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06050039 CITY OF CUPERTINO BL'iLDING DS.VISION PERMIT � ' ' T 1� ? M4 ;TI�N: BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT"°'06050039 10089 RIDGEWAY DR PERMIT ISSUE DATE OWNER'S NAME: DEANZA OAKS HOA 502 HORNING ST QS'104/2006 SANITARY NO. CONTROL NO. 3NE: (408) 278-0330 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 Jp Z LICENSED CONTRACTOR'S DECLARATION Job Description %U C 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing Z u, with Section 7000)of Division 3 of the Business and Professions Code,and my license is y in full force and effect. TEAR OFF SHAKES, INSTALL 1/2" CDX AND GAF GRAND Z License Class Lle. J`S QUO IA. 50 YEAR CLASS A t DalK,—_n ,e! / Contracto ARCHITECTS DEC RAT N Z < 1 understand my plans shall be used as public records �qU a n Licensed Professional y OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the in O following reason.(Section 7031.5,Business and Professions Code:Any city or county <m Pi which requires a permit to concoct,alter,improve,demolish,or repair any structure: r prior to its issuance,also requires the applicant for such permit to file a signed statement Valuatil6 5 0 0 s< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 990 Sq.Ft.Floor Area u t— (commencing with Section 7000)of Division 3 of the Business and Professions Code)or L that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(5500). 34241021 . 00 ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. 1 ❑I am exempt under Sec .B&P C for this reason Owner Date WORKER'S COMPENSATION DEC RAT1 I hereby affirm under penalty of perjury one of llowing declarations: ❑1 have and will maintain a Certificate of Consent to sel-insure[d&Wor*es pen-i sation,as provided for by Section 3700 of the Labor Code,for t(ie rman odd t ! work for which this permit is issued. t ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My War is Compenitation Insu carrier and Polity num arc: Grrier. �f� ! T No. CERTIFICATE OF EXEM FROM ORKERS' COMPENSATION INSURANCE z (This section need not be completed if the permit is for one hundred dollars($100) or less) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z► CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is it construction lending agency for the performance of (Yr the work for which this permit is issued(Sec.3097,Civ.C.) WW Q Lender's Name 0, z Lender's Address U 0 1 certify that I have read this application and state that the above information is V.r- correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building concoction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. CL (We)agree to save,indemnify and keep harmless the City of Cupertino against ,may co) liabilities,judgments,toss and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date APPLICANT UNDERSTA D WILL COMPLY WITH ALL NON-POINT Issued by: S77.EGULATIONS _0 lJ Re-roofs Cel Signature of Applicant/CoNtraEtor Dale Type of Roof XA7ARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes No If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? - ❑Yes �AIt► I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code.Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant.that it is my responsibility to notify the occupant of the requirements ich Must yto ofac 'rroe ct�ytcr. Signature of Applicant Date l pO ��((IJ All roof coverings to be Class"B or better Owner or authori724 ggrA Date' w- ti Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 #UPEkTIN0 Building Department JOB ADDRESS: }} PERMIT # OWNER'S N PHONE # GENERAL CONTRACTOR., FAX # I am not using any subcontractors: ignature Date Please check applicable subcontractors an com lete 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 0 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: �6 A'Y17?—' r~ O 4� �_' (2)'-k - Job Site Address: /e26) S-Cj /41 Y1d Roofing Company Name: Applicant's Signature: Date: & Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO em 6 of 7 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 34241021 . 00 DATE ISSUED. . . . . . . : 05/04/2006 RECEIPT # . . . . . . . . . : 34240 REFERENCE ID # . . . : 06050039 SITE ADDRESS . . . . . : 10089 RIDGEWAY DR 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 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 CITY OF CUPERTINO oQC6cDSq i � REROOF CUPER�TINO PERMIT APPLICATION FORM APN# Date: Z_ 6-ZZ O(o Building Address: 100S9 AFII�Pr, Owner's Name: Phone#: Contractor: � { Lice��� � v Q'LSotiS o0 Contact: Cupertino Business License #: 1� Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles M'Asphalt Shingles JW- Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) __ ❑ Other(Specify) Number of existing coverings / ❑ Provide I.C.B.O.Report# Ja To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: "q n k F :S"JAGS -I z" CDY 1 0.,%aJL 6, A- �'�"`� $uct r Residential ,5;. _ Commercial ❑ Fire Zone: Yes ❑ No-4�] Confirmed with Planning Dept. if there are an restrictions: lJ Cost of Project: oo Type of Conssttr_uction: Occupancy group: Re 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