13070037 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10851 NORTHFORDE DR CONTRACTOR:FOUR SEASONS PERMIT NO:13070037
ROOFING
OWNER'S NAME: KASIM SHAIKH PO BOX 1668 DATE ISSUED:07/08/2013
OWNER'S PHONE: 4087779464 SAN JOSE,CA 95109 PHONE NO:(408)278-0330
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALE]
License Class Li..# t t TEAR OFF(E)ROOF SYSTEM,INSTALL(1)GRAND
SEQUOIA COMP SHINGLE ROOF SYSTEM OVER(E)
Contractor Date PLYWOOD.
I hereby a rrm that I am licensed un a the 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 theworkfor which this APN Number:31637051.00 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 IT 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 DAY LED 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 ;",3 3
granting of thi nnit. Additionally;the applicant understands and will comply sued by Date:
with al n-point ource regulation per the Cupertino Municipal Code, ection
9.1 .
RE-ROOFS:
Sign Date All roofs shall be ins ec d 'or
to any roofing material being installed.If a roof is
installed wit 90 rst obtain g an inspection, agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION '7
Signature o
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ACL 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,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 comlllian with t e upertin Munic'pal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health& ety ode,Sec s 2550 5 n
Section 3700 of the Labor Code,for the performance of the work for which this Owner or.. e 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
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REROOF.PERMIT APPLICATION 0 V
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 M�
408)777-3228•FAX(408)777-3333•buildino aC�cupertino.om \ 1
CUPERTINO
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❑OWNER ❑ OWNER-BuILDEP ❑OWNERAGENT YCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENC"NEFR ❑ DEVELOPER [:]TENANT TENANT
CONTRACT R NAME n LICENSE N[JMBER LICE�i3T�PE BtJ��I
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ARCHrrECT/ENGMEER 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: w_
STRUCTURE: ❑ Commercial 1
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY)aW�,.,iuQ�C".�
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REMOVE/REPLACE YESTtTAFNO, PLYWOODfA ❑ : —PLYwD ❑OSB PTTCH: ROOFNOLAYERS: " TYPE: CDX :12 CLAS :::A
• [CGES REPORT#
PROPOSED ROOF TYPE: 13BUILT-upROOF )(ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES Elarm
DESCRIPTION OF WORK:AQ*
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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 infonnation 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 abov -id pm r inspection purposes.
Signature of Applicant/Agent: Date: � � r---
SUPPLEMENTAL INFORMATION REQUIRED
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If building is associated with ti home Owner's Association'provide letter
of approval from HOA.
Provide Planning approval to verify if there restrictions. ' k �F
any
_Provide copy of Manufacturer's Installation Specifications. 1� i s t tsar a
69
Provide signed copy of C no s Tear-Off Policy.
4
ReroofApp-2011.doe revised 03/16111
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 10851 NORTHFORDE DR DATE: 07/08/2013 REVIEWED BY: MELISSA
APN: 316 37 051 BP#: *VALUATION: 1$2,600
'PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1 SFDWLROO
WORK TEAR OFF E ROOF SYSTEM, INSTALL N GRAND SEQUOIA COMP SHINGLE ROOF SYSTEM
SCOPE OVER (E) PLYWOOD.
FEE H) ROOF AREA
(s.E)
1 REROOFFRES 1,000
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1'luwb.1'i an Check rle<.I'hw
1££: . t°ee
t}=racy, Plim,Ir:..,r3. a:>t 71 <..;' ,;, Li
_ £,£;..s7.."`
�-,eo:
NOTE:This estimate does not include fees due to other Departments(Le.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 De t or addn'l info,
FEE ITEMS (Fee Resolution 11-053 Eff. 711112) FEE QTY/FEE MISC ITEMS
Man C"heckP'ee:
Pen-nit Fee: $160.00
Crt:s
Tax: F-1
Work Without Permit? ® Yes No $0.00
l7"tt;'t' k €3�'td€?£,'d's'7
Strong Motion Fee: IBSEIS111ICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
TOTAL FEE
I $161 50 $0 00 z_ _._. $1
s.:. 61 50
Revised: 07/01/2013
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REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA 85014-3255
(408).777-3228•FAX(408)777-3333•buRdina a(�cupertino orp
APN k
PHVC F-P
TREET ADDRESSFX
CITY, STATE IP41-6
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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 requested inspection date.
Please call (408) 777-322g.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 re uired. 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 lEnspection 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 ofI/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:- 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 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 understand and agree to comply with the re-roof policy stated above. I also understand that .
smoke detectors and carbon monoxi ectors are requ' o be installed in accordance with Sections R314 and R3-15 of
the.2010 California Residential
11r/z
Signature of Applicant/Agent: Date:
ReroojTolicy_2012.doe revised 10/7/12
f
01
NORTHPOINT HOMEOWNERS ASSOCIATION
Northpoint Homeowners
Association 23, 2013
10880 Northpoint Way April
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:408-229-6000
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