02030220 clBUI OF
NG DIVISION
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
912 NEW HAVEN CT FOUR SEASONS ROOFING 02030220
a OWNER'S NAME: APPLICATION SUB DATE
TOM WILLYOUNG 645 HORNING ST 03/29/2002
PHONE: (408) 278-0330 SANITARY NO. CONTROL NO.
O zo ARCHITECUEI4GINEER: BUILDING PERMIT IN
w_ BLDG ELECT PLUMB MECH
u u u u
as
i LICENSED CONTRACTOR'S DECLARATION lob Description
i Z m I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing
with Stedct(ioon 7000)of Division 3ofthe Busie. andPod-11dea
onacondmyficense REROOF.
is� Ln�a"nse79,sme°`d` — Li� � d-1 T/0 SHAKE, INSTALL 1/2 "CDX PLY
iLLag cD ARCHITECT'S D ARA ON INSTALL PRESIDENTIAL.
I undersuM my plans shall be used as public rtcordx
Y
1 6 p O Licensed Professional
OWNER-BUILDER m the CoATION
u� 1 herby.(Bete dim 1 am exempt from the Contras Cod License law for the
te
C?< fallowing maws Permit
to
7onsum Business and improve.
de o demolish,
Code:Any city or county
CFC which requires v permit w ronxwct,alter,improve,demolisM1,or repair any mmnum
ca
cam_prior eW Its ls insUM rsuammresthe applicant for Ne such permit file a signed statement.. .__ ..._......_._ __
.._- ....___. .._..
mo�nm 7i vat-"_.also provismmm twsuemttlaw(chager9 ,._ S FLFloorArea, ation
mmmmemg,imse=tian17 W)of Division 3onne Business and vrore:=ions code) ii C I';2-Ykq`.+1,; 5 •i. `t Z:Z C75'J $8!�®�
or that be is exempt themfrom and the basis for the alleged e$emptiusi.Any violation
of Section 70315 by any applicant for a Permitsubje as the applicant to a civil Penalty
:of not mortdons rose hundred do)[.S50)). 3566E NTb'TO t':. 't l .., Occupancy Type
111.es owner of the property,ur my employees with wages as their sole compensation.
will do the'work:'aad the'swcture isnot intended or offered for sale(Sec:-7044; - -Bribes,add Professmns Cade:The C.roomm,a License law doses not apply to out; 305 - FRAME Required Inspections i •' ,
owner of property Who Wilds or improves thereon,and who does such work himself
or thro,ssly his own employees prov ded that suchimprovements a tmended or 307 - INSULATION
�dReied fa soli If,However th<budd ng o p ...Id th e yam or. _ ._ __.....__... ._ ...._ _ ..._._ -.._ .. ... __.
completion,the owner budder will have the burden of prov ng that he did not build or 6 01 - ROOF TEAR 0 F F
mprom for purpose of sale.). 602 - ROOF PLYWOOD NAIL
_ c e property,am axclmsdal,commohng with en�nratims to. ._.. _... ..._.._60.3.. .-. 'ROOF BATTENS ._._. ..-._ .. .,-_ .. . ...
❑Los castrated the .,.
_ - construct the project(Sm.appl]044.Business and Profusions Cade:)The improves
tnreon, 604 - ROOF IN-PROGRESS '
License law dos not apply man owner th property woo bulice se i purl a thto the
o.mmnens.fLessuch Projects-with v.cmmnnmr(g.licenud pursuant to the. .,_- ------_._ .. -
01 samors License IoW.
- ❑lam exempt urWcr Su. ',B&PCfor this rtawn .I i) P. l t' 8L
Owncr Dain' FINALED
WORKER'S COMPENSATION DECLARATION
Ihereby affirm under penalty of peijur,one of the following declarations: APR 1 0 20 02
❑ 1 have and will maintain a Cenific,te of Consent to self-insure for Worker's
Compensmian, as provided for by Section 37W of the Labor Code, for Ne
- performance of the work for which this pcmdt is issued. .
_ - D I have and will maintain Worker'.Compensniiun Insurance,as national by SectionBUILDING
3700 of the Labor Code,for the parfumnnce of the work(o'rwhich this permit is
dr MyWorker,Compensation Indeed c e and Polley hr arc
�4t(-.x0.4(.� a"t GdCa�SLQ� 7 7 ( l:.,R l t.p. - l ff z y .��,:•
,'CEmF1CATIONOFEXEMy ONFROMWORKERS'��' -' - �•� I I .l'�.' I
_ .-...I COMPENSATION INSURANCE',�e„e..,_r,_..._... _._.____..._......-....__... .__ ..... .____.__...._____ _....._____.
(This udron need nm he completed if the permit is for one hundred dollars ” '' '• I i. i(S 1100)or less)
r.,q 1'cWBytht'n'he pefrm ce ot the work for whinch"dinapc 1' ',.ad,l
shall not employ any'fammn to any manner w as to become subject to the Workeri
Compensation Laws of California:Date^ '
.Applicant...
NOTICE TO APPLICANT.'if,after making this Cenificme of Exemption,you should
become subject the Worker's Compensation provisions of the Labor Code,you must
ked.
Q O Forthwith comply with such pro or thisPermit shall bshe tt N rt o
V� b "'CONSTRUCTION LENDING AGENCY ',` •'
I"" ""' I hertby eRim that them s e rmnsvucuon IerWing agency for tde perforinance it
W-a�-I of Ne workfor which this permit is issued(Sec.3097.Civ.C.)_, "•"
�
Leader's Name-^' -
'.z Lenader's Address .,,.••, .. ., t -. . '.,. „•I
V' I certify that 1 have rad this application and sum that the above information is
6w cmmet.bagree to comply with all city and county ordinances and state laws relating
Q-[) to building cons,rctibm and thereby amnon.mracamouives of this citymmmerupon
',:W theahove-memioned pope ray for inspection purposes.,, _
{{....,, CW (We)agate to save:t damnify and keep hrmadiss the City of Cupcitino againm sit
V V
ice.-Vj liabilities,ju mems,cost and expo es which may,is any way acme against said
CU'y City in con cq ace of the gra i g l permit.."I I ' '
APPLICAI TU DERSTA' RL COMPLY WITH ALL�NONIP�INT Issuedb Date
SOURCE V A7TON JJ rZi. �0 Y'
mare of Appliccrou1 RIy0U5 MATERIALS DISCLOSURE deter, �� '•' Re-roofs
" - l
Will ilic.Ppli6ancir hicareWilding ocimisaint stare or tui dge nauNoas mmmal .Type of Roof . - - -
:defined by the Cupertino Municipal Cao Chapter 912 and the Health d Safety f` " _ „ i,,
Code C)Ye 25532(1 i .� ".
All roofs_shall be,Inspected-pnorlio any roofing,matenal being installed.
'Will thq applicant Y t building occupam use equipment c which If a roof is installed'without first obtaining an inspection';I agree todremove
emit heaardous au conummanu 6 defined by the Bay Arca An Quahty Management ,
District] all new materials for Inspection. Applicant understands and will comply with
°Y° r,";t t t �" , . all non-point source regulations.
�4 1 hatva,rasd,tlbl hausind6in,olaremils eymrcmenu under Cnepur 6.95 ofthe
California Health&Safety Codc,Section 25505,25533 snd 25534.1 undenurM that _
ifihe but ' dos not corm y vc nam,thin it is my responsibility to notify the
cup n of.t y m ch M1e m i prior o issuance f Ccnipcete of
DCCI� Y . .
•. �j�J Signature of Applicant Date
n
D aummr,e rat All roof coverings to be Class "B"or better
•� _- _ . ` OFFICE -
V 1
m. Building Division
10300 Torre Avenue
F Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTiNO
Building Department
Subject: Reroofing policy for the City of Cupertino.
i. 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 1/a" 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: jet
Address: 11 N 2 4c-w P x Ci—
� 1
Reroofing Company Name: C
Applicants Signature: Date: -z,
Joe Antonucci
(Chief Building Official)
6/25/01