The URL can be used to link to this page

05060146z z.. H WQ .a�7. Z UO OU U W U� CITY OF CUPERTINO BUILDING DIVISION PERMIT ��cONTRACTOR INFORMATION BUILDING ADDRESS: L2806 POPLAR GROVE SO FOUR SEASONS ROOFING PERMIT N005060146 OWNER'S NAME: PERMIT ISSUE DATE LAURA H HAMMER ONE: SANITARY NO. CONTROL NO. (408)278-0330 ARCHITECTYENGINEEK: BUILDING PERMIT INFO BO BO mum 0 LICENSED CONTRACTOR'S DECLARATION Job Description I hmby affirm that l am licensed under provisions of Chapter 9 (commencing with Section 7001) of Division 3 of the Buunesa and Profeaaions Code, and my license Is infnnforceandert Lwense Class 39 Lw.• 47- . +� p REROOF W COMP. ��j))j i�j(1��, / NA Dam 4 92—mac— Canuacwrz<.r [n_. r.. +:�L'� 1undersand my plans CHIIbe73 upublRATION / 2005 Licensed Pmfessumal OWNER -BUILDER DECLARATION I hereby 4Rtrm that 1 1. exempt from tiro Cosies c License Law for tit following mean. (Sween t I am, Businesspt from and he Cosiuns Code: Ansi city w county rt In IS It�l Ijj �I which requires a permit to construct. altar. impmw, demoiah, or repair any structure II I)` prior In is issuance, also requires thcapplicant faraach permit in file a signed Matament that he is licensed pursuant m me provisions of me Contractor's License LW(Chapmr9 Sq. Ft. Floor Area — v Valuation (commencing with Section 7000) of Division 3 of ass Business and ProfessionsCode) or ]—- that he is exempt therefrom and the basis for th, alleged exemption. Any violation of r0 0 pe Occupancy Type Section 7031.5 by any applicant for a permit subjects than applicant m a civil penalty or not mom man Ow hundred dollars (SSW). ❑ L As owner of the property, Or my employees with Wages As mein sets compensation, Required Inspections will do the wish, and mea nneu e is not musumd or offered forego (Sec. 7(44, Resumes And professions Cade: The Comrmmrs License Law doe ncl apply m an marcs or properly who builds or im proves thereon, end who does mch worthimself or through his own employee. provided nonsuch improvements are not Intended orortemd for sale U. however. the building ar improvement la mid wimin one year of cempimm, to owner builder wilf haw she harden or proving that h did Out Wild or improve for purpose of aid.). ❑ 1. as owner of the property am exclusively contracting with licensed wntrecmY to construct the project (Sec. 700. Business and Professions Code:) The Conmscude, Lb cents, Law doe not apply m an owner of property who Wilda or impmw thereon, and, who contracts for such projects with a mntrmtor(s) licensed puavarn in ths Conaacteh License Law. ❑ lameemPtunder Sec. .B&PCfwmismuon Owner Data WORKER'S COMPENSATION DECLARATION I heo" affirm under penalty of perjury one of Om following declamation 1 haw end will msintain l CeNftcam afCom.1 m self.i.Y. far Workers CamMn- ,tion, As provided for by Section 3700 of me lather Code, for the performance of me work for which this permit is issued. ❑ 1 haw and will maintain Workees Compensation Insurance, as required by Section 3700 ofthe labor Code, for the performance( the Werk fwwhich this permit is lewd. ' My Workers Compensation Insurance carrier ane- d Policy number am: Carrier,�T. Su.fls •e / /�'"PollFs� No.: `sGAVoxar'oa/ CERTIFICATE OF EMPION FROM WORKERS' COMPENSATION INSURANCE (This sxdoo wed not beeumplemd lith permit is forum, hundred dollars (SIM) or less.) , 1 certify mot in me performance of the work for which this permit is isswd. I boll nes employ any person in any manwrm As In become subject to the Workers' Compensation Laws of California. Dare Applicant NOTICE TO APPLICANT: If, after making this Ce tiOom of Faempdw. you should became subject An me Woher'a ComPcrwdon provisions of the Lahor Code YOU MM forthwith comply with mch Provisions or this permit Mall he deemed rewked. CONSTRUCTION LENDING AGENCY I hereby affirm that them is a construction lending agency forth performance of the work for which ma permit 4 issued (Sat. 3097, Civ. C.) ' Landers Name , Lender's Address I certify the I haw mad this application abo sum me the abow informadw Is coma I agree m comply with all city and county ordinances and Mate laws miming m t building ewsmuction, and hereby aumorim repremnatives of Nis city tomer upon me , above-mentioned property for Inspection purposes. (We) acme in eat, indemnify and keep hemkss the City of Cupertino against liabilitias,judgments,cosY and expenses which may in any WAY accuse agalnsteid City In conuegwnce of thc granting of anis PcrmlL APPLICANT UNDER DS AND W L COMPLY WITH ALL NON•POINT Issued by:S Date G- Z z - Re -roofs Type of Roof gra ofAppliwnDam AZARDOUSMATERIALS DISCLOSURE Will the applicant or future building Yreul ant Yom or handle hazardous ma nisi As dcOwd by the Cupenino Municipal Code, Chapter 9.11. and 0th Health and Safety cods. Section 25531(U7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes ON. If a roof is installed without first obtaining an inspection, I agree to remove Will tbe applicant or future building wcupem use equipment or devices which h havardom air contaminants as donned by me Day.Ama Air Quality Management all new materials for inspection. inrlc17 ❑Yes 0 N I haw mW the hazardous materials requirements under Chapter 6.93 of the Califon _ Health & Safety Code. Sections 255D5.25533 and 25534.1 undemund shad if the building Z. does not currently have a sena t�tluI Its my responsibility In notify than weupant of the nis which a= epimt mauve or a Ccnificam of Occupancy. 6riatu of AppliC Date M All roof coverings to be Class "B" or better owner amherixedag Dam t� Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/ Contractor Signature Date 0 • . Community Development Department Building Division City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408) 777-3228 U ��0 Fax: (408) 777-3333 Building Department Subject: Re -roofing policy for the City of Cupertino 1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards and manufacturers specifications on re -roofing. 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 re -roofing 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) Pre -inspection 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 a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re -inspection fee of $176.18. The re -inspection fee must be paid before another inspection can be scheduled. 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 on inspection. I understand and will comply with the above stated policy on re -roofing. Homeowner's Name: f!mew l//� 1J,4N7",e .. .. i♦ r. —•.. Roofing Company Name: Applicant's Signature: Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper Date:�Q_ps ,CUPEkTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM 6S—v 6/'n'l t Qty. if d nnlir�hlP RPP rn FPB Descrintion Fee Groun BPERMFEE 3 � APN # Date: BENERGY 3yz3 0 -� BSEISMICRE Building Address: BUILDING Owner's Name: Phone #: BUILDING BPLANCHK Plan Check Fee BUILDING C tractor: Phone #A&S License #: BUILDING 2�ra- e-) y Cont a t I Phone #: Noe Cupertino Business License #: p U T3 0 Type of Roof Covering:. Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles ja�, Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles .*, Other (Specify) CGMinloo[I ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: b Description: I BkA Residential Commercial p Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: U Coof Project: Type of Co truction: Occupancy group: 0Da t Qty. if d nnlir�hlP RPP rn FPB Descrintion Fee Groun BPERMFEE 3 � Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING 6 -D 7