06050213 (2) CITY OF CUPERTINO
. BUILDING DIVISION PERMITydb! R. f-aQR IAT�A 0IZM� dNg!',
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT ND.06050213
22814 LONGDOWN RD
OWNER'S NAME: PER1917ISSUE DATE
DEANZA OAKS HOA 502 HORNING ST 05/24/2006
NE: SANITARY NO. CONTROL NO.
(408) 278-0330
ARCHTfECT/ENGINEER: BUILDING PERMITPLIJMBO
Q0 PO MECH
30o LICENSED CONTRACTOR'S DECLARATION Job Description
u 1 hmchy dffm that 1 Am licensed under imm imine of Chapter 9(mmmewing
1 with Section 7(MID)of Division Sof the Business and Prolquin.,C An mylle....e
in mu fonds nddr k �l Q TEAR OFF (E) SHAKES, INSTALL 1/2" CDX AND GAF
i q Lienjq DeUc.I �pp,�r
' m cantOcm o ooRAN,D SEQUOIA SHINGLES. 50 YEAR CLASS A
ARCHr1ECTSDEC ON
t I understand my plans shall he used ns moved,
rtrd,
y
s ata l.icenseJ Professional
y
OWNER-BUILDER from
DECLARATION
Mi I humby a1Dm mat I sec exempt from the Contractor's Co License law for me
M o following um en.(Section 703 cont,Business and Pre.dem ll Cole:Any City OT cmnty
u, which rcqums•pcmh m ernes the ape¢Improve.de permit
i ri e.sig any mwwm
_Z i prior m its i ensed pursuant atw requires provision O for such COALMwit m file a fi aw(Chtamcnt
€< matturnamenseJeSoci move provisions Of the Camrst. Uccvclaw(Codtar9 Sq.Ft.Floor Area Valuati$6500
gq p (can cis inPwph Swtiournand w Division3.1'of doeeged exempt Rahny vi Code)An
C 3 that o m exempt mertfrom and me balm rat bj alleged exemption.Any violation of
Section 70314 by my applicant(Oc a perch Objects the applmant w e civil penally a( N Number Occupancy Type
rot mom than 0w hundred daime(SIM 3 4 2 33008 . 00
0 1,As owner of the property,or my employee with wage As their Ole mmpenvdoa.
will do the work and the muchm mast mended a offered for sam(Sw.7044.S.A. Required Inspections
and Profesdov Cale:The Contractor,License Law does not apply m an mweI of q p
property who build,orimprove merton,and who does such wok himself a through his
own employers,provided that well lmprowmma am trot intended woffued formic.If.
however,the building orimprovement Is sold within ane you of completion.the owner-
Wilder will Mw the inumet of proving"I he did rot mild ar improve for purpose of
sale.).
0 1.a owner of the property,Am cammiti sly commW ag with licensed seromas,to
construct the project(Sec.7044,Business and Professions Coda)The ConmmrS Li-
mese LAW dans not apply w An ami of property who builds or impmws thereon,and,
who convects far such projects with acomusadO licensed pamrvmt in the Contractors '
License law.
❑I ane eaempl undo See .B A PC for thin mann
Omr Dam
WORKERS COMPENSATION DECLARATION
I hereby affirm under penally of perjury ane of the following dmluations:
I new and Will maintain aCardEasta of Covent to self-w ure fa Workers Geopen-
.don.As provided for by SeNm 3700 of we Labor Code.(or the performance of the -
Worle for which this Permit is issued.
0 I law and will maintain Workers Compensation Iruumnce,As required by Section '
3700 of me Labor Code,fa the per...of the work fa which mix permit is Leaned.
My War rs CompemWon In m e 'a aanndd Policy)number art: 1,
Cartier. PORyNo] _2A2gAk&
CERTIFICATE OF EK PnON FROM WORKERS'
COMPENSATION INSURANCE
(ThtssectlCo wed not be aompletaJ I(me permit Is form hundred ddlare(310n)
or lea,)
1 Certify that In the performance of the work for which this permit is imwd,l shall not
employ any person in my..Term as on become subject to the WMIMM'Campevatim
Laws of Califurem.Dew
Applicant
NOTICE TO APPLICANT:IL aper making this CcniBcam of Emmption,you should
become subjwt to the Workers Compensation provisions of the taper Code.you mat
.,O forthwith Comply with each provisions a mu permit shall be dwmod revoked.
'Z'� CONSTRUCTION LENDING AGENCY
[-+ I hereby drum dm mem Is.Cons vation lerding.g ney for the performance of
f� the wo t for which itis permit Is issued(SAC.3097,Civ.C.)
I+]i Lenders Name
0.z Lenders Addmas
U Q 1 certify mat 1 saw had tide application and sum list de abew infarmadun m
Is.h COMM.I gree to comply with dl city and county ardimmeam and seem laws misting W
�U buildingeonwucdon.and hereby Aumorile MpresenULiws of this city to Comm uPnn me
�L31 alevc-mend.....pmpcny far ivpectim purposes.
gL (We)Agree m saw.indemnify and keep harrnkss the City of Cupertino agaivt
rA imbilhits.j.d3aenes.Cass and eapemas which may in my my accrue Against said City
fJ Z A APPLICANT
NDEI n' is romp. Issued by: Date �� Z i -(�
APPLICANT Uf the NDS A WILL COMPLY WITH ALL NO POINT
WRe-roofs
Sig ur Ap Tem Ca tractor Oak -
1TARDOUS MATERIALS DISCLOS RE Type of Roof
Will the p t or future building Occupant store err hams hazardous mawrull
as dcnwd by 0 Municipal Cork,Chapter 9.12,and the Health and Safety
Cade,Section 25533(.)7 All roofs shall be inspected prior to any roofing material being installed.
CYe o
Will tie applicant a Comm building occupant use equipment a devima which If a roof is installed without first obtaining an inspection,I agree to remove
mit hwamnus air contaminants u dc0ned by lie Bay AMA Air Quality Manajcment all new materials for inspection.
Dm dct7
DY. o
I have read the hm M=mamdamrtqulmm uun.cr Chapmrd.95 Aide Califor.
nu Hca1N ASdetyCode,S.Amis 33105.25533 and25534.1 undenmM matifine building
data immaturity hew A mm It u my MspondMllty m m y Je sass 1. me
n me W.anccar,Csmtinam r loSignature of Applicant Date
own rammabc amt All roof coverings to be Class"B"or better
CITY OF CUPERTINO
!m 4 of 5 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34233008 . 00
DATE ISSUED. . . . . . . : 05/24/2006
RECEIPT # . . . . . . . . . : 34539
REFERENCE ID # . . . : 06050213
SITE ADDRESS . . . . . : 22814 LONGDOWN RD
SUBDIVISION . . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DEANZA OAKS 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
OEE 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
10300 Torre Avenue
iClOF
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408)777-3333
WUPERTINO
Building Department
JOB ADDRESS: PERMT
jOSe' 2l3
R S N PHONE #
GENERAL CONTRACTOR FAX #
I am not using any subcontractors: CD
Signature Da
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/Coniractor Signature Dale
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: Ly Nmr,, C-),-Aa
Job Site Address:
Roofing Company Name:
Applicant's Signature: Daterb�;-CI4
• Greg Casteel
Building Official
Revised 11/2/04
00
CITY OF CUPERTINO O50 �I
REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
But ding Address:
ILA
Owner's Ne: Phone#:
s 400 -;2749-0'3-30
Contractor: Four geC[!'On5' R.00)Qi License#: 4,712ca
ContactTh a r•1 l s p I ed rc Cupertino Business License#:
21323
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles A Asphalt Shingles
8 Wood Shakes ❑ Wood Shakes
❑ Wood Shingles .0 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, UndeTstand and Will Comply With Cu ertino's Tear Off Polic :
Job Description: o ¢.� 1 ds tns Dx ,o.+d Ak r CASA 2L�ot�
S b C L.S
Residents ❑ Commercial ❑ I 6
Fire Zone: Yes ❑ No �J 96Confirmed with Planning D I. if
there are any restrictions:
Cost of Project: T of Construction: Occupant roup:
Ct> o° - KG` o 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
•