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06050105 CITY OF CT,IPERTINO BINLDING DIVISION PERMIT +C� RAGTOR I� BUILDING ADDRESS: FOUR S EASONS ROOFING PERMIT NO.0 6050105 10109 RIDGEWAY DR OWNER'S NAME: PERMIT ISSUE DATE DEANZA HOA 502 HORNING ST 05 12/2006 jNE: SANITARY NO. CONTROL NO. (408) 278-0330 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH i O p LICENSED CONTRACTOR'S DECLARATION m I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description -Z 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 1/211 CDX AND GAF GRAND Licenciclas5 uc.s QUOIA SHINGLES 50 YEAR CLASS A p Date\7 1 n Conit r ARCHITECI"S DECLARATION a< I understand my plans shall be used as public records )yU O in Licensed Professional �0� OWNER-BUILDER DECLARATION q< 1 hereby affirm that 1 am exempt from the Contractors License Law for the COO following mason.(Section 7031.5.Business and Professions Code:Any city or county <m V which requires a permit to construct,alter,improve,demolish,or repair any structure it�} prior to its issuance,also requires the applicant for such permit to file a signed statement _ Valuat e that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area F-$ (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 Nwyl er 0 0 Occupancy Type not more than five hundred dollars(5500). 3 Zz LL��1 3 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.704l,Basittess Required Inspections and Professions Code:The Contractors 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.). 0 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 U. 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 ConraclRes License Law. 0 I am exempt under Sec. B&P C for this reason Owner Date c WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following dedarati 0 1 have and will maintain a Certificate of Consent to self-insure for Workces compent, / 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 Workers Compensation Insurance,as required by Section (J { 3700 of the Labor Code,for the performance of the work for which this permit is issued My W kers Compensation Ins cc carrier and Policy number arc: 1 i i Carrie olicy No������ -- CERTIFICATE EMPTTON FROM WORKERS' COMPENSATION INSURANCE i (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 Workers Compensation provisions of the Labor Code,you must .J Q forthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of fY.h the work for which this permit is issued(Sec.3097,Civ.C.) WCI.A Lenders Name z Landers Address V 0 I certify that I have read this application and state that the above information is [I. 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 W above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against ,Fy to liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the grantin of this permit. )L_ APPLICANT UNDER ND W L COMPLY WITH ALL NON-POINT Issued by: Date - 2 SOUR ULATTO . Re-roofs Signature of Applicant ntractor Datc H DOUS MATERIALS DISCLOSURE Type of Roof Will the plican r future building occupant store or handle hazardous material as defined by Uta rhino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(x). All roofs shall be inspected prior to any roofing material being installed. C]Yes No Will If a roof is installed without first obtaining an inspection,I agree to remove ll 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? 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 docs not currently have a ten Utat • my responsibility to notify the occupant of the re icn mmst lte t priof to' an a ccrificatc of Occu�� Signature of Applicant Date Owner or authoriz d agent Date All roof coverings to be Class"B"or better CITY OF CUPERTINO sm 1 of 7 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34241023 . 00 DATE ISSUED. . . . . . . : 05/12/2006 RECEIPT # . . . . • • • . . : 34375 REFERENCE ID # . . . : 06050105 SITE ADDRESS . . . . . : 10109 RIDGEWAY DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER DEANZA 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 Community Development y 10300 Torre Avenue Cupertino CA 95014 ,n. Telephone(408)777-3228 CITY OF Fax(408)777-3333 7UPERTINO Building Department JOB ADDRESS: PERMIT # I01e 0-\1) �'�U fWo OWNER'S N PHONE # GENERAL CONTRACTOR: P S FAX # I am not using any subcontractors: �1 \ 'gnature 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 caner/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: d )e- t—\r-1ZG-,- 0 Es, Job Site Address: `0I )11 C �,wG`�l �U�2 r"C1'(\D Roofing Company Name: Applicant's Signature: Date<,� ] �o(0 Greg Casteel Building Official Revised 11/2/04 0(p[6 0 10E) CITY OF CUPERTINO 5CITYor REROOF CUiNO PERMIT APPLICATION FORM APN#q 2 1 , \` © �3 Dater 1 - 11 I Building Addre Owner's Name: Phone#: c s 400 -,�7S-0330 Contractor: Four gen!�On% 9 ODPi9a License#: 4-11218—11218 Contact:.n^ a mi s p i-ecl r� Cupertino Business License#: ' 1' I 21323 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles p' Wood Shakes ❑ Wood Shakes .❑ Wood Shingles ..a 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,Unde stand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: b Lei he,kes , ;nsC_1>X ar,c� 45 A F (-%V- e,16 ePLJai� Residenti ❑ Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: U 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