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03060008 CITY OF CUPERTINO '_ BUILDING DIVISION PERMIT V,CONRA.CTUR IN ,ORMA.TION, ,'.. BUILDING ADDRESS: FOUR. SEASONS ROOFING PERMIT N003060008 nnn DR OWNER'S NAME: 645 HORNING ST P°°" IYOn2/2003 E ANZA OAKS HOA NE: (408) 278-0330 SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 00 LICENSED CONIRACnder Provisions DECLARATION rd IherebyaffirmInIamliub.BeunderndPrMChapter 9(commencing Job Description with Section 7000)of Division 7 ofthe Business and Pro(cssiuu Code,and my license la fool nacrr 0 REROOF �� D sect. r Data Contractor ARCHITECTS DECLARATIO # -n l undcnund my plans shall w used as public carm JUL 0 3 2003 �yU / o Licensed professional OWNER-BUILDER DECLARATION +'� q 1 herthy affirm that 1 am exempt from the Consaetots License Law for the BUILDING p 0 following mason.(Section 7031.5,Business and Professions Code:Any city or county K m which requires•permit to coasfeurL alma improve,demolish,Or repair any =to. prior m is issuance.also requires the applicant for such permit to file a signed stramcnt s< that he is liccucd pursuant to the previsions of the Conuxtea's liana Law(Chapter 9 Sq.Ft.Floor Area L:=� 4Njy®tion zt-$ (commencing with Section 7")of Divition 3 of the Broncas and Professions Cock)Or .. that M u exempt therefrom and the basis for she alleged eaerapum.Any violation of Section 7031.5 by any applicant fm a permit subjects the applicant to a civil fatally of 3 4?&�919er 0 0 Occupancy not mora Nan fin hundred dollars(5500). p Y Type i,uawrcr of Ne pmputy.or my employers with wagesu0evule ampuaauan, will do Newark,and the sancwre u notinwMed croQucd forage(Sec.7W,BusinesseG and Pmm fa esinCode:The Cavalcades License Law dors MI apply to an Owner of 307 7 - INSULA"V1Vtttje d Inspections property who builds or improv Nraeon,and whodoetsuch work himself or through his ....play..provided Nusuch improvements are notim¢MW or offered forule.If. 601 - ROOF TEAR OFF however.the building or improvement is sold will.ors Year of completion,Ne owner. builder will have due mtmen of proving Nat he did not wild or improve for purpose of 602 — ROOF PLYWOOD NAIL sal`')' 603 - ROOF BATTENS ❑I,uownerof ct Sec.70Y.,Business confessors with licensed .tract la U. 604 - ROOF IN-PROGRESS ca.La the es act(Sec.o.. Business sed Professn,who Code)The Contractor's rid cense Intra coca not apply e U with of of property who wilds or improv thereon,sed, whocontractsLacs for projects with a convacmr(s)licensed pursuant ro Iso Confeacmr'a License Intra. Cl I am exempt under Sec. ,B k P C fur Nis reason 1371W, tafthe ner Data WORKERS COMPENSATION DECLARATION I hereby affirm under pcvlty of perjury ors of the following declarummu 1 ban and will mai.ain a Cartificad,ofCoase.,m self-iuure for WorkeriCamprn- on,u provided for by Section 3700 of Iso UdWr Cade.for the peaformena of the work,for which this permit is issued. cva and will maintain Wmkets Compewuon Insurance,u required by Section Laver Code,for the performance of the work for which Nu permit is issued. Wurketa Coptirin `afire and PoHey.ulBwfira�O��er. "-cert �W?Polity No.; 0 an — CERTIFICATEO EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (The,scala.need not W completed if Iso permit is(man hundred dollars(3300 or Mss.) I ccnify Nat in ON,performance of the work for which Nis permit u issued.I shall not PI any pc .any manner sou cootcL�bjccua the Workers Compensation Laws of Calif i Dis d CA Applicant NOTICE TO APPUNTT-.If,after making this Certificate of Exemption,you should become subject m the Workeb Compensation provisions of Ne talar Code,you muss .,O fOMwil amPly with such Proviunas m Nu permit shall be&=ad revalued. 'z '-' CONSTRUCTION LENDING AGENCY r (-� Ther whichiamthatthert iaaauSec.3 lending agency fortes Performance of a 0m work fur which Nu permit u issued(Sec.7119'!,Civ.C.) az der.Nam. z L Lernders Aedrass t)Q 1 cenify Nat I haw read this application and sate that the awn infotmatiun is f+ cortcsL I agree to comply with all city and county mdinamxs and sure laws relating On OU building caufeuction.and hereby aurhafiae mposeenativ of this city an enter upon ft ctrl ahon-menuonedpropcnY fm instatethat puryoses (We)agree to save,indemnify and keep hornless the City of Cupertino!OML h liabilities,cmqadc Of aatsue ex pussrswhich may in uyway aaauc againu gild City U z in caurgeence of the granting of this permit. F-t APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:9 * DSOURCE REGULATIONS. Signature of ApplicasuConsuetor Data Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will thc applicant or fumm building occupantamre or wodk hmardous maaand u derided by Iso Cupertino Municipal Code.Chapter 9.11,and Ne Health and Safety ,dekode.Section 25532(a)7 ❑tta 4No All roofs shall be inspected prior to any roofing material being .stalled. Will lea rant or future Wilding Occupant ase a If a roof is installed without first obtainingan inspection,I agree to remove PP g p a Air a lily Management when p it ha'rardnu air conaminanu as defined by the Bay Area Air Quality Muagcmcnt all new rials for inspec[i District' ❑Yes 440. 1 haw read she Warm ms mueatudl cquirem.nu undo Cwptea6.95 althe Califin, nu Health Cedes. 5 533and 25534.I vodmru ftsaif Ne wilding does,not c rid an•temY responsibility to rodfY the aaupant of the `S a Q•,3 aquimmen whit muse miss um of a Cerifcate of Occas ,) Signature of phi Date owner author , a D,m All roof coverings to be Class"B"or better Building Division 10300 Tom Avenue Ghpecdno,CA 95014-3255 Telephone. (408)777-3228 Pax: (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 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 musthave a minimum of%,.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 polity. Homeowners Name: Qcl k o Address: j U I S� �-F\' ^woo A f� Reroofing Company 1".dV•4— �S ©telr A . Applicants Signature: Date: Joe Antonucci (( hief Building Official) 6125/01 CITY OF CUPERTINO b 3 REROOF CUPEkTINO PERMIT APPLICATION FORM Date: Building Address: ' C Owner's Name: Pho #: Contractor: hont#: Li ense #:Fool- Sc somas app 033 1 I ofS Contact: Phone #: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: O Built-Up Roof ❑ Buift-Up roof ❑ Asphalt Shingles 7� Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ! ❑ Wood Shingles ❑ Wood Shingles OF Other(Specify) CQ"tt/�rPJ ❑ Other(Specify) Number existing coverings ❑ Provide I.C.B.O. Report# ❑ To bee Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand nd Will Comply With Cu rtino's Tear Off Folicy.'R— I Job Description: j e%�L�'s tt d CTi�*'I S v vac` Residential Commercial Fire Zone: Yes ❑ No Confirmed with Plannin t. if Cost of Project: Type of st to there are an restric ' ns: ��� yP D Occupancy group, e-too-4 Qty. if A li a le Fee ID Fee Des crition BPERMFEE Fee Grou Bid Permit Fees BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BSEISMICOMBUILDING Seismic Commercial BBUILDING CHK Plan Check Fee BUSLISLIC BUILDING Business License BUILDING •