06040174 (2) CITY OF�UPERTINO �" "� '"n„�xZ • rt
BUILDING DIVISION PERMIT CONTR,�'Q ',"NEQ1R� MAT10
rz_.rs,�.� ......mH?. >:`ypxks
Bu1LDINC AOORFSs: SEASONS ROOFING PEaMITNo.06040174
10112 FIRWOOD DR
OWNER'S NAME: PERMIT ISSUE DATE
DE ANZA OAK HOA 502 HORNING ST 04/27/2006
JNE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECOENGINEER: BLDG BUILDING PERMIT INFO
0EIPLT PLUMB NECX
0
;Op
LICENSED CONTRACTOWSDECLARATION
IObDaSCrI teen
i 1 hereby affirm than 1 tea licrenad under provisiaU of Chapter 9(ammencing P
ww3eorce Ad� CrIate0ividoa3arJueaainw Sue Prolessiamde
co ,as my license i,
ull tome and tlfas ,
TEAR OFF SHAKES INSTALL 1/2" CDX AND GAF GRAND s t7
Dam—Commtor SEQUOIA SHINGLES 50 YEAR CLASS A
1
ARCHrrEcrS DEC ATION x
PqU I Processionin mall my piece be usstlaspublic recrecordscor ������®
CCCo LicensedProfessional
DECLARATION
1 arehy alE n Not I em exempt f am ISO Contactors Licon o Law for to
CC following reason.(Sacsi•tiun 7031.5,Buens ad Profession;
Cade:My city or county ,
le Pi which requires•permit to canaahe.shot.impmw,demulW,or repoh my stamure
prior In its hetumm,ala Requires Nc appliat far Such permit to fie antioed auumcm
<
that he U licensed parwwnt to the provisions of the contractors Elwin Law(Chapter 9 Sq.Ft. Floor-Area Valuat b 5 0
FK 9 (commencing with Section 7000)of Division 3 ofthe Buainessand Pofessiom Code)or
e that he U exempt thercfom ad the basis for the Ocip d exemption.Any violation of
Sema 7031,5 by MY Suppliant for a permit Subjects Me applicant to a civil peruhY of3 ppm N�lal Occupancy Type
t
amoa Nve an Ohundred doll as(5500} 4 2 3 3 .i
O Lasownerof to plapemy,a my employee with"Sum doh ale amperuatla,
Will do the work ad the swam hnotinunddura@Sul forne,(Sm.7044.Butmss Required Inspections
.
ad Pothemiom Cade:The Conhacmes LiamLaw dam em Apply to ownere ns an of 9 P
property who build,Sur(mpat[a thea em.ad who deal such Park binYGB a amoth his
now employees.provided that Such improvements are at intended or offered for salt If.
however,Ne building or improvement Is Said within am you of completes.Mc mvrcr-
builder Arid haws to bulla of moving that he did at build a improve fa purple of
ARM).
t]1,as Owner of the papmy,aro exclusively cahrating with laved aR==he
construct Me pojen(Set 7044.Busing and Profession Cade:)The Contaeees Li-
came law doa not apply b a owner of property who builds or improve,tureen,ad,
who constants for such prejeau with acatraaar(M licensed Panama[to Me Camactoh
License law.
❑Iunmemptunda See ,B&PCfortha Haan
owner Dee
WORKER'S COMPENSATION DECLARATION
41 1 hereby affirm under pewty a(perjury me of the(mowing acwatimtc
❑[banned will mdnu)na CeatOauaf Camentmelf•InaumfaWarteraCompen-
ssdm,u povided fa by Sadao 3700 of Me Leda Cede,fate parfomunm of the
work for which this permit is issced.
❑I haw ad will maintain Workers Compensation Imuanm,As Required by Semon
3700 of the Labor Coal,for the performace of lite work forwhich this permit is Issued.
MY Wagrk�ees Campemma hoe mania ad Policy number am:
i,ry 1 a.h.. &V1/Policy No.
CE IFl TE F ON FRO WORKERS'
COMPENSATION INSURANCE
v
Cnisectla net not be clmple ed Iran Permit Is(mane hundred dodge($100)
or kis)
I cenih that in Ne perfarmace of the work fa which this conk is road,l Moll at
employ any person in my matter so 45 to became subject to the Worlun•Comiums ton
Law of Ca ifamis Data
Applicant t
NOTICE TO APPLICANT:IL afar making this Cenifiau of Exemption,you MeaW
bream aur to Mc Worked Cnmpenssda pmvWm of Ne Labs Cede You mass
,J 0 forthwith comply with such prvisiom a Mu permit Melt be de mnt revalued.
zy CONSTRUCTION LENDING AGENCY
F+ 1 amhy eance Mat there is a comamtinn lending agency for the perform.of
ori the wall for which this permit is Island(Sen.3097.Civ.Q
W A Iandets Nate
z Zandm
Latices Addr
U Q 1 certify that I Mw read We application W suss that Me above information h
V, P coma 1 agree to comply with dl city ad county ardhemsts and SUM law Milting to
lit, building conduction.ad hereby Ruthann repreaenutiwe of this city to enter upon the
W show-mcmiuned property for immcetan purposes
(We)agree to an,indemnify ad Map harmless tte City of Cupertino against
v,w Cn Ilabllita,judgments.eau ad expemm which may in my way acerin against said City
t.)2, in consequence of the grating of this parmii.
"•' APPLICANT UNDE ANDS AND WILL COMPLY WITH ALL NON
�-POINT Issued by: Date
Re-roofs
Sigmmrc of Appl onusnor DAM
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Wil a applkat a future building accupatssam or handle haurdoa mamnd
as denncd by the Cu is Municipal Code.Chapter 9.13•arm the Health ad Safety
Code.Seton 25532(,). All roofs shall be inspected prior to any roofing material being installed.
41 r]You o
Will the applicant or forum building occupant tee equipment or avian which If a roof is installed without first obtaining an inspection,I agree to remove
_ shim haudnus air coninanU u de0md by the Bay Arta Air Qudlty Management all new materials for inspection.
District? oll
❑Yes $Mu
I hew read the haaamrea mu miaUa ibimmema arukrCMpur 6.95afte Califor- _
nLaFulth&Safety Cora.Sectiau25505.35533and25534.Iunar dMmifte building
dace at currently haw A tens,Mat It h MY Responsibility to notify the occu Ant of hM
re hichm�rtoissussReofACertifeauafOccupancy rQ. Signature of Applicant Date
Owner M Sumhariss a em Date All roof coverings to be Class"B"or better
Community Development
00 Torre Avenue
,14416, Cupertino CA 9 014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPERTINO
Building Department
JOB ADDRESS: PERMIT #
0 ood, a 66 vol-7v
OWNER'S NAMErDk , k PHONE #
GENERAL CONTRACTOR:-4-7 . (Z FAX #
I am not using any subcontractors-
Signature Date
Please check applicable subcontractors an complete the following information:
61 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
L�- 0(�
er/Contractor Signature Date
CITY OF CUPERTINO
am 5 of 6 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34233033 . 00
DATE ISSUED. . . . . . . : 04/27/2006
RECEIPT # . . . . . . . . . : 34163
REFERENCE ID # . . . : 06040174
SITE ADDRESS . . . . . : 10112 FIRWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DE ANZA OAK 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
40FEE 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 ADA.V.d Ipo/lliicy on re-roofing.
Homeowner's Name: ,[� An7,r,, of � A
job Site Address: I D I I I WoOd
Roofing Company Name: • .
Applicant's Signature: Date*2-1-0 4
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
• ' REROOF
CUPERTINO - PERMIT APPLICATION FORM
APN# Date:
Z' 33-b Z7 O(o
Building Address:
101 „
Owner's Name: Phone#:33U
a Q V
Contractor:C License#:
JQtSonS �oo� 7 / Z V
Contact: Cupertino Business Ucense #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
O Asphalt Shingles VP Asphalt Shingles
AY- Wood Shakes O Wood Shakes
O Wood Shingles ❑ Wood Shingles
❑ Other(Specify) _ ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O. Report#
;a To be Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: T(04(-F £) 5 ttisFti�� z ` Gp�lt qn (o A, G�+n $uor¢
t o
Residential ,&Z Cormnercial ❑
Fire Zone: Yes ❑ Nom Confirmed with Planning Dfept. if
there are an restrictions: u
Cost of Project: oo Type of Construction: Occupancy group:
S SOO _ R¢ _ o v ��
Qty. if
RBUSLIC
Fee ID Fee Description Fee Group
PERWEE Bld Permit Fees BUILDING
ENERGY Ener BUILDING
SEISMICRE Seismic Fee Res BUILDING
SEISMICOM Seismic Commercial BUILDING
PLANCHK Plan Check Fee BUILDING
Business License BUILDING
•