06040129 (2) CITY OF CUPERTINO ' " "°.ttxf
BUILDING DIVIS16N PERMIT -CON„+TItACT•C)R I�`'Q:,,RMATION
BUILDING ADDRESS: ASONS ROOFING PERMITNO. 06040129
10092 FIRWOOD DR
OWNER'S NAME: PERMIT ISSUE DATE
DE ANZA OAKS HOA 502 HORNING ST 04/21/2006
NE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECTIENCHNEER: BURRING PERMIT INFO
BLDG ELECT IS O PLUMB MECR
O O
Op LICENSED CONTRACTOR'S DECLARATION Job Description
1 haffirm Nw r
thereby at 1 ho tsed a under provinoof Chapmr 9(cmnmerming p
Z with Section 70110)of Division 3 of the Business and Prafeuma Code.and my linens is
+pn, in full foramdefrnn. 4:1 TEAR OFF CEMWOOD SHAKE ROOF, INSTALL 1/211 CD+
'•8� c` c —�'"��, GAF GRAND SEQUOIA COMPOSITION 50 YEAR CLASS
3e Q
ARCHITECrSDECLAXAM14I
L cy7 1 underwnd my plar s e1W 1 be red AS public rtcato,
)u �I
u8 Licensed Professional
OWNER-BUILDER DECLARATION A
a1 herchY+(firm m, I am uempt from the Contractor's Code:My c law far the
p o following exon.(Section 7031.5.are Buai er, and P000w,duoro h.OMy city or county
which requires•permit m AMI, An alta.improve,&permit t ri e asir any mnenre
�x patAniss iuuarme,rive requites An of On on permit to Uteeasimed stmaneChip=m UAI ValUati SOO
c (c mmc licensed pa=Lion7 h)of Dieloaoflhe Contractor's nd ftflave(CbPla9 Sq.Ft.Floor Are VIr g'
vd $ (cammendng with Section 7000)WOivfion3of the Bunnevand Profrssiaa Cnde)Or ' j
m, that bets exempt therefrom and the bub for the alleged esempdm.My violation of ft
e
section 7031.5 by any Applicant for a permit objects the appncant M a civil penalty of31'20
ApN�T Occupancy type
am roam than five hundred dolWs($500). 4 2 3
❑I,AS Owner ofte property,or es my employewith wages a their Sole compad
emon, '
will doom work,and the amectum 4 an,intended of ofernA far ask(Sec.7016.Badness RTTAU ns
and ProreWoa Cade:The Commences LiamLAW dam not apply to in war or
prapertywho builds or improves demon.and wino domsuch eroak himaelf mer Nmugh his
awn emplayaa,provided that aucb Improvements sm Out Intended cropland for sale.If,
however the buiidiagor improvement Amid within am year ofcmapletion,the Owner-
builder will have the burden of proving that An did not build or improve far purpose of
tile.).
Cl
1,As an=of the property,am evAusinly comb I with B¢mn d Common e
construct the project(Sec.7014.Business and Profession Cade:)The Depositors1.d•
ease law dots nen Apply o an Owner a property be bail&Or improves thereon,and.
who Contracts fa such projects with a contractm(a)licensed purnant An the Contractors
Lineae Law.
❑lammemptunderse, .B&PCfathis Moan
Owner Rase
WORKER'S COMPENSATION DECLARATION
41 1 herby affirm under penury of perjury nm of the following declarWmmc
❑]Ken,and will mainWn a Gnifraoof Consent in elf-iaum far Workers Campmo-
sada.AS provided rear by Section 3700 of the Labor Code.for Ota performance of the
work for which this permit Is issued.
❑I Use and will maintain WOWS Compensation Imuran+,AS required by Semon
3700of dm labor Cade,for the performance ofum wark for which this permit is Issued. '
MYW aCamp9naWa hmou1aa1a eartier and Policy musbor am:
f•...t. Pr tow Yl�t/ 1ky No.:l
CERTIFICATE OF EXEMP ION FROM WORKERS'
COMPENSATION INSURANCE
(This section and Out becampcied Rthe permit is fmone hundraddollan($100)
rar lea)
1 ardh• that In the performance of the Work fa which this permit Is issued.I shill nm
employ any person In my mmnerm AS An bamm subject to the Werken'Compemation
Laws of CIIIHO niL Date
Applicant
NOTICE TO APPLICANT:If.after making this Gnlfmc of ExcmpOon.you should
became ohjact o the Workees Compematian provisions of see Luxor Code,you run
,J O fanhwit r comply with Such pmvinaa or this permit ShA11 be demand mwked,
Z0 CONSTRUCTION LENDING AGENCY
[.. I hereby Afton that them Is a construction lending agency for the Performarra of
r1.r7 the Since fa which the permit is issued(Sen.3097.Civ.C)
LeMcfs Name
=z Lain&es Addams,
U0 I certify that I have read thin Application W Sum Nal the above information A
LL F nano 1 agme M comply with all city and county Ordinances and SAM laws elating to
OU building construction.and hereby mthoae representatives of this city to enter upon the
LA above-mendonW property for inspection purposes
LL (We)agree in ave,indemnify and keep harmless tine City of Cupertino against
Sive y
liabilities.judgments,nom and expr^...Mich may In my way accran aµW'aid City
U z m eoaequeae of the granting If this 16 _'�
APPLICANT UNDERSTANDS A L COMPLY WITH ALL NON-POINT Issued by: Date
SO TIONS.
Re-roofs ��—
signature a(AppHans/Ca Dam
HAZA DOUS MATERIALS DISCLOSURE Type of Roof
WAR the fuuuo building aaumum care or handle haardoa material
a defined by the CupsMunicipal Code.Chaper 9.12,and the Hpc And safety
Code.Smrtion W32UI? All roofs shall be inspected prior to any roofing material being installed.
❑Yes No
Will the applicant a future building occupant tie equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
7niaHutle&SAIeLyC&.SmdM25505.25533and25534.iun&�MI[dw
t hvallouf air cnntamiants a deficit by the Bay AMA Air Qualily Management all new materials for inspection.
❑Yes gNo
I have mad the hanndmas nwedaf requlremrats uruferChapterb.97Of time Glifor[dw buildinges ml currently haw a¢na4 Net it h my roponsibility o notify dw.occupant of the
ui hichmmtbemet mivofaCcmcA a Signature of Applicant Date
I��mmnoathifind or DAm All roof coverings to be Class"B"or better
Community Development
aCOF
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
WUPERTINO
Building De artment
JOB ADDRESS: PERMIT # `6
R
l00 2 9,r o o 0 r l
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: J= FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors 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
HSheet Rock
Tile
�-2�-0 j
er/Contractor Signature. Date
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• CITY OF Telephone: (408)777-3228
C�^r�����O Fax: (408) 777333
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:� /�Z k. �s L ' A
Job Site Address: 100&) -2— [ l i 2( ,X�O d
Roofing Company Name: 1 — _^
Applicant's Signature: l�'0 ` Date:q,
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
�m 2 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34233037 . 00
DATE ISSUED. . . . . . . : 04/21/2006
RECEIPT # . . . . . . . . . : 34090
REFERENCE ID # . . . : 06040129
SITE ADDRESS . . . . . : 10092 FIRWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DE ANZA OAKS HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2640
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
•
CITY OF CUPERTINO
REROOF
UPEIkTINO PERMIT APPLICATION FORM
APN # Da e:
�l 3 O '�Cv
Building Address:
Owner's Name: Phone#:
I e R N2sk Ods t4 8' 3—f 0
Contractor: Phone #: License #:
'Foul S2y.So. s okt 7 ?,/O8
Contact: Phone#: Cupertino Business License#:
Frt� CaZale3 52-3
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles 7 'Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
)0- Other(Specify) CeM W,,,4 54+y-e S ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O.Report#
A- To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑
ob Description: o C Q,.v.w®o 5t-� C
4F .fc4waQ C 4
Residential 12r
1 jo Commercial ❑
Fire Zone: Yes ❑ No j9_ Confirmed with Planning Det. if
there are anrestrictions: LJ
Cost of Project: ccs Type of Construction: ^ Occupan zlroup:
t'�"
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