02080024 (2) 'ClTYi
BUILDING VISION o CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BOIL'DINGADDRESS: . PERMIT NO.
101'761.,:CAMBERLEY LA . FOUR SEASONS ROOFING 02080024
OWNEWS'NAME: APPLICATION SUB DATE
HENDERSON LOREN F TRUSTEE 645 HORNING ST 08/06/2002
PHONE: - SANITARY NO. CONTROL NO.
qqqq (408) 278-0330
'ARCHITECT/ENGINEER: - BUILDING PERMIT INFO
<E .,BLDG ELECT PLUMB MECH
.. r-1 L.1 L_1 I-.-t
Z =Z '''t' LICENSED CONTRACTOR'S DECLARATION '- Job Description
O'Z`'0 0 I hereby of im,that l am licensed under provisions of Chapter 9(commencing REROO F
u� with Section 0001n Division 3 of,he BusinessaVd Brofcsams Code,and my license
'D Is int I ean_e- ,. A �'�
rc < . ss Lic.N E®
ARCHnECf'S DEC A ION ,
S ,. 1'undersmnd my plops shall M used as pu lie records
: o;0 LlcensedProfessional . JAN 3 0 2003
.• , OWNER-BUILDER DECLARATION
;,I hereby affirm that 1 un exempt from,he Contractor's License Low for,he $BOO O
following reason.iSection 703 1.5,Business and Professions Cade:Any city or county ��'
„ A,•O ,which acquires a Petm"a m construct,alter,improve,demolish,or repair any structure L�
Pnor to m laeYtion:also acquires the applicant for such pemutt file a signed uasemera .
that bo 5lcesfed pontoon,to The pmvleiom of the corma,mor's License Law(Chapter 9 ,( O�p,�ea. Valuation
(cmnipepcng with Sttuen.7{p0),o(Divisom3of,hc Byia,"gd Pmfcssi...Code) �,i!";;y34Z b �.Vvrl sg�ll't•.5�,y.{F�; L' .
{olahat heir exempf therefrom and,he basis for the alleged exemplar.Any violation i
--uf section;031:5 by epi'nFplicant for a permit subjects the apps cam to a civil Penalty' s p Occupancy Type
,of oatrmoommin,f,ohmWrtddouars(5300). 305 APN�r _ i'"'+'.!'•'\m
❑1.m owner of Nc pmpeny,or my employees with wages m Neinole compenmtion,
nm
111 ori' wamiassiand'the strucok:The
is not intended License
a Law foe said ISMapply ILPin iN� -
I Bdsinesi proper,Who
Code:The C ve,daror•e License Law docs h apply m an 601 - ROOF TEA93e�ARFI Inspections,-
owns ofproper,his ow Who builds or improves tmacon,end who does such wah intended
or 602 - _ROOF PLYWOOD NAIL
of Through Pa his own W vc.as.,pmvided That such improvements art;rot intended or .... _....
-.comple'fi.sore if.Lo ' to ,nave the Widen fold hdid be of " ._....- ..603 ROOF BATTENS ,• ,. .,.i.i ru. '. :
-------
completion,fn,the ase of inle.).will have the buNrn of proving that he did nm build or
improve fpr paepose of sale). 604 - ROOF IN-PROGRESS
Vi e• con:ue,magf'Ne Propenyam Businesslymntrofowi ,Cade:afedm intrumto
ronswn the met
(Sec.70Ya,Business and property
who
Code:)The Compeer's f;.;, •h;l T i.
{ Liceme Law does no,apply ro an owner of progeny who builds or improves thereon,
;_ .. and whocomanifor.such.pmkcts.wiN.a commctoms)L_censedpurstiam to ehe. ....... ... ._ __ _-
'n Conuactots License Law.....,,,... _ .. .. .. t
Olem exemptomer Sec. "B&PCTs, .
• R KER'S COMPENSATION DECLARATION . ..'.. .• .
Dole
' .
'
I hereby affirm under penalty of peij6iy one of de following dalentions:-.
11 I have and,sill'mvintairt it Cc
nifcmdof Consent to mlGimure for Worker's
Compemation,-m providedfor by-Sectiun-3700 of-the-Lalor Coca, for the
peril..laeof @e wmk far sehich,his permit is
,0lhav �andwill iim.inWoAer'sCompensationlasumnci.as iequircd by Sermon
,3700 ofthe'Lebar Code;16,the peffoirini of,he two k f r which this'pormh Is
r -
ssued My WorkeCompc fui on Ins mnSin
_ " r and Pot y number me: ., _, __ .v ._ `.� �. ��•V^ ,. ,r,rw�-.,
/ et CRTIFlCATiON OP EK ON PROMV RK$9623 `. aye AeT 5i ts.J 'L 1sT icll,ly t iT dylvh, xv'�tit.'! I.,1
._u +. COMPENSATION INSURANCE ..r;.,.. ,. ._,.,.,-,...,,,.„„..._...,_.._. .__ .._._.______...-....,.-......_.._..._____._._..__......_... -_.._. ._._..
a 'sects . to termiti or
" arils section need not be�cnmpined d drc Permit rs for one hundred dollars -
•(1100)aless.) .
y Iceme,ylyhat ny the pem `once of th wortobeco a mi petiteWorke I pm: {I
'shall not.Compensation
y Laws
6f raan m any mournerso m m become subject m the Workers'
,Compensation Laws,.California.Dam
AOrI ETnt H ovate the iutiur Cad
^NOTICE TO APP LICANrker&Cmpensn ,higCnfeme of Exem eon,you ehoultl •I-` -
becnmith co coo the such ps Compensation pmvsi a od, must
Q O fodh ,h comply with such provisions or This permit shell be dared revoked'_
r ' r' �•°' CONSTRUCTION LENDING AGENCY -
^.� 1 hereby efim,th t the non
a con m, leading agency f m
the perfaance 6'r '
err of)he work fowhich this Permit Is issued(Sec 3M7,Cn,C) _ -Y
-Lender s Name 'a
Lentleex Addreas v
V 0i :: • _ ,
Ltrr 1 ttmfy,ha[I ha a read this appl¢auon and nate that the above information is
La ,a bu, 1 agree to comply withal[wry and county a timie and m laws enter
upon
'Q.r°.) w bva-rnattraction,dd h or i poh ase preacme,vas of N,i my m cnmr upon
y W 1 to bove me unried pmpeny for uupauon p h l.,,
EF.r lir (s,)agreetosesmJetnnifyondk which
yinth Clay aCupertino pemid
y -
iabi i 'cs eque To c t d expense wh h may in any y ar rve against said /V
V:
try m cons q enc f Ne gram 6g of,hes Parma .YC1MV
PLICE UNA DNSNbS ANWILLCO\IPLYWITH ALLY ' "
RCE REGuI.A arts m Issued by: Dale
.I "acture fApplicant Cammcmr " „ am Re-roofs / -
} ', 'o HAZARDOUS'MATERIALS,DISCLOSURE Ip ''
s' ")
Will dee aPPI cad,or None Wildoij sespan,some o berme hau'deas muerim Type of Roof.- .--.+--. .. ........
;®defined by Ne C.Nmim Munmc pal Coda Chapter912 end @<H Health stet Safety •'— - � �� -� ���• •, .. ,
rCodt S non 255J3(a) i 1 s J +.., }9 i i 9q 1'.f t C k L .l t t k'. ,_•
f" All roofs"shall be inspected,pnor to_any.roofing,material be g.installed.
![7 Ye 17 No � .,
y„ appl t
future building occupant use equipment ordevices which If a roof is installed without first obtaining an inspectton°•I'agree to remove
Will,he
ern District,
. s air Lamm n[s is defined by the Roy Arm A r Qu. ty Menegemen,
of met m ns Applicant understands will comply with
_._.all new materials for inspection. nt a ands and
❑Yee , .- . .- . •. - ._:. .. . ..
all non- amt source re ulAtions .. „.
}41 t..: ,�, rNo ' 1�: '.' - „ � p g ..t,r:.1LJ
1 have read the hazardous maenals acgmmmcnts weer Chapta b.95 of dee
Califtimia ing dos 5 f ly Code:aveuom 25505;25533 is and 2553x:1 understand that' ` _ ^ ^ �/
dehebu,lofthe requiremnot ents
hi h, m ant et ,e is my respomibfa faclity to e,
notify the' 1 (�.9- _� az-c% &L
- occ pant of the requ ere is which m v be met p ler,o ass tt of a Ce„team of Q.`n!e
upaney a 8 ��'
^Ostore of Applicant_
Cn
f arras ho seed ag m pa, All roof coverings to be Class. B"or better
.. . .....OFFICE
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEI�TINO
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 VV 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: n
Address:
Reroofing Company Name: T9 Vy
Applicants Signature: _2J 11'� QXSC1ZDate:, No O2
Joee Antonucci
(Chief Building Official)
6/25101