06040128 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT � c��v�r=1u.c�r ''�r ' a�MaT R
_x.,Yxa ad.R`�s't;n.-...�a'ys �.E4�s. �..-RMAae.;E4tsd
BUILDING ADDRESS: SONS ROOFING PERNLITND.06040128
10100 FIRWOOD DR
DINER'S, ME
NMEPMMIT ISSUE DATE
DE ANZA OAKS HOA 502 HORNING ST 04/21/2006
ONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDGEIECI' PLUMB MECH
t� t� 0 t�
:00 LICENSED CONTRACTOR'S DECLARATION JD05Cr1pt10n
1 herby affirm that I am licensed under provisions of Chpur 9(commencing
t�
with Section 70(10)of Division 3 niche Business and Professbe Coda,and my Ikats is
in full rota and eHacL TEAROFF CEMWOOD S INSTALL 1/2" CD+
Llan ClLk.a Z
iQ48- Date �T —cARCHn`ECrs 1�SID GAF GRAD SEQUO 50 YEAR CLASS
L I understand my plans Nall be used as public Remao V` /
s WC�
Licensed Professional ✓��
oC
Oat I am exempt
from
m CIA0.AT10N
� I WRhy alum that I am tamp from the Convenors I3canx Law for Na
p o following mason.(Section 7071.5.Business and Professions Code:My city or county
$(Vi which Rqumus•Permit to enwwel,aitor.W pmw,demolish.m repair any suwWm
S Law 9 Sq.Ft.Floor Area 21'' prior to its issuance.also rtf.ires the applicant for much permit to file asi,mcwtmmem
r< feat W b liccwcd pumtanito OR pmvisloas of the Comecon's Ucenm Valuati 500
�$ (commencing with Section 7000)ofDivision 7 of Ute Businessand Profesione Cade)us
z feet he b hemp,therefrom and the Mob for the alleged etsmpdm Any violation of ,s pv7•�;{1t�,,7 {,yam
Section 7031.5 by any applicant res a permit subject,the applicant be a civil penalty of 3 4 G.]J��O r 0 0 Occupancy Type
not more than ftw hundred dolbrs(SM.
0 1,as owner of the property,or my employee wife wages as Joh sets eompewa0w.
vol do the work and the structure is not intended or offered for We(Sm.7044,Business Required Inspections
and Profaaloe Code:The Contractors LlenseeLaw,data C not apply m an owner of 9 P
property who buildsof Improves them .and wMdoessuchworkhuuntfmIltroYgh his
awn employees,provided that such Improwmenu ate not intsrldrd martercd(anile.If.
however,the building m improvement b sold within oro yearof oompledam.the owner-
Milder will haw the burden of proving that he did net Wild or improve for purpose of '
ale.).
❑1.as ower of the property,are exclusively contracting with licensed contrusam to
cummov the prokn(See.7044,Business and Pmfessiona Cade:)the Contractors U.
Cents law does not apply to an owner of popery who buil&or impxws thereon,and.
who contracts for such projects with a eontracub*)licensed purwnl to the Commerce.
License Law.
❑I are esnnpl under Set .B&PC for this naw
owes' Dab
WORKER'S COMPENSATION DECLARATION
I hereby a01m under penally of perjury ane of tW following declatWonc
Ihaw atm will mainWn•CmdOna of Cowen)totslf-lauR lm Workers Campo-
wiw.a provided for by Section 3700 of the Labor Cade,far the performance of the
wmt for which Nu Permit is issued.
❑I haw and will maintain Worker's Compensation Insurance,as myuimd by Section
3700 of tho Labor Coda,for she performance of th.vat far which this permit Is issued.
My Wohae.Compwdon farm corm and Policy number am:
GMer. ��.L4� Polity No.:
CEIMFICA ^OPEX3IPTIONFRO WORKER '
COMPENSATION INSURANCE v
Thisxctlan need not be completed lithe Permit Is foram hundred dollars(SIM) a
lir las4)
1 anify that in the performance of the wart for which this Permit Is Wised,I awl net
employ anypermn in any manacrm as m hocoma subject to JY:Worsen'ComPematlon
Law.of California.Dare
Applicant
NOTICE TO APPLICANT.If.aticr mating this Certificate of Exemption.you should
become subject to fee Wo&rXs Compcmadon provisions of the labor Cade,you a=
0 O forthwith comply with such provisions or this permit mail be doomed revoked.
Z .~yesCONSTRUCTION LENDING AGENCY
(-s 1Wmby.M.Jotshemi..eona dmiendingagcre forthcla:rfmmaweor
> that work for which this permit is issued(Sem 3097,Cl,.C.)
It7 0Landers Name
az Lander.Address
V 0 I cunify the I have Rad this application and sum that the show informed..b
w F MMCL I agree m Comply Wife all City and county ordinances and state laws relating to
0V building construction,and hereby mthorie representatives ofthis city to enter upon the
W above-mentioned property vrty far iropcedon pur se•
A. (We)agree to raw,indemnify and hap homeless the City of Cup: against
rrA liabilities.judgmcns,cess and expenses which may In any way accrue against said City
U z in conaryuence of the granting of this XMIL
APPLICANT UNDERSTA D WILL COMPLY WITH ALL NON-POINT Issued by: 6a Date 6j,?.0 aG
LATIONS Z z
Re-roofs
Signature of A po HO.11C.MlIsm, Dam
usMATERIALS DISCLOSURE Type of Roof
Will thoapp ,ww bulldingEmupanty..Mmdkhaerdow MWIW
as deRned by the Cup; Municipal Cade.Chapter 9.13.and dre Health and Safety -
code.Senian2ss32(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes ❑ o
Will the appRcmI or future building occupant use equliamen or dcviw which If a roof is installed without first obtaining an inspection,I agree to remove
emit baamnW air coouminams as defined by tM Bay Arca Air Quality Management all new materials for inspection.
D trin7 ��
❑Yes ❑Nu
In mW the hnandauo mucdabrequircmcmu umkrCNptsr6.9Sof theGllfw-
ma Hcalfe&Safely Coda SccdmZ05.35533and25534.Iun&a dthatlrJv building a
dues tot curRndy have.unanL my RapenaibilitY to notify the aceupant of the
I hmud met 'onto ance.(.Cenkaua�upan� Signature of Applicant Date
G �4 All roof coverings to be Class"B"or better
Owne sulhodRd eel Dam'
Community Development
1410300 Torre Avenue
it Cupertino CA 95014
Telephone(408)777-3228
C110VCI 0V Fax(408)777-3333
OUPEkTINO
Building De artment
JOB ADDRESS: PERMIT
OWNER'S NAME: F PHONE #
GENERAL CONTRACTOR: /� FAX#
rs:
I am not using any subcontractoLrN ` 21
SiViature Date
Please check applicable subcontractors and co lete the followin 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
• dl�- y 21'o co
Owner/Contractor Signature Date
CITY OF CUPERTINO
.em 1 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY' # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34233036 . 00
DATE ISSUED. . . . . . . : 04/21/2006
RECEIPT # . . . . . . . . . : 34090
REFERENCE ID # . . . : 06040128
SITE ADDRESS . . . . . : 10100 FIRWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DE ANZA OAKS HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2642
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
_W' City of Cupertino'
10300 Torre Avenue
CTelephone: (408)777-3228
ITY OF
Fax: (408) 777-3333
U P E��'N O
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: I �Y1Z/�r ��k�A U
Job Site Address: ) J�d () /✓ I�0 (L
Roofing Company Name:
Applicant's Signa Date:Date: 'i�-2,,'C7
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO 0(Q040 I(.6
REROOF
�UPEI�TINO PERMIT APPLICATION FORM
APN # Date:
'd ce
Building Address: n
/0/00
Owner's Name: Phone#:
-b, RN?.h ()at4s A- F -o33C)
Contractor:: Phone #: License #:
'Fou / &e-Lsmns Y7 2108
Contact: Phone#: Cupertino Business License#:
`( (Ao (fa Zal�_v.g
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ;M'Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
-Pd. Other(Specify) (1,¢M wooaQ FJ,- e^S ❑ 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:
obDescription: 7 o_o E) C-QAM"w C
C�cQ 44F t" $E ool�i ) C14
.SS
oT I $0 ( SS 1�
Residential /6 Commercial ❑
Fire Zone: Yes ❑ No g Confirmed with Planning Det. if
there are anrestrictions: LJ
Cost of Project: SO c o6 Type of Construction: Occupancy group.
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
•