03060010 CITY OF CUPERTINO
BUILDING DIVISION. PERMIT V�t\?L�VTQI�IL\Pqq�R1Yl�lT,l%N
BUILDING ADDRESS: FOUR SEASONS ROOFING 1ER11N003060010
a OWNER'S NAME: 645 HORNING ST "E"M1fR1b° i2/2003
E ANZA OAKS HOA
NE: (4 0 H) 2 78-0 330 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: - BUILDING PERMIT INFO
BLDG EIECT PLUMB MECH
0 0 0 0
Op LICENSED CONIRACTOWS DECLARATION
in I
n1 thereby art,.thus 1 am licensed under provision of Chapms 9(commencing Job Description
with Sacdon 7")of Division 3 of dm Rusinev and Purfessicon Coal,and my Ike=is
full force and eRttt L__ LinL/ Zoe
016, REROOF
ARCHg1EC'S DECLARATION
g�i 1 understand my plans dull k used u public records
�yV
`LLt; Licensed Professional - I
OWNER- amour food
,JUI 0 3 2003
COO e F I hereby affirm that 11. escrupt from k Casiom o :Any Law for lk
p' which
mgreason. etch t 7031.5.Ls,Business and Professions Code:Any city or roomy
LL which RGuirta a pcmlil la ClmyN[l,alter,impraM,dcm1111Rh,of Rpair any SWCIYm
°i6prioruits Lcsuance.alwmquimsrkapplimiforsuchpermiLm Blcasigmdsummdt h,pA
Nat k is licensed pursuanuo the provisions of the Conurmtor's Licene Law(Chapter 9 Sq. Ft. Floor Area 4 W9 j
g (commencing with Section 7")of Division 3 of the Bnsi.and Profcuimu Coot)or
that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicants for a permit subjects the applicant to a civil penalty of 3 4%2`14 34bilh5er 0 0 O
not mom then five hundred dollars(S500). ccas panty Type
❑1.n owner of the property,army amployres with wages as Iheusole compemuion,
willda the worleintOttoan.is not inuildar offered forsale(S .7044,Business — �(tttlre
and Professions Coxaacw
:The Conrs License taw does trot appy m in owner of 3 0 7 — INSULA"V'
1"UN d Inspections
property who builds m improves iherean,and who does such work himself or through his
Own employers,provided thatsola imprweencnuan notinmmed proffered forsale If. 601 — ROOF TEAR OFF
however,Ne building or improvement is sold within one year of completion,the Owner-
, WilxrwiBluAelkWrdenofprovingthatkdidnotWildorimproveforpurymcaf 602 - ROOF PLYWOOD NAIL
.R.). 603 - ROOF BATTENS
I,as owner of the progeny,am exclusively contracting with licensed contractors in
construct um pmjea(See.7044,Business and Processions Cade:)The Contractors U. 604 — ROOF IN—PROGRESS
cense Law dost not apply In an owner of property who builds or improves thereon,and -
who contracts for Such projects with a contra tads)licensed pursuant to the Conuastmes
License law.
l cru exerup,under Sec. ,B k P C for this moan
Owner Data
WORKERS COMPENSATION DECLARATION
1 hereby afrnm under penally of perjury one of the following declantiom:
1 have and will maintain a Canifnam of Consent m self imum far Worker's Compere
7'17(W"
on,as provided for by Section 3700 of the Labor Code,for the performance of the
rt for which this permit is issued.
have and will msiuin Workers Compensation Insurance,as acquired by Section
ofthe Labor Cox,far Ne performance of the work for which this permit u issued.
Worke CoT�matron Inwnt¢c arter end Polity n/up��kr art:rie ) �� Polity Na.: ✓u1C
CERTIFICA OF OT�P IONFROM WORKERS'
COMPENSATION INSURANCE
(Th'utseetipn need not In completed it be permit is for an hundred dollam(SIW)
nr less.)
I certify Navin the performance of the work for which this permit u issued.I titin not
employanypersonin yin oft sp8ct esubjcci a the Workers'Compensation
Laws of CalifomiaRsln �7 r/.�✓7
Applicmt ;
NOTICE TO APPLICANT:.I✓afmr making Nu Certificate Of Exemption,you should
become subjecuo NC Worker's Compensation provisions of On Labor Cads,you most
.JO forthwith comply with such provisions Or this permit shall he accrued invoked.
z` CONSTRUCTION LENDING AGENCY
[-•r Lhertby affirm that there is a construction lending agcory for the perfurmancc of
!Yi the work for which Lou permit is issued(See.3097,Civ,C.)
0.A Lenders Name *Date zLmdc,'s AddressU Q 1 certify that 1 have read this application and sum that the above information uly F cprrc t.I agree to comply with all city and county ordinances and sum laws reining to
0Ubuilding conswction.and hereby authorice rtpresenmives Of this City m enter upon Bmabove-mentiaxd progeny for inspection purposes.
y (Wc)agree msaw,indemnify and keep harmless Ike City ofCupertinoagainst
liabilitiesjudgments,costs and expenses which may in any way urns,agalOSl said City
U z in consequence of the granung of this permitAPPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
SOURCE REGULATIONS.
Signuurt ofApphcanUCantracmr Dam Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ike applicam Or future building occupant sure or handle hansdi us material
as defined by the Cupertino Municipal Code.Chapter 9.11,and Ike Health and Safety
Id.
le.Section 13532(a)? All roofs shall be inspected prior to any roofing material being installed.
MY.
Q3 0
Will the applicant or fu�Awn Wilding occupant ase equipment m devices which If a roof is installed without first obtaining an inspection,I agree to remove
it hazardous air contaminants u defined by the Bay Arca Air Quality Management all new materials for inspection.
trict? e$"O
❑Yes
1have read the k.Sam mamrialsrequirementsunsendedundOwof the Califon
HwlN&S afctyCodc,Scnioas 25505.15533 and 25534. in
oetum Iofthe
rs Ito nay kxe c u it I my en DI`2lMity ic to Ofy Ike pceupant or the
uirt n which s riot las issuance oh Certificate of Qcupan a Signature of Ap C t Dale
Owns,or au0o cm gam All roof coverings to be Class 'B"or better
B ildingDivision
10300 To=Avenue
19C Cupertino,CA 950143255
Telephone: (408)777-3228
CUPED-rINO FM (408)777-3333
VVI
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
Wand 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 V4"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: _Op4-A- Qci Ic
Address: 17 a F ✓ w U p C
Reroofing Company N �D IJ
Applicants Signature: Date:
Joe Antonucci�
(Chief Building Official)
6/25%01
(�G.. CITY OF CUPERTINO
CITY Of
REROOF
CUPEkTINO PERMIT APPLICATION FORM
APN #
NOE:�:_Building Address:
Owner's Name: l Phone #:
Contractor. Phone ##:v
—av� SC�SOtiS �i� a7� � 3 License #:
Contact: Phone #: Cupertino Business License #:
Dow
Type of Roof Covering:
Existing: Proposed:
U Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles
❑ Wood Shakes Wj Asphalt Shingles❑ Wood Shingles ❑ Wood Shakes
Z3 Wood Shingles
0 Other(Specify) CQ"t ✓C° ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand nd Wil] Com 1 With Cu rtino's Te az Off Policy:
. Job Description: 0 � ,_o
e Id-
Residential
Residential Commercial ❑
Fire Zone: Yes ❑ No jAb
Confirmed with Planning Det. if
Cost of Project: there are an restrictions: Ll
Type of Constructio Occupancy group:
QtY• i
A 1 ab Fee ID
BPERMFEE Fee Detion Fee Grou
Ener
\ BENERGY Permit Feess BUILDING
En
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOMSeiBUILDING
smic Commercial BUILDING
BPlan Check Fee
BUSLI CHK SLIC BUILDING
Business License BUILDING
2, �/