02060055 OF
C[BUILDI C DIIVISIONNOPERMIT CONTRACTOR INFORMATION:
SS
BUILDING
EPINEVILLE AV FOUR SEASONS ROOFING PERMIT No. 02060055
D I� PJ�V LLOYD C AND A A 645 HORNING ST APn7tTY14. 'w52
E PHONE: SANITARY NO. CONTROL NO.
(408) 278-0330
MI+-Z ARCHITECT/ENGINEER: BUILDING PERMIT INFO
I,V❑ BLDG ELECT PLUMB MECH
FF LICENSED CONTRACTOR'S DECLARATION
O v 1 hereby farm Dai 1 am licensed under s or cna ter 9 mommencin lob Description
N_G Ya provision P g REROOF
F with S,cioia 7kX))of Div. Jofhe Business vnd Professions Code.and my license
is in III fort andeI 3 Z/o T/O WOOD SHAKES, INSTALL 7/16" OSB
o w License Class V Lic.a
Date a Contra or & 30 YR COMP .
LLC� - A�fi ITLCf 5 DECLARATIO
S I understand my plans shall be used as public records
Y
l p O Licensed Pro&ssional
o Oar I mor BUILDER DECLARATION
_ I greasy a(Gfm on 11. exempt from the Cosions C a License c Law co do,
t?< following reason. eormitnt IDnstr Business and Professions Code:Any city or county
Fd x o which requires v peanut m construct,atter,improve demolish,or repair any swoon
3 that t u nee,also req 'res the inions of for Such pamiuoflevsigned statement - -
thhi h licensed pursuant i the provisions of the Contractors License Law(Chapter Coat I A, , $6 M10ation
(com 6 ih Section]fl(gl) TD vision 3 of the Business anddPProfessionsasCode) l,v S ,Sq. Ft, Floor Area
of that he Is exempt therefrom and the basis for the critical exemption.Any violation - •"
-of Section 70.11.5 by any applicam for a permit subjects the applicant to a civil penalty
,of not more than ave hundred dollars 0500). 3 6 AP130,11l ®0 - Occupancy Type
❑1.as .net of the property,or my employees with wages as their sole compensation,
will do the work,, ad the swcturc is am intended or offered for sale(Sen 7044. 3 0 - F E
•Business end Profcssinns Cade:no Contractor's License Law does not apply to an Re aired Inspections'
q
owner of pfopeny,who builds or improves thereon,and who does such work himself 3 07 - INSULAT I ON
or through his own employees.provided that such improvements an not intended or _.... _.__ ..._ --TEAR,
"offered for sale lC however,the building or improvement is sold within one year of 601 ROOF OFF-",,,�,
'rampladon, heowne,.huRde,will have the burden ifpoot.,that hedid nmhuEdor602 - ROOF PLYWOOD NAIL
improve for purpose of mlc.).
-- _-- '-.__.-- .-_.._. . _ _ _ .603--- ROOF -BATTENS ---
coI,ax ownerprthe jecpmpe.lam exclusivelydPromoti withodcaad conooaottm ' :i,41 .:I: Iii
construct me project Bee.]IHa,Badness and Promotions ender)The conwanr's 6 04 - ROOF IN-PROGRE S S2,.,: :,- 'r I ..,.
- License Law docs nm apply to an owner of property who builds or improves thereon, '
-. ,.
--mad-who contracts for such projecu with,a conteactons)licensed pursuant.to.the__-_. _ _... ..___.._._.._.-__.-_____.--_ ----- _
_ Chis License Law.
1 mr,c .
- ❑ am exempt under gK" .B&P C for hix reason �' 1', ' ];');.L.':1 •
Ownpr' - •'Data
WORR'S COMPENSATION DECLARATION
"' Ihcrtby alarmKEunder penalty of perjury one of the fellow rig declamions: q
�f ❑ 1 have and will maintain a Ceitiacam of Cnnam to self-insure for Worker's �l J
C}�a{ Compensation, as provided for by Section 37W of the Labor Code. for the
ti
pcrh Ll"�Tp�trthlPermitt igds
❑1 aM III anmokeCom ar i I
req ned_by Se
cZtions
ii
Y ..tiJ]M ofthe LboCode,for the Performance f th k'! h h thispermit
ed ftyW k Isp � i carrier and Policynumber arc.
n //ts 'ePY N . \N
came.— � Nppb _p0 ,• -_ ...._,
,i CERTIFICATION OF EXEMPTION FROM WORKERS"
G
COMPENSATION INSURANCE _-_,.-._t•`.., J?_ r, s. f_- ., \O`�
i'
(Fri,
Th s sea on need not In complemd time permit is far one hundred dollars 't w`V t,` j; it s Jl-- - ------
($I00)orlcssJ
c ' 1 employ
n n ig pert f th o to b me subs ct to t o to.� I ( i
P Y a Y Person Y moons subject •• .._. . .
iom,st roto n to became b no the Workers I 'Iti'" i "'•'
Appli 'un Incas of CI f "Uat- '
Applicant. .N kin _
NOTICE TOctin he ANTIC a@rmakttimn swilia,ofcate of Exemption.youou oil
Z become soimpy the Worker's Compensathis parmi, hall be eLabor re,cRe . must
CC
r simply whti such provisions o,this permit hall be deemed revoked.
O fdnhwiih com I �
F_� -""' f'+.•CONSTRUCTION LENDING AGENCY-
�i 7 "1 hereby alEmi tbm thcrdis a conswniun lending agency fnr the performEnce �f 1 •t
� � of the work for which thii permii is issuetl(Sec.Jo97,Civ.C.1_ •.c .-�_ _.-- __._.. _. -_..
(� Lend N e • '� - - - _ _ .. _. .. ... .__-..-- _- _ ___._ ...
z Lerida Add - i ' �4
V- Icertfy than I hdth pplc fon and aid admi thertheam utfirmanuumis
LL't y fare t 1 agree tPIY II d county om hers d state I ling
t
>, building construction:and he au
by ' hmie p lives off iM1inementer upon
,A. the abo(We)agree
mo,e:nyfor in.potionpurposes. .
A. (Wjudgme mauve.andepenseskeep which sx
wa; 11yacruof engainstno aid / 1
.Zm.
liabilities,judgments f h and expenses which may in any way accrue against said
C.7,.Z.I City in consequence of he granting of this Permit.
- APPLICA. UND TAI CD mU COMPLY WITH ALL N6N�POYNT r\
sOUNCE cm Iolvs:C ,' �'?(0.-3 Issued by: Date
. Sisnvture o—f,pplii nvcontfa(or Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
wRth "apph,Irm orfunum building ocp t stomorharrialle hazati oatcnal Type of Roof. • .. ... - - ---
def ed by in u Illantri 1,C,ode.Chapter 9.12,and fire Health and Safety
e -1.
CodSect 25SRta1^ ..i 1 ' .Y + k ,v, 1
El - ]No,.,;, All roofs shall be[inspected prior to any roofing material being-installed..
` wntna pPLnmo f,a Wilding occupant use equipment or devices which Ifaroof is installed•without first obtaining an inspee[ion,-Pagree to'remove
emit Ifraidous e c m miis se defined by the Bay Area Air Quality Management
D Ira+ all new materials for inspection. Applicant understands and will comply with
oY's1 P - ' all non-point source regulations. :
it use mad I the h raw arr al rerpt imments under Chapter 6.95 of the
fth Hugh Br Softy Cod Section,25505t it
ad 25534.1ild dchat
T the W Id ng dee Safety
C e h mnant that n i ny rayons h lily a notify the - -
occupy t f the c is hmh must b,met p o o Issuance of a CemOcate of
Q eat,. m „ ' �i
—o Z Signature o Applicant Date
S D o x as ag i Date All roof coverings to be Class "B”or better
;_: ::_ ' OFFICE
f _ Building Division
10300 Torre Avenue
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.
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 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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
Address: L6 Y q 7 Y 1 A -e— V I H 'I - ,/T�
Reroofing Company Name: t o44 r"/
Applicants Signature: Date:
Joe Antonucci
(Chief Building Official)
6/25/01