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07050270 CITY OF CUPERTINO n�n,i f-� BUILDING DIVISION PERMIT �% � � Tl� • PERMIT NO. BU1LD11t 166"ES�IRW00D DR FOUR SET.SONS ROOFING 07050270 l U tS 11 PERMIT ISSUE DATE OWNER'S NAME: CMS C/O DE ANZA OAKS HOA P 0 BOX 1210 05/29/2007 SANITARY NO. CONTROL NO. NE: (408) 27E -0330 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH p p LICENSED CONTRACTOR'S DECLARATION Job Description vI hereby affirm that I am licensed under provisions of Chapter 9(commencing Z with Section 71100)of Division 3 of the Business and Professions Code,and y license is REROOF—F-EMOVE SHAKES, INSTALL 1/2"C DX a• in full force and c1_1 > z Licen Class Lic.B PLYWOOD, INSTALL 30LB FELT 15 SQ, CLASS A GAF •Ftp Datc — — Contractor ARCHITECTS DECLAR TIO GRAND 7 cd< I understand my plans shall be used as public records )WU SEQUOIA SHINGLES. a 1- Licensed Professional y J OWNER-BUILDER DECLARATION > 1 hereby affirm that I am exempt from the Contractor's License Law for the .00 following reason.(Section 703 1.5,Business and Professions Code:Any city or county m which requires a permit to construct,alter,improve,demolish,or repair any structure } prior to its issuance,also requires the applicant for such permit to file a signed statement Ft. Floor Area Valuation • < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Eq. $8000 tis a (commencing with Section 7000)of Division 3 of the Business and Professions Code)or L 5 9 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 3 4 2 3 3 0 4(i �Number Occupancy Type not more than five hundred dollars($500). ❑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 ask.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.). C3 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 Contractofs License Law. 1 am exempt under See. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION 1 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 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 Work Compe sation I surance carticr and Policy number am- O'O Carrier. Policy No. CERTIFICATE F 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 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 affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(See.3097,Civ.C.) W Q Lender's Name z Lender's Address U 0 1 certify that I have read this application and state that the above information is iL correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize 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 V) liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of thi rm• Date ►+ APPLICANT UNDERSTAND COMPLY WITH ALL NON-POINT Issued by: ATIONS. K_C__2:� Re-roofs Sign um of Applicant/Con toil Dare Type of Roof H OUS MATERIALS DISCLOSURE yP Will the applicant tune 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 E hall be inspected prior to any roofing material being installed. E]Yes o Will the applicant or future building occupant use equipment or devices which If a roof iE installed without first obtaining an inspection,I agree to remove - emit hazardous air contaminams as fined by the Bay Area Air Quality Management all new materials for inspection. District? Yes o 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, 't is responsibility m notify the occupant of the rc m must be met rior i u cc of a Certificate a ancy_ Signature AApplicant Date All roof coverings to be Class"B"or better Owner or authorized age t Dae CITY OF CUPERTINO 2 ITEMS OF 8 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34233040. 00 DATE ISSUED. . . . . . . : 05/29/2007 RECEIPT # . . . . . . . . . : BS000001485 REFERENCE ID # . . . : 07050270 SITE ADDRESS . . . . . : 10080 FIRWOOD DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CMS C/O DE ANZA OAKS HOA ADDRESS 10080 FIRWOOD DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : FOUR SEASONS ROOF CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323 COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING ADDRESS P O BOX 1210 CITY/STATE/ZIP . . . : ALAMO, CA 95407 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 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 Community Development Department Building Division ' City of Cupertino iN�AhrM 10300 Torre Avenue 1 --.' 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 ie-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 na:l inspection is required. 6. Any roofing which is applied withou+ first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be pei formed. 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 abox e stated policy on re-roofing. Homeowner's Name: Job Site Address: A 00'5C Roofing Company Name: A plicant s Signature: ' 7 � "h _-Date:t� D'7 Greg teel Building Official Revised 1/30/03 Printed c n Recycled Paper M CITY OF 1CUPERTINO ) 7dRE .00F 7�52 11Y OF CUFVEkTINO PERMIT APPLICATION FORM APN# Date: -3 B �- uilding Address: G _O0 d e sA Owner's Name: Phone #: Contractor: License #: �� s�so�s G� � y�12 /o Y� Contact: Cupertino Business License #: ::5,5 3 c> / -3 a 3 Type of hoof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ar'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: S-4�'f't �� Nft+�� .�c ��� f��x .�'/y«-,0 , Ar3o d a/f ��76//wvy+iKht cCiJ®//tea✓ �'/�f C%f!/�" t!I,.t,7G/ x �.s, �t �Sl.�vr /�f, Residential Commercial ❑ ► 'S Fire Zone: Yes ❑ No []- Confinned with Planning; Dept. if there are any restrictions: LJ Cost of Project: ye e of Construction: Occupancy group: �CX /aa, Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Pen-nit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING w Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 "UPEkTINO Building Department JOB ADDRESS: PERMIT #� acs � j►�u� d. �v.�.� OWNER'S NAME: PHONE # GENERAL CONTRACTOR: - FAX # I am not using any subcontractors: c Sifnature Date Please check applicable subcontractors an cm 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 OVT�er/ Signature Date