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CITY OF CUPERTINO°
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�BVILDINO DIVISION PERMIT
CON' V"CTORINFGRMATIQN
BUILDING ADDRESS:
FOUR SEASONS ROOFING
PERMITNO. 06050036
10099 RIDGEWAY DR
OWNER'S NAME:
PERMIT ISSUE DATE
DEANZA OAKS HOA
502 HORNING ST
2006
NE:
SANITARY NO. CONTROL NO.
(408)278-0330
ARCHIIEC PENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
(�. t� 0
LICENSED CONTRACTOR'S DECLARATION
lob Description
P
Wreby affirm Nan I me licensed under provisions of Chapter 9 (commencing
with Section 7M(f) of Division 3 of dee Business and Professions Code. aM my license is
in full frren and effectTEAR
(
OFF SHAKES, INSTALL 1/2" CDX, AND GAF GRAN
L1eCn"ad. Lic
Da {�ContECL
SEQUOIA SHINGLES. 50 YEAR CLASS A
ARCHITECTSDOds
! I understand my plans shall Ile used u public msords
LiaucJ Professional
CLARATION
Oat
from Nc Conuanmo License Law far um
m
I am aU rept from
I Wrehy .(Seco thus 1
I
i 1..Bumps
llowing mood. 7(q LS Busted and Pmfde iuoli Calc: Any city or county
foNALED
which rcquis a permit w conswc, alcor. Wpmve, demolish. Or repair any structure
re Permit r
prior w its issuance. sm, requires Ne applinnt fo,such permit to fit. signet summenl
Connector's LJcuum Law 9
Sq. F. or Q a Valuati 5 0
that he is licensed president b the provisions of the (Chapter
(commencing with Section 7000) of Division 3 of the Insiders and Profcssinns Cade)ur
_
900
that he b exempt therefrom and use bur for Ne slegcd csempua, Any vtedt, of
C
ei Occupancy Type
M
Section 7031.5 by arty applicant for a permit subjects the applicant m a civil penalty df3AjYj
not mom Nan five hundred dollars (55001
1, u owner of the property, ter mY ctvploYcn with wage as dmv sore compcnssdon,
will do Ne work and to drucbre Is not intended or offered forum (Sac. 7014. Business
a
cottons
and %nfeau. cede: The Gonmcwes License Law does Mt apply m ad .. of
property who builds aimpm sthereon, andwM doessuchwortbimselfor though his
'
own employees, provided that such impmw:ma ds am not intended arofremd (orale. If.
however. the building or improvement in sold within ane year of completion, the awner-
builder will have the burden of proving Nat W did mat Wild or impure for purpose of
til,.).
(7 1, as owner or On Property. am exclusively..mune& with ncerued contractors to
construct the project (Sec. 7044. Business and Poressiou Code:) The Conraners U.
,
use Law dose not apply to an owner of property who Wilds or improves thereon, and.
who ecouncts for such Valens with acmuamor(s) licensed pursuant to the Conercmrs
License Law.
❑ 1 am exempt under Sec . B & P C for Nu noon
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under peulty df perjury mm of dm fallowing dedanmans
0 1 have and will maintain aCertifcete of Cunsenuo relf-insure for Workers Comped.
ration, as ppovided for by Section 3700 of the Labor Cade, for On poll.. and of do
wart for which this permit is added.
0 1 ban and will malnlaln Workers Compensation InSVMCC, M required by Section
3700of NC Labor Code. for the perferne. or circ work for which thin patent, I, Issued.
.
My Workers Compensation insurance a a and Policy numhv>2:
CarrxrtilYpJlyj i�,
CEfrTIFlCAM OF E%EMPIION FR OM WORKERS' `
COMPENSATION INSURANCE
(ibis seeued reed Write Completed ifft permit is forome hundmddolars (SIM)
nr less)
I codify Nat in the performance of IW week fa which this permit is den ed, I "I not
employ any person in any mannose as to became.subject to the Worker Comperuauon
Laws of California. Date
Applicant
NOTICE TO APPLICANT: IL after making this Certificate of Exemption, you should
become subject to the Workers Compensation provision of the Labor Godo, you mug
v forthwith comply with such provisions or Nu permit sWli W dccmcd revoked.
j CONSTRUCTION LE.lemliAGENCY
1 W out dirt u
30 rending agency for cite perlormarl¢ of
' cite r whaffirm
.
for which Nil Permit u issued (Sec. 3(19'1, Civ. C.)
s ed (Sc
Landers Nam.
le"s
landera Ada.
1 certify, 6.11 have mad Our application and sum that the aWve information is
' correct. 1 agree to comply with all city and county ordinances and sum laws mlating W
Wilding convection, sod hereby authorise mpmaenuus of nhiacity no enter upon the
aM1ovt-mentioned popco, for ur,cupn purposes.
(We) agree to give, indemnify and keep hand leu the City of Cupertino against
j imbilitim udgments,cosu and expenses which may in any way amueagaiutsaid City
in consequence or the granting of this permit.
• APPLICANT UNDER AN WILL COMPLY WITHH ALL NON -POINT
Issued by: Date
SD
REG ULA%
Re -roofs
Type of Roof
S umuf Appli nV numb' Dam
AZARDOUS MATERIALS DISCLOSURE
WIIIth�pdentnefuwm handle
"alCg,t. Chaptgoom
Honaltousmamrisl
u defined by � C nines Municipal code. Chapter 9.1x. tib cine Health and Safety
'
cna4. scored us3x(a).
❑tins No
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtainingan inspection, I to
Will thea linget or foto. building occr ant use ter devices which
pp e c.
agree remove
P g
emit harardnua air canuminanu u Jefncd by IW Bay Ama Air Quality Managcmcnt
, Ail Qat
all new materials for inspection.
Disv ctT
Ores
I have real the Wau dous mom ids requirements under Clupmrb.95 of Na Califor-
niaHUI"Safety Cade, Seemed 25505.25533 and 25534. l undcrswd thmifute bolding
does not curremly have a moan, ther it u my res,desibild, W notify IW eo upsm of the
nts hxhmuNWmet Inrancenr,ceufcamnf oc^upmtey.
Signature of Applicant Date
All roof coverings to be Class "B" or better
Owncr or mdugired ag n DOW
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
Job Site Address:) QO C iyl
Roofing Company Name: i --
Applicant's
-Applicant's Signature: ` Date��(j
• Greg Casteel
Building Official
Revised 11/2/04
eem 3 of 7
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 34241022.00
DATE ISSUED.......: 05/04/2006
RECEIPT #.........: 34240
REFERENCE ID # ...: 06050036
SITE ADDRESS .....: 10099 RIDGEWAY DR
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
•FEE ID UNIT QUANTITY AMOUNT
-------------------------------------------
BPERMFEE VALUATION 6,000.00 126.36
BSEISMICRE VALUATION 6,000.00 0.60
TOTAL PERMIT : 126.96
0
PD -TO -DT THIS REC NEW BAL
------------------------------
0.00 126.36 0.00
0.00 0.60 0.00
---------- ---------- ----------
0.00 126.96 0.00
e
CITY Of
WUPEkTINO
is
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building De artment
JOB ADDRESS:
bO9E�
PERMIT #
o6 a X00 3-"
OWNER'S N zc„
BUSINESS LICENSE #
PHONE #
GENERAL CONTRACTOR.'
FAX #
I am not using any subcontractors: �O 3'� (10
jgnature Date
Please check applicable subcontractors and plete 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
/Contractor Signature
6;r_?-6Co
Date
E
0
�..
CI,Y7Y Of
CUPEkTiNO
alp 05od,;Jzz
CITY OF CUPERTINO
RE ROOF
PERMIT APPLICATION FORM
APN #
Bld Permit Fees
Date:
'2,'Z—L- —02'Z„
Enerov
Z7 O(2
Building Address:
Seismic Fee Res
)Oo
Owner's Name:
BUILDING
Phone #:
F
BUILDING
BUSLIC
Contractor:
BUILDING
License #:
Fa.1-
�2oof
% / Z F
Contact:
Cupertino Business License #:
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
❑ Asphalt Shingles
V8 Asphalt Shingles
�IY— Wood Shakes
O 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: _qofr1-
C£ 5{_ g tNs�y�� t Z' Cp)!t 0
1 v R
cs
Residential ®. _
Commercial
Fire Zone: Yes E] No-jE Confirmed with Planning Dept. if
there are nnv restrictions: U
Cost of Project: ao
Type of Construction: Occupanc group:
S Soo —
'� _ (zE,o F ,3
Qty. if
A licable
Fee ID
Fee Descri tion
F G
BPERMFEE
Bld Permit Fees
ee rou
BUILDING
BENERGY
Enerov
BUILDING
BSEISMICRE
Seismic Fee Res
BUILDING
BSEISMICOM
Seismic Commercial
BUILDING
BPLANCHK
Plan Check Fee
BUILDING
BUSLIC
Business License
BUILDING
evo(g