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07050267 777777777777...,, CITY OF CUPERTINO " BUILDING DIVISION PERMIT � ` ` � PERMIT NO. BUILDING DDRESS: 2253 LONG DOWN RD FOUR SEF.SONS ROOFING 07050267 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 ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p O LICENSED CONTRACTOR'S DECLARATION Job Description 1 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 REROOF—I:EMOVE SHAKE, INSTALL 1/2" C DX y in full force and iffca 01 t Z License Class Lam•d ~ 1 006 PLYWOOD, 3 0 LB UJ ConDate - CHrrECPS EC RATIO FELT UNI)ERLAYMENT-15 SQ, CLASS A GAF GRAND ,a< 1 understand my plans shall be used as public records SEQUOIA 7yU 'u.F Licensed Professional <� OWNER-BUILDER DECLARATION SHINGLE. 1 hereby affirm that 1 am exempt from the Contractors License Law for the ,p Co 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 prior to its issuance,also requires the applicant for such permit to file a signed statement ';q.Ft.Floor Area Valuation < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 >q t F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $8000 11 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 ,�j Number Occupancy Type not more than five hundred dollars(5500). 3 4 2 4 0 01 r� ❑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 Contractors 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.IL however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that be 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 Contractors 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: ❑I 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,is required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Works Co nsa'an Insurance carrier and Policy no cr Carrier.ry`r Policy No. l < +I 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.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 Oforthwith comply with such provisions or this permit shall be deemed revoked. Z " CONSTRUCTION LENDING AGENCY F~t CA 1 hereby affirm that there is a construction lending agency for the performance of Q!> the work for which this permit is issued(Sec.3097,Civ.C.) OWn A Lender's Name Z Lender's Address U C) I certify that t have read this application and state that the above information is Lt.u correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction.and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. Ll. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting opermit. Date O APPLICANT UNDERSTAN S WI L COMPLY WITH ALL NON-POINT Issued by: ATIONS. Re-roofs Signature of Applicant/ mract r Dare T of R sof RDOUS MATERIALS DISCLOSURE Type Will the appli future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Cotte,Section 25532(a)? All roofs:shall be inspected prior to any roofing material being installed. C3Yes If a roof i.s installed without first obtaining an inspection,I agree to remove Wi11 the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes ❑ 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,that it is my responsibility to notify the occupant of the quircme ch must a or issuance of a Ccnificatc.Af Oc Signature of Applicant Date All roof coverings to be Class"B"or better Owncr or authorized cm Datc CITY OF CUPERTINO 2 ITEMS OF 8 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN 34210014 . 00 DATE ISSUED. . . . . . . : 05/29/2007 RECEIPT #. . . . . . . . . BS0)0001485 REFERENCE ID # . . . 07050267 SITE ADDRESS . . . . . : 2293 LONG DOWN RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CMS C/O DE ANZA OAKS HOA ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2657 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 tid..d c Community Development Department x , Building Division City of Cupertino 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 re-roofing. 2. New roof coverings shall not be appl:ed without first obtaining all inspection and written approval from the buildilg inspector. A final inspection and approval shall be obtained from the l: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 withou t 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/, " 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: G� ii o Job Site Address: 1 � .Lri�1 4�r Roofing Company Name: "`` Applicant's Signature: �'l2 -Dater Greg Qdteel Building Official Revised 1/30/03 Printed in Recycled Paper w CITY OF CUPERTINO REROOii CUpER,TINO PERMIT APPLICATION FORM APN# Date: JW Building Address: r� Owner's ame: Phone #: Contractor: License#: Contact: Cupertino Business License #: &oD Type of Itoof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Cg,'—Asphalt Shingles L"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 Citpertino's Tear Off Policy: Job Description: �6i./sve �X�S�iier t S1is�c ruci r+sig// h'e c✓ �iJ X /�/y•••ee c%•e.,�.Se as, Residential Commercial ❑ ►s Fire Zone: Yes ❑ No [}_ Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project: T e of Constntction: 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 BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING Community Development 10300 Torre Avenue afy Cupertino CA 95014 Telephone(408)777-3228 CITY Of Fax(408)777-3333 7UPEkTINO Building Department JOB ADDRESS: o PERMIT #� OWNER'S NAME: PHONE # GENERAL CONTRACTOR--)j::7-, _ FAX # I am not using any subcontractors:�dvtc�,— �� –� 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