02070128 CITY OF CUPERTINO
r BUILDING DIVISION PERMIT ,,CONTRACTOR INFORMATION: '-
BUILDING ADDRESS: PERMIT
843 LILY AV FOUR SEASONS ROOFING N 82070128
' o , xE:SADHANA R TRUSTEE 645 HORNING ST APPLICATIOOI.SItB,DA1g2002
,,•PHONE: (408) 278-0330 SANITARY
UNO.
/ GL/ CONTROL NO.
G ZO ARCHITECT/ENGINEER: BUILDING PERMIT INTO
z iai BLDG ELECT PLUMB MECH
'Z. I I C=1 L.7 U
8s.�i LICENSED CONTRACTOR'S DECLARATION
;Zyo Ihearhyaffirmthat Iamlicenudunder prmisionsorChapter 9(commencing REROOF Job Description
w t^; with Section 7011 Division 3 of the Business and Professions Code.and my license
in full forte and eRe�k
be 3 License elnss C Sq . Lic.0 b F1 NALE13
0 p y Daae Contractor ♦ - NALE
ARCHITECTS DECLARATION
0< I maimstad an,plans shall be uud as public records FEB 18 2003
i S O O Licensed Prefesai...I
OWNER-BUILDER DECLARATION
1hereby.(Sentothat 7 1. exempt from the Cssions oe:AnycLawforthe BUILDING $9000
hg0 which'ingrtesapariiot ]onstruBuslneuavidve,demolish.
Code:Any city or county
F F❑ which requires a permit m construct,afilter,pplicant
improve,demolish. file
repair any swaurt
o thin he'ie ficinsed udoanndtbc'ravl,lons off Contract..Licenedgnednornmem - - __......__._....._.......__...____..._--.__.__....._.__._._
Prior m i¢issuance.also rcquirts the aPwlicom for inch permino file a
- D D e law mu,Code)
,.,: ,. 3 5 Q"d VIb6r.tgOla { , -,•, Valuation
(commencing with Section 7000Jof Divisum 3of the Business end Pre(siona Code) �.t-]�''-'3.-ids,_„�?': a,,',,'� p t•�LY..i�.4.-.1 At t.
or that We ix enempi themfmm and the basis for the alleged mnapiion.Any vialadmi
of Section 7031.5 by any applicant for a permit subjects the applicam to a civil Penalty
Of not more than five hundred dollars($500). 3 0 5tPN i`F] E : .., '':n Occupancy Type
❑1,as ownerofthe nd the property,to myemployeeswith wog..their solecompensation,
307 - INSULATION
'flusl.na shed Pm end thR nn is nualte.License red Ton".le-(Sec:1.an . I ^ '
Business-and erty Who
Wilds
Code:Thc Consmmors thereon,and w Low does not ork pito if 6 0 2 - ROOF PL ectioiis'"
ow a of p pent'W rr bu sc proves tIncd who does such work nded quits
orer uh hiso'n howls ,spm ded,Nats roimprovements erenot hin..c year or
off J r sole 14 ho cr the bolding p einem is mid within one year of6'0 3 -'-="ROOF' BATTENS- r,-,,_
completion,the owner budder will have the burden of Proving that he did not build or
improve forpurpase of sale.). 604 - ROOF IN-PROGRESS
-
,os awnerp the property,am exclusivelycontractingPronfniowirdbccnud,Contractor's
hi:illi;
construct the project(Sec.appl 7064,Business end Pmfesvob Code:)The Co thereo s '12t.t•
and
License Low dine not apply,p an owner of property who builds or seimproves thereon, -
.,,,.__... . .... ”
'.�= .nod who.contntlx for,wch.projau.withacom.acmr(s).licen¢d.punuenb to the.. _.__........... ... ... .. .._.. _...._....__._.._._.___.._.._..n.__.� � `._... ....._...
:. .. Conwood Linnu Low.-.. __...__:.._...__....
❑Iain errx^e--apt unCder�Sec."''npr'.�.i r:?::: `.';,cB'Jr P C far this reason
-" Owner'f'Ol]Y•CJa_4l`�tiC 'ZZ.�Q^Lp,.
-'WORKER' COM OJSATION DECLARATION
I hertby affirm under poralty of perjury one of the following declarations:
1.-S ❑ 1 have and will riminuin e Certificaie of Conuni 1.self-imam for wm,m, '
Compensation,-.;provided far by Section 3700 of the laim-Code, for he
Performance of she work for which this permit is issued..
hve end will meinmin Worker's Compenswioe Insurance,ai"uued by Section
3700 of the Labor Cade:for the,performance of the work for which this permit is
.sued My Wo kelt C open soon Insurance caviler rid Polls nu -y(.
.., - gaq.. - .yyY -R,IID
Comer sec C�l'PoqNn:'[1 I4�Act1 .� . . ' _ - - -
1MR
NOF PXEMPTION FROM WORKERS _ .Y. + I• -.11 !.t., ,L ,.y) t",, . .. - .'vt. __-.....
COMPENSATION IN SUR NCE, t
P.,.
fid'.
flhn seduon'rieed not berompleied if The permit is for one hundred dollars '
ISI00)ar leu,) ' '
-"' i 1'cemfY3Met in the rf mimce'o(tha ark for which this,", "•""-"-
pe _ pemut l issued I !- „hc
shall m employ any,pe m any Data r, m.to biloma a b)act ro'the Workers • '
C. s uon Lews of C hf mlo Den''-
-APPI t - -
NOICEAhIe WTIf rmeAir;this Cmfcme—Exemption you
bac mthokdr Compn.t fin provisions the Labor Code you must
forth ihu.mPy isch Provisions or this Permit hall
'
"
be deemed rmetiked.
tat Y ''°CONSTRUCTION LENDING AGENCY -"" - 1 . .1 ;.
�',; "' I h 'by:Rini th t Ne s mnswetlen 1 ding egenry for the pe Ibrnunce ,
{sl •r of the work for hich Nrs pe.mlt ucd(S c`7097 C v,C) .I ._meet. -
Q
U.:0 J 1 anJy that I love reed N appl c t on wd oat Chet the ebo e f.mad.is -
tf+,-[� carred 1 eg m comply nh 11 ctty.prid coumy d enc.avid n t la s relating
Q V to bu ld'ng conn ct on andh rttiy evihonu nprcse tduves of thuctty to enurupon
y W the bo x mem o cd property f r mspenion purpos .. _, . . ,f, /(^//
LE..i y IWe)aWeetb m s:mdeKm(y end Aeep huMeu the C ty a(Cupenm..8 or
'1/Y
In liabthuca.)udgmenu,cos.e d.penses wh ch may m any et'accrue agents:said
V,rZr City n consequcnee of th granting ofthis perm. - l "?�.
'APPCICA.NT IIN'DERSTANDIS ALD W'fl,L COMPLY NM1TH ALL NON one-
CE
sot REGu pTIM% Issued by: Date
Signatrea APPI¢an� UConvacmr " s v -Dave 'Y.
Will
the applicant orfuwrn buildin oecu crSu� 111 ima is Re-roofs
<:I MALsRDOUS MATERIALS DISCLO
PD g pmuiort handle Health and
Type of Roof. _ _
asde0nedby Ne Cupen no Municipal Code Chapter 9.12.and the HWme dSafety - I ' ' _. :--- - -.-
Code S❑cYn 25533(e?7ttw
.,.All,roofs shall.be Inspected,prior to.any,roofing material being installed__.---_
emat w,uNe.ircon ma f`arc definedbytheB pueauPmemordevrccswhich If a roof is idstalled'without first obtainingan ihs ectiori',•:l a ree:t&remove
eon haxerdous ur numina t ssdefnedb the Ha Arca An
P 8
Dhmet rY �No all new materials for inspection Applicant understands and w_ ill corn 1 with
1❑heve rced.Ne h.ardoui materiels requirements uncle Quality
95 0!the
CelitmeHelh&Safer CodeSecllons 5505remenYd3�n5b11'ndeo.ntk'hc all non-pointsourc�re ulanons
P.Y._
P 9
��
9 P
. P Y nmcrrctlyhve e¢aut.thnnsm y y "_ \—O ' `v�q,p _ ... ..
if the Wilding docs ,mmenu xhnh mun,be mei p o m lasuene fa Cercifidim b( ��� 011l.�•�V�.� `s` � C'fJ � - '' �- •-'?-'Z eU'�
'obmat (there . '
Signature of Applicant -.- _ _- . -
Date
Own ro o icdagem ��,cI t Z De^ie�?^ All roof coverings to be Class "B"or beifer
OFFICE
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
4CMF Fax: (408)777-3333
CUPEI�TINO
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 VV'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: Tc-. oc�lrrn ctio. r t� tQe - �oUr SSS-
Address: • 841 L i A -
Ay-Reroofing Company Name: (esSor\g
Applicants Signature: ' oCdx , �a c0 _ Date:
�Joe Antonucci _
(Chief Building Official)
6125/01