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07050089 CITY OF CUPERTINO OR BUILDING DIVISION PERMIT � 4� r �� ' BUILD N ADD ESS: PERMIT NO. ��052 FIRWOOD DR FOUR SEkSONS ROOFING 07050089 OWNER'S NAME: PERMIT ISSUE DATE CMS C/O DE ANZA OAKS HOA 502 HORVING ST 05/10/2007 )NE: SANITARY NO. CONTROL NO. (408) 278-0330 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH i O p LICENSED CONTRACTOR'S DECLARATION Job Description V C I hereby affirm that I am licensed under provisions of Chapter 9(commencing z m with Section 70(X0)of Division 3 of the Business and Professions Code.and my license is REROO F—REMOVE(E) SHAKE, INSTALL NEW 1/2" CDX in full force and z License Class � 9 Lie.x PLYW00, +� ARCHITECPSD CLARATION 30LB FELT 16 SQUARES. o Dale 4-3a-1v">! 7 a a < 1 understand my plans shall be used as public records )yU a in Licensed Professional Z 0 OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the in o following reason.(Section 7031.5,Business and Professions Cole:Any city or county .9 which requires a permit to convect,alter,improve,demolish,or repair any structure Z y prior in its issuance,also requires the applicant for such permit to rile a signed statement _< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 >q.Ft.Floor Area Valuation x t—t7 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $8000 y 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 Number Occupancy Type not more than five hundred dollars($500). 34233045 . ❑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 forsale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does 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.). ❑I,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 am exempt under Sea B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: LJ I have and will maintain a Certificate of Consent to self-insure for Workces Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑f 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 Wor s Compensation Insurance carrier and Policy number arc: Carrier. Policy No.AJ�-3►�yi�y Il D� 1 CERTI KATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for ane hundred dollars($100) or less.) 1 certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so az 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 Coda you must Qforthwith comply with such provisions or this permit shall be deemed revoked. Z, CONSTRUCTION LENDING AGENCY Fr►fin 1 hereby affirm that there is a convection lending agency for the performance of a> the work for which this permit is issued(Sec.3097,Civ.C.) QLender's Name 2 Lender's Address U C) 1 certify that I have read this application and state that the above information is LL`- correct.1 agree to comply with all city and county ordinances and state laws relating to 0 V building construction,and hereby authorize representatives of this city to enter upon the a above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against Hc4r) liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. Date ✓'/ O _� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCEGUL Re-roofs Signature of A canUContractor Date HAZARDOUS MATERIALS DISCLOSURE Type of R)of Will the applicant or future building occupant store or handle hazardous material az defined ly the Cuperti o Municipal Code,Chapter 9.12,and the Health and Safety Cede,Section 25532(7)? All roofs,hall be inspected prior to any roofing material being installed. ❑Yes No Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants az defined by the Bay Area Air Quality Management all new m iterials for inspection. District? [3 Yes �jlu 1 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 docs not currently have a tenant,that it is my responsibility to notify the occupant of the re arrc ch mus t nor to issuance of a Certificate of Occupancy. Signature if Applicant Date L:. ��1 O 'O"1 A11 roof coverings to be Class"B"or better Owner orauthorizea.gent Dale CITY OF CUPERTINO 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34233045. 00 DATE ISSUED. . . . . . . : 05/10/2007 RECEIPT #. . . . . . . . . : BS000001276 REFERENCE ID # . . . : 07050089 SITE ADDRESS . . . . . : 10052 FIRWOOD DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . : OWNER CMS C/O DE ANZA OAKS HOA ADDRESS CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2640 RECEIVED FROM . . . . : RECEIPT INTERFACE 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 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 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 297.52 AE FOUR SEASONS --------------- TOTAL RECEIPT 297. 52 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 305 FRAME 307 INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS Cr,mmtiniiy T)evelohment Department r A r ` Building Division City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 L U P E IST I N O Fax: (408)777-3333 Building ]Department Subject Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agrE,e 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 buildin€,inspector. A final inspection and approval shall be obtained from the bu Ming 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 mat trial down to the sheathing, so a proper City inspection can be performed. 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 reroofing. Homeowner's Name: Job Site Address: Roofing Company Name: �`� A plicants, Signature: ----- ��h Date: 1(7 - Greg teel Building Official Revisec 1/30/03 Printed on F recycled Paper CITY OF C'UPERTINO RE -OOF _ CUPCITY S TING PERMIT APPLICATION FORM APN# Date: .3�� 3� S �5_10-0-91- Building Address: Owner's Name: Phone #: Cm s5ya J� ,¢,�Z� o�k S ,ya•9 ('r`f 6_52- /Z 77 Contractor: License #: Contact: Cupertino Business License #: 3r-0 3 3 a / 3 3 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles & Asphalt Shingles a`-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 Cur ertino's Tear Off Policy: Job Description: 17-Lewwwve exi sl.v 5-,4 C.6C rao " W rj,&�l h e 4-, 30 e/f ��ld�/ �t a�®/`uw �'/�f �f�f Fi..f.,�.S� a., Residential [r Commercial ❑ la Fire Zone: Yes ❑ No Rte' Confirmed with Planning Dept. if _ there are any restrictions: t� Cost of Project: T , 0 e of Construction: Occupancy rou . Qty. if Applicable Fee ID Fee Description Fee Group J 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 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY Of Fax(408)777-3333 -UPEkTINO Building Department JOB ADDRESS: PERMIT#) o 0,5-LC=, �-W�� D� ��2057%6-9 OWNER'S NAME: (�� !�� Ls 1 PHONE #4 o GENERAL CONTRACTORS : c,s5 lj�,; FAX# 0;Z--- I am not using any subcontractors: Signature Date Please check applicable subcontractors and comF 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 er/Contractor Signature Date CITY OF CUPERTINO BUILDING DIVISION PERMIT PERMIT NO. Bu1LDITMEShRW00D DR FOUR SEASONS ROOFING 07050156 OWNER'S NAME: PERMIT ISSUE DATE CMS C/O DEANZA OAKS HOA 502 HORNING ST 05/16/2007 )NE: (408) 273-0330 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH !0 p LICENSED CONTRACTOR'S DECLARATION Job Description %WI hereby affirm that I am licensed under provisions of Chapter 9(commencing Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is REMOVE EXISTING SHAKE ROOF, INSTALL NEW 1/2" C DX >>y in fullforce an rr I () PLYWOOD INSTALL NEW 30# FELT UNDERLAYMENT AND j r�Z License las Lic.aY F p DatcLA F O"V Contractor w ARCHITECTS DECLA ATIO NEW W a 1 understand my plans shall he used as public records CLASS A GAF GRAND SEQUOIA SHINGLES. 15 S qs >aU P u.y Licensed Professional `-y OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county i .9 which requires a permit to concoct,alter,improve,demolish,or repair any structure Z a prior to its issuance,also requires the applicant for such permit to file a signed statement r .Ft.Floor Area Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 tLl 8 O 0 0 xF (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty ofp,p Number Occupancy Type not more than five hundred dollars(5500). 3 4 2 3 3 0 4.3 :tF l 0 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 far sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of q 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.). 0 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. ccnse 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. 0 I am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby atrtrm under penalty of perjury one of the following declarations: 0 I have and will maintain a Certificate of Consent to self-insure for worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 1 have and will maintain Worker's Compensation Insurance,as requircd by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Wor Compensa ion Insurance carrier and Policy number re: Carrier. Policy No.. , , CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Chis 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.I 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 ,J O forthwith comply with such provisions or this permit shall be deemed revoked. z" CONSTRUCTION LENDING AGENCY I hereby of inn that there is a construction lending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name Lender's Address V p 1 certify that I have read this application and state that the above information is (L 0--4 correcL I agree to comply with all city and county ordinances and state laws relating to CU building construction,and hereby authorise representatives of this city to enter upon the W above-mentioned property for inspection purposes. Q. (We)agree to save,indemnify and keep harmless the City of Cupertino against to liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date ► APPLICANT UNDER S D WILL COMPLY WITH ALL NON-POINT Issued by: r S TION . —� Re-roofs Signature ofApplicanyC&puactor Date Type of Roof HQkRDOUS 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;;hall be inspected prior to any roofing material being installed. O Yes 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 which - emit hazardous air contaminants defined by the Bay Arca Air Quality Management all new materials for inspection. District? 0 Yes Nu 1 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 it is my responsibility to notify the occupant of the rc u' ich m be t pro issuaruce ora Certificate of Occupancy. Signature Of Applicant Date 5�'I 1a-d4- All roof coverings to be Class"B"or better Owner or authorized a nt Date CITY OF CUPERTINO 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: kiersaw COPY # 1 Sec: Twp: Rng: Sub: Bll': Lot : APN . . . . . . . . : 34233043 . 00 DATE ISSUED. . . . . . . : 05/ 16/2007 RECEIPT #. . . . . . . . . : BSC00001355 REFERENCE ID # . . . : 07050156 SITE ADDRESS . . . . . : 10062 FIRWOOD DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CMS C/O DEANZA OAKS HOA ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2640 RECEIVED FROM . . . . : FOUR SEASONS ROOFIN CONTRACTOR . . . . . . . : DIRZ, ALFRED LIC # 21323 COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING ADDRESS . . . . . . . . . . : 502 HORNING ST CITY/STATE/ZIP . . . : SArf JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 278-0330 FEE ID UNIT QUANTITY RMOUNT 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 Community Development Department Building Division t City of Cupertino } 10300 Torre Avenue CITY OF' Telephone: (408)777-3228 C O P E IST I N O 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. NeNv roof coverings shall not be applied-6thout first oblairning allinspection and written approval from the buildin€;inspector. A final inspection and approval shall be obtained from the bu Ming 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. 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: Job Site Address: Roofing Company Name: "`' A plicant's Signature. _ � C�-l.2 Date: Greg teel Building Official Revised 1/30/03 Printed on 3ecycled Paper CITY OF C'UPERTINO 0105016-a FROOF • CUPS OF PERMIT APPLICATION FORM APN# Date: 4A - 33- 0,� 3 _ _ �uli�ldinAddress: OU Owner's Name: Phone#: Cites J� 547zg e��k S 1y019 /27 77 Contractor: License #: Contact: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles CAsphalt Shingles W'-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 Cupertino's Tear Off Policy: Job Description: AoW-f✓e eX/5-1�0/t 5/4 s�c /'moo i .fig.// H e-— //2 e,D X f�/5y e� i /AX 14-11 Ize 30 � a/f •-�6/ter/.a-y�'.rc�t �tam/su�✓ �'/�1 /� �f�f c .x.,�t� ae, Residential Commercial ❑ 1 5 Fire Zone: Yes ❑ No Confirmed with Planning Dept. if _ there are any restrictions: lJ Cost of Project: T e of Construction. Occupancy group. Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Pen-nit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF,ISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING CITY OF CUPERTINO BUILDING MVISION PERIVL BUILDING ADDRESS: PERMIT NO. 1478 FALLENLEAF LA TBD TO BE DETERMINED 07040223 PERMIT ISSUE DATE OWNER'S NAME: CHUA, ROY AND TAN, KNG KER 05/08/2007 SANITARY NO. CONTROL NO. ,VE: BUILDING PERMIT INFO ARCHITEC VENGINEER: BLDG ELECT PLUMB MECH i p p Job Description LICENSED CONTRACTOR'S DECLARATION UI hereby affirm that I am licensed under provisions of Chapter 9(commencing z� with Section 7000)of Division 3 of the Business and Professions Code,and my license is REMODEL HOUSE TO EXTEND LIVING ROOM, CHANGE OLD "o'm in full force and effect i z License Class Lic.S LIVING ]ZOOM INTO KITCHEN 3 La ARCHITECTS DECLARATION NON—STRUCTURAL Z a< 1 understand my plans shall be used as public records )qU U.F' Licensed Professional OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's Liccnse Law for the `COO following reason.(Section 7031.5,Business and Professions Code:Any city or county <29 which requires a permit to construct,alter,improve,demolish,or repair any structure y prior to its issuance.also requires the applicant for such permit to file a signed statement _Gthat he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q.Ft.Floor Area Valuation (commencing with Section 7000)of Division of the Business and Professions Code)or $40000 L that he is exempt therefrom and the basis for the alleged exemption.Any violation or Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of ARNumber Occupancy Type not more than five hundred dollars($500). 3 5 9 2 8 0 2,)-.-Uv 0 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.7041,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 arc 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.). m L 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- ccnse 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. 0 I am exempt-der c. B&P C f �tfhii reason Owner Data WORKER'S C PENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen. sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 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 Worker's Compensation Insurance carrier and Policy number are: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars(S 100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner as to sub' W Compensation Laws of California.Date Applicant NOTICE TO APPOCARM,after m Ing this Certificate of Exemption,you should become subject to the Worker's Com tion provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY (�CA I hereby affirm that there is a construction lending agency for the performance of ai> the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name 4 z Lender's Address U Q 1 certify that I have read this application and state that the above information is LL t.r correct.I agree to comply with all city and county ordinances and slate laws relating to 0U building construction,and hereby authorise representatives of this city to enter upon the U above-mentioned properly for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against HCo) liabitidcs,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date S, ^Ci 7 �+ APPLICANT UNDERSTANDS AND WILL GGONpPCY WITH ALL NON-POINT Issued by: SOURCE REGULATIONS. Cy/_ b V0,7/07 Re-roofs Signature of Applicant/Contractor Date 'Type Of Roof HAZARDOUS MA ALS 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,hall be inspected prior to any roofing material being installed. 0 Yes ON. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove - emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new m,iterials for inspection. District? 0 Yes No 1 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 at it is my responsibility to notify the occupant of the requirements pr to issuaruce or a Ccrtific te of cupancy. Signature Jf AppllCant Date !/ Cg"d7 e All roof coverings to be Class"B"or better Owner or authorized a rat Date CITY OF CUPERTINO BUILDING;DIVISION PERMIT BUILDING ADDRESS: PERMIT NO. 10060 FIRWOOD DR FOUR SEFSONS ROOFING 07050157 OWNER'S NAME: PERMIT ISSUE DATE CMS C/O DEANZA OAKS HOA 502 HORNING ST 05/16/2007 ONE: SANITARY NO. CONTROL NO. (408) 27E -0330 ABUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH i p p LICENSED CONTRACTOR'S DECLARATION Job Description Lu P I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing �z 8 with Section 70tw)of Division 3 of the Business and Professions Code,and my license is REMOVE EXISTING SHAKE ROOF, INSTALL NEW 1/2" C DX a in full force and ffe .Z)' License Clan e► Lic.x ?^�0 PLYWOOD, INSTALL NEW 30# FELT UNDERLAYMENT AND E-a Datc n-1• contractor - NEW ARCHITECTS DECLARATION V1 understand my plans shall he used as public records CLASS A GAF GRAND SEQUOIA SHINGLES. 15 SQS 0.e U.y Licensed Professional C a OWNER-BUILDER DECLARATION aI hereby affirm that I am exempt from the Contractor's License Law for the COO 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 o Zprior to its issuance,also requires the applicant for such permit to rile a signed statement a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 id.Ft.Floor Area Valuation xF (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $8000 y 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 �Q�N Number Occupancy Type not more than five hundred dollars($500). 34233044. . V V ❑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 oroffered forsale(Sec.7044.Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of 9 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.). ❑I,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. ❑I am exempt under See. B&P C for this reason OwnerDate WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insure for workees 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 Workees Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Wor�s Compensation Insurance carrier and Policy number are: Carrier.J _Policy No.1l J 7 IISO Ll I I C)j 17, CERT FICATE 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,I shall not employ any person in any manner so as to become subject to the Workcrs'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 Qforthwith comply with such provisions or this permit shall be deemed revoked. Z"" CONSTRUCTION LENDING AGENCY Htom. I hereby affirm that there is a construction lending agency for the performance of a, the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lenders Name ]Z Lender's Address V 0 1 certify that I have read this application and state that the above information is VJ t—' correct.l agree to comply with all city and county ordinances and state laws relating to 0V building construction,and hereby authorise representatives of this city to enter upon the W above-mentioned property for inspection purposes. O (We)agree to save,indemnify and keep harmless the City of Cupertino against nF'„t liabilities,judgments,costs and expenses which may in any way accrue against said City f V Z in consequence of the granting of this permit Date Z� t t APPLICANT UNDERS NDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SO R GULATI Re-roofs Signature of Appl' t/Contracto' Daw T of R sof AZARDOUS MATERIALS DISCLOSURE Type Will the app hcant or future building occupant store or handle hazardous material as damned by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(x)? All roofs:;hall be inspected prior to any roofing material being installed. ❑Yes at< Will the applicant or future building occupant use equipment or devices which If a roof i:;installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new m iterials for inspection. District? ❑Yes u 1 have read the hazardous materials requirements under Chaptcr 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building docs not currently have a tenant,that it is my responsibility to notify the occupant of the rcyuircm whicnmust t • miasuaneeorac«tirtcatcorotttp �= � Signature Df Applicant Date All roof coverings to be Class"13 or better Owner oraWhorizcagent Date CITY OF CUPERTINO 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: kiersaw COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot : APN . . . . . . . . : 34233044 . 00 DATE ISSUED. . . . . . . : 05/16/2007 RECEIPT # . . . . . . . . . BSC00001355 REFERENCE ID # • • . : 07C50157 SITE ADDRESS . . . . . : 1OC60 FIRWOOD DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CME C/O DEANZA OAKS HOA ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : MOI= SERENO CA, 95030 RECEIVED FROM . . . . : FOUR SEASONS ROOFIN CONTRACTOR . . . . . . . : DIF.Z, ALFRED LIC # 21323 COMPANY FOLR SEASONS ROOFING ADDRESS 502 HORNING ST CITY/STATE/ZIP . . . : SAID JOSE, CA 95112 TELEPHONE (4C8) 278-0330 FEE ID UNIT QUANTITY FMOUNT 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 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 297 .52 6859 --------------- TOTAL RECEIPT 297 . 52 CITY OF CUPERTINO 0nSC) 1 RE'f OOF CUPEkTINO PERMIT APPLICATION FORM APN# Date: 34a- 33-o44 - - Buildin Ad�dcress: �� 1 ,r^ 0 0 Df o Owner's Name: Phone#: rm S / �� z� ��k S ya�9 �4ia� s5'9- 1Z 77 Contractor: /� License #: s �2 ��' e7 /6 Contact: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Cr--Asphalt Shingles W"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 CL pertino's Tear Off Policy: Job Description: 1:&,oeove exp sf1V sh."F-C �irjf-vl/ mak. 30 d� �/f �'y6//•�-y"�as�� a�m/ftt�✓ �'/�r•*r /� ��AF c,�,7•:.,r/ S� a., <Sl:�re /es, Residential Commercial ❑ IS Fire Zone: Yes ❑ No [J' Confirmed with Planning Det. if _ there are any restrictions: LJ Cost of Project: T e of Construction: Occupancy group: 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 ' Community Development Department d Building Division ' ' = City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 CITY OF Fax: (408) 777-3333 CUPEI�TINO 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 budding 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 apprcval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed, a plywood nail nspection is required. 6. Any roofing which is applied without f rst obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be perfc,rmed. 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: —Z ,e ��a� Job Site Address: Roofing Company Name: A plicant's Signature: 7� 2 Date: Greg teel Building Official Revised 1/30/03 Printed on Recycled Paper .K* Community Development 10300 Torre Avenue r' w; Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 -UPEkTINO Building Department JOB ADDRESS: PERMIT # LO v 0?0- �S OWNER'S NAME: PHONE # y GENERAL CONTRACTOR: - , S FAX # l I am not using any subcontractors: O gnature Date Please check applicable subcontractors and c fete the following information: SUBCONTRAC'T'OR 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 bwn er/Contractor Signature Date