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07060012 CITY OF CUPERTINO BUILDING DIVISION PERMIT *4TI ' PERMIT NO. BUILD t)TIESIONG DOWN RD FOUR SEASONS ROOFING 07060012 OWNER'S NAME: PERMIT ISSUE DATE DEANZA OAKS HOA P 0 BOX 1210 06/04/2007 INE: (408) 273-0330 SANITARY NO. CONTROL NO. ABUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 a a 00 LICENSED CONTRACTOR'S DECLARATION Job Description U.1 I hereby affirm that I am licensed under provisions of Chapter 9(commencing JUEzU, with Section 7000)of Division3oftheBusi and Professions Code,andm licenscis REMOVE EXISTING SHAKE AND INSTALL ASPHALT !<y in full force a efi t v�z Lice. las Lic.# o SHINGLES Date Contractor LU a AR HITECPS DECLA ATION ,2-4 a< 1 understand my plans shall be used as public records )yU LL.in Licensed Professional y OWNER-BUILDER DECLARATION > 1 hereby album that 1 am exempt from the Contractor's License Law for the j p O following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct.alter,improve,demolish,or repair any structure Z y prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation _< that he is licensed pursuant to the provisions of the Contmctur's License Law(Chapter 9 3q.Ft.Floor Area $8000 a i-$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 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 ofe� Number Occupancy Type not more than five hundred dollars($500). 3424000):t� ❑1,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 docs not apply to an owner of q p 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 Contractors Li- cerise 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 am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: L]1 have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code.for the performance of the work for which this permit is issued. ❑I have and will maintain Workers Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Wo 's CoIQf�(l[nsati Insurance carrier and Policynumberare: i, ` Carrier. ^V z PolicyNo.:W e_��O e I U 1 U 1 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (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,t 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 O forthwith comply with such provisions or this permit shall be deemed revoked_ z" CONSTRUCTION LENDING AGENCY E~- I hereby affirm that there is a construction lending agency for the performance of p4> the work for which this permit is issued(Sec.3097,Civ.C.) 14 Q Lenders Name z Lenders Address U C) I certify that I have read this application and state that the above information is f3. correct.1 agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorise representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. (We)agree io save,indemnify and keep harmless the City of Cupertino against NrA liabilities,judgments,costs and ez hich may in any way accrue against said City in corse ue c granting of is pc z NT ERSTANDS ND WIL LY WITH ALL NOW-PO Issued by: Date S RCE ULATIONS. �/ r - Re-roofs Signature of Applicant/Con for ATERIALS DISCLOSURE Dare Type of Roof HAZAR OUS M Will the applicant lure building occupant store or handle hazardous material as defined by the Cupertino Muni'pal Code.Chapter 9.12,and the Health and Safety Code.Section 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed. ❑Yes u If a roof i;installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices wh' emit hazardous air contaminants as defined by the Bay Area Air Quality Managcmtgt, all new materials for' sp o . District? / � Cl Yes Qat I have read the hazardotaq materials requirements under Chapter 6.95 of the Califor- � nia Health�n.bw� afety Code,Secti 5,255 25534.1 understand that if the building a ten t,that my nsihility to notify the occupant of the rcqu mst be t priortu n ce n cer,irea[q�rocs �(�► Signature of Appli ant Date l� �l �1'G All roof coverings to be Class"B"or better owner or authorized ag t Date CITY OF CUPERTINO 2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 34240009. 00 DATE ISSUED. . . . . . . : 06/04/2007 RECEIPT #. . . . . . . . . BS000001528 REFERENCE ID # . . . : 07050012 SITE ADDRESS . . . . . : 22931 LONG DOWN RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER DEAVZA OAKS HOA ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2682 RECEIVED FROM . . . . : FOUR SEASONS ROOF CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323 COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING ADDRESS P O BOX 1210 CITY/STATE/ZIP . . . : ALAAO, CA 95407 TELEPHONE . . . . . . . . : (40B) 278-0330 FEE ID UNIT QUANTITY A40UNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 8, 000 .00 147. 96 0 . 00 147 . 96 0. 00 BSEISMICRE VALUATION 8, 000 . 00 0 . 80 0 .00 0 . 80 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 148 .76 0 .00 148 . 76 0. 00 a-ay Community Development Department Building Division ! + City of Cupertino } t_ 10300 Torre Avenue ' Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 CUPEkTINO 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 i•e-roofing. 2. New roof coverings shall not be appl ed without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the t uilding 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 aPF royal. 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 pe-formed. IMPORTANT: 1. Flat roofs must have a minimum of 1/E " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be o:z the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: Job Site Address: �a�1 ( LC7, CyVj1 1 Roofing Company Name: "'� lo� SG �� A plicant's Signature: �l2 Date:��- Greg teel Building Official Rev sed 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION FORM I APN# Date: B�lding Address: \ Com' Owner's Name: Phone#: C'/YJ S �c .�i•�ZG �.�.tc s ,yo.9 (�/a� SS�- /,�7 7 Contractor: License#: Contact: Cupertino Business License #: a / 3 a 3 Type of:3oof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles LS'Asphalt Shingles 2"Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Capertino's Tear Off Policy: Job Description: 1:j�owww&,e eX / , i X111 1 s,4., ,e V2 X 09 x //y~00 l sti•v///�c.� 3� t/f �n`�//Tl"res7t �.rr®/iu�✓ �'/!�f /' C%r9F e i4w,-1 5,4;,. Residential Commercial ❑ Fire Zone: Yes ❑ No R- Confirmed with Planning Dept. if _ there are any restrictions: LJ Cost of Project: T e of Constriction: Occupancy group,: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bld Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING