02070205 (2) ciBDGDVSOVO
BUILDING IiiNPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
a 10166 CAMBERLEY LA FOUR SEASONS ROOFING 02070205
OWNER'S NAME: APPLICATION SUB DATE
ARONSON MARC 645 HORNING ST 07/30/2002
PHONE: SANTTARY NO. CONTROL NO.
(408) 278-0330
ARCHITECTIENGINEER: BUILDING PERMR INFO
❑
Z 0 BLDG ELECT PLUMB MECH
Z y i LICENSED CONTRACTOR'S DECLARATION Job Description
G Z_ I hereby aBum Net I am licensed under provisions or Chaner 9(com ona" 9 REROOF
F:C with Section 7000).(Division 3a(the Business and Professions Code.and my license
is in full force end c f b
aYs < Licenx Class 9 Li0 N
3 a u Date-� Comrector
O gEj
/'-3D 'ARCHITECTS DECLARATI N
y 1 understand my plans shall be used ax public rccoNs
apo Lice sed Professional
a' OWNER-BUILDER DECLARATION
'3^
0
I hereby affiran that I am exempt from the
$ pn requires the limns for such wr Contractor's License Law for the 8 O O 0
ro
t??< g Code:My city or county
rany
C
(Co..
also are a sigedavucmrc
3_ ._ .. pis gray Oo file,aigvAauxmen[. ... ....... ....
(ollowin reamn.(Sation]071.3,Businex ere Professions
❑ _which requires a pemrit ro conswcu alta,improve,demolish.
flaskI alicenxtl rsuahl to Ne elpsppna of the Croons, Licenx law(Chaper9 3,4. fL-Ff,�F'tnOT�'Ca 5.1--. Valuation
. 48 wYh Seption.70gd)of Division Safe Bryiveu end RP(wiom Cadet ('�;!'3,': t•: .. I_ k.i\1:a' 3t.i:�'
or Nat He leas an theiefmm and Ne basis for Ne allege ei6
dµi06
.Any violation 1
of Seeslon]0715 by eny-appli om for a pemdt aabia, Ne applicant ne a civil penelry �p
,of a., me than ova handmd dooms("', 3 0 5 APN 9 ;r!.'1.,,'i . Occupancye
❑1,u owneruf the property,or my employees with wages a their aide compensation,
-will'do''e'watk;end'the'nrucmrc is nor intend 116-11 oRertrx
d'tole(Sec:'78,4- ' faxal
B'eiineis'aad Pfofesaions Code:The Comracror'e Licenx Lew does not apply m en 6 01 - ROOF TEA$egtl$�21 IfISpeCIlODS Its•'i 'i:C.'i
owner of property,Want builds or improve Narcan,and who dues such work himself 602 - ROOF PLYWOOD NAIL_
or through his own employees,provided that such improvements are not intended or
7.1151-.-d fort-WC IThiramscr,the baildinea impioveti i is soldivithin one -"_'-"'--" - -'"-_- "�----"-_ -"--- -- til.`:h.it-�__.___-._.-._,-
'completion,the owner-builder will have the butchers of proving that he did not build or 603 ROOF BATTENS "-
impravefor parpoxotama). 604 - ROOF IN-PROGRESS
-----'-- --- ---- -- i---- ------- ------ ------- .__—--------. --------- ----------
construct
------ - --
r nI,trowner ocoot,Sec.7 ,m eusinivelyd Prating withlicensed Cmmminm
conswcr the oes n(gee.70,4.Business and property
Professions Code)The Co therso'e
Licenx Law docs not applym an owner of arocomm who builds m improves'an ft
_aM,whocantacu.(Law. proiecss with a.contrecmr(sLEttascd.pursuantm'e. __ _-.-_...________-.___-._._.._--...___-.-..____5..__-__.____.__..__-._____-.-jr Contractor's Co wet is Licenx
S
-
mo epi underSn, `•�-' BA PCfonhisrcasms .�,{pT f'.a I .k . '(i�lLrtil
Owant Pi111�a�%-F-®
WORKER 5 COMPENSATION DECLARATION
'� ,)t Ihercby effiw nd pcvitY,of perJuryr rte of'ef lluwrn6 dcclmnions - Q A aO.t
❑ I Ahve'nid'iviil'm amm e'Ceuificaie'of Cmcxm m self-insum for Warker'a
Compensation.as provide-for by Section 37M of the Labor Code, for the
__ - 'performance of the work for which this permit is issued,_tr,
h, dwill'hammn Wine Compc uo rinsumntt req see bj Section
^ ]00 of the Labor'Cotle for the perionranc of thq wa k f wh h th permu u M
-: i s ed My'..Wo e s Co enn yon Ina ce dant end Policy umbo m:
Polre •,�,,11{'d - PS "r! a ... `Ob.
Carver. . ' ZI 2 ! ti, Y' i-
C ERTIFICATION OF EXEMPNo'.'
PROM WORKBRS•f lIy t a.'''wo C11�•, a:.l'(...,, 4i.li .J �.
tura sen COMPENSATION INSURANCE' ^' •1'
Ice 1 r ion need not be complete if the pcwd n fm one hundred dollars '11't s ""•' I�� - --^_�'-'\r :Jl(
(5100) Ic s) •
6e 1'gMd'y''eim the perfonname of'e'inkfar wmcn thu pemdt is Iss ed'1 ,sUa'. rs$'):Y.^,1.l! ON i
hell'no!employ"any,person In any'manneesb ai m become subiect to the Warraii '
is
Co.pe^ser o -Lows rCahfornr a.Datel
AppI
'NOTICE TO APPLICANT:If,after making this Cei[iBdme of Exemption,you should - . • ' . . nt�l `:,
1 he b affirm th NSTR r e ou seri
0 fonhw th c m l -nh such v s o s nh
bac me sub�at'theW rkef Compenxuon provsoru❑(the labor Cud y m
p y p pcmnt hall be tleemed rt❑ked
(� -' CONSTRUCTION LENDING AGENCY - - � �_ I R� i I-0
W.QLend r e Address g v C) ' performaha
a 6 C) r _. ._...__- _ _ .._._._. ...
_ �.1 ttndy that I have read this application end�ite_.. _ .. _...._ _.. ._.__.. ._..__.._. .. ._..,_- .. __
of the ark fm which N s em t s sued IS 3097
L d r v theme -
a72
_ V-0 to that above information is
farvey cornet.1 agme m comply,with all,city anJ coonry�ordinemea roti smm law.rchtin,
to buildingconsmictfonland hereby autnoAu representatives of this city to enter upon
the above-mentiomd prapenY for inspection purposes.
L O:r IW 1 gree io a mdemafy and keep harmless the Ci,,.f Cupertino against
rr Vi lab I t e, L dgrgun is and expenses which may in any y uterusagainst said
V
Cit n conxq ce f the emmrng of rh L permu /'s
APPLIGA\T VDEA pSAhD WILLCOMPLI' SIfHL\vO�CPo1hT ' I VL/
< SOUR R ULA n�s';' ,. p'Z Issued by: Da
S IAppl'panaC ntfncur, , , Dater,"' Re-roofs
f ✓ HAZARDOUS MATERIAL$DISCLOSURE
7 7w de applicant or rumre bolding occulnm nae ar handle hainrdarsmatenal ..Type of-Roof._._ ..- __.,,.... .�..,
eadefmd bythe Cupertino Municipal Code Chapter,917 and the Hel'andSafety
Code Section
Yes 2557713 rl nryi o I yl kt ' r s•irrs
I tAll,roofsshall be inspected pnor.to.any.roofing material,bemg mstaUed
...... -
pp g p egarVmemorae see men If a roof is iitsfalledlwittiout fust obtaining an inspeehon I'agtee to remove
Wr!I the a htt t or !sere baddm oc am use, .... __
emu hazard❑s av conammams n defined by the Bay Arca Air ent ty Manes which
District? all new materials for inspection Applicant understands and will comply with
--st aYes I_ y o _ . ... _ - - _
q p all ion-point source IaClOns , I li
occu am of then&5 ode Secuc s 75505 25533 and 75534 1 undersand that _ _ __ _
1 h g ee amen rch m e ma norm s c of e C nificea
J
a
if tbebudtlm does the here nt uhavee en,m'sumnnti❑Mer nib itt moot f t'of ' a:'. n•, . .,
mY Poa Y h
? Oc ppnc P ., e .. -_
' cdry ,xeals
of- ---Appjklal --- - -- -- `-- - -- Date_ _.- - -- -- - - -
�j.�t_ Si nature
Own m e i gi,al Data A roof coverings to be Class"B"Gibetter
i -- - - -OFFICE
Building Division
10300 Torre Avenue
f . Cupertino,CA 95014-3255
Telephone: (408)777-3228
Fax: (408)777-3333
CUPERTINO
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 V"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: .Q3 Gx
Address:
. Reroofing Company Name: Az�
S' o� c
Applicants Signature: Date: 730-0
�Joee Antonucci
(Chief Building Official)
6/251ol