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03060007 CITY OF CUPERTINO A"W^' _ BUILDING DIVISION PERMIT ITRACTaR°INFORMA.TION BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT N003060007 01r`;0 PTRWOOD pp OwNER'S NAME: 645 HORNING ST PERMT 'F?Tb2/2003 E ANZA OAKS HOA "E` (408) 278-0330 SANITARY NO. CONTROL NO, ARCHI ECDENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH u00 LICENSED CONTRACTOR'S DECLARATION O O O O F Job Description I hemby affirm put,l am licensed under provisions of Chapter 9(commencing wiNSmdon7")of DiviMon3ofthc Buvnessas ofessiuv e.mdmylicenuis ��� Q E® ^� infull torce and cff La REROOF B� '^' jya? License Clay Contractor at-q Dau: tf� Sea IUMcrsandmyplmaalW Musedas,Nmmcmdt JUL 0 3 2003 Dktj Tu. LuensedPmfcssianel BUILDING 0 OWNER-BUILDER DECLARATION ON 7.7. E 1 Wmhy.(Sero Nal 1 eump,from thee Cantrmmr'a License law for the o O following m1.ason.(Section 1rD LA Buttes and Pmfectlou Code:Any city or county 9so which re9usu•permit mmnthe aleCWProw,h Perlia�re a sig edcwment _i< Oat its;ssumce,alw mquims,Wvision of for suchpermiuoiccnm aw(Cha statement E o (commencing pursuant )ofDiviounfNCConuiness Liccnselaw(Chadmr9 Sq. F[. Floor Area $4�1(gI®tion Y�$ (cat he is xempth mfro IDnd lin Division f r of do,al Buseged cos and Proon.Any Code)or . L� Nal he u comp, an yfmm and the bur far be alleged eumant to Any violation of Section mom miry applicant rena,roti,subjects de applicansmacivil penalty of $ � al8er00 Occupancy no,more than fin hundred dollars(SSW). Type ❑I.uownu ofue propesry,mmy cmploym wisA wageu Noir sole campeueum, will do use work,and dresnmurt u not Wended or oRered for sale(Sm.90114,Ross. j Ub — j��t11]'e and Profession Code:m Thsee Cmursemra Loewe Law does Out appy m m awaen or PIAN d Inspections property who Wilds impos thereon,andwho doessuchwmk himmlf or Wough his 307 — INS own employces,provided Natauch improvements are no,intended or offered for We.U. 601 — ROOF TEAR OFF howewn the Wilding or improvement it mid within ore year of completion,the ownm- builder MR have the Witim of proving that he did m,Wild car improve for purpose of 602 - ROOF PLYWOOD NAIL y1e')' 603 - ROOF BATTENS ❑1.as owner of de progeny,am exclusively contracting with licensed contractors to construe,the project(Sec.T0",Business and Professions Cade:)The Contractor's U. 604 — ROOF IN—PROGRESS cera Law does not apply in an Owner or propeny who Wilds or improv demon,and, . who contracts for such projects with acon isc,nr(s)licensed pursuant in the Conuactofs Limp.Law. El lamuemptmdm See ,B&PCfm N;smamm 0"mr Dat WORKERS COMPENSATION DECLARATION 1 hemby affirm under penally of perjury one of tbo following dseW,ions: 1ha and will maintain a Certificatecamof Content to self-insure for Worksripe Comn- Lidon,u Provided for by Section 3000 of the Labe,Code,for Ne perfarmmes of the work for which this permit is issued. base and will maintain Worker's Compensation Inurmce,u myuised by Scctim TW of the tabor Code,for the performance of the work fm which this permit is ironed. My Wrolme ompeu�tioninwrmacaniermd PalicynuZtber�rtG� Carrier. Cf too JJ Polity No.: Ulf/ �J CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu section used not bscomplemd Rthe permit r forum hundred dollars(SIM) or mss.) I mnify that in the performance of Ne work for which this permit is issued.l shall not imPloyanypctsoryittOtty in sots luIn cmbjmuo Or Wmirma Campensmion awsof Cal'r^rn D n Apple.. NOTICE TO AFPL ICAN�:IL after making the Cenifieam of Eaemp,ion,you shouldbecome subject in de Witrkcri Compensation provision of the Labor Code,you mel .,O forthwith comply with such provision ter Nis permit shall he deemed revoked. Z�y CONSBUCTION LENDING AGENCY F 1 Wrcby alarm that Ncrt is a committed.lending agcney for de performance or C tic murk fm which Out permit u issued(Sec.309],Civ.C.) QLender's Name z Under'sAddress U C) I curtly Na,l have mad this application and sate Nat thy above information is 0 Ur. wilding 1 agree to comply with y city roti county oNinmues and cult laws relating m U Wilting cottoned ion,and hereby authon p mprexnuuv of this city m erten,upon the LQ above-menuoned property for inspection which may t gy (We)agree m save,indemnify and keep brimless the City of Cupertino agaiut h in udgincrus, ntsuW expense which may in anY way accuse agaiut cudCtry U z in consegmrce of the granting of Out permit ti APPLICANT UNDERSTANDS AND WILL COMPLY WIT"ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Signature of AppltnnUConowtor Dom Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Ne applicant or factum building occupmt now or handle loinscous material udefined by the Cupertino Municipal Code,Charm,9.12,and the HcdN and Safety Botic.Section 2ss32(a)'! All roofs shall be inspected nor to an roofing material beim ❑re � P P � Y g g installed. Will the applicm,or future Wilding occupant use equipment of devices which If a roof is installed without first obtaining an inspection,I agree to remove it W amou air conuminma as dehned by the Bay A.Air Quality Managemcns all new materials for inspection. District? cr we. Ihave mad the ba,afdnua materials requirements under Chmand.95 of the Calding nice Hcnit have ctyCude Sectio r So, re and nts unduChapteddhu ifthc Wilding Jens t cu ndy haw a m y responihiliry m nodly tic mcupant of tic mOur menet em tat no,m;yamaaraCmuheeorOccupmcy�� Signature ofApplican Date owner or aathorim n, Q,m All roof coverings to be Class "B"or better Building Division 10300 Tone Avenue Cupmtbo,CA 95014-3255 Telephone: (408)777-3228 F= (408)777-3333 CUPEkTINO 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 manufaclures.spedficatlons 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: L. Flat roofs musthave a minimum of YV.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: Address: 1� R -W dm C` Reroofing Company Na4vr\ I' .0Q•J' �S © A5j���, Applicants Signature: Date: • Joe Antonucci (Chief Building Of dal) 6/25/01 (�C, CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION FORM APN # Date: ~ a 03 Building Address: Owner's Name: Phone #: i Contractor:rr-- t Phone#: I—OV✓' SC�+SO�t.S � a7� 033 License #: Contact:: Phone #: Cupertipo Business License #: vpth C-J Type of Roof Covering: Existing: Proposed: U Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Wood Shakes 7j Asphalt Shingles❑ Wood Shingles El Wood Shakes ❑ Wood Shingles J' Other(Specify) C-e'"l ✓�` ❑ Other(Specify) Number ol'emoveting coverings O Provide I.C.B.O. Report# El To be Reemoved ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand nd Will Com 1 With Cu r[ino's Tear Off Polic (� _ Job Description: j ��`6 �, p (T ` dttr v -,Q-1 0vtc.l Residential Commercial F-I Fire Zone: Yes ❑ No Confirmed with Planning Dept. if Cost of Project: T e o there are an restric ' n' L� ctio DD Occupancy gro Qty. A cable Fee ID Fee Description BPERMFEE Fee Grou BENERGY Bld Permit Fees BUILDING BSEISMICRE Ener BUILDING Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BPLANCHK Plan Check Fee BUILDING BUSLIC BUILDING Business License BUILDING • � 2z°vi