The URL can be used to link to this page

04020111. CITY OF CUPERTINO•.! r v !' (aa^ a c •'! du�, i. BUILDING DIVISION PERMITCONTRACTORANFORMATION BUILDING ADDRESS: : 16Q Hj.Z1TRR2TQN PT ALL SEASONS ROOFING SERVIC ffMIT N004020111 OWNER'S NAME: PERMIT ISSUE DATE ONE: SANITARY O. CONIAOL NO. ARCHITEC (ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description P I hereby affirm Nal 1 am licensed under provisions or Chapter 9 (commencing with Soctiyyyand my license is in full fphC and eBeesC�� 3 �j Lie Licenf%d�� l,T , l g a� REROOF Damcanl tor S T/O SHAKE & COMP. /INSTALL COMP. TL {�ARCNr7ECfS D kRATION I understand my plms shall M used Chile aCmdC Licensed Professional OWNER -BUILDER DECLARATION I hereby allure Nal 1 am Cacmpw from IM Conuanoh License Law for the following reason. (Section 713L5. Business and professions Colt: My city or county which mquires a permit to convmct. alter, improve, demolLch. at repair any structure prior to its issuamo, also requires the applicant forsuch Permit o file a Signed summenl Cmuactors l.iconse law(Chapser 9 ' Sq. Ft. Floor Area Valua"500 Out he uliccn.d form umtltotho Emvisionanrthc (commenting with Section 7000) of Division 3 of the Business and Professions Code) or Chat he is exempt thcrtrom and the haste for the alleged exerepllm. Any violation of - APN Number Occupancy Type Section 7ML5by any applicant for a Permit subjects the applicant to a civil penalty of ani mom Brain Rw hundred dollars (S500h 36221018.00 1, as owner of the property, or my employees with wars" their sole Compensation. Required Inspections P will do the wok, snit theawnum is Out intended or offered mrmle(Sax. 7044, BmiM•• an owner of and perforsiour Code: The Contractor's License Law does nas appy to w q property who builds ar i mprom mercon, and who does such work himsel f or through his own employes, pmvidcd that suchimprosemmu artnot intended aroffered forsale If. �'��LI mpletion, e awmrr however, the building or improvement is mid within one )car of Cote D builder will have tha human of proving Chas he did not Guild or improve for purpose or ak.). ED 1, a owner of the progeny. am exclusively convecting wit licensed contractors to MAR 2 4 2004 consumes the project (Sec. 7061. Business loud Professions Cade) The Contrmto/s Li' Conte law docs not apply to an owner of property who builds or improves theme, and, who Contracts for such projects with a comnmons) licensed pursuant w the Conmmtons Licenselaw ❑ 1 am exempt unit. Sec. B & P C for this reason OwnerDate WORKER'S COMPENSATION DECLARATION 1 hereby afOrm under penalty of perjury one of the following declarations: eak n.Compcn- 1 haw and will maintain aCemOeam of Consent a eelFinsum for Weaken'. Compan- sation. a provided fm by Section 37M of the labor Cade, for the perfirrmante of the saflon. work for which this permit is issued ❑ 1 have and will maintain Workees Compenation Invuance, as resulted by Section 37W of the Inbar Cade, for the performance of the walk for which this permit is issued. My Warkeh cmimpannuffin, Immrattce c�am/y and Policy number me: micr.-� rL=nA I Policy No.: Ql?f5Sv?'OZ CERTIFICATEOF EXEMPTION FROM WORKERStU-r-O't COMPENSATION INSURANCE (This .,it. med mol ha completed if de permit is form. hundred dollars (SIM) or kers) 1 certify tom in the performance or the work for which this permit is issued, l shall not employany person in my manmr m as to become subject to tM WorkeR Comainot at Law, of Calihorhis. Date Applicant NOTICE TO APPLICANT: If. eMr making this Cenibcate of Exemption, you should become Subject to the Worker's Compensation provisions of the labor Code, you mute forthwith comply with Such pmvisinrs or this Permit shall bo doomed mwkod. CONSTRUCTION LENDING AGENCY 1 hereby construction0 lending agency for Che performance of thi that thea is aed(Sox. the work for whicM1 this pemnil is issued (Stu. 309], Civ. C.) ' ich � Condoler Namc Lenders AdNcv 1 certify mat 1 have mad this application and sum Out the show information is • correct. I agree to comply with W city and county ordir meas and sum laws relating to building construction, and hereby authorice representatives of this city so enter upon Ne 7 about-mentioncl property for inspection purposes. (We) acme m saw, indemnify and keep harmks the City of Cupertino against liabilities,judgment, casts and expenses which may in my way accuse against said City in conaequenec of the growing of this permit. * APPLICANT UNDERSTANDS AND WILL COMPLY WITH ON -POINT Issued by: Date Re -roofs Type of Roof i[ of AllpficarbUthurectin Date HAZARDOUS MATERIALS DISCLOSURE Will dte applicant or rusure building Coeupmt vote or handle h.ndous material as dcOned by the Cupertino Municipal Code. Coupler 9.12. and the Heald and Safety Cade, section 255320)7 All roofs shall be inspected prior to any roofing material being installed. ❑Y. VNu If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant m future building occupant use equipment or devices which it hasordnus air contaminants m dcOncil by the Bay Area Air Quality Management all new materials for inspection. DiWiCl7 yes ON. 1 haw read due hUx mous mawrialsmquitements under Chapmr6.95 of the Califor- niaHealth & SafewyCode, Sections 25505,25533 oil 25534.1 un )moral thvirthe building dors not Currently haw a mmol, that it is my responsibility to notary the occupant' of the ajOccupancy . requints whim gyrt W met prior to issuance of a certi0nmf Signilittie of Applicant Date / r All roof coverings to be Class "B" or better o 5e r r mho and arm Date ' CITY OF �UPEkTINO JOB ADDRESSy Fj OWNER'S NAME: Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department PERMIT # 0 � C2 PHONE tj y7 FAX # I am not using any subcontractors :P a Signature Date ____J+ho fnllnvrino infnrmation: Please check appucable 511M ,llunuvia SUBCONTRACTOR a L. �W. -,-1- ---- ---- — – 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 V ATilea , bi"e4/Contractor Signature 10/28/03 oZ -17-ay Date CITY OF OF UPEkTINO Community Development Department Building Division City of Cupertino 10300 Torre Avenue Building Department Subject: Re -roofing policy for the City of Cupertino Telephone: (408) 777-3228 Fax: (408) 777-3333 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. 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: 3 h an T Job Site Address: 1169 Me,1-; 1+Xsd/7 f la_c.i Roofing Company Name: u/n J ✓e S A plicant's Signature: Greg teel Building Official {� Date: Revised 1/30/03 Printed on Recycled Paper 17, CITY OF CUPEkTINO CITY OF CUPERTINO 1=1919M PERMIT APPLICATION FORM C)�40�L)(i( APN # 2 GZ ZI f BUILDING BENERGY Dater /? D Building Address: BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM G .S� BPLANCHK Owner's Name: /was �nf Business License Phone #: oFt 203 2679 Contractor: Phone #: License #: 44 7/ ss D 9/ Contact: Phone #: Cupertino Business License #: e2eeiligco 508. 97/. r/SS o)/03 5 Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles ,K Asphalt Shingles 0 Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings -.5 ❑ Provide I.C.B.O. Report # A To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: -ia7afal/ n/ 2az� ays Az 1-n >` S:. os, ,05� rl- 47- 9 Residential Commerciar❑ Fire Zone ---Yes ❑ No 91 Confirmed with Planning De t. if there are any restrictions: Cost of Project: Type of Constructi : Occupancy group: — Ob / i Fee ID Fee Descriotion Fee GrouD 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 � ZfS�38