06050210 CITY OF CUPERTINO z ` �" '��`" `" '
BdILDINC DtvlSlON PERMIT COI s�RACTQR5II�'f}XZ'�'IATIR
Bu1LDINGADDRESS: FOUR SEASONS ROOFING Print., NA'06050210
22824 LONGDOWN RD
OWNER'S NAME: PERMIT ISSUE DATE
DEANZA OAKS HOA 502 HORNING ST 6
NE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITEC IENOINEER: BUILDING PERMRINFO
BLDG ELECT PLUMBMECH
loo LICENSED CONTRACTOR'S DECLARATION Job Description
1"r V I hereby affirm Met I am licenced under provisions of Chapter 9(commencing
with Smdou 7000)of Division 3 of the Business and Profcssiuns Code.and my license is
±H inmumrremdenenp TEAR OFF (E) SHAKES, INSTALL 1/2" CDX AND GAF
)YJZ Lke CI Lk.a
�. ; RAND SEQUOIA SHINGLES . 50 YEAR CLASS A
3 ARCH'.ECTS DECLARATION
t I undersand my plans shall be usW as public nxoms
p U
s c
Licensed Professional
OatNem car IAER DE CO RATION
1 hereby alarm on 1 em esempl Item the Canvas Co :My c taw for the
p o following mama.(Sadat 703 nstru Butlness and improve,
de i demolish.
Cale:Any dry or county
re
5$ whkh mqufm]a permit n construct,aline improve,hPer iit t ore a sig any structure
-Zi poor toMet IMItsccumm,aluantto the the
ovisiosofcant for Connermi'm61easgnw(hmmanl
p Gthobercial Jpursuammthe pmvi]imu3Ofit.mnenceanccnmLaw
rmsCodmr9 Sq.Ft. Floor Area Valuat fn500
t�$ (crone I&exa ild Section7000) f basis for
tflWBusinmmpton.An violation of— That W ts aampt IWrtfrorm and are bats(or 11m slgW exemption.Any violation al
Section 7031.5 by arty applicant for a permit subjects the applicant m a civil penalty,ofpp�ppvNN NNpp CCUanC P Occupancy TY
nal mare arm five hundred dollars,(S5o0). 3§L 3 30 6. e
0 1,as owner of the property,or my employe"with wages as tlm4 role compensation,
will do the work and Mestrcame 6 Outinlended IXoRemd her sale(Sm.71344,Businsa Required Inspections
and Pon each"Cade The Canmctaes License law doese not apply m an Manor of q P
property who builds"im pow thereon,and who does such week himsel f a 16mugh his
awn employee,pavided that such Improvements art nmimm�oroRerW for ase If.
however,the building or Improvement Is sold within aro year of completion.the owrter- .
builder will bow the burden of proving that he did m i bulk or improve for purpoa of
an
0 1,as owner of the property,am exclusively contracting with licensed confusion to eg ��
construct it Out (Smapply
an an meBusr of and property
who
Cade:)Timms,th star']U. "S"�`J�W1
who Law does eat epp r jean agar of property aha Wiles or improves Ibetean.roti
veld caaMame fIX aaL paJCCL{MN a ConVYIMI(a)It"nRd pufNam m die CanVKtaYa ,
License Law.
❑Tem uempt under See .BAPC Tor Nie moon AI;fa' mY{]'`��
Owner Data 2OI/(}UQ
40 WORKERS COMPENSATION DECLARA770N Q�
I thereby
ad will
CinlYof reperjuryoroofthefallowfor declareWorkers common,
o
T hew ark will For by eCertificate of the Later,
Code.fate far Wmkes's Camp the hyJ `/,J tltltl r'��7tiv
worn,r provided fpe by Beldon 3700 of the Lehr Code,far the perfarmenco of the
work for which this permit is leaned.
0 1 have and will maimain Workers Compensation Insurance,u required by Section
3700 of the Labor Cade,for are performance of the work fee which
lhts permit ts
My Workers Compensation Wuranco caroler and Policy be am:
c„rim:1242�44 ON FRO
CERTIFlC
COMPENSATION
INFRA ORKERS' f ,
COMPENSATION INSURANCE
(The aatiom reed notes completed Ifthe permit Is forome hundred EaIW(Sloe)
Of IML)
I certify that in are put.. se a the wart for which this Permit is Issued.1 shall ret
employ any person in my manner as as m became subject in the Workers'CompelWtian
Laws of Calilmoh,Dale
Applicant
NOTICE TO APPLICANP.If.after making this Quill iso,of Exemption.you should
become subject In the Worker]Compensation previsions of are Labor Cede,you most
OZ
faMwith comply with mach Provisions M this permit Nall be dee ncd rcunkc4
,'ZCONS17tUCf10NLENDINOAGENCY
(•" IWmbyalnmthuthemkaccessumdnn Icm1mSagenry fartieperformanceof
CG the work for which Ws permit is blued(Sec.3097;Civ.CJ
GQ Iember Name
]z LetderaAddrea
U Q I comfy Thu I haw read this application std sack Nal tho abew infotmadun Is
U. aanecL l as=in comply with all city and county omkanas and some laws relating in
DU buildingconstruction,and hereby seaman repremntatives of this city to enter upon the
W above-mentioned property for Inspection purpnes
0. (We)agme to ave.indemnify and kap harmless the City of Cupertino against
rrh liebilliksjudgmems.c"Iand"penseswhich mayln anywaysecrargficaaidaty
(„)z in conseganm Mf the gtmang o I Z(T
APPLI ERSTAND AI}D WILL MPLY WITHAL 140th-P INT Issued by: Date
RE ONS.
Re-roofs
sigram=of ApplicantICoa t Da
IIAz/JI AUS MATERIALS n1saOSUR• Type of Roof
Will are apparent ortum building acupmtsaa"handle haama"material
Or dented by the Cupertino Municipal Cade.Chapter 9.11,araC IW Health ad Safety
Coda,Section 35333a1Z__. All roofs shall be inspected prior to any roofing material being installed.
Dyes DNu
Will the applkanl or future Wilding Occupant oma equipment Or devices which If a roof is installed without firs[obtaining an inspection,I agree to remove
mit heramtns alr mmemmints as defined by the Bay Am,Air outstay Management all new materials for inspection.
Conflict?
0Yes
thaw mW de haammus forecasts requirements under Chapter 6.95 of the Csifor.
nisi Haul"Safety Cade,Sections 25505.15533 and 27534.1 understand that if the Wilding
J I haw a tenmL Lha mY ou pmmMlily m nodfy time oaupar f do
WA rave m"tbeme or of,Ccrun"k Q Signature of Applicant Date
Owner or aulharixedage te All roof coverings to be Class"B"or better
CITY OF CUPERTINO
�m 1 of 5 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34233006 . 00
DATE ISSUED. . . . . . . : 05/24/2006
RECEIPT # . . . . . . . . . : 34539
REFERENCE ID # . . . : 06050210
SITE ADDRESS . . . . . : 22824 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
•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
•
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 Nam �e� A -Z, axk<
Job Site Address: .-,/�2S&A L-Ur' cLwr\.
Roofing Company Name: i
Applicant's Signature: Date G(Q
• Greg Casteel
Building Official
Revised 11/2/04
r Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
cl OF Fax(408)777-3333
�UPERTINO
Building Department
JOB ADDRESS: IPERMIT #
D e 0 � 2- t d
OWNER'S NAME. PHONE #
GENERAL CONTRACTOR: F,' FAX #
I am not using any subcontractors: 2--Is-
Signature
Please check applicable subcontractors an m lete the followinginformation:
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
/Owngr/Contractor Signature D to
CITY OF CUPERTINO
0- REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
bD OCP.
Buildin Address: �
Owners Name: Phone#:
s H .o4c� -a��-o330
Contractor: Four 2'ea2W% {J0FIf License#: 4-7j 28
Contact: �^ S i r� IC�0JI Cupertino Business License #:
1 I 1 2 1323
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles et ' Asphalt Shingles
Zr Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ Tobe Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: o E) t,a e> ,h S K D x o ,d A C—,,�-•� CPL o06
�' r S be ON's
Residenti ❑ Commercial ❑ I q6
Fire Zone: Yes ❑ No Confirmed with Planning D_pt. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occup group:
C7D YP e- o �
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
•