AND
�,'v�z Licenm Clw 3 Lie.• !'11110
5 Dam Canlranmf s Is Ir•+c• GAF GRAND CANYON COMPOSITION SHINGLES CLASS A
3Z� ARCHITECTS DECLARATION
I understand my plans shall M used an public records
)BV
s u. LmcnseJ Profcuianel
='y� OWNER-BUILDER DECLARATION
I Mrchy slRw
that 1 am exempt Oum the Conuacmes License Law far the
OO following mason.(Sadun 713I.S.Business and Promssinm Code:Any city or county
3$ which requires a permit in construct alcor.ImProve,demolish,or hopes any swcture
Prior m its issuance,also acquires the applicant Tor such permit m file a signed suuchum ValuatiplrD500
FF c
that he is licensed pursuant mmeProvisions oftactm
Conance'LiessmLaw(chapter 9 Sq.Ft. Floor Area
Y�$ (commencing with Station 7000)of Division 3 of the Business and Professions Code)or _
— Nat he In axempt Nerefmm and We Lucia for the alleged exemption.Any violation of PIA I'A
Section 7031.5 by any applicant for a permit subjects the applicant In a civil penalty of pYN Number cy Type
nut mos Nen Ova hundred dollars($500). 316 36045 . 00
❑I,bownv of the propertY•ormY wplayces with vngesb Heir sulo compensation,
will do the wont and the structure is not Intended OceOered for sale(Sal.7(144.Bum.
and,n,who
Calc The ComMm/a Llaeme Law aces ret apply m an awmr of iD peCtlQnSjO
cum cro whe Lulldamthmmehimmandwho am oucuselehwark Mraffeeethrough his a 06
how a however.
theu,provided inorI mataah imProsmrau in orm yeeded aOBshea far sale.IL ye.
however.Ne building ouimprovementlasold withinens year of mprove for du awe of
sale). will have tier WNm of proving Wt ha old not 4dM or improve far PuTuse of
sale.).
❑1.as owner of Use Propmy.am commovely,mvir dog with licensed conuavors to
construes the project(Sal.7044.Business and Professions Code:)The Cmwctoes Li-
recom Law does ant apply an an ownv of property wha builds or improves common.and.
who contnM for such project,with a conuavor(s)licensed pvremnt to the Conunemea
Liana Law.
❑lam exempt unM See .BAPCfarth4reucoe
Ownv Dau
WORKER'S COMPENSATION DECLARATION
41 I bunchy affirm under pemlly of pedurY nae of the following declamtione
❑I has and will maintain a CmiRamof Consent mself-Insure fa Warkees Compere
smien.an Provided for by Section 3700 of the Labor Code,for thus performance of the '
work for which Nial Permit is issued.
have end will maimein WMImes CompensationInavarhm,as acquired by Sweden
]00 of dm LAW Code,for the part..em of the work for which this Permit 4 about.
My Workmen CompemNon leamance carrier and Policy number am:
Cartier. A• I•I A : Policy No.: 2 !��M
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
I
(Thin section need not be completed If the Permit 4 return hundred dollars($100)
or lees.)
T certify that In the Performance of the work for which this permit Is issued.I shall not
employ any person In any manacse u to become subject to the Workers'Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this Conlacate of Exemption,you should
become subject to the Worker's Compemetion provisions of the Labor Code,you muss
.,O forthwith comply with such provision or this Permll3hall be canted revoked.
z.~N.• CONSTRUCTION LENDING AGENCY
(.w I hereby alarm mat mem 4 a construction loading agency for the performance of
r!7
the work for which this permit 4 issued(Sea.3097,Civ.C.)
QLinde/h Name
r'7 z Lendeh Address
U O 1 aarfy mu I have mad thin application and ser¢taut me above infmmvion 4
w F correct 1 agmen to comply with all city and county mdlmMYal sed saw lam misting he
OU building canutuction,and hereby eulhonse representatives of this city to enter upon the
W above-mentioned pmperty for inspection purposes.
P. (We)agree to save,indemnify and kap harmless the City of Cupertino against
(W) liabilities,judgments.cow and expenses which may in my way amus against said City
UZ in cmnequrnce of the gMdng of this Permit.
^� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCER TIONS
'U6 Re-roofs
Signaumof pu r ' Dau
H US MATERIALS DISCLOSURE Type of Roof
WIIImeapplicant buildings pmLstomorhudleheuallommamnaI
as defined by tib Cupertino Municipal Cove.Chapter 9.13.and the Health and Safety
Cade,Section 35531(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes PN.41
Will the applicant or future building Occupant use equipment or dcviaa which If a roof is installed without first obtaining an inspection,I agree to remove
emit havalloua alar cmuminmu b JeOned by the Bay Area Air Quality Management all new materials for inspection.
Disula7
ayes 091u
I have mwi the harWuuamatedab acquirements under Chapter 6.95 of me Cali(or.miaHmI �J
Jauc nettcurrentlyyham•WnmMthe�Sls My3mspmn11111hy m nod fy theeLifft occPant of building
m —17-0 C
rcqulremc ichor me r issuance ofacenlOcateorocmpancy. Sign ica
Of ppint Date
0 -O C.
Owner er aamm awt t1t Dam 'Woof coverings to be Class"B"or better
CITY OF CUPERTINO
am 2 of 5 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31636045 . 00
DATE ISSUED. . . . . . . : 04/17/2006
RECEIPT # . . . . . . . . . : 34017
REFERENCE ID # . . . : 06040087
SITE ADDRESS . . . . . : 10826 NORTHRIDGE SQ
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT H.O.A.
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0526
RECEIVED FROM . . . . : FOUR SEASONS ROOFING
CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323
COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING
ADDRESS . . . . . . . . . . : 502 HORNING ST
CITY/STATE/ZIP . . . : 'SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 278-0330
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ------ ---------- ---------- ---------- ----------
BENERGY PERMIT FEE 126 . 36 60 . 65 0 . 00 60 . 65 0 . 00
BPERMFEE VALUATION 6, 000 . 00 126 . 36 0 . 00 126 . 36 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 187 . 01 0 . 00 187 . 01 0 . 00
•
Community Development Department
Building Division
City of Cupertino
• @:tn. 10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408) 777-3333
CUPERTINO
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City,the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
• 5. If plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you.call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be Raid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: �LI �� :H C)•
Job Site Address: �A )C) �
Roofing Company Name: T 5 P
Applicant'sSignature: TS=
Date:U
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CI OF Fax(408)777-3333
OCUPERTINO
Building Department
JOB AD VKESS: PERMIT #
D in
OWNER'S N PHONE #
GENERAL CONTRACTOR. FAX #
I am not using any subcontractors:
Signa Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum / Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO OW0400�1
REROOF
CUPEkTiNO PERMIT APPLICATION FORM
APN # Date
IU to Ou -I�i-oCv
Building Add ess: n U
d r C-
Owner's Name: "" Phone #:
o(+Lo a+_ . o, 14�.
Cactor: }� Phone #: License #:
tr
C>r e a Qookl Y69 ZZ S -0330 /0 8'
Contact: /1 hone#: Cupertino Business License #:
c C'jo l�Z 0.fe� .2 7 $ -0 33 0
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
o Asphalt Shingles ,2�, Asphalt Shingles
❑ Wood Shakes ❑ Wood'Shakes
❑ Wood Shingles ❑ Wood Shingles
jai Other(Specify) Ca 8ka K.0 ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O. Report#
-�r To be Removed O Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will ComI With Cu ertino's Tear Off Policy:
Job Description: �� S 54e .lk 3o l I E4
r-A > !or �- (n g9Mc ,, ^c!"'n lcs — Cass
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are any restrictions:
Cost of Project Type of Construction: Occupancy group:
Qty. if
A licable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•