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03060006 (2) CITY OF CUPERTINO '_ �=� - +-'• °�' '' �•-mw BUILDING DIVISION PERMIT CONTRACTTORJNFO LMAT QN A . BUILDING ADDRESS: FOUR SEASONS ROOFING PERMITNO03060006 OWNER'S NAME: 645 HORNING ST MRNm"`f' T62/2003 E ANZA OAKS HOA (408) 278-0330 SANITARY NO. CONTROL N0, ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH u00 LICENSED CONTRACTOR'S DECLARATION Job U 1 ion? affirm that I am of due Bu under provivuas of Chapter 9(commencing Description with Section 7g10)of Division 3 of IM Businessand Profcssiom; and my license is 'Lice fore and erten 0 a«naecl a ' tic.« -(7de-� _ i REROOF I�Q�,yI!��9��® Data Contractor �tf' ARCHTIECI'S DECLARATION I understand my plans shall be used as public records JUL 0 3 2003 JyU G Licensed Ptofessmaid OWNER-BUILDER DECLARATION f 1 hereby affirm that I am ucmps from the Contractors License Law for she BUILDING COC following mas .(Section](01.5,Business and Pmfr_ssiom Code:Any city or..my $ff which raprit s•'permit m construct alu,improve,demolish,or must,any structure sl 0 poor toits issuance.also requires;the applicant for such pctmiuu file asigncd summcm Nal he is licensed Pa...,toshe provisionsIf the Contractor.Limn.law(Chapter9 Sq.F[. Floor Area $41(�jy®tion y (commencing with Section]000)of Division 3 of the Business and Professions Coca)or i $ that he is attempt themrrom and de basis far Ne alleged exur un.Any violation of Section]031.5 by any applicant for a permit subjects the applicant to a civil penalty of not mom than five hundred dollars(isms). Occupancy Type ❑Lasownerof Nepropcny,mmyunnl dwishwagemd utheh.leeampew will do the work and sheswaumunotintended oroReforsak(Sec.]OM,Business 305 - r.D and Professions Cade:The Contractors Licime taw does rot apply b an owner of 307 - I NSULA1Bi V1V d Inspections ,trepan who builds or improv Ihrsmn,and who docsauch work himself.through his ownemployees,provided thl such improvements are not indicated mortared mraale.B• 601 — ROOF TEAR OFF however.the Wilding or improvement is said within one year of completion.the owner- Wilder will have ds Wrdon of proving Nat he did trot Wild or improve for purpoc of 602 - ROOF PLYWOOD NAIL "1e')' 603 - ROOF BATTENS ❑t.u owner of the property.am inclusively convecting with licensed contraction;in 604 - ROOF IN-PROGRESS canimct the 066 project(Sec.7 ,Business and Professions Code:)The Contractor's V- came,law docs not apply to in owner of proveny who Wilds or improv themon,and who cunusects for such projects with a contranor(s)licensed pursuant to the Contractors License law. ❑I am exempt under Sec. ,B&P C for Ibis mason Owner Data WORKER'S COMPENSATION DECLARATION I hereby affinm under penalty of perjury one of the following declara iota: I have and will maintain s Ccnifcam ofCWmnt to self-insum for WorkersCompen- 7371M o.,as provided fm by Section 3]00 of the labor Code,fm the performance of the ms for which this permit u issued. ban and will maintsin Wake's Compensation Insurance,as seamed by Section of the labor Cade.for the peformance of the work for which this permit u issued. Worke's p d' lnsararme eerier and Policy another�a1m:rier. A.lG1 Policy No.: [�f-�l0 OL L"90 CERTIFICATE OF EKEMETION FROM WORKERS' COMPENSATION INSURANCE Musection band not tecmapleted if tW permit is formic hundred dollars(5100) (Ir less.) I cenify Nat In the performance of the wark for which this permit is issued,i shall not cmployanypermninanymanoers st1. C subject to the Workers'Campcnsation Lawaof Califon . a tt Applicant NOTICE TO APPLICANT.IL after making this Ccnificam of Eacmplion,you should immune subject le lW Worker's CmmpenYtion previsions of the labor Code,you most .Jz forthwith comply with such provisions or this permit Nall W deemed ormled. z CONSTRUCTION LENDING AGENCY (•+ 1 Wteby affw Net there is a coonnmtiun lending agency for the perfarmvae of athe work far whichu issued 3(19] this pmmit ued(Sec. ,Civ.C.) MI Q leadces Name D z Lenders Address U C 1 e nify that 1 base mad Nis application and sum that shim move infmmation u D.,Hcomma.1 agree to comply wish all city and county ordinances and sum laws miming to DU building construction,and hereby aothorlm mpnsentativ of this city to enter upon Ne rrA aWvomm judgdPropertyst for inspection expenses purposes. (We)agree to save,indemnify and keep hornless the City of Cupertino against Z inconsopurseofo,costs and ettpertsmit. may in any way accrue age lnalaaid City C.)z A APPLICANT of UNDERSTANDS or this permit. ^' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. y�__ Signature of AppbcanUuac Conmr Dam Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will dm applicant or fun.Wilding ompant uom or handle harudne,mammal "1111as dclined by the Cupertino Municipal Code.Charm,9.13,and Ism Health and Safety Cade.Section 35533(a)? .,...�na All roofs shall be inspected prior to any roofing material being installed. ❑Yes �o If a roof is installed without r t obtaining an inspection,I agree to remove Will she applicant or flanking occupant use cyuipmem or devices which g P g it harardnus air cmnlamirlans as defined by Ne Bay Arta Air Quality Managcmcm all rte ma rials for i n. a? �J ❑Yes B« o I have mad she hassrdoosemNinabilitymnotilytheoccup"'tifthm enuunder Chapter 6.95of0mCalifor- 7d. Hcalth& WV Cede,Secdo35534.1 understand that ifthe Wilding not cu ally son a tenet uimmenk whit mus brre Ccnifcam of Occupancy. Signature Of II rat Date nermaum.n.dagcn Z Dam All roof coverings to be Class"B"or better Building Division ' 10300 Tom Avenue (Upertino.CA 950143255 Telephone; (408)771-3228 Pax: (408)777-3333 CUPFQTINO 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 musthave a minimum of YL".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: Qc{(�5 Address: Reroofing Company N 0 f' �S © A t Applicants Signature: Date: 4? �Joe Antonucci~^' (Chief Building Official) 6/25/01 eut�, CITY OF CUPERTINO ���� REROOF CUPE�Ti ►v0 PERMIT APPLICATION FORM APN # Date: 1 03 Building Address: 1 OI` I , F. r Owner's Name: �A /l 1—�n Phone #: Contractor:r y y 1��Phone #: 1—dc)✓— �� Sp t C trp�j a�� 033 License #: Contact: `L I Phone #: Cupertino Business License #: �o�t c.J Type of Roof Covering: Existing: Proposed: U Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles it Asphalt Shingles ❑ Wood Shakes C3 Wood Shakes ❑ Wood Shingles Cl Wood Shingles QF Other(Specify) C9— "t l/�9 g Number of existing coverings ❑ Other(Specify) ❑ To be Removed ❑ Provide I.C.B.O. Report# ❑ Provide Mfgr. Installation Specs. • I Have Read, Understand and Will Com I With Cu rtino's Tear Off 11:1 1 Job Description: ResidentialCommercial ❑ Fire Zone: Yes ❑ No Confirmed with Planni Wit. if Cost of Project: Type there are an rest ' tons: c 'o LJ 1-f yp on Occupancy gr up: Qty. if A lica e Fee ID BPERMFEE Fee De [ion Fee Grou Bld Permit Feess BUILDING BENERGY Ener BSEISMICREBUILDING Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BPLANCHKPlan Check Fee BUILDING BUSLIC BUILDING Business License BUILDING