06050211CITY QF CUPERTINO
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BUILDING DIVISION PERMIT
�ctnv?rlcrex TNFrUY.tMr�'TTON:
BUILDING ADDRESS:
FOUR SEASONS ROOFING
PwmirND'06050211
22832 LONGDOWN RD
OWNER'S NAME:
PER'WT ISSUE DATE
DEANZA OAKS HOA
502 HORNING ST
05/24/2006
NE:
SANITARY NO. CONTROL NO.
(408)278 -0330
ARCHITE-TYP.NOINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTORS DECLARATION
Job Description
o P
r I am licensed under provisio of Chapter 9 (commencing
1 hereby of lam Ou provisional
with Section 7000) of DiArm.3 aid. Budtmss and Proicasm. Code,and my Ikea is
m 11 fare and off t. '�'upQ
TEAR OFF (E) SHAKES, INSTALL 1/2" CDX AND GAF
o cl cunDE nn
11 RAND SEQUOIA SHINGLES. 50 YEAR CLASS A
'''1
ARCHfIECTS Osp R
orris
I understand my plans shall he ad u public records
J
Licensed Professional
OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Canmactoes License Law for me
following meson. (Section 7031.5, Business and Professions Cade: Any city or county
which requires a permit to construct. altar. Improve, demolish. or minor any mmeture
prior at its issuance, also requires tW applicant rorsuch permit as file a signed sWCmem
Contrnxure. Limn. Law (Chapter 9
Sq. Ft. Floor Area
Valuati
Nat be is licensed pursuant to the provi,hnsor the
(commencing with Section 7000) of Division 3 of the Busineuand Professions Code) or
tiur he is exempt therefrom and the basis for the alleged ea erapdoe My violation of
p�rN
{b�
p y 1 rp
ccu anc e
Sadon 7 031.5 by catty applicant fw a pc mit nbjeeta Oc applicant m a civil penslty of
Out mare than". hundred dollars (550a).
3421�3BT5e.00
0 Latawxroftha Property, army employes with wagesu OC'vsele compeation,
-53
.7 I I6
N4 Othho
Re ire Ins c o'
will d0 the watt. and thaawaureismtlmm�dedwoRered forssle (Sec.IINA, Budws
and Proresdans Code The Cmu xmrs License law does cot apply he an owns, of
9 P
property whe buika winspaw tiaean, and w erdoessuchworkhimselfarthougla his
,rte
ownemployee .provmedthatixhimproverxnuart Out eara(dwaaerre far sale U,
R (.
withinat f completion, thcowws-
Milder thcame
L ({q� 5
®�
the of prant6seid
bold
Wader will have Om WNm of proving Nor K dire rot build w impure far purpose of
/,ry
`T1
ssta.L
0 1. se avner of the property, am exclusively cantrxting with OamW conmctors an
wnstruet doe project (Sec. 70th. Business add Profession, Code:) The Condensates U.
coa Law duce not apply to an owns of property who WIIM1s or aprovaa thereon, and.
who contracts for such projects with a conmcmr(O licensed pwano nt m the Contactors
'
Licea Law.
O lamesempturtder See .B &PCfwdusmaann
owner Data
WORKERS COMPENSATION DECLARATION
I hereby a01rm under penalty of perjury ax of the following declensions:
I he. and will maintain a CardOmta of Consent to self -buurt for Workers Camper.
sedan, as provided for by Section 3700 of the Lahw Cade, for dm perfoametxe of the
work for which this permit Is Issued.
0 1 haw and will madman Workers Compuadan Insta., u required by Section
3700ofthe Labor Code, forme performanceof Omwork forwhich thispermir is awd
'
M W es Cons ansadue I cox carrier and Policy nom are:
Y P �!
�jj''��{H t♦MY Policy No.: 2
CT'RTIFICATE F XEM ONFROMWORKERS
COMPENSATION INSURANCE
'
(This section xed nothe composed if the perish is furone m ndreddo0an ($100)
or less)
I certify thnt In the performance of thin work for which this Permit is issued I shell not
employ anyperson in say mannerso u to become subject in tie Warken' Compensation
Laws of Caliromia. Dam
I
Applicant
,
NOTICE TO APPLICANT: If. after making this CeNOcata of Exemption. you should
baome subjem m the Workers Campeadun pmvidom or that Taber Code, you muse
foMwith comply while each pavaata w this Permit alal be tamed raveled.
CONSTRUCTION LENDING AGENCY
I hereby "them construction agency, for Un pwrarmance of
thi that then is
which o Sm30leoding
me work far which this permit isaad(Sa. ]097, Civ. C.)
'
Landers None
Landers Mdreas
I cenlly that 1 haw used this application and mm that the above inftamadon is
h roman. I agree to comply with all city and county ordinances and sum laws aladng an
hadding consumcu nand hetebyauthwt.repreenurivesaf this city to enter upon floc
above- mentioned property rot inspection purposes.
(We) ,ma to save• indemnify and keep harmless the City of Cupertino against
i IdabilideLjudgmenu.eam and experucs which may in any way warm agatnstsald Ciry
in coagwxe of the granting of Lbit rournit.
a APPLICANT UNDERSTAN AND COMPLY WITH ALL NON -P INT
Issued by: Date -/
LATIO
Re -roofs
Type of Roof
Signodurc afApplican ntrxl Data
H RDOUS MATERIALS DISCLOSURE
WOltheapplle or to,=building occupantsmrc or "Odle hesndoua material
as lefxd by tins Cupertino Municipal Code. Chapter 9.12 and dm Health and Safely
Cade, Section 25532(a
All roofs shall be inspected prior to any roofing material being installed.
0 Yex a
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant w fumrc building aco gazan a equipment or devices which
emit hvamnns air c mane u defined by the Bay Arta Air Quality Management
aN��n\
all new materials for inspection.
District?
0Ye QMu
I hex (cad the hLnmdanmatadab mquimmenm mmerCWpter6.95 of the Califor-
nuFkatth &Safctyca . 15505.25533and"' lundemmndOmU building
doe it N. a ta I. is my aspernihill;Y m 'fy des ore i of On
pit
tcha= tptor afacemf.ae rQ !_
Signature of Applicant Date
J �IJ
All roof coverings to be Class "B" or better
Owneraratrtnari sale ant Da
am 2 of 5
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN . 34233005.00
DATE ISSUED.......: 05/24/2006
RECEIPT #.........: 34539
REFERENCE ID # ... : 06050211
SITE ADDRESS ......
SUBDIVISION .......
CITY .............:
IMPACT AREA .......
22832 LONGDOWN RD
CUPERTINO
OWNER ............: DEANZA OAKS HOA
ADDRESS ..........:
CITY /STATE /ZIP ...: ,
RECEIVED FROM
CONTRACTOR ...
COMPANY ......
ADDRESS ......
CITY /STATE /ZIP
TELEPHONE ....
*FEE ID UNIT QUANTITY
---- - - -- -- ------- - - - - -- ---- - - - - --
BPERMFEE VALUATION 6,000.00
BSEISMICRE VALUATION 6,000.00
TOTAL PERMIT :
40
OPERATOR: amyw
COPY # : 2
FOUR SEASONS ROOFING
DIAZ, ALFRED LIC # 21323
FOUR SEASONS ROOFING
502 HORNING ST
SAN JOSE, CA 95112
(408)278 -0330
AMOUNT
PD -TO -DT
THIS REC
NEW BAL
---- -- - - --
126.36
---- - - - - --
0.00
---- - --- --
126.36
---- - - - - --
0.00
0.60
0.00
0.60
0.00
---- - - - - --
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 $176.18. The re- inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re- roofing.
Homeowner's
Job Site Addre;
Roofing Company Name:
Applicant's Sig—nafYrTU
• Greg Casteel
Building Official
Revised 11/2/04
V\O
Dahl I o KJ
is
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777 -3228
Fax (408) 777 -3333
Building Department
JOB ADDRESS: \\
CAD 2
PERMIT #
0
SUBCONTRACTOR
PHONE #
GENERAL CONTRACTOR 5
FAX #
I am not using any subcontractors: C)
ignature Date
Please check applicable subcontractors an plete the following information
Contractor Signature
Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Contractor Signature
Date
C
•
oWo5cq►
CITY OF CUPERTINO
am REROOF
CUPkTiNO PERMIT APPLICATION FORM
APN #
BPERMFEE
D e:
Building Address:
,
BENERGY
V
Owner's e:
.s
Phone #:
400 -oQT -0330
�,
BUILDING
Contractor: 'Four 2620,00nS' R.COQi
License #: 4-71 2$
Contact, Th u n-)cj S p 1 -ed rcj
Cupertino Business License #:
21323
BPLANCHK
Type of Roof Covering:
Existing:
Proposed:
• Built -Up Roof
❑ Built -Up roof
• Asphalt Shingles
Zr" Asphalt Shingles
eQ Wood Shakes
❑ Wood Shakes
❑ Wood Shingles
❑ Wood Shingles
❑ Other (Specify)
O 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: o 15VN1
es , ) r, StKII YZ" C > X ,o.nd Cb A C.-+. cPL�ot
s 50
n s
Residenti ❑
Commercial ❑ 1
I (0 96
Fire Zone: Yes F] No
Confirmed with Planning D_pt. if ,
there are any restrictions: LJ
Cost of
)t o ° -
Typ e- f Construction: group:
�S
blo
R �c5=
Zc,Occupancy
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