02080025 (2) i
CITY OF CUPERTINO "
BUILDING DIVISION' PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10180FIRWOOD DR FOUR SEASONS ROOFING 02080025
OWNER'S NAME: APPLICATION SUB DATE
MUNRO DEAN .AND SUSAN 645 HORNING ST 08/06/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 278-0330
9 p ZO ARCHITECT/ENGINEER: BUILDING PERMIT INFO
kC ag
U C BLDG ELECT PLUMB MECH
,a�
LICENSED CONTRACTOR'S DECLARATION
ZO �+o - 1 hereby a1Brm that 1 am licensed under provisions of Chapter 9 aommancing Job Description
p:tw wins«n ] oolaruivismn3mmeea.me arrofeaaiansevae.anan,yucenae REROOF
m ion r na erred.
Tac"6 uemx �DNALF-0
n' a V
Data �a b Con�ra�a� l1aarr// .,a,\ at ar+t.4
u3—.LLO� � ARCHTfECT'S DEC'EetttAT10N
,g rsmntl my plans shall be used as public rccoNs 2 9 nos
a O Licensed Professional A�
c R 1 1 t.t. OWNER-BUILDER DECLARATION [�
vo 1 hereby affirm Ilia I ion exempt from,he Commactor'sCar License taw for the �'�®1��/ BOO 0
t?a following arson.(Section]on um r.allms and Professions Code:Any city or county G C
I O which xqu..wv pemti,to conswn,ultra.improve,demolish,or repair any swcturc Y
a.3 m ..port t n '.' ace.al quve ,he DVhcam farsuch peRi mfile astgned smtemem
'Is, SI nxd pursLLa noamp .inns of the Conttacmrs License Law(Chapmr9 or e, . i Valuation
(coma : g 'thy-',an700)ofDvson 30f the Businesv.aad Profcstons Cade) z;',y-.•'a'34 B ,b ';. d� \„ tl. p,i ; �,„
m Na,he a exempt,lin dw and the bass far the alkgW exemption.Any violation - - - 1
of
Section]OJ 65 by e..isP"werm or
r pemut wbgais the
applicmuo a civil penalty
•ar not more mar.n
five hnndrcd Talars(ssoo). 3 0 5 APN PojM4Lr " . Occupancy Type
X01,as owner of the property,or my employees with wages as,heir sole compensation.
-1Bidge s and P assumne I"Woode:The
isnot imcndctl or License
Law for sdo,apply
9011;' - - - - -c - - _.___._.._.___
owner of ponfir,Whirl Cade:The Comnam's,and W law d«s no,apply,o an 601 - ROOF TEARec(iDt�efd Inspections, -
orvWufhhisowne°oieesor.pividedtatsuc improvhodoessuch mnotintendedkhiat 602 - ROOF PLYWOOD NAIL
B employees.provided that ro improvements rc , or. .. ..._ .... .. _._._._ ....._ _..._..._..
r . "offe bdf -I 'OWne he building p 'vi old lhd one year of 603 - ROOF BATTENS ....r. '�l I.-
improve
.
Completion,the owner bu Ider Will have,he burden of proving that he did no,build or - -
improveforpnryrmofavin). 604 - ROOF IN-PROGRESS
-. [71,ssowner of,he ro n exclusively<on,rxtin .-_---_ .. _--- -- '-------- - - -
PP< Xamenc y gwithosanxAa Creamito ,1.f.L ..,• .,._,
- _ conswd me prolcn(Sec. ,...Business arid .y wyhm h Chea The e,flicmm. „
License ,co does nmr such
,pan owner o(propcny who builds se improva thereto, - -
`
and woo,convas,for such prolens w,h.a conuactor(s).licenscd pursuant m theCon .
ut License Law
•. Olam exempt under 5'e •'''. r' ".B h P C for this xmon ,.•l' 1 _.,_ _......... -_._.__..
. ] ..., ..
1C O,�ner Data
WORKER'S COMPENSATION DECLARATION'
•` 1 M1 by R d K maty of pe L ry n 11 of the following declamations "
0 1 have dM'I Illmaintain' CeniRwtc of Crxmxol oto self re for Worker's
Compensmmn, as Provided for by Section 37M of the labor Cade, for the
performance of the work for which this .it is issued.,.
,01 have and will m5intuin Warker'a Compensation instimncx,as required by Section
37M f,hc Labo Cad fo th performan f thework fo which this permit is
u d, Work. C pe , Itsu end Pol cY be are,'
,\� .....�-,.., e,..m..•,... . ....
,... .,. .. .. , t _.,. _.. .... ...._..._..-
am NeiT.n\-s';>v1 Pot ot�{'24q\R96C� ' 1 -
t CERTIIICATIONOFEKEMPTION FROM WORKEIIS' .tlt.. d I!.'.,, (t./,
" "COMPENSATION INSURANCE c
' (Th s acct n n eJ not be complued if the permit is for one hundred dollen ••1 t t 1 t ,"i' I•.__ .,,. _
- - ....._. _ .. c..
<fs Icnfythat theper,... amrM kfr h hu ct in
this
I - - -
h n ,employ y pe n any mann as lin become subject to Ne Workers Coinicant.on Laws of C bfom a.Dion
s NOTICE PLICA morIt.e,
mak g,h Cnfica¢ fExemption,you shaultl, - "" ....... "----' -
z bee e s b)'uo,hd workers Compcns t pro 'ins of,h Labor Code,you mum ''
Q forth uhply'with uch for ons opermit th s shall ,deconed revoked
zin .. .. ._....... __ ...._ _
vl pert lima«el ..._. .......... ....___. _
ef„s s Chat him CONSTRUCTION melig.NG AGENCY
�. �y " Ili by Which this Pe rc. w t til d g d6 ) ,h
of nd k for Which this Permit s d(Sec JOY] Gv.C.)
y C Lenders Name _.
pl ....
1 agree thio 1 have read this city
a at rat and rime romances
a above taws r lata is
tat'F. concur.I agree to goon.a dhe all city and county ordinances and store laws enter
upon'
Q,W i to the
- rat. eJ Property for
inspection"ie Purposes.
representatives
t t cc f this ',y, ter upon
[ti 0. (W)agrc t e dionfy and keep h Ic. the city or Cuperi oagainst
_h 'liabilities,judgments, ., J expenses which may in any y we against said
C„) z City sequence of th framing of,ht permv. yy-y '
_ 'APPLICANT UNDERSTANDS AND WILL COMPLY WITHALLNON-POINT `''L/
soIicEREcuur Ns.-_°' '^'v" Issued by: ate
Izvhis , Q
,sig trc rAprtern nmmmor -",, p
I ❑Y ]SHAZAR1DOUSM1dMATERIALSpDt aIiSdCeLoO
ShUand
°l nunrJn r ma, m Re-roofs
Will lhppIicm16rfutwc
sciefirgedby and,he Hardihood S lety RAof/ot
fi
°. -•__.
N I, ' I •„tsAllCodS"on5311
L.W
roofs shall be inspected poor to.any roofing material being installed.
wnn. .pn ,a rt bar ld..d cv t Arco
alayM Mor devices anagement
n ._..re11—move .,
emir ic r J on, t JefineJ by the Bay A A Q Ity M nagem , If a roof is installed Without first obtaining an inspection I'agree to'remove
-i - all new materials for inspection._Applicant understands and will comply with
t ❑Y fi. N ,, _ ._ .
t 511'non-point source regulations . -
1 hit mad the heard s ma, 'alChaptert ) '"
req nc d 6 YS of et
California Health&SJfe,Cod hoe s25505 titin d2553) l tl .t dthat
if,N b Id 6J t u tly have rc , thio ,is my responsibility to of!
y the
� ,^
«i• p t of"m a9otrcme t h'ch'mus,be t p fissuanceofd Certificate of �x n`0 M ^Q
Ce No cy j. Signature of Applicant s�/Y/ff Date _
ow- mori,m_ag t Date.,Cro-O All roof coverings to be Class `B" or better
(` " OFFICE -.. _. .
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPFRTINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing.
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 reroofing 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) Preinspection 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 that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of 1/a"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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
Address: _ I O I g 0
Reroofing Company Name:
Applicants Signature: Cai�.4 _ �9 *rrctig Cp Date:. 07
• Joe Antonucci
(Chief Building Official)
6/25/01
CITY OF CUPERTINO z =
BUILDING DIVISION PERMIT § CONTRACTOR INF6RLM IO,N� -
au1LOINGADDRESS: ROYAL SERVICES PERMITNo.0306012S
r DWNER'SNAME: 4398 WICKER COURT PERMIrL5s1Ub/ 18/2003
NE: SANITARY NO. CONTROL NO.
(831) 462-0539
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
O o LICENSED CONTRACTOR'S DECLARATION Job Description O O O O
Ise 1 herby affirm that I am licensed under previsions of Chapter 9(commencing
with Sectio�]a9u)ref Division7of NC Business Rofessions Code,and mylicense is
+��
on
CdaOperr Z 7y66 f REBUILD CHIMNEY
2
�k- Dale oun reemo ✓r R sd >/ t
ARCHITE
�ndcrtand my plans shall hc�uudDnypM,'frt Ods
JUN a-
6 2003
g G t; Licemed Prefessianel
OWNER-BUILDER DECLARATION
coo IWrthy.[firm Chad exempt from the Conine Co Licenselaw forthe BUILDING coo following mason rS.it I AD t,5,Business and Professions Cade:Any city or m tum {•I t V
<S of which itquirts a permit re construe,ppcq improa,de era ft t or repair my suucmm
11 y that he its censedcc.
purse requites lW applicant toe such permiuo file a signed(ommcm
£rp that he ening sed pursuant to the of Divine of the the
it I'mr imea Coulee)or Sq. Ft.Floor Area $ I�g100
el- thammencinompt Sauon]OW)of Divessfr the
the Buena andon.fAn vi Cade)or
Nat k u u1.5 b therefrom and de beau for Ibe alleged exemption.Any violation of
Section 7071.5 ot N
airy applicant fora perms,subjero the applicn,10a civil pcully of 3 ABAI'I 0411er 0 0 Occupancy
nmoa n fiven hundred dollars(5500), p y Type
❑I,u owner of the prptrq,or my employers with wages as their sole compensation,
will do the work and the awcsurt is not intended mcdff ad for We(Ser.7044,Bus. iul - �rsv
RAPS
and Pmfessims Code The Conuacmrs Liana law dose ms apply inan owner of d I apes OJ
prepeny who Wilds or impmm thereon,and who dasnch work himselfor through his 312 - CHIM"UUNN BAF+
own employees,provided that such improvement are notimended oro@red for sale,If, S14 - FINAL PUBLIC WORKS
however,the Wilding or improvemnan
t is sold within e year of comon ar
pletithe ow -
buil m will lore the Wrden of paving dol he did Out Wild or improve for puryau of
tile.).
❑1.as Owner or the prop4ny,am exclusively contracting with licensed crntncmrs in
comuum the project(Sec.7044,Business and Professions Code:)The Contactors Li-
cense Law does not apply to an owner of properly who Wilds or improves thereon,and
who conuaco for such pro Ices with a comraoter(s)Barred puraeant on the Contractors
..law.
Went exemptun&,Sce. B k P C for thiswon
il
ners Date G G/l
WORKER'SCOMPENSATIONDEC ON
1 hereby affirm under penalty or perjury e e of the following dzlantions:
base and will milnu;n is Certificate of Cmnem to self-insure for WorkeraCoupon.
xenon,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑1 M.and will maintain Workers Compensation luminance.u required by Section
37WOf the labor Code,for the performnce of Ne work for which this permit is issued.
My Workers Compeuetio t bnu mance tamer and Polity number art:
Cartier: Policy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
or less.)less.)Thu
( accrd coW per
tion net completed If the mit is for me Inbound dollars(S 100)
I certify that in use Performance of the work fu or which this permit issued,I shall not
employ any. nnY mnnfr 5outp come auejaDo the Workers Comperlsatlon
La w cal;AZ Da /tN/
APp� t le
NOT TO APPLICANT.If.after making this Cenifreeoe of Exemption,You should
become subject m the Worker's Compcation previsions of the Lathan Codc,you mesa
Oforthwith comply with such provisions or this ferret shall M domed mwked.
zvy CONSTRUCTION LENDING AGENCY
1 hereby affirm that them is is emsdo ctinn lending agcmy,or in,performance ser
x r the work for which this yemlit is Incd(Scc.3097,Civ.C.)
1 A Lender's Naerc .
D z Lenders Address
j C) 1 certify that I have read this application and soon Nat the Aben information is
y COMM I a&=to comply with all city and county ordinations and so¢laws relating to
U Wilding convection,and herby ambodu mpcamostin,,of this city to enter upon ft
shove-mentioned property for i e pectin puryoux
f1, (We)agree m use,indemnify and kap harmless the City of Cupenino aguuo
h liabilitiesjudgment,comesandexpcuesson. may in say wayamuc agtinso=it City
Jz APLICANcc of thegaming of this pnmit,
^' APPLICANT UNDERSTANDS A WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOSnREGU ,NT10NS,
Situations of ApphcanUConuacmr GDate G J Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occuper stem or handle hazardous maknod
u defined by the Cupemno Municipal Chapter 9.11.and the Health and Safety
Alif,o0c.5ccyes 35532(x)? All roofs shall be inspected prior to an roofing material being Yes P P Y 8 g installed.
Will the applicant or roma builds occupant use calto. en,err devices;which If a roof is installed without first obtaining an inspection,I agree to remove
it hazardous air contaminants a cd by the Bay Area Air Quality Management all new materials for inspection.
istrico?
❑Yes
I have read the hvaNrme materialsaquimment unde,Ormer6.95 of the Califor.
nia licalN k Safety Cade,Secuom 25505,15533 and 15534.1 understand thaoirthe Wilding
dors not currently baro tenant,that it 4 my aapona bility m nouly aeupnt of the
a
ure o
'qum
i cntwhichmua '
bc orwssuna
iofaCcniRnm� �T Yj Signature ApplicantDate
C to
Owner oradhonredagent I Date All roof coverings to be Class "B"or better
'(Cd CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
D 3GYot/�5
Building Address: C
2l�ot F
Owner's Name: STcIDc4 SIS 1 Phone#: 2��75 ;Z 3 7 y
Contractor: �ry License#: r-7 L�l b&q
ayA ( Ic�S
Contact: Toh fid!EL g3� t/6a 05�3`� Cupertino Business License#:
-7/-
Building Permit Info:
Bldg V' Elect ❑ Plumb ❑ Mech ❑
Job Description: (W neY
Residential [" ,Z cet -cj I 4rU Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Pr ' ct: 360 Occupancy oup: 7
Type f Construction: J
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to IM Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
PBENERGYALM
XR —C- Hotel
–Resi/Mobile BUILDING
00 Elec 600V <= IOOOA ELECTRICAL
01 Elec 600V > IOOOA ELECTRICAL
00 Elec Svcs 600V <=200A ELECTRICAL
Y EnergyBUILDING
Energ Add Multi BUILDING
GA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit,-Fee BUILDING
Z ,) -,76--2-
1 of 3 /
-/2 6
k ip, CITY OF CUPERTINO
4�r+
CITY OF PERMIT APPLICATION FORM
CUPEP,,TINO
Quantity Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BNEWMULTI Multifamily Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multifamily Res PLUMBING
BNUSFD New Single Family Res BUILDING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE PbIg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water HeaterNent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reins ection Fee BUILDING
BREMACOVER AJC Unit > 10,000 cfrn MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Buswa rs ELECTRICAL
BREMFD{T Li tin Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
2 of 3
�C. CITY OF CUPERTINO
CUP TYOF O PERMIT APPLICATION FORM
QuantityFee ID Fee Description Fee Grou
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch& Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BRENMSAPP Remodel Res Appliance ELECTRICAL
BREMSIGNAD Rmdl Sios Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issuance PLUMBING
PPLBG Plumbing Fee sq foot I PLUMBING
ZADDCHG Address Chane BUILDING
3 of 3