06050214CITY OF CUPERTINO
'RACTQR`'TN 'U: ATI' T1
BUILDIN3 DIVISION PEIRAUT
N. '
BUILDING ADDRESS:
FOUR SEASONS ROOFING
PERm"ND'06050214
22812 LONGDOWN RD
OWNER'S NAME:
PERMIT ISSUE DATE
DEANZA OAKS HOA
502 HORNING ST
QS/24/2006
NE:
SANITARY NO. CONTROL NO.
(408)278-0330
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
1 t=
LICENSED CONTRACTOR'S DECLARATION
Job Description
p
1 herby affirm that 1 am licensed under pmvisiols of Camper 9 (commencing
with Section 7") of Division 3 of the Business and Professions; Code. and my license is
in full force and affect,
TEAR OFF (E) SHAKES, INSTALL 1/2" CDX , AND GAF
Lice CµSg.,.f,��.Lk.N
Dau.Y( �Q17� Contrec h
D SEQUOIA SHINGLES. 50 YEAR CLASS A
,�
ARCHITECTS DECLARATION
I underatsnd my plan 'hill he used as public records
Licensed Professional
OWNER-BUILDER DECLARATION
I hereby affirm Nat I em exempt from the Commodes License Law for the
following mason. (Section 7831.5. Business and Profussious Code: Any city or munty
which mqube a permitm c xwuun alter. improve, dcmaluh, or repair my stmmum
prior to its issuance. Wu requires the applicant for such permit m Ole a signed allotment
Sq. Ft. Floor Area
Valuati$6500
ee Law (Chapter 9
the provisions of the CamtersLcas
Nat he in licensed purmmt m m
(commncin{with Section 7000)of Division 3 of to Business and Preficul s,Cade)or
that he is exempt Nesefro m and the basis for the alleged exempdam Any vkladen of
Number
Occupancy Type
Section 70313 by any applicant for a permit aubjtm s the aPPliesnt m a civil Penalty OfN
not ream than five bundnd da1Ws (SSBBL
3 4 2 3 3 0 0 9. 0 0
❑ L u omm of tie pmpvey, ar my employee with wags u the'vmk eompesuatlon,
S
f,eale(See.in aawmar
doclework,and,- mromumumes
Of
and Rofetsiaus Code: The Conuetoh l.krnse law don set apply b an awms of
and Licadmawda
'
��Lb,g7,,.Tye,gl
pmpcny who bulbs of impmws thermn. atb who doas soh mark ht—If or Nrougb his
ED
cavo employes, provided that such Improvements art rel imeMed waRemb for,ale U.
-\QV*YgWWlyf9kylG`y-Sttj4-11tyLyll7
however, the building or improvement is mid within sole you of completion, the owner.
builder will Mve she burden of proving that he did set ddb or improw for purpose of
sole
�j
y JOIN
J(IN �'�' EO��
0 1. as owner of the property, am exclusively contracting with licensed contrac an m
mmtmt the pmkn (Sec. 7014, Business and Professional Code) The Contrmmri U.
cense law does not apply toe m owner of property who bulbs or improve Deman. sed,
/�74y
wkoconuacu(or Loch prokma wlNaeontracmr0)0camed punusntmthe Convenor'
t�r�\\�I�I�Jt{\I��jJ�� '
HUM) ��VI
Licca Law.
ttdjvpjl�
VIN"
❑Lem exempt under See .Bk PCfar Ms moan
Owner Dau
WORKERS COMPENSATION DECLARATION
1 hereby affirm penury of perjury aro of the following delaruio se
I haw and willmaimain a Cemflau of Comentioself-insert for Woriters Comper,
ation, u provided for by Section 3700 of the Labor Code. for W perfamamv of the
were for which this permit is Issued.
❑ 1 haw and will maintain Workers CompeeW on hssWance, as required by Section
3700 of the labor Cade. far the Pufamme otthe work forwhkh this permit as issued.
My Wo ,Com P.W. Ino n carrier and Policy num
Cartier: A. licyNo: 2 2
CERTIFICATE O • E fEMPI10N FROM WORKERS
COMPENSATION INSURANCE
,
rNksenlon nW notbeconphted lfNe permit is farce hundred down (51001
or lea)
I certify that k the Performance of 0e wort for which this Permit is Wood. I shall net
employ any penin in any manner an u m become subject m the Wahsrs'Compeusatkn
Iowa of Califomla. Dae
Applicant
NOTICE TO APPLICANT: IL after making this Certificate of Exemption, you should
become subject to the Worker', Compensation provisions of the Labor Cade you most
forthwith comply with such provisions or this permit shall ad demd rewlam.
i1 CONSTRUCTION LENOINCAOENCY
agency for the perfumance of
1 hereby Alien that Nam Is ted
(m . 30 7. Cin{
theLe wart for which this permit u lasned (Sec. 3097, Civ. CJ
-
LendersN,mo
Leader's Addrtus
j I teary that 1 Mw read this application and mm thea he %bow information is
' coon. I agree to comply with all city and county oNhwace. and Tam laws miadng to
building construction, and hereby authorize representatives of this city to enter upon the
I shove-mentioned property for i.,ouctn purposes
(We) agora to saw, indemnify and keep ham4ss the City of Cupemina against
i IiabilhinjudgmanWm coand expenses which may in my way ammo agaust said City
in consousrce of the {ranting of this Parrott.' APPLICANT UNDERSTA WILL COMPLY WITH A NON- INT
Issued by: Date ZLtr, p
ULAT10NS
O
Re-roofs
Type of Roof
mat Appl'onuacmr w
A"ARDOUS MATERIALS DISCLOSURE
WIB Ne kmlorfuuue Wilding acempantatme ohatAk husNmer material
u defined by Ne Cupertino Municipal Code. Chapter 9.11 and doe Health fib Safely
Code.Same. 25533(.)7
All roofs shall be inspected prior to any roofing material being installed.
❑Yrs
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous Arc minanu u dclincel by the Bay Ares Air Quality Management
all new materials for inspection.
Dis"ict7
[3 Yes ❑No
I have read the hmnrdaus materials requirements underChapmr 6.95 of the Califor-
nia Hui" Safety Code. Section, 25505,25533 and 25534.1 uMenoM the lithe building
'
des not cumney how a enant Nat It u my rmpoWMliay m notify the upset of e
re nmot pan is ancemiresma
ignature of Applicant Date
All roof coverings to be Class "B" or better
owns rarantharived at DataG
CITY OF CUPERTINO
�m 5 of 5 PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 34233009.00
DATE ISSUED.......: 05/24/2006
RECEIPT #.........: 34539
REFERENCE ID # ...: 06050214
SITE ADDRESS .....: 22812 LONGDOWN RD
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER ............: DEANZA OAKS HOA
ADDRESS ..........:
CITY/STATE/ZIP ...: ,
OPERATOR: amyw
COPY # : 2
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
TOTAL RECEIPT :
•
634.80
*EE 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
634.80
------------------
005554
TOTAL RECEIPT :
•
634.80
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408) 777-3228
Fax: (408) 777-3333
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 $176.18. The re -inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re -roofing.
Homeowner's Name: 1-W\"Zh,
Job Site Address: �1 i•L L-�r
Roofing Company Name: `— • 5
Applicant's Signature:
• Greg Casteel
Building Official
Y\.
Revised 11/2/04
Data�0 (�
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS:
(�,�, ,.� r
PERMIT #
Go sa' 2/ Y
OWNER'S N C
PHONE #
GENERAL CONTRACTOR *;7. 'S _CZ
FAX #
I am not using any subcontractors:
Signature
Please check applicable subcontractors and complete the following information:
C-2�O(P
Date
Contractor Signature
U blv
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SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Contractor Signature
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CITY OF C,UP
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RE�ROC
CUPERTINO PERMITrAPPLICA
APN #.Dat
BUILDING
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Building Address:444 alr"°,
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Owner's N e: ut:a r
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Phone #:
409 -. 72 —0330
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Contractor: ., ier 'f' ,�, • d
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License #:
4� 2$
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Ci4no Business License #:
- 21323
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Phone #:
409 -. 72 —0330
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BUILDING
Contractor: ., ier 'f' ,�, • d
F'Cur geo,266.
License #:
4� 2$
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Ci4no Business License #:
- 21323
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Existing: " .',Proposed 4rxr�
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O Asphalt Shingles r �
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Wood Shakes "i V� ��� ,4�i' r+i ❑� Wood Shakes'i�•a � r � ,. '
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❑ Other (Specify) i a? ' t p Other (Specify)
Numberof overin gs -.
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Reisting moved }r r� .�k ,❑xfProv3de Mfgr.
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I Have Read, Understand and'WiU Com`Ti;Widi Cu ertino"s�Tear.Off Policy:, '
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Fire Zone: Yes ❑ No k x , . `}, ' E� �"lt s Coafumed with Planning D_pt. if
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Cost of Project: o r e'of;Construn6hop�'� "'(" ", Occupancy group:
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Amlicable ' .Fee )1'1.] 161 _ .6*1, '1;x_ i,��, Fnn rli,anrintinn Fnn l:mnn
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