03090165 r CI'T'Y OF CUYER'I'INO ^u s �a rq. � yez'-�.ws ,"
BUILDING DIVI SION PERMIT �,i_ RA CT,QRI,NEORMATIQN
BUILDING ADDRESS: ALL SEASONS ROOFING SERVIC 9"""03090165
OWNER'S NAME: - 2640 PACER IN PERMIT ISSUE DATE
COMPASS
"E' 4089724455 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
C�
±ore L ICENSED CO NTR ACTOR'S DECLARATION
F de
1 hereby from that I am licensed unr prowiaimns sir chapter 9(ommencing lob Description
EiE with Section 701))of Division 3 of the Business and PoNkilinm Code,and my license is
sor'n in full fmmeao fig
),'a? Liccnr�S.Clus .�r Lic.N pp`®
p DOW Y—U Al Convacmr ��E® g�LJg R®
'I j ARCHITECTS DECLARATION
I C a 1 understand my plans shall be used az public records
o Licensed Professional
NOV 2"4 2003 AOVy -'(?03
S OWNER-BUILDER DECLARATION r
ay 1 hereby affirm that 1 em exempt from the e Contractor's License Law for me
O Ko following mason.(Section 703 L5.Business and Professions Code:Any City or county 10UILDING R]QUANG
ZOO
E which requires a permit m construct,alter,improve,demolish,or repair any auction,
YZY poor(it its issuance,also requires the applicant for such permit m file a signed statement
csM that he is licensed pursuant roto provisions of the Contractors License Law(Chapter 9 Sq. Ft. Floor Area Valuation
[$ (commencing with Section 7")of Division 3 of the Business and Professions Costs)or
i 3$ that he is exempt thcrtfrom and Be,bmis for the alleged exemption.Any violation of 356028015 . 00
Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of APN Number Occupancy Type
not more than rive hundred dollars(S500).
P Y YP
❑I,u owner of the property,or my employees with wages az their sale cmmpcnhat ire,
will do the work and the avuaure is not intended or offered tartaric(sec.7044,Business 3 Ub — FRAM and Professions Code:The Conuacmr's License UseRequired does not apply to an owner of 3 0 7 - INSULATI ON Inspections
eo
pmpeny who builds or improves thern,aesnd who dosuch work himself or through his
ben employees,provided that such improvements are not immndad or offered for a ale.If, 601 — ROOF TEAR OFF
however,Nyear of building or improvement is sold within one yof completion,the owner,
builder will han the harden of Dmmng mat he did not wild or improve for puryuse or 602 - ROOF PLYWOOD NAIL
sale
01.as mono,of the n 603 - ROOF BATTENS
❑ Sec. y,.Business
contracting with The
comwct theesnot apply
to anowneincssandity who
uids or
pro esnvacmri Lb 604 — ROOF IN-PROGRESS.
ante Lawdocsoatapplymu with
arofproperty ohm buildsor Improves thereon,art ,
who me,Law.far such projaca with a contrctor(s)licensed pursuant m the Convenors
License Law.
❑lam nempt unties Stt. ,B6PCfmr thismazon
Owner Date
WORKER'S COMPENSATION DECLARATION
1 wreby.farm under penalty of perjury orc of the following dalam;ore:
I haus and will maintain a CeNfieem of Consent o self-insure for Workers Comics.
sation,az provided for by Section 3700 of the Labor Code,for the perfm onme of the
work for which this permit is issued.
❑1 have and will maintain Wurkcrs Compensation Insurance,as required by Section
3700 of the Labor Cont.for the performance of the work for which this pemri,is issued. -
MyWork7Cortlperu 0 Inysnna canicaand Policy numberimi
Cartier.c 7J'Jr/K-'RPasv1/ Polity No.: �II.�L
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section sited nut be completed if the permit is formic hundred dollars(SIOB)
or less.)
1 Qcd y that in the performance of the work for which this Permit is Wood,I shall Out
employ any person in any manner sen as Or become subject o tw Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,atter making this Ccoi licate of Exemption.you should
become subject in the Workers Campemation provisions of the Lawr Code,you must
wJ z forthwith comply with such provisimm Or this Permit shall Is,deemed..ked.
z O CONSTRUCTION LENDING AGENCY
PI hereby affirm that there is a construction lending agency for Oc performance of
01> me work for which this permit is issued(Sec.3091,Civ.C.)
U.1p Lender's Name
ILz fender's Address
V 0 1 certify mal I hate read this application and scale that Ocmove information is -
CG P correct I agree to comply with all city and county ordinances and sate laws relating to
0V butilding Cmaknoomilinn,and hereby cannot,mpresentatives of this city to enter upon the �( /�.[q,/td//' /�/
ahovefics,judncdpmpcst for wmection purposes
F y
(We)agree to save,indemnify and keep howls.the City of Cupcnino against
p3 Iiabiliva,judgmcnB.cost/and apcmcs which may in anyway seems against said City
L) z in mnseyucnee of the granting of this permit.
^ APPLICANT UNDERS NDS AND WILL COMPLY WITH ALL NO POINT Issued by: Date
5 RCEA L S.
SJ -` Re-roofs
S' orc of an'Convacmr e¢
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
dl the applicant car future building Occupant store or handle ha uus material
a defined by me Cupertino Municipal Code.Chapter 9.12,and Ore Health and Safety
Code,Section 255J2(a)?
❑YesNm All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or fwure wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
til hri=cm air conmomprom as defined by tw Bay Ams Air Quality Management all new materials for inspection.
Diwict?
❑YesNu
I have read the".Wool``materials ret,i¢menu under Chapter 6.95 of the Califor-
nia HcalmS Safety CDM,Sccuum 25505.25533 and 25514.1 underscaM thuif dte wilding
does no it 'a tenant.Nat it is in,ma, 'bity m nor the acupam or me 07
rmm
me stw cenifateofOccupan gnatu Applicant ate
o�
caner ter am dzm ageat ,m All roof coverings to be Class "B"or better
Building Division
10300 Tone Avenue
171.
Cupertino,CA 95014-3255
Telephone: (408)777-3228
F= (408)777-3333
CUPERTINO
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 IY"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:
Reroofing
d
Reroofing Company Name: I' e Oki
Applicants Signature: Date: 9 z
Joe Antonucci
(Chief Building Official)
6/15/01
CITY OF CUPERTINO b 3 J
REROOF
CUPEkTINO PERMIT APPLICATION FORM
APN# Date:
Building Address:
10
Owner's Name: Phone#:
S p 330
Contractor: License #:
Contact: Phone#:
Oz1 -97/ — 1/`4 "
LS-
Applicant/Contra r: Fax#:
S Ca So.zs �oo� r y0� - 938 z11 7
Building Permit Info:
Bldg Elect Plumb Mech
• Job Description:
Residential: ,e-Q t .-t Commercial:
Sq.Ft. Floor Area: $/Sq.Ft.:
1904 66
^�
Architect/Enginee . Valuation:
Type of Co traction: Occupancy Group:
� do
Qty. if
A i bl Fee ID Fee Description Fee Group
rxBPERMFEE Bldg Permit Fees BUILIDNG
BENERGY Energy BUILIDNG
BSEISMICRE Seismic Fee Res BUII IDNG
BSEISMICOM Seismic Commercial BUILIDNG
BPLANCHK Plan Check Fee BUILIDNG
BUSLIC Business License BUILIDNG