06040136 CITY OF CUPERTINOa" ` . u^'�. ,c�wn� "`""A" �� �"'
BUILDING DIVISION PERMIT
BUILDING ADDRESS: ONS ROOFING P.W1 NO.06040136
10823 NORTHOAK SQ
OWNER'S NAME: PERMIT ISSUE DAM
NORTHPOINT HOA 502 HORNING ST 04/21/2006
ONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITEC IENGINEE: BUILDING PERMIT INFO
9LDGO ELECr 1� PLO 0
LICENSED CONTRACTOR'S DECLARATION IOW Description
I hereby afanm Wt I am licensed under proviskas of CMp er 9(commencing P
with Section
and.fo Division]af the Builrcs sed Professloo Coda.and mylkenmb REMOVE CALSHAKE ROQF INSTALL 30LB FELT AND GAF
u a full(arta and effect
? Licen Class
Lic.g
I O
Dam j Inc �ConDLn EC r .. s � D CANYON COMPO jjV
1 CLASS A
3eg�
ARCH I'IECI's DECLARATION
10( I undanand my plus,shall he sed as public recordsCU
a CCCCu•r3 Licensed Pwruomnal
am OWNEueexemDERDECLARATION MAY 1006
I hmodo .Inca that 11. exempt form an Nolo OM o :My C Law for the
p O following moon.(Salon 7fD IA,Business and P.fesilom Cade:Any day or county
S$ which naluiro•pn:mnil m common.ober.improve.damWbh,nr repair any avaeure
shy prior m is,issuance.also requires the applicant far such Permit w ale a signed auanmem
€< &at he is acclucd pursuant in the provision,of the Conumor's Uccnse Law(Chapter 9 Sq.Ft.Floor Area Valuate
27 (commencing with Section 7008)of Division 3 of die Business and Profesions Cade)or
e dot he Is exempt therefrom and the bub far she allryed evanpdou Any violation of
Secdon 7031.5 by any applicant far a permit subjects the appOcant m a civil penalty of 3/CPN I1tJtp6ei 0 0 ecupancy Type
cot mom than five hundred dolWs(SSW3 1"b"4 1 U 11 "N
❑L u mwneraf die property,a my employees with vnteam their sole campeuadon,
will do the work,and ran sanctum b rmtimmied"ofered terane(Sec.7044,Business Required Inspections
and Prafeasiou Cade The Conuwmrs License n Law doant apply m an owner of 9 P
property who build,or important tianman,and who does such wart himself a through his
we employ=.provided that such Improvements NO not intended or offered for sole.U.
however,the building or improvement Is sold within aro you of completion,the awe-
builder will have W harden of proving that nd did Out build Or improve for purpua of
sale.).
❑1.as Owner of the property,neo exclusively contracting with Ranted conuaemn m
construct the projem(Sec.7014,Business and Profession Cade:)The Coatrwnors Li-
cam law doe at apply m in Owner of property who builds or impmw demon,and.
who contracts for such projects wed a commensals)accused pursuant k do C muscmr,
Licemu law.
❑lamuempnwadeses. .B&PCro Nisreason
Owner Dau
WORKER'S COMPENSATION DECLARATION
1 hereby aflbn under penalty of perjury and W she following data Woo:
❑I ham and will maintain a CetiOam OfCoaem in self-im a,fa Worker's Compen-
u ion,our provided for by Section 3700 of the labor Code,for the performance of the
work for which this permit Is issued.
❑1 hoc and will maintain Workers Compensation Insurance.out moored by Section
3700 of tine labor Coda,far the perfarmmick Of she work for which for permit b Owed
My War s CompeltsWon l ace artier and Policy�nquHmber see:
Giller.f Bay No.:a✓L2U anti
CEROFI 7(EMPI'ION FROM WOMERS'
COMPENSATION INSURANCE
a
MW section need wtbccamplemd if rhe permit is Inane hundmddollau(SIM)
or less.)
1 cenih-that in rhe pefmmaae of the work fed which Nis pmnlr b issued.l"I not
employ any person in say meaner an an se become subjat m she Workers'compensation
Laws of Cil(knort.Dam
Applicant
NOTICE TO APPLICANT:If,afar making this Cenificam of Exemption,you should
Warsaw subject to the Workers Compceation provisions of the labor Code,you muss
.J O foMwio comply wish such providoo Or this permit shall b:domed revoked.
z CONSTRUCTION LENDING AGENCY
1 herebyaflirm shat she.ba coacadon lending agency for the perfmmm maof
a> the work fm which this permit b ended(Sec.3097,Civ.C.)
Qfames Name
=z lender,Address
t.p Q I certify Nu I have rad this application and task One the be.infmmadun is
IL correct.I agree in comply with all city and county omivaea and sum 1.clon-8 k
O U Wilding consternation,and hereby audhonee mpasnmives or this city m cnkr Open the
W ahovomenduncd property for iopccdoo purposes
(We)agree k save,indemnify and keep harmhc s rte City of Cupertino against
Ta%3 liabilities,judgments,cots and expenses which may in say way accrue against mid City (,�
U rzI." APPLICANT UNDERSL of the NDS ANDOf WILLWILL COMPLY WITH ALL NON-POINT Issued by: Date C -'L.I'_p
AoupevtGULATI
U Z I�aO Re-roofs
Signature ofdcenuatemr Dam
Rc
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding occupant van,Or handle haardou mamriil
as denmd by the CuAp Municipal Cade.Chapter 9.13.and she Heilsh sed safety
Cade.Sued.35533(.)7 All roofs shall be inspected prior to any roofing material being installed.
Ely. No
Will the applicant or future building=spot are equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hull.aircolons u&fired by the Bay Ares Air Quality Management all new materials for inspection.
Disdriet7
❑Yes 0N
I bac read the horandoe materials requirements under Chapter G95 ofshe Collier.
nb Health&SalmyCoda,S.dats25WS.25533a 25534.1adcr thdifthe billing
dens not currently hue a annual dust It is my responsibility to mall,the occupant of Ne
rrqulmmenu which must be dormSssu cola CcrtiOcete rotewpancy. Signature Of Applicant Date
21 Dow
Owner m wthoto DamAll roof coverings to be Class"B"or better
'
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228.
CITY OF Fax(408) 777-3333
OCUPERTINO
Building De artment
JOB ADDRESS: PERMIT #
f O n 0 6 ?3 P�
OWNER'S NAME: o H. . A PHONE #
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors -z I "0 (,i
Signature Date
Please check applicable subcontractors and complete the following information:
60 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
Community Development Department
s if Building Division
City of Cupertino
la` 10300 Torre Avenue
• Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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 paid 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.
Homeowners Name: IVOI A
Job Site Address: (o19� �� O0� S4 by 9501LI
Roofing Company Name 2
Applicant's Signa re: Date:y-_k_-NP
• Greg Casteel
Building Official
Revised 11/2/04
Printed an Recycled Paper
CITY OF CUPERTINO
am 6 of 6 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31641021-. 00
DATE ISSUED. . . . . . . : 04/21/2006
RECEIPT # . . . . . . . . . : 34091
REFERENCE ID # . . . : 06040136
SITE ADDRESS . . . . . : 10823 NORTHOAK SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NORTHPOINT HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0521
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 6, 000 . 00 126 . 36 0 . 00 126 . 36 0 . 00
BSEISMICRE VALUATION 6, 000 . 00 0 . 60 0 . 00 0 . 60 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 126 . 96 0 . 00 126 . 96 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 761 . 76 005472
TOTAL RECEIPT 761 . 76
•
CITY OF CUPERTINO O�2 ��a La
REROOF
•FUPEkTiNO PERMIT APPLICATION FORM
A211 PN #(_0 H ( p Datei/
But ding Addr s: L
b o C S At'r,0 Sv l
Owner's Name: �1 11 Phone#:
C tractor: Phone #: License #:
e q 12 C yos 2,'i S -03 30 /o
r Contact: hone#: Cupertino Business License #:
Frio C�zV'res 7 g -0 $30
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles X Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
Other(Specify) Ca($6rp— ❑ Other(Specify)
Number of existing coverings / Cl Provide I.C.B.O.Report#
p' To be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read, Understand and Will Com 1 With Cu ertino's Tear Off Policy:
ob Description: Y/�� p 5 ��Sht.l 3 0 C 1 an
Gf O- CJ4%-> ON G0 0:1Wp,, �tS 6i,S
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
r BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•