02060112 CITY-OF CUPERTINO "
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
B 9
1Lp18"S "un DGEWAY DR FOUR SEASONS ROOFING PERMIT No. 02060112
G 2SNabStP2A OAKS HOMEOWNER ASSOC. 645 HORNING ST AU�CtIj0g"i�U2
1 PHONE: _ (408) 278-0330 SANITARY NO. CONTROL NO.
QOZ 'ARCHr ECTIENGINEER:' -' '- BUILDING PERMIT INTO
m F "' BLDG ELECT PLUMB MECH
h i`orf IuJ�
,y" LICENSED CONTRACTOR'S DECLARATION
"_ I herchy afnrm but l am licensed ander proviti.ns of Crime,9 fcmmaenc!Ag TEAR OFF EXIST.Jo� Bn INSTALL 1/2 11 CDX
rot -an Sectinn70fX)Iof Division 3orthe Buturessand Professions Code.en ny license
2x in(anmreea «ep �f COMP. r'�NA�aalr�'�
4,
rG License CI e J L!c.p / f/
0 2 ,Da¢ Contractor
ARCHITECT'S DECLARATION
a
l
e,
stand my plans shah be used as public records JAN 3 0 2003
r o Q Licensed Professional
OWNER-BUILDERDECLARATIONhe ommon -
:+� `I hereby a(0mt ohm 1 am exempt from he Cosion;C s Licenu Law for the
�?C whichingrcuom Permit
]o3L5,Business and improve,
Profession;Code Any city or county BUILDING _
which¢quirts a pcmnit oo conswct,alcor,improve,demolish,or repair an srrvcturt
d es-pdor 30 its insurance,also requires one appliemrt fm such pamit to file a signed su¢mem __$_B O,O_Q_...__ — _____
That 65iALcensed punulnil me provisions of the Conaxim's License Law lChapur9 t .Sq.�I" �1D0 Area t Valuation
(commeticmg wah Secti ]000) f D,vis,on 3 of the B.Ime it nd Prpfors ons Cade) (_ .1,,'1'r'a', ;S d'g ore ' R:�i i`d,
or that he is exempi oh from nil thebasis for the alltged eAampS,p Any violation 3'4 2 41"0'18':0 b �I
of Section 70315 by any applicant for a pemnt subjects the applicant m a civil Penalty p y •J p
infant mom than five hundred dollars($50% APNNumber Ii�e:L r'�n Occu ane e
°1,as owner of the property,or my employees with wages as their sole compensation, 305 - FRAME
'witI do-the work:And the structure is not imended'or offered for'sale'(Sec:703q 307 _ IN LA
- - -
'B'u.xfneii and Professions Code:The Contractor's License Law does not apply to an fired Inspections' •-
owner f property Who builds improves thereon,and li d o work himself 601 - ROOF TEAR OFF
or Ili n t h a npl y c Provided that such cop ova t am n ofintended r
-arra, illi . m"Irer-b Inllavet p that he ------ -602- '-ROOF.....PliYWOOD NAIL.. . ..__ _.._. _..._._..-.__
<bnrove la the owner-budder will have the harden of proving mm he did not build or
improve mr patpaxe of:ale.). 603 - ROOF BATTENS
' -� - "Ol;vaawnerofinepropeny.amexdusivelycomrutingwithlicenudcomreaorsm 604- ---ROOF--I-N-PROGRESS--------'-'- -------------
License the does
project(Sec. 1104,Business And Professions Code:)The Contractor's t t r
License Law das .f apply m an owner th property who builds or improves thereon. "'
:'" _; aod,who comrade.for.such prolaos.whh.a covuutogs).licemed pumuant.m.tlm. ____...___..__�____._ _ _.__._._. .._..__.__..__.�.__._._-____._.._.__.._ ...__.......___.______ ..._._.
- 01 am
License low„-, -nc f' t .t'
❑lam aemptuMer Sec.' ,B&P C for this reason .. !'• l'ew;•ri^:”)n
Owner• :. :.Date.:. :..i .,. .... ... ..•.nbvu"
WORKER'S COMPENSATION DECLARATION
1 hereby if irm under p.] fofperjury one rc.of the following declarations:�-
•° 1 have end will'unnatitin`a Cmiflcmfbf Consent to ulf-irium a for Worker's .
Compensation, u;provided-for by Section-3700 of the Labor CMe, mr-the
'performance of:he work for 1 .11which this permit is issued..
°1 farm e'd a ill mainmm Worker's Cwriansmathm"Imurfunce.as requited by Section
3700 of the Labor COI toy the Performance of the- ork'f r which thispermit is
IC'sued My W rs Compe set O Inssm c e and Policy rr be
- nve ` µ'Poli Na.:
_ ".. _t , , OS"`alit �iCf j ,y� ..,.,,.,___._s.�_...:• ... ..__ -,..`.-
'I 'pct tZ RTIFICATI EXEMYPTION FROM W ftKaRS t r.,x 3 L 1„ f 1l, i �v
" "COMPENSATION INSURANCE'S'; sec' - r
( i d not be completed tribe pcnnn ms for one hundred dollars I ',FPI' . .. I_rx i trr P7'1
: IT s i n Nees
ISI W)mlcsa.)
I,Imp that in the a,.anyn urrours'ffibe rfar mberrowhich this pe nrsW1. orke 1 ,� t, „1 Phi trtt,l " -
shall not employ miy'CcjH m any manner,u a to become uh to the Workers
Compe noon Laws df Galdbmm DadI - Rho % 1.
_Apel cant. ,.n .y ..... I:": .,.... ....
NOTICE TOAPPLICANT.If.'after making this fenifice¢of6cmption;you should i
becomeh Isamoy the inches Coman,oris pannal odeof deemed
Cale,you morn
Z O ")fio-'itb'co-- with loch pmvis__or this permit Nall- deemed revoked. - - _ —
rot __ _ _ . -__ ._ .._ ._. - .__.. ... .__.._.__
_-V� '"It d' 1 s (LONSTRU(.TION LENDIN id, 11 1 Y ' "^ ' :.('P j;'H
1 h by fhk th t Nerc a co iwct n Iantl g'g cy f nhe perform ntt .. ', , ,I,• "
Q
fine wink(r h h N s Permd s issued(Scc 3097 Civ C)
taJ z lied r Addr<s r r" .* ... ,t b .
1 ecifify that 1 have read als
application
scat n and slat that the ahs f mion is
t 1 tcomply m 11 city and county ordinances end nam minting
tobubuilding and
h by eumoM1ze reprOsmitatives,of il vilyn_enter upon -
gV m-Lobo m o'cd pr perry fO polio p rpose
y We)agree m se e,mdemmfy and keep ha mless ilia Coy of Cup conn egem
y Habil t es judg ms Sts end p nus• ho h m y n any way age nst said
� is
V'� City n co s qts f me m ng f this petmot � 6/O/)
APPLICAMU R DS AD WILL COMPLY�N�'rJf�LIy�N INT''
souxc Er ,'n - fir• 6//8/� � Issued by: i Date
r - Signpmrc o ppl canUCommno " , -" Dat Re-roofs
"t + HA7ARDOUSMATERIALS DISCLOSURE � '
' " 'Will the ppl nm a f mm di Id'ng acvpant store or heMle haaatdws mammal Type Of Roof
u deEned by Ne Cupe7mno Mun c pal Cod Chepm 9 12 d me Nealm and Safety i . -
COEe °Ysv255J2`a)+fq QNbr+I i 1 a. ef`i 6_l+Ar1 t 4ex, �ii,r-idf:i'erJl'�. Tit i'!i^t7aS 1(.s� Lift '
All roofs shall be inspected poor to any roofing material being m&taped,
_ — - ----
'f$~I W ll theepp brm rf t rtb.ddingxc p t seequip t rat!<ea.amm� If a roof is installed•without first obtainingan ins ection, I a i'ee:to remove
each haratdous a r contammams a defined by theBay'Area'Art Quality Management P g
Dymcty , I., - I ' all mater' s for_ins ection Applicant understands and w I comply with
°Ys)14"' r f� N' ''; i"°r'1' all non pot tutee ulauons a
h efraud Ne'haimd s roam rds ob,imn bit a"nEcr Chapter 695,of the
Clifm Heahh&Safety Code Secnoi 2550525 and 255341 understand that
111
hhe hu ltl ng nal cu sly hoe t trhm!t!s my shlty , ufy tbc' --
0.pant 1 qts r o m which mut be met p or to Sts a of en f ate Of
l� Z SIg___are of Applicant Date
'r 0 OC Of authorized agent Dme All roof coverings to be Class=