06040170 (2) CITY OF CUPERTINO
BUILDING t)IVISION pEjjNQT CONT 0RjNFwiMATi ;1
�....�. .,
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMITNO.06040170
10122 FIRWOOD DR
OWNER'S NAME: PER'MI'T ISSUE DATE
DEANZA OAKS HOA 502 HORNING ST 04/27/2006
ONE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECTMNGINEER: - BUILDING PERMIT INFO
BLDGO ELECT O PLUMB MECH
O O
�oo LICENSED CONTRACTOR'S DECLARATION - Job Description
i i hemhy affirm that 1 am licensed under provisions of Chapter 9(am onclry p
with Section 700n of Division Sof the Business and Pro(essinm Code.and my licase,is
+'1 Iutullto=andeffm- Is TEAR OFF SHAKES, INSTALL 1/2" CDX AND GAF GRAND
;14o:re CCl Omrxy� py SEQUOIA SHINGLES 50 YEAR CLASS A
)eQ ARCHITECTS DECLARATION__1
f�+cy3 1 undemund my plans will he mod As public mards
s lid Licensed Professional
is
OWNER-BUILDER ER m the RATION
Commem 1�
2 a i I hereby anirm on i 1. exempt from the CAntracmes c License taw for the 'vp•'�rGi
O O following uiaeon.(Section 7(D stro Business and Profession,Cade:My oily or county
$ which as isms•permit b cemmet.eller.Wprove,demur W,ore A sig any atwnum
I�^ "he iuWwnw,alsure to Me the applicant far such Commerce bRkaeLaw(Chapter
22 C thuheislkemcdpursunntmtheprovision,oftheConuecbraUamclaw(Chapm9 Sq.Ft.Floor Area JUN Valuati L5500
in romancing with Section70DO)nf Division Sof the Busines,and Profession,Cnde)af V 2006
e that he is exempt therefrom and the bash for the alleged esmnp0on.Any violation of
Secthon 7031.5 by airy applicant for a Permit objects the applicant to a civil penally or p,N Number Occupancy Type
Act marc than nes hundred dollars MOIL 3 4 2 3 3031 . 0
❑1,As owner of the property,or my employees with wgu As their auto compcwdon.
will do the work.and this su sem.is nmaunkd moffered fmNa(See.7044,Business
std Pneleeslan,Cade:The Contractors Llano Law does ant apply to Reg
an owner of u MFc
Property he Wilds or improves thereon,and who dessOchwmit himself a,through his
owe employes,MoMed that such impmwmenu art not Intended maffered far We.if.
however,the Wilding or imprownteo isold within orc year of completion.be orman-
huilder will law the human of proving that he did not build Or improve for purpose of
oto.).
❑1.An owner of the property,am inclusively commeting with licensed c muanon Or
comtmct the project(Bac.7064,Business atm professions Code:)7h Condolences U-
C.
•C vee law docs AM apply b An Awner of property who Wilds or Improve Nocton,and,
who contracts be web projema with aha a anoo(s)licensed Manuel b the Contrxtors
Lken,e law.
❑IamescmptunderSec. ,B&Pcformiamawn
Owner Data
WORKER'S COMPENSATION DECLARATION
40 1 hereby aO)rm under penalty of perjury,arc of the following dOcleoatiarm
❑1 have and will matnWn aCeniOnoaf Comenl b eel(-Isom fm Workers Compeo-
nation,As provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is intend.
❑1 haw and will msimain Workees Compensation Imuran¢,An rtguired by Section
3700 of the tabor Cade,for the performara bods wok for which bis permit is usual.
My Wa rs Compemahm insumoe canter and Policy number are: -
Cartier. PaI1cY NolPROM
WO 7.0LA'
CERTIFICA 0•
COMPENSATION
ON RAN WORKERS'
COMPENSATION MSURANCE r
(Thu owes heed notbe eomplened if the permit isforene hundred dallas($IO")
or last)
I certify that In Ne performance of the work for which this permit is issued.I shall not
employ any person In my moneran an An bewma object to the Workan'Compen,don
Laws of Cuiiromit Data
Appnasnt
NOTICE TO APPUCANr:If, her makiry this Cerdnche of Eompuen,you should
became subjtct in the Worker's Compensation provision,of the Lollar Code,you mus
'7z forthwith comply with man provisions or this Permit Mail k deemed mwked.
Z`v CONSTRUCTION LENDING AGENCY
to 4 I heroby M.that them iso consuuNont lending agency folhe perfmorsom of
lYi> the work:for which this permit is Wum(Sec.3W7,Civ.C.)
WE Laudon Name
]z lander,Address
V O 1 certify that 1 kw read this Application and sats that the,bow information is
(y f" cartes I stmt,to comply with all city and county ordinatces and Also laws milling tu
0 U Wilding construction,and hereby,authorize representatives ofthis city in cora upon the
`, LU akvomenuuned property for inspection purposes.
(We)agree to on,indemnify and keep harmlw the City of Cupenina agaimt
v.v IA liabilides,judgments,emu and expense,which may in any way accrue against old City
V v,[ to consequence of the granting of This permit.
^" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
HAZARDOUS
Signature of ApplicaDau
HAZARDOUS M.STERIALS DISCLOSURE and Type of Roof
Will the Cupertino
Tatum hpal Code=pantnesemandM h ealdammaudW
As de0ned by de Cupesthro Municipal Code.Chapter 9.12.and tic health and Safmy '
Code,Sa.Won 27532(.)? All roofs shall be inspected prior to any roofing material being installed.
41 ❑Yes ONO
Will the applicant or future building Occupant use equipment or deal=which If a roof is installed without first obtaining an inspection,I agree to remove
emit huesmnus•ir canuminams as dcfiOcd by the Bay Ama Air Quality Management all new materials for inspection.
District?
❑Yea ON.
1 haw mad the haven"s mauriahmquiremena under Chapierd.95 of the Callfor.
na Haslth&Safety Code,Seacus 255W.25533 arm25534.fundamental thatifde Wilding
dean not currently haw a enan,that it is my responsibility in naify the occupant of the
nequimmcus which must be met prior On house:or A certificate of owpancy. Signature of Applicant Date
Demur arwmaraed anent Dem' All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
aClOF
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
`WUPEWINO
Building De artment
JOB ADDRESS: PERMIT #
O Zo d'Y 6 /-7 6
OWNER'S N t PHON
Q c. E #
GENERAL CONTRACTOR-} S . K FAX#t
I am not using any subcontractors: -0
Signature Date
Please check applicable subcontractors an complete the following information
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
er/Contractor Signature Date
CITY OF CUPERTINO
06m 1 of 6 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 34233031 . 00
DATE ISSUED. . . . . . . : 04/27/2006
RECEIPT # . . . . . ... . . : 34163
REFERENCE ID # . . . : 06040170
SITE ADDRESS . . . . . : 10122 FIRWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DEANZA 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
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 statedlIpoliccny on re-roofing.
Homeowner's Name: 1_�)C AnZe, Oc,k5 H •d•ti
Job Site Address: 1012-& P;r-Ly po C'.
Roofing Company Name:
Applicant's Signature: Date: U(9
• Greg Casteel
Building Official
Revised 11/2/04
` 044017)
CITY OF CUPERTINO
Z
REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
Z:3 -0 2 0(o
Building Ad ess:
o o (l
Owner's Name: h Phone#:
G. V �J
Contractor: License#:
� SQtiSonS �200� 7 / Z O
Contact: upertino Business License #:
TL P t2
Type of Roof Covering: zns
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles N' Asphalt Shingles
JF— Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings / Cl Provide I.C.B.O. Report#
j6 To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Poli
c
Job Description: TQojrF is ( 't P.).5 y CD)( I a 6&4 G�w $uor�
1"'
o Lf
Residential �]._ Commercial ❑
�6 he
Fire Zone: Yes ❑ Nom Confirmed with Planning Dept. if
there are anrestrictions: U
Cost of Project: ao Type of Construction: Occupancy group:
Qty. if
A licable Fee ID Fee Description Fee Group
BPERMFEE Bld Permit Fees BUILDING
BENERGY Ener BUILDING
21
LF
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•