06040171 (2) CITY OF CUPERTINO v'-;s,�,^nwf"„,F�76T '
BUILDING DIVISION PERMIT a`GONTRA. OR�oRMA' 'I ''''''
s t' fSSJ" �'d:'I?','�.ai`r(�.•,'v�,a�R'i6 7 s�S. �'aI
BUILDING ADDRESS: FOUR SEASONS ROOFING "FE"TNO.06040171
10130 FIRWOOD DR
OW NER'S NAME: PERMIT ISSUE DATE
DE ANZA OAKS HOA 502 HORNING ST 04/27/2006
DNE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
3o j LICENSED CON RACTOR'SDECLARATION 70b Description
i 1 hereby affirm mat 1 am licensed under provisions of Chapter 9(commenctna P
wins Section 700)afDividon 3 of the Budhhecsand ProlousheN Code.and my license is
1.full In.andeffem 41 0$ _ TEAR OFF SHAKES . INSTALL 1/2" CDX AND GAF GRAND
'j= Lran clas Lm.a SEQUOIA SHINGLES 50 YEAR CLASS A
i Decal X4''S�—Cmtrmm 1J ^ lea.J
ARCHITECTS DECLARATION
I 1 undermnJ my
plan.mall be used ss public records III��� qqq
e LicensedPrufcasional As u T�ff
a� OWNER-BUILDER from
DECLARATION
COC I hereby.(firm on i am tempt Imre the communicateso : c law for Use
O o fallowing mean.(Section 703 ostr Business and Professions Code:Any city s county
COC
$�
which rtqulma a permit m cnnswcL oiler.Improve,demolish,or repair any structure
priorm its issuance,alsoneequires theappliesnt forwchpermitmbk aligned suxmem -�j
< ren he isIimmucal pummam to the provisions of the Cimttamfa U.law(Chapter9 Sq.FI.FIOOr fir— ZOOC ValDati$fa500
8 (eommeneing with Sermon7")of Division 3 of the Business and ProfeWOns COCA)Of
v U
.. Nat he is exmpt therefrom And the basis for the alleged exmpnon.Any violation of n
Section 70314 by any Applicants far a permit subjects the applicant m a civil porulty of APOccupancy Type
ret ream than five hundred dolts.(1300). 3 4 2
❑I.As owner of the property.or my employees with wages As their mle compeNadon,
will do thewark and Umsaumum ts mainumdedaroffemd forsale(Sec.RNV,Business Ruire Ins actions
and Professions Code The Contrmthfs Liceuse Law data not appy m an e owner or q P
property who builds m improves thtaeun,and who d oea auch work himself m thmutb his
awn employed.provided Out such improvements am ret intended oroRered for sale.If.
however.the building orimpenwment in sold within arm yex of completion.the mmm-
Wilder will haw the burden of proving Nn Ise did net Wild Or Improve for purpose of
Ask.).
❑1,as Owner of the property.am exclusively contracting with licensed eontracmn An
construct Ne project(Sec.7044.Businm and Professions Cade:)The Contractor's Li.
cc=law does me apply An an owner of property who builds or imprews therein,and,
who comncu for such pmjeets with amnuarm(U licensed pmxaot As the conuscubes
License law.
❑I am exempt under Sec .Bk P C for this maven
Owner Dam
WORKERS COMPENSATION DECLARATION
1 hereby afrror under penalty of perjury an of the fallowing deumadans:
IhamandwillmainWna CerdAmwofca ntmulf-lesumfmworkceseorpen-
" salon,u provided for by Sanson 3700 of the labor Cade.for the performance of de
work far which this permit Is Issued.
❑1 have and will maintain Workees Compenss,lon INurame,As required by section
3700 of Ue labor Code.far the perfmmaree of the wort far which this permit is hued '
My Workefs Compeasalm houprece Cartier and Palicy nu�nOCfraam:
Carver r• • Policy No.12 A2_
CER IGT OF-F,EMPION FROM WORKERS'
COMPENSATION INSURANCE r
(ThisseNnn need rat Ise completed if to permit ts franc hundred dollar($100)
or lesa.)
1 cenify Not in the performance of the work far which Nis permit b IssuM.I shall ret
employ any person in any mannerx As to became subject in the Wort era'Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:It.After mating this Cervi Lente of ExmpUon.yin AmW
became subject m the Worker's Compensation provisions of the labor Cade.you must
,J O forthwith comply with such provisions or this permit shall W deemed revoked.
Z tiCONSTRUCTION LENDING AGENCY
(r 1 hereby M.that there is a consuucUnn lending Agenry,far the performance of
rG > the work for which this permit is issued(Sec.3097,civ.C)
4 Q Lmaces Name
z Lenders Addreas
U Q 1 sonify that I have read this pplication and sale this the above infomasiun is
LL P correct 1 Agree in comply with all city and county aNlnances and sum laws relating to s
C r.1 building cousttuction,and hereby authorise mpmannuuwa of this city to cna,upon the
W shove-mcntitmod Property far inspection purppes.
(We)agree to save,indemnify and keep harmles,time City of Cupertino against
cn liabilities,judgments.costs and eapenw which may In any way acerae against Sold City
U Z in consequence Of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
S GU Nj
Z-�'�� Re-roofs
Signature ofiammUoutmor Dna
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WIII the applicant or future building occupants,am or Mndle haxNous material
u defined by tie CupeNm Municipal Cock.Chapter 9.13.and the Health and Safety
Cade.Sued.235324)7 All roofs shall be inspected prior to any roofing material being installed.
41 ❑Yes —*N No
WIII the applicant or future building Occupant Sox equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit husato air Maltz i=d As Claimed by that Bay Area Air Quality Managamem all new materials for inspection.
Dis rimT
❑Yes No
Ihaveread On,hasardmsmamdahmquimmenuunderClupmr6.95ar Lia Glifor-
riaHeal"SafetyCode.Satiw33505.35533am123534.ImhmnW UmlfUe building
done not currently haw a mnanL that It u my responsibility An mufy,the aeupant of de
requlmme uwhich mus, t prior m iasumco o(a CeNnate o(. cu Signature of Applicant Date
Owner err Damw All roof coverings to be Class"B"or better
wth 'e a col '
Community Development
10300 Torre Avenue
aClOF
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
fEUPEkTINO
Building De artment
JOB ADDRESS: PERMrr # Y Or ?
OWNER'S N PHONE #
GENERAL CONTRACTOR FAX #
I am not using any subcontractors: o
Signature Date
Please check applicable subcontractors and complete the following information:
60 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
Owner/Contractor Signature Date
CITY OF CUPERTINO
�m 2 of 6 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34233030 . 00
DATE ISSUED. . . . . . . : 04/27/2006
RECEIPT # . . . . . . . . . : 34163
REFERENCE ID # . . . : 06040171
SITE ADDRESS . . . . . : 10130 FIRWOOD DR
SUBDIVISION . . . . . . :
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : DE ANZA OAKS HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2642
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 BAIL
---------- ------------- ---------- ---------- ---------- ---------- ----------
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 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'sName:� ar\-7c% Dd� bA
!4 .
Job Site Address: I O 130 r Woo
Roofing Company Name: S- 11
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
0(00011
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION FORM .
APN# Date:
I wilding Address:
Owner's Name: O Phone#: n
c. 7
Contractor: / License#:
� Sa'tSonS �oo'F 7 / 'Z 8"
Contact: Cupertino Busi;te�License #:
T1 q � t 2�
Type of Roof Covering:
Existing: Proposed:
❑ Built-up Roof ❑ Built-Up roof
❑ Asphalt Shingles JN'—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#
Tobe Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: "f(oFF S tN3k�� y CD)( , or G� Gr�t� $uora
st ® o
Red , sS
Commercial ❑
16�
Fire Zone: Yes ❑ Nom Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Project: oo Type ofConstruction: Occupancy„gro
Qty. if
A licable 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
•