03090162 CITY OF CUPERTINO
BUILDING DIVISION PERMIT kCONTRACTt0RINFORMATION
BUILDING ADDRESS: ALL SEASONS ROOFING SERVIC FSMIT"x'03090162
OWNER'S NAME: 2640 PACER IN PERMIT ISSUE DATE
COMPASS MANAGEMENT
"E` 4089724455 SANITARY NO. CONTROL NO.
ARCHITECfIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30o LIC ENSEDCONTRACTOR'SDECLARATION IbDescription
I�+ I hffi
thereby arm o
tier 1 am licensed under provisions of Chapter 9(commencing
with Secure 70(11))of Division 3 of the Business and Professions Code.and my license is
+ � mOnmrceamerr , q/ REROOF
,g= oc.n Imo _ coo amar �IIVALED
ARCHITECTS DECLARATION
I I understand my plena shall be used as public records
O� Licensed Pmfcssiunal NOV 2 4 2003
OWNER-BUILDER DECLARATION
I I hcrehy bflirm that I am exempt from the Contractor's Lieenm Law for rhe
00following mason.Secure 7031.5,Business and Profession,Code:Any city or county ���1� ,
which requires a Permit to construct,alter,improve,demolish,or repair any aB9emre BUIn• D• N
-iyprior m its issuance.also requires the applicant for permit 7o File a signed atatemenl
SZ< that he is licensed pursuant to the previsions of theConanotur'sLicenselaw(Chapmr9 Sq. Ft.Floor Area Valuation
e I-� (commencing with Secure 7000)or Division 3 of ma Bminem and Profcrsions Code)or
$ that he is exempt Nertfrom and the basis for the ailcgcd exemption.Any violation of
Section 7031.5 by any applicant fon permit subjects the Applicant to civil Penalty of APN Number Occupancy Type
not more Nan Bw hundred della.($300).
Q 1,as owner of the property,or my employers with wages As their able compensation,
will do the work.and the awclure is not intended or offered fonalc(Sm.7064.Business 305 - FRAME Re uired Inspections
and Pmfassione Code:The Communities Liao¢Law does not apply m an owner of p
property who builds or improves themon,andwho dousuchwmkhimselfor through his 307 - INSULAT ON
own employees.provided that such Improvements are not intended oraRered forsam.If. 6O1 — ROOF TEAR OFF
however,Ne building or improvement is mid within one year of completion,the owner-
builderwillhavetheburdenof proving that he did not build or improve for purpose or 602 — ROOF PLYWOOD NAIL
oI. 603 - ROOF BATTENS
❑I.re owner of the property,.B edam add convecting with licensed ntrammn to
canceLaw oesject otApply.7Dw,Bnerof analtywhoWildsorimpro Contractor's 604 - ROOF IN-PROGRESS
ante Taw does r s apply Ie ts owner of property who builds or improve Centro,and,
who camracu for projects with a contactor(s)licensed pursuant to are Contractor's
Licence Law.
❑1 em exempt under Sec. ,B&P C for this mason
Owner Date
WORKER'S COMPENSATION DECLARATION
1 hereby&Rimy under penally of perjury ane of the following decHrnione
I have and will maintain a Cenificem of Consent to self-inmm for Worker's Cumpen-
tion,As provided far by Section 3700 of the labor Code,for the perfarmma of the
work for which this Permit is issued.
❑I haw and will maintain Woad,Compevsalion Insurance,u required by Section
37017 of the labor Code.for the performance of me work for which this Permit is issued.
My WorkerI Cn�mpe/p�saeo/n�lmumnce�certicr and Policy numberem:
Cartier. .'S//lrL/rar..4 Policy No.: C01I,167_
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu acetiml aced rot be compteed if the rermh is faronchundmildolla.($100)
Iran.)
1 cenify that in the performance or the work for which this permit is Issued.I shall not
employ any Person in any manner an As m Weaned subject o the Worlma Compcmation
laws of Cahiroroia.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Ccnificate of Exemption,you mould
became subject to the Worker's Compensation previsions or the labor Crile,you must
.J2 rorthwith comply with such provisions at this Permit shall be decreed invoked.
Z'O CONSTRUCTION LENDING AGENCY
E(-+4 I hereby affirm that then its constmction lending agency l'or the Performance of
�: thn wad fur which this pcmtit u issued(Sec.3097.Ci,C.)
Id7MQ Undoes Name
Z Lender's Addrtas
V Q 1 cenify that 1 have read this application and sum that me above information is
s,4 F comet.I agme to comply with all city and county ordinances and state laws relating to
DU building construction.and hereby authorise repamersdaea of this city to crier upon me
N 0. alcove-mention il agree
I.save.
for indmnify An keep ha.
F (We)agree la mw.indemnify and keep harmless she City of Cupertino gains(
N liabilities,judgments,costs and expenses which may in any way same against mid City (7
of
U 7 iAnPPLICANT U DERthe ranlrngDSthis AND Permit.
WILL COMPLY WITH ALL NON- DINT. Issued by: Date s,7
rte— SOU
9 Re-roofs
azure of nUConummr
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Ne applicant ar fold.building occupant stn.err handle hevuduu...mdd
m defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
cmle.SectionY"25532(a)? All roofs shall be inspected prior to any roofing material being installed.
MY" No
Will the applicant or future building occupant me equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it hamdous air ximmu ata u dctincd by the Bay Arca Air Quality Management all new materials for inspection.
evict?
❑Yes 1[INo
mad m
I have e rental\materials mquimmenu under Chapter 6.95 of me Califon
nice Health&Safety Code.Sevum 25505,25533 and 23534.1 undca and mat if the Wilding /7 -,
doe not currently have a moan,that It u my rmpbmihility m mu fy the aeup.,of the 7
m nu ich alR-7010
poorloiseu r ceniBeamerxaaupaney. ign of Applicant Date
nerunw agent D All roof coverings to be Class nBn or better
r Building Division
10300 Torre Avenue
Cupertino,CA 95014.3255
Telephone: (408)777-3228
C Fax: (408)777-3333
CUPEI�TINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing.
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 reroofing 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) Preinspection 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 that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of V"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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: 00
Address:
Reroofing Company Name:
Applicants Signa Date: r—
• �Joe Antonucci
(Chief Building Official)
60/01
CITY OF CUPERTINO o 3 ,2
0 �-
REROOF
CUPEkTINO PERMIT APPLICATION FORM
APN# 3 6 Date:
9 z�
Building Address:
Ow 's Name: Phone#:
n
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Contractor: License#:
Contact: Phone#:
jai V " Ez/ — —
Applicant/Contr ctor: Fax#:
Builcling Permit Info:
• Bldg Elect Plumb Mech
Job Description: Tkeo 8dor: zpY 0P
Residential: ee Commercial:
Sq.Ft. Floor Area: $/S Ft.: c
31V y
Architect/Engine - Valuation:
Type of Construction: Occupancy Group:
Qty. i
App1j6qbl Fee ID Fee Description Fee Group
L Ll BPERMFEE Bldg Permit Fees BUILIDNG
BENERGY Energy BUILIDNG
BSEISMICRE Seismic Fee Res BUILIDNG
BSEISMICOM Seismic Commercial BUILIDNG
BPLANCHK Plan Check Fee BUILIDNG
BUSLIC Business License BUILIDNG
2
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