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05070038 (2) CITY OF CUPERTINOxxvt BUILDING DTVI SION PERMIT CORACTORINFORMATIbN BUILDING ADDRESS: FOUR SEASONS ROOFING PERMIT Nrb5070038 10190 FIRWOOD DR OWNER'S NAME: PERMIT ISSUE DATE CHRIS MITCHELL 502 HORNING ST 07/06/2005 NE: SANITARY NO. CONTROL NO. (408) 278-0330 ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH _op LICENSED CONTRACTOR'S DECLARATION Job Desfrcnrptionl e w C I hereby affirm that 1 am licensed under provision of Chapter 9(commencing $2tw) with Section 7aM))of Division3 of NC Business and Prefcssiums Code,and my license is n'z mmnrarceameerr .^ 9 Lie.» t't.�,�t� k REROOF W/SHINGLES p vj_ Liana claw Z , Data ^ Cunuscurr I/a'a o H ARCHITECTS DECLARATION y '1000 I understand my plans shall W used as public record G J JU C. Liccmcd Professional (J {t p c Oat I WE aCm,l f DECLARATION <P 1 hereby alHrm Not 1 am exempt from the Comuaor's License Law for the I�Ia1.1 LIQ V 11 ry� DO following anon.(Section 7031.5,Business and Professions Code:Any city nr County 5'm which reyuirm a permit to construct.eller,improve,demolish,or repair any structure $6000 xi prior to its issuance,also myuins the,applicant for such Permit let file a signed ataremcnt s< thatheisliCcmedpuooamtotheprovice+omurdamContractor'sUamclaw(Charter9 Sq. Ft. Floor Area Valuation it-a (commencing with Section 7")of Division 3 or the Business and Proressiam Code)or i that M is eumpt therefrom and the basis far the allcgcd Gumption.Any vialadon of Section 7031.5 by any applicant for a permit subjects the applicant 10 a civil penalty Of -3'A-P$ftqWA(1r0 0 Occupancy Type not more than five hundred dollars($500). 0 I,as owner of the property,or my employees with wages as their sole compcnsadon, will do the,workmd thenmaure is not intended as offered for sale(Sec.1014.Business Required Inspections and Pcolma a s Cade:The Comrsetols License taw does not apply o combere an comber of fl p progeny who Wildso,improves thereon.md wh.drea uch work himself.,through his , own employees,provided that men improvements are notintended at offered for sale.If, however,the building or improvement is sold within one year of completion,the owner builder will have the burden of proving that M did WE Wild or improve for purpose of sale I. ❑1,as owner of the propeny,am uelusively contracting with licensed common to construct the project(Sec.70d4.Business and Profession Cade:)The Contractors Lh cone law does not pply to an owner of property who Wilds or improves themon,and who comsom for such projects with a comnaor(s)licensed pursuant us the Contractor's Likes.Law. U 1 am cxcmpt under Scc. .B A,P C far this reaznn Owner Dat WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the fallowing declaration: 1 have and will maintain a Certificate of Consent o self-insure for Workers Compere sation,az provided for by Section 3700 of the labor Codc,for the performance of the work for which this permit is issued. ave and will maintain Worker's Compensation Insurance,as myvired by Section of the labor Code,for the performance of the work for which this permit is issued. My Workke r's_Compensation Insurance and Policy number art: Carri�r.[Xa �$Waawt 11C.a liry No.:w�O�utoyo QOOb� Q CERTIFICATEOF EKEMMON FROM WORKERS' J� COMPENSATION INSURANCE A(- (This ser nneed nm WComple¢d if the permit is for one hundred dollars(51110) or less.) 1 Certify Nat in the performance of the work for which this permit 0 issued,I shall not employ any person in any manncrx as to become subject to the WorkersCompensation Laws of California.Dan, Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should become subject In the Worker's Compensation previsions of the labor Codc,you must .J O forthwith comply with such provisions or this permit shall W deemed revoked. Z s-. CONSTRUCTION LENDING AGENCY [—�� I Wreby affirm that there is a construction lending agency for the performance of fYthe work fur which this permit is Wood(Set.309/,Ci,C.) LQ Lender's Name z l<ndcr's Addrna U Q 1 cenify that I have read this application and state that the above infOormn n is Iy F Correa 1 agree to comply with all city and county ordinances and state laws relating to OU Wilding conswaion,and hereby authorize representatives or this City to enter upon the Lkl above-mentioned property for impaction purposes (We)agree to save,indemnify and kap harmless the City of Cupertino egaimt F y liabilities,judgments.costs and expense which may in any way accrue against said City U in coneyuence of the granting his pont. ^ APPLICANT DERS ILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCER 15�lr 7-6`0 T Re-roofs s r L Signature of AppliandConttaeor Date HAZARD ATERIALSDISCLOSURE Type of Roof Will the applicant or fu Wilding occupant som or handk hummom material az defined by da Cupcnino Municipal Code.Chapter 9.12,and IW Health and Safety ossa,titian 2ss32(a)+ All roofs shall be inspected prior to any roofing material being installed. Yes Will Ne applicant or ruwrt building occupant sex cyuipmcm ar devices which If a roof is installed without first obtaining an inspection,I agree to remove it hmardous air conmminanss as dafincd by the Bay Area Air Quality Management all new materials for inspection. Wi 7 YCS I have mad Ne Wvardo s mamrials requirements under ChaPter695 ofthe Califoo- / ria Health&Safety Code,5c om25X)5,25533ud25534.lundcmamdthuifthe Wilding �i6 _O� Jas not Goren M1m,C a tens Nat it is my rmp.mibility w nOdly the MCUPam mf the reyuirtmem is mmpriorwinuanccofa Ccnlfcateof Occupancy. Signature. Applicant Date o anma agent �—�uate All r overings to be Class"B" or better Community Development 10300 Torre Avenue y. Cupertino CA 95014 Telephone(408)777-3228 . CITY OF Fax(408)777-3333 �UPEI�TINO Building Department JOB ADDRESS: PERMIT # /90 © o OWNER'S NAME: l�1,9,e, APHONE # GENERAL CONTRACTOR: , FAX # I am not using any subcontractors: -1-75-05 Signature Date Please check applicable subcontractors and complete the following information: 60 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 Owner/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: 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An LC.B.O. report is required to be on the job site at the time on inspection. I understand and will complywith the above stated policy on re-roofing. n Homeowner's Name: (�/7•Y p /S/Olt h9/ k/76/ _11 job Site Address: ' -An Roofing Company Name: c/ Applicant's Signature: Date: Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper CITY OF CUPERTINO _ REROOF aCITY0 CUPERTINO PERMIT APPLP ATION FORM APN # Date: LIZS— Building Address: 0o Lrr Owner's Name: / Phone #: Mr�s ' W" /e// Co;t ; : Phone #: Licet tv a i oPhone Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles /' ❑ Wood Shingles XOther(Specify) I/2l�OC. ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Have Read, Understand and Will Comply With :Cu ertino's Tear Off Policy: � Description: ti Residential Comm rcial 0 Fire Zone: Yes E] NoConfirmed with Planning De t. if there are any restrictions: u Cost of Pr t, D T ofCo ction: Occupancy group: 00 Qty. if A licable Fee ID Fee Description _ Fee Group BPERMFEE Bldg Permit Fees _ BUILDING iBENERGY Ener _ BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING