13050198 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10807 NORTHRIDGE SQ CONTRACTOR:FOUR SEASONS PERMIT NO:13050198
ROOFING
OWNER'S NAME: MARY WYLECZUK PO BOX 1668 DATE ISSUED:05/29/2013
OWNER'S PHONE: 4082576277 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
13 LICENSED CONTRACTOR'SDECL TION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALI
License Class r Lic.# p1 (10 SQ'S)TEAR OFF(E)COMP SHINGLE,INSTALL(1)
50 YR COMP OVER(E)PLYWOOD
Contracto Date
I hereby affirm that I am licensed under the provisi�_ofpter 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 perfonnance.of the work for which this APN Number:31636036.00 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 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
granting of this permit. Additionally,the applicant understands and will comply sued b Date:
with all non- t sou a reguI do per the Cupertino Municipal Code,Section
9.18.
yam- RE-ROOFS:
Sign ure Date `7 :2 All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaini an inspection,I agree to remove all new materials for
inspection. '
❑ OWNER-BUILDER DECLARATION
Signature of Applicant Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL R OF 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 isnot 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 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I.have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sec' 2555, 533 5
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agen 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,atter making this certificate of exemption,I CONSTCTION LENDING AGENCY
RU
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
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COMMUNITY DEVELOPMENT DEPAR-1•MEN T o BUILDING DIVISION
10300 TORRE AVENUE o CURER T INO, CA 95014••3255 }'
(408)777-3228-FAX(408)777-3333 fatu�iii� t�c til:, i�u.nri /
PROJECT AD/ C/ / e.
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❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACT R NAME s� - LI�C�NSEN ER LICE� TyPE BUS. H
COMPANY NAME 7' �E-MAIL FAXXi(V-�d)
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ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
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STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY)
REMOVE/REPLACEYES IF NO, PLYWOOD ' 1/:" ❑ PLYWD El PITCH: ROOF
❑ NO #LAYERS: SSS: 5/8" TYPE: CDX '12 CLASS:
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
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. 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 Io
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-iden/fredgpr erty for inspection purpo s.
Signature of Applicant/Agent: � Date: /
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
If building is'associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROu G stye'
of approval from HOA. VER-THC-COUNTER CI BUILDING PLAN
_Provide Planning approval to.verify if there any restrictions. (((❑ EXPRESS ❑ PLANNING AN REV'i
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroofApp_2011.doc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 1=0807,NORTHRIDGE SQ DATE: 05/29/2013 REVIEWED BY: MELISSA
APN: 316 36 036 BP#: *VALUATION: 1$5,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Du lex PENTAMATION 1 SFDWLROOF
USE: p PERMIT TYPE:
woRK 10 SQ'S TEAR OFF E COMP SHINGLE INSTALL N 50 YR COMP OVER E PLYWOOD .
SCOPE
FEE ED ROOF AREA
s.f.
1REROOFFRES 1,000
kfech. Plan Check Plumb,Plari Check Elee..Plan Check
Nle(A Perwit Fee: Plumb.Permit Fee: Elec.Permit Fee.
Other leech.1rup. Other Plumb Insp. Other Elec.Insp.
,lfiech.Insp. Fee: Plumb. hal).Fee: Elec.insp.Fee:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These fim are based on the prellinina information available and are onk an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Supp Fee
Plumb.1i'v1ech./Flee
Permit Fee: $150.00
Suppl. Insp Fee
Plumb. Mech./Flee
Plumb.IiWech.l lec:Permit Fee:
Consiruction 7err:
Adrninistriative.Fee:
Work Without Permit? 0 Yes (E) No $0.00
Advanced Planning Fees:
Travel Documentation Fees: �
Strong Motion Fee: IBSEISMICR $0.55 Select an Administrative Item'..
Bldg Stds Commission Fee: IBCBSC $1.00
$151.55 $0.00 $151.55
Revised: 04/29/2013
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
CUPEk NO
(408)777-3228•FAX(408)777-3333•buildinoCc�cupertino.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 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 given a two hour window.
3.1. 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.
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 I/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 on-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 another 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 unders and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon poli, '$ det t ere ire installed in accordance with Sections 14 R31.5 of
the 2014 California Resid tial e.
Signature of Applicant/Age Date:
ReroofPolicy_2012.doe revised 10/7/12
0412212013 22:57 4089960226 NORTHPOINT PAGE 02102
NORTHPOINT HOMEOWNERS ASSOCIATION
Northpoint Homeowners
Association
10880 Northpoint way April 23, 2013
Cupertino,CA 95014
PH:408-996.3734
FX: 408-996-0226 City of Cupertino
UNC Community
Management
6840 Via Del Oro
Suite 265
Son Jose,CA 95119 Re: Roofs
PH:408-229-6000
FX:408-229-6001
To whom it may concern;
Northpoint Homeowner's Association has contracted Four Season's
Roofing to install new GAF Grand Sequoia Roof Shingles on homes
hereat Northpoint.
Sincerely,
d"
Linda Stamen
On Site Manager