06050110 (2) CITY OF CUPERTINO '*'� ��
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s3`+t' ;sty T 4 SY.:L g'r
PERMIT CO12
NTAlbiQRiIIItMATTQ1� r
.BUILDING DIVISION .�a n ,.
,e ' 1,ar,v G
BUILDING ADDRESS: FOUR SEASONS ROOFING PER.11 No.06050110
22804 LONGDOWN RD
OWNER'S NAME: PERMIT ISSUE DATE
DEANZA OAKS HOA 502 HORNING ST 05/12/2006
E: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHnECrfENGiNEER: BUILDING PERMRINVO
ELDG p . ELECTO PLUMB MECH
O 0
;op LICENSED CONfRACrOWSDECLARATION IObDescription
! 1 boroby affirm that 1 sus licensed under provisions of Chapter 9(commenclnB
with Section 70M)of Dividan 7 of the Business and Professions Code,and my license is
mf lrow.ad.f(eor 7 1 TEAR OFF SHAKES INSTALL 1/2" CDX AND GAF GRAND
E n,�" iZ.^9ta 6',;1"„cuss rEQUOIA SHINGLES 50 YEAR CLASS A
ARCHRECPS DECLARATION
1 understand my plans.hall he used u public records
yyU
rot; Licensed Professional
I OWNER-BUILDER DECLARATION
i S 1 hereby shims into I am exempt from the Commetofa Lraa law ror the
o C following mason,(Earthen 703 I.].Business end Profession Cade:My city at county
la ff which mquiru a permit m ems muse,alter.improve.drmnlisb.ar repair any swsnure
_Z� prior m its issuanco.auto mquim the applicant far such permit m Ilk a signed saremcot
< that aseulicensed punuatte the Pavialansathe cmarsence,U..Law(Chspter9 Sq.Ft. Floor Area Valuati LD50
e€ro (cammendns with Saetion7000)af Division l of the Business end Professions Cade)or
y $ Nat an k eampr therefrom"the basis for the alleged cxerepthna My violation of ppN N e
Section 7071.7 by my applicant for a penNt subjects the appliesnt m a civil Penalty of
trot 3 423 3 8T�0 0 0 Occupancy Type
mon than five hundred dollars ISM
01,uowner aftiepmpeny,army employees with wagers,thebxekcompe don.
willdothewark.adthe=m isnotkta@doroQertdforaak(Sa.7004,Buuea Required Inspections
and Profession Cade:Thar Conuacmh License law dean Out apply mut owau of q p
pmpeny who buildaarimprovertheaon,and whodasruchwarkhimself or through hu
awn emplayeu,provided thalium imprevemenu am m tinended oranemd fnsak.if.
however,this building or improvement is said within one year of compledon,the awnr-
Wilder will have the hurt.of proving that he did not Wild or Improve for purpose of �� n
cera). N NLED
❑1.a awns of the property.am aselaively.onbaeung with licensed conaacmm to {NYdy�
cowrom the puska(Sec.to in owner
of roue rrofeumn CodeI The Catracmf.red
.cuss law dais not apply m an wither of property who builds or Improves Nonan,end
who contracts for such projects aide canuamor(a)Iicened Punuatmthe ConsumersJUN '
Lkand Law. 9X1006
[I I am exempt under Sea ,B d P C far silo mason
Owrty Dau DOWN .
WOR :rpar OM PENSary am DE use fRAw0N � N� tl Alk .y �S
1 herby sffum under Penalty of perjury arc of use following dedarWaitc l�"f yjt f(JJJ lFf Ilf s\,\�'/Jf 4((1�/T�✓C—'v!
I hue and will maintain aCeniBeru of Consent in sell-inew far WorkNsCampa-
ada,u provided for by Section 7700 of the Labor Code,fm the Performance of the
work fa which mt.permit k issued.
❑1 has ad will maintain Waterer Compensation We rnxe,u required by Senior
7700 of the labor Code•res,the performance of the work for which this permit is toned ..
My Workers Campemuian hsas a�arriser_ad Policy
�number
�am:
Cartier. �yION No.:•_ KERS' al
CERT KATE 0 COMPENSATION
N FROM WORKERS'
COMPENSATION INSURANCE r
(This seetian need asst be completed Ethic permit Is farce.hundred dollar($100)
or less)
I certify that in the pu(ormace of into work for which this p.I,is issued,)Nall not
employ any person In any mater to u Or become abject to the Work.ri CompeaNan
Laws of California.Dau
Applicant
NOTICE TO APPLICANT.If,&fur making this Ce tiOcau of Exemption.you should
accused aobjen in the Wuseres Compensation provisions of the labor Coda you muse
O r"Mwide comply with such provision or this Permit shall be deemed revoked.
z srN.� CONSTRUCTION LENDING AGENCY
[-' I hereby affirm and thtrt k•ces.an"knoll,atncy for the performance of
(X the wart for which this permit k inured(Sec.7097,Civ.C)
QLenders None
2 laMels Add.-.
U O I cmfify Nat I have read this application aM sista dist the above information is
IL f”' coma I agree in comply with all city no county ordinances and ruse Ian relating to
0U building construction,and hm.byamhome represaumes mfthis City m enter Ulan this
0. above-mentioned propeny for inspection purposes
(We)agme in ave,indemnify and keep harmless the City of Cupertino again
rn liabilities,judgmans,cru and expend which may in ay way accroeaNno said City
U Z in consequence of the granthng of this permit.
^^ APPLICANT UNDJUUANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
U 0
10 Re-roofs
Sf V
netureo ��—
pli omncmr Data
RDOUS MATERIALS DISCLOSURE Type of Roof
WIII cant or furore Wilding occupalsmre or handle hairdos,manurial
AS de0ned by the CvpcqLo Municipal Cade.Chapter 9.10.and the Health and Safety
Cada.Section W32(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yu Na
vnn the )rat or fume builtling occupant use equipmat or ilevims which
If'a roof is installed without first obtaining an inspection,I agree to remove
.mit IuaNnu tl taminats u defined by the Bay Arta Air Quality Management all new materials for inspection.
DisLdct7
❑Yu u
I have mad the haamwsmucnau requirements aderChaprerd.97 of the Califor.
nu Real"S.1myCede.Scd.25707.25377 and WX l unsaturated dentifrice building
dais tont cu..dy haw.tsars that It at my responsibility Or notify the ore mat of de
tai 1%muvIwar anaaraCerdBnrcofOccupan .� Signature of Applicant Date
Owner or aumharia a c Dam All roof coverings to be Class"B"or better
CITY OF CUPERTINO
em 6 of 7 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34233010 . 00
DATE ISSUED. . . . . . . : 05/12/2006
RECEIPT # . . . . . . . . . : 34375
REFERENCE ID # . . . : 06050110
SITE ADDRESS . . . . . : 22804 LONGDOWN RD
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : DEANZA OAKS HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
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
EE 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
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
6UPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
Q1A
OWNER'S NAME. ONE #
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
t>(0
Signature Date
Please check applicable subcontractors and 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
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: (n� I 'oIY\71n
Job Site Address: ` 'S0 L1 Lon db 1 A) Y-\
Roofing Company Name:
Applicant's Siz tur� Date!f�rl Z'C)
• Greg Casteel
Building Official
Revised 11/2/04
I
DQ050 i 0
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
1 'ng dress:
0 inn
Owner's Name: Phone#:
c s 4N -�27d-0330
Contractor: FCur 2,e0,2 7n R�J-1 License#: ' 11 12(8
Contact:Th
h a rn S P I-ed r�i �•LJJ :Cupertino Business License #:
I / I 21323
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles -
0 Wood Shakes
❑ Wood Shingles .❑ Wood Shingles
O Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.0. Report#
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read, Unde stand and Will CoE12!y With Cu ertino's Tear Off Polic
Job Description: 0 p x o76 di A r ta.-n,-,.4
Residenti ❑ Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning D�t. if
there are an restrictions:
Cost of Project: T e of Construction: Occupancy roup.
C7D
Qty. if
qFee ID Fee Descri tion Fee Group
PERMFEE Bid Permit Fees BUILDING
ENERGY Ener BUILDING
SEISMICRE Seismic Fee Res BUILDING
SEISMICOM Seismic Commercial BUILDING
PLANCHK Plan Check Fee BUILDING
USLIC Business License BUILDING
•