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04060132 CITY OF CUPERTINO "yra,�a��r>'/- y�yy� Fyy�a�♦'� �^s BUILDING DIVISION PERMIT '%-. �1\•L.lttl.4W .1�Ll.0 Q1V.1V�F1? W�. - _ - - _ ` BDILDINc noDRFss: FOUR SEASUNS ROOFING - PERmIT N404060132 -- 10205 POTTERS HATCH OWNER'S NAME: PERMIT ISSUE DATE DEANZA OAKS HOA 645 HORNING ST 06/15/2004 ONE: SANITARY NO. CONTROL NO. (408) 278-0330 ARCHITECUBNGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH +�O o LICENSED CONTRACTOR'S DECLARATION �¢u F 1 hereby affirm that I am licensed under previsions of Chapter 9(commencing Job Description n< with Soetion7")of Division 3 ofthe Business and professions Code,and my Hecate is < in full force and effect./10`14 REROOF =Z License Gla}: r�cout 7108 e Date� y O V ConOector ARCHITECTS DECLARATION I understand my plans¢lull be wed n puhlic moods DyU 30 Licensed Protnaional 3 OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Commences License Law for the po following return.(Suedun 7031.5.Business and Profession Code:Any city ver county which requires a permit to construct,tltee improve,dcmnllsh.or repair any structure $8000 FZj, pdomn its ismanm,alsu requiresthcapplicam forauch permit o file a signed summent that he is licensed pursuant o the provisions of the Common's License Law(Chapter 9 Sq.Ft.Floor Area Valuation B (commencing with Section 7")of Division 3 of the Business and Professions Code)or that be Is exempt therefrom and the beau for Cw alleged exemption.Any violation of Seotlon 7031.3 by any applicant for a permit subjects the applicant to a civil penalty of 3 50 9AMeOccupancy e not mom than fin hundred dollars(5500). P Y TYP ❑1,ssawnuofthepmpcny,ormyemployceawithwagnolheirsalce MMnwdan, will do the work.and the structure lsnotimanded oraRCRd farsele(Sec.7W,Business Required Inspections and Prafessian o Code:The Communes License law oa dors t apply to an owner of q P properly who builds or imp.thereon,mulatto dee¢such work himself or through his own employci provided that such improvements are not intensW uaffered foraala If. bNti the bu improvement is within ofcompletion,theowner- builder builder will have bu the rden of proving that he did Out build or Improv for puryose of sale.). ❑I,as Owner of the property.am exclusively contracting with licensed contractors to contused the project(Sec.s 44,Business and Professions Code:)The as themon. cad cense law don not apply w an owner of property who builds oramt to the Corton,and who se Lacts(or each projects with aconlsacmr(q Ilcertsed pursuant la the ContractoM1 0 1 are Law. ❑lam exempt under Sea ,BBPCfor this mason 10wra, Date cry WORKER'S COMPENSATION DECLARATION I hemhy affirm under penalty of perjury one of the following declension: eve and will maintain a Certificate of Consent to self-inume for Workers Compere me,n provided for by Section 3700 of the labor Coda,for do Performance of the ' rk for which this permit is issued. 1 have and will maintain Worker's Compensation in¢urence,as squired by Section 00 of the Labor Code,fu the performance of the work far which this permit is Issued.yWorkee o personas Insurance carrfu and Policy number amrder: ;065 Policy No.: 22 r CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This rection need notes completed If the Perm tt is far omc hundred dalhrs(5100) or last.) I certify that in the performance of the work for which this permit is issued,l shall not employ any person in any manner an as to became subject to the Workers'Comp ruadon . Laws of California.Data Applicant NOTICE TO APPLICANT:If.ufmr making this Certificate of Exemption,you should become subject w the Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply wit such provisions or this permit shall be doomed revoked. r r~�.. CONSTRUCTION LENDING AGENCY �-r I hetbyuRrm than there iaaconstruction lending agency for the pnermanauf tYi 7 the work fur which this permit is issued(Sec.3097,Civ.C.) t QLender's Name Q z Lenders Address C)Q I certify that 1 haw read this application and sum that the above informadon is (L F coma 1 agree to comply with all city and county ordinances and sow laws relating in QV building convection,and hereby authones mpmsenmives of thisCity w enter upon the U above-ment(oned Properly for inspection Purposes (We)agree to saw,indemnify and keep harmless the City of Cupertino against r;ypj Ilabilium,Judgments,costs end expenses which may in any way memo agamn mid City U 7 In consequence of the grantin this permit. r-t APPLICANT NDERST AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE T !) U Re-roofs ' Sig tar Ap IicanU ver Dam - H RDOUS MATERIALS DISCLOSU E Type of Roof Will tc applicant or future building occupant store or handle baseman metrial as defined by the Cupertino Municipal Code,Chapter 9.12.and the Health and Safety - od 0 Section 255324)? All roofs shall be inspected nor to an roofing material beim installed. ❑Yea ❑Na P P Y g g Will the applicant or future building occupant are equipmam or devi=n which If a roof is installed without first obtaining an inspection,I agree to remove emit harurdaus air conuminsnts as deEncd by the Be,Area Air Quality Management all new materials for inspection. District? �y Oyes ON. I n&SaBl the ckavardauamatrial¢requimmcnts under derPm d than fthc Califon via Halt&Safmy CodC.ScemomrSsu hiu iti2myrsnd S53a.1 an deoccCe Wilding 14 Jars not curtenC M1ave a tun n it is my msponsiM1ility w notify do aecupant of to sl rcyvircmcnss ch tial issumccofaCcnifiestaf09cu�I�� Signa re ofAp (cant Date Owmcrara orindagml (�/�/ - rlato All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 �UPEkTINO Building Department JOB ADDRESS: PERMIT# yo o/3z- OWNER'S NAME: AZA S PHONE # yo8 z 8—d 3Q GENERAL CONTRACTOR: AX# MOD 7,78-6 333 I am not using any subcontractors: Si a Date Please check applicable subcontractors and complete the followmi information: 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 caner/Contractor Signature Date Community Development Department Building Division City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 U��'�O 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. 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: 0t�NZ,9 OW-5 1704- Job Site Address: 10205'- AY' Roofing Company Name: fi/i' <;LaWWLX 904 7_ . A plicant's Signature: /��_ Date: Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper ' CITY OF CUPERTINO a v 6°4 REROOF CUPER INO PERMIT APPLICATION FORM APN# 9 Z 3_�,_ oT Date: Building Address: OLb ' axg Owner's Name: Phone#: ,fJkwu- ops _ /j/G 7Z� Contractor: Phone License#: Contact: Phone#: Cupertino Business License#: ? 9—a Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles JwL Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ' ❑ Wood Shingles [Y Other(Specify) li�h[G/ J ❑ Other(Specify) Number of existing coverings / ❑ Provide I.C.B.O.Report# D�To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Descriptign: C s Aextn r ,4 1 r-.64w xozu A,dA / ae� T l �4 P Gr uo Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project: Type of Construction: Occupancy grou CZl3 ! �®F S Qty. if Applicable Fee lD Fee Description Fee Group BPERMFEE 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 - � 7 � 0