03060011 CITY OF CUPERTINO °'*' - *^�- ' 'r f ''W"t '
BUILDING DIVISION PERMIT 6 C}QNI RACT®R4NFORMATIQN
BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT N003060011
2934 LONG DOWN RT)
OwNEWS NAME: 645- HORNING ST F""ffT bV"2/2003
E ANZA OAKS HOA
ONE: (408) 278-0330 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
o BLDG ELECT PLUMB MECH
Y00 LICENSED CONTRACTOR'S DECLARATION p�
1 beeby afroh than l sm limned under provisions of Chapter 9(commencing fwOtl. Job Description
with Seen..70(Ilpof Division 3ofthc Boomer and Reticule.C .andmylicenseis Ary p�
eo
infull rormar err REROOF r�
LDiac�nae au _5 Contracdor Q .
q ARCHITECTSDECL TION JUL 0 8 2003
jF 1 undersand my plans shall he used As public records
Sg4E Z ttte$.333.
Licensed Professional OWNER-BUILDER DECLARATION
BUILDING
2 1 aEm that 1exempt
from
the
COnoLicense taw for the
following reason.(Section 7031.5.Business and ns Cook: ny city or county
which u a to construct alae torten,clsoli or rarely any structure
prior bits issuance.
sue.Alm requires;
ethe applicant fmeach prorrit to file a signed statementtht,lccusedFueto doe vislocsotraehJmseaw(Chapter 9 Sq. Ft. Floor Area
$4N( h9tion
(omunncwith Section
7")ofDivialoforaftheBuand Cnde)o
that hatal exemt mercfmm and the bum fm me allegedcumption.Any violation of
_
Section 7031.5 by a"Applicant for a permit subjeeu the applicant to a civil penally of
.of more Nen It.hundred dollars(5500). IX' Occupancy Type
0 I.As owner of the property.m my employees with verges u Heb ark mmpenaaon,
willdo the work,and the structure boor intuded ororfeeed for salc(Sec.7044,Business _ dinspections
sed Professions Code:The Convacar's License Law does not apply b an owner of 307 - INSULA-i"
Property who bui Ida ter im proves thereon.end wha doeuuch work himself or through his
awn employes,provided that such improvements Are,not intended aroEered total*.If. 601 — ROOF TEAR OFF
however,me building or improvement is sold within one year of completion.the owner.
builder will haw:the burden of proving than he did not Wild or Improve for purpose of 602 - ROOF PLYWOOD NAIL
al..). 603 - ROOF BATTENS
01.As owner of the property,am exclusively contracting with licensed mntracton t. 604 - ROOF IN-PROGRESS.
construct Ore project(Sec.7014,Business and Profusions Cade:)The COnttacars Li.
mnse Law docs not apply in an owner of property who Wilds or improves(hemp,and,
who contacts for such projects with a mnsactor(s)licensed pursuant o me Contractors
License Lew.
0 l em exempt under Sec. ,B&PC for this reason
1�nurr Date
WORKERS COMPENSATION DECLARATION
i I hemby afntm under peulty of perjuryom of the following declmdou:
1 have and will maintain a CCNficaa of Consent to self-imum for Warker'sCompen-
m.,u provided for by Section 3700 of the Ulmer Code,for the performance of the,
k for which this permit u issued.
1 have and will mainuin Worloes Compensation Inmeanm,u required by Section
0e(Ihc faWr Cone.for tee mrformancc o(ae wwk fmwhich mu permit is iuue .
Worke Ca p1ew9on I ace nryyer and Policy number am:
ier. ot�`45 l�\ ` Polley No.: WC OaOO
CERTIFICATE OF MEMP ION FROM WORKERS'
COMPENSATION INSURANCE
('Dds secaon head not W completed Ethe Permit is forenc hundred dollars(SIM)
or lute)
I am(y mat in me peeformanm of me.,it for which this Permit is issued.l shall not
employ any perm in any mappar�oulo heeomblmua me Workeea'Campensetlan
Laws a(Califo Ie Dae
OTIC -
AOTICm J
NE TO APe In. .�,Conomaking this onions of of Latuor Can,you should
.,Obecome subject y the Wohm;Coon.d io prmwit"of me Ire Wr Cade,you muse
forthwith comply wire such pmvisioium orb permit shall WdeemW arcked.
Z'—' CONSTRUCTION LENDING AGENCY
lY.E4 T hml ereby arRthat there iso construction lending agency for the performamm of
7 the work for which this permit is issued(Sm.3097.Civ.C.)
14Q Lender's Nam.
7 z lander;Address
U Q I ceniry that I have mad this applies ..and auu than me Also.infonhadun It
gLL^F CORCCL 1 agree to Comply with All city and County ordinances and aWC laws relating to
0 building construction,ad hereby mthorim nepeesenutives of this city to tour upon de
a above-mentioned property for impecdon purposes.
H (we)agree 10 nave,indemnify and kmp harmless the City of Cupertino against
tR1 liabilities,judgments,costs and expenses which may in any way acme against said City
U 7 in cmisequence of the gnnang of this permit.
rte• APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Da
SOURCE REGULATIONS.
Re-roofs
Signswrcof ApplicaDem
HAZARDOUS MATERIALS DISCLOSURE Type Of ROOF
Willy at the C applicant Or future builMunicipal
Code.
Chapter
or handlAnd ith h eatdomd Safer l
As defined m the Cupertino Municipal Code.Chapter 9.12.m0 de Health and Safety
A.section zs532(a)7
❑res .dtLg_ All roofs shall be inspected prior to any roofing material being installed.
1 Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
I
t havaraous air contaminants u defined by me Ray Area Air Quality Management all new materials for inspection.
rict? f/(
0 Yu
I have read are huaNwsmatenam requirements under Cluper6.95 of dre Califon M
Hculth ctyCodc,Satlmu 25505,25533 and 15534.1 undcrsuM thsif the Wilding f r'
not one ly have a en s my responsibility b notify do occupant of me C•/
ire naw ich mus rte isnuancc oft Certificate of Occupancy, Signature ofA i int Dat
Owner or aulhorizca egcm Dam
All roof coverings to be Class"B"or better
.
Biding Division
10300 Toga Avenue
Cupertino,CA 950143255
Telephone: (408)777-3228
Pax: (408)777-3333
CUPEF�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 musthave 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. _ Qp 2r^ ��cLCS
Address: aa�3 q
Peroofing Company N
Applicants Signature: Date:
Joe Antonucci
(Chief Building Official)
6125/01
Saoa CITY OF CUPERTINO
- REROOF 3 ° (er " �J
CUPEkTINO PERMIT APPLICATION FORM
APN # Date:
03
Buildi Address: ,
0 �91V Lo,4�f doav vI
0wncr's Name: Phone #:
Contractor: Phone #: License #:
Fay✓- C So1S b' x? 033 C�7a 10�j
Contact- Phone #: Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
U Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles 0j Asphalt Shingles
❑ Wood Shakes 13 Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
U' Other(Specify) CQ "t ✓c(29
Number of existingcoverings T ❑ Other(Specify)
g ❑ Provide I.C.B.O. Report#
U To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: R__
Job Description: VO tf,�Lt t
` 7 d /cvl S U C)i ('k,
Residential Commercial ❑
Fire Zone: Y ❑ Noy Confirmed withh anntng D—e,Pt. if
there are an tem strictions: u
Cost of Pr ect: COD Type o Co t Occupan group
QtY• •
A tc bl Fee ID Fee Description Fee Group
BPERMFEE BId Permit Fees BUILDING
BENERGY Enei BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM --T-ismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING