06050212 CITY OF CUPERTINO
77777
BUILDING DIVISION
PEIRMIT 'WORANDO
BUILDING ADDRESS: FOUR SEASONS ROOFING 06050212
22822 LONGDOWN RD
OWNER'S NAME: FERMITISTIEDATE
DEANZA OAKS HOA 502 HORNING ST 05/24/2006
NE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECTIENGINEEW. BUILDING PERMIT INFO
BILD0 ELECT PLUMS MWH
I= 1=3 cm 1=
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0 LICENSED CONTRACTORS DECLARATION
I thereby alliore that I son limuseed under provisions of Chapter 9(cormounCing Job Description
with Section 7000)arDivision 3 ofthc Business and profession,Code.and my ficence,is
I filf d if .� q TEAR OFF (E) SHAKES, INSTALL 1/2" CDX AND GAF
at 41 D 9�
I. 'GRAND SEQUOIA SHINGLES . 50 YEAR CLASS A
L
uacm&oAct.KKK
ARCHrTE DEC ATION
I It anyplaossalmlibcusculati,blicremodas
or
V
Licensed Professional
OWNER-BUILDER DECLARATION
I heraby starts that I am catempt force ft Contractors License LAW for the
00 following reason.(Sections 70 1.5,Business and Professions Code:My city or county
as
which atultsi..permit In construct.sher.hrPnJ dcon-loh.-repair My Ionalmot
pow to I"issuance.him onquires ft applicant far such permit to,rile 4 signed wriumcru
dust IN ist licensed pursuant W ft provissom a ft Contractor's Umom Isw(Chapter 9 Sq.Ft. Floor Area Valuati$[5 5 0 0
(consurnamicl with Section 7000)of Di�.3 Of the Business Mal Prefessimn Cox1s)a,
that he is Jacemph mereflarm and ft basis far the alleged coureapdon,my violation of
Section 7031.5 by My applicant fort a permit subjem,the applicant th,a ci,,il Penalty of Y8Tber 0 0 Occupancy Type
ran mom"f1w hundred dollam(M� 31M 7 .
0 1.sachummofthe property.Or my employees with miles hadmirsalcmanapermardon,
and Pmradou Caft The Cmummor's U�Law does act apply in an owmar,of Required Inspections
property wW Wilma cairmisrom,themna.mul mucluessuch work hirmselfc,through his
ountemployces.pmuidecal ishishch imprownwents,Me ouraffermil Icarsale.ff.
Jacowwr,do,billiard;or impoommemat is mid within one,year o(compledom.me awom� FINALED
buildent will haw the burden of proving ft,IN did not build or improm for purposse of
sals.).
0 1.as Owner a(ft property am exclusively contructing with licensed contramora to
consumal ft pmjm(Sec.7044.Buslema had Prafcssirum Codc)The Contractor's U. JUN a-Y-2006
occuse Law door not apply in an Joamor of property who Wilds or Improws durem.and
who conumm;for such project,with.courtractar(s)licensed ponamm'to ft COntonallAr"
License Law.
C]I can,annual under Sec. _.B A P C far this mucher BURECINNO
OWN, ____Data—
pWORKERS COMPENSWION DECLARATION
I hereby alarm under penally of Perjury ON of ft following�lamfim:
I haw and will maintain a Certificate ofCamsent in scif-insturc forWarlatel Compen-
.....provided for by S�tion 37W of ft Labor Coda.for ft Performance,of ft
worle for which gas Permit Is issued.
0 1 haw and will maintain Workers Compensation Insurance,a required by Section
3700 Of ft Lsemr Code,15".performance of ft work to,which his Permit is Issued.
MyW, esciarponsua,a..III. cano I or and F.12 moft,
I
�CERTI CATE;OFEM ;;FROM WORKERS'
COMPENSATION INSURANCE
(This Junsfian mcal not be completed irthe permit Is foram hundred dolise,($100)
or lea.)
I cardly that in the performance of the work for which this permit is Ismused,I sh.11 nor
employ any ismstan in any manner an as to become subject to IN Workma'Compermation
Lam ofCaliformia.Data
Applicant
NOTICE TO APPLICANT.If.after making this Cenificata,of Exception,you should
become subject W the Worker's Compensation previsions of ft Lather Coade.you must
OZ forthwith comply with such provisions or this permit shall be Normal roorked.
z 0
CONSTRUCTION LENDING AGENCY
rA
1 hcmhy affirm that them Is,consimaninct landing agency Jar the performance of
the work for which this pernit ii unusual(Sm.31197,CN.C.)
J.'em"ar:
D z Lattice Addrem
U 0 1 condry that I m.real this application and Miss dust the.1i utommumi 6
0, courrect.I agree to comply with all city and county onlimarms and start,laws testing Us
0 vilcm,construction and hereby tolmoin,reprosernatiw..(this aity,o..I.,up..the
U ahow-mentioncd po,xrty for impaction purposes.
W -nim against
(We)agree to saw,indemnify and keep hannicas the City of Cups,
liabilities judgments,must and expenses which may In My My imme against said City
I this PMIL
me O"M Ir" Of
men rICA17UIDS' AM A 0 POINT Issued by: Date sn"',e-
Z— AIP S �&.a
_10� 2.�
4c� _ie-roofs
SigrAmme a[ApplicAqUCan�r
ARODUS MATERIALS DISCLOSURE WK Type of Roof
NAB ft uum building acm plettsuare,ar handle hazardous material
as deffam!by Code.Chapter 9.12.and the Health and Safety
Code.sees.25S32(a)T`1,,0 N. All roofs shall be inspected prior to any roofing material being installed.
0yes If a roof is installed without first obtaining an inspection,I agree to remove
Will ft applicant or future building occurpagra,bee equoposent or divims which
emit laroArdout, I,caustarminsurts a dclinual by ft Bay Aram Air Quality Management all new materials for inspection.
District? �1�
0 Yes
I how road!the hLeaudeas momiuls requirmasons,underchamer 6.95 of ft Califor.
�Hul�&Safc[yCodc.Sec�=25505.25533�B334,1�ftifft building
dea,mcamonly wa�A!ly responsibility 0 Nor ft case Not orthe
hlchm bamen r som of.Cartirmue a GLI Signature of Applicant Date
Owk,chonhonted , Ail roof coverings to be Class"B"or better
Olient
CITY OF CUPERTINO
•m 3 of 5 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34233007 . 00
DATE ISSUED. . . . . . . : 05/24/2006
RECEIPT # . . . . . . . . : 34539
REFERENCE ID # . . . : 06050212
SITE ADDRESS . . . . . : 22822 LONGDOWN RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DEANZA OAKS HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
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
qEE 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 . bo 0. 60 0 . 00 0 . 60 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 126 . 96 0 . 00 126 . 96 0 . 00
•
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:
Job Site Address: �OYI�i 0
Roofing Company Name:
Applicant's Signature: Dat : /Q(p
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
;I
t' ' ' ✓' ` Cupertino CA 95014
a
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
WUPERTINO
Building De artment
JOB ADDRESS: PERMIT #
u O 06 S"a `z-/"Z-
R N PHONE#
GENERAL CONTRACTOR.; S FAX #
I am not using any subc ntractors:
Signature Dat
Please check applicable subcontractors m lete 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
Own /Contractor Signature D to
- � Q5021�
CITY OF CUPERTINO
REROOF
• rr
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
Z Cn
Building Address: 1
11
d
Owner's e: Phone#:
s 4C)9 -XS -0S-30
Contractor: 'Four gien 2W% {�,.�O License#: 1+11
L1 12a
Contact, -h
u��S Pl�i�dr� ICWJ Cupertino Business License #:
I I 1 21323
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles -6' Asphalt Shingles
Ar Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: b c) ha es , n s aI VZO a D x ,a ori A rr C-A - ePL001
>, s (f>0 ) Cltis
Residentikr ❑ Commercial ❑ 19
Fire Zone: Yes ❑ No Confirmed with Planning Det. if
there are any restrictions: IJ
Cost of Project: T of Construction: Occupancy group:
C7D o' K G'
Qty. if
Applicable 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
•