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02070001 (2) CI run�F,c upESSIIONN� PERMIT .CONTRACTOR INFORMATION: BF4112gbAIIDRfbNG DOWN RD FOUR SEASONS ROOFING PERMIT n070001 IO "IG�l6WARRHAROLD E AND SHIRLEY 645" HORNING ST APPLICA�JMJAYE2002 PHONE: (408) 278-0330 SANITARY NO. CONTROL NO. Qz0 ARCHITECTENGINEER: BUILDING PERMIT INFO m C BLDG ELECT PLUMB PATCH LICENSED CONTRACTOR'S DECLARATION E 'S N fflmoLIC that l am reamed Ander prDECL R Chapter 9(commencing REROOF 1 b Descri [ion ._C�W with Scction]IN)IB of Divisionlohhe Rosiness an Prufcxi...CWc.ondy(y'licenu FIN is in full forte and Ecm � G Lir.p Z B U c�< Liccnu Class O U Dam GOmmn« ?a O ARCHITECT"S DECLARATI N JAN S 12003 1 um Are,,cid my plan.ehvlI be wed as public records ys�Y i 6 p o ureAaen PrnfensionmWILDIIrG o OWNER BUILDER DECLARATION ¢i='to I hereby affirm that I min, m exempt from the Commctur s License Law for the $8000 t?Q following reason.(Section 7031.5.Business and Pmfeuions Code:Any city or county xhich requires a permit to conswn.Aller,improve,demolish,or repair Any strvnom that e3� thin s e.cdcep.uarslsm.nceuq.uttrehrsthreovapepofc: tfftl C Ipcmrhofn'License. Law IChA pmteern9 (marm s v xJ... .. „ _ V_.al_ua._t_i_o.ni ._. _ or that he is exempt therefrom and the basis far the.Ilegcd e%empmn.Any violmion of Section 7031:5 by any applicant for a permit subjects the applicant to a civil penalty of of m..than file hundred doll.,SRA( 307APNXWW6ATION Occupancy Type °1,as owner of the property.or my employees with wages as their sole compensation, will do the work.And the structure is not intended or offered for sale(Sec.704, Business and Professions Code:The Contmaor'A License Law does not Apply m untions owner of propeny,Who builds or improves tremor,and who does sash work himself 602 - ROOF PL 88 111 fr or through his two however,employee,.the provided that such improvements are no,intended of 603 - ROOF BATTENS -- offend for wle.If,however,the building or improvement is sold within one year of compilation,the miner-builder will have the hurdennfpmving that he did not Wild or 604 - ROOF IN-PROGRESS improve for purpose of sale.). °1 s owaser.of the psm.7 Ain exclusively contracting with licensed contractors to - Li t t th project(Sec )044 Bos eros and property w ons Cade)The vetmm�or) t. License Law does not apply to an owner h propeny who).lin nor ed.pmva thereon. ' ond.who Liens for such pmjeas with a c.nvanor(s).littnscd.pursuant.t.the 01Contractorsexept under law. f l ❑Lem exempt under Sec. ' ,8&PC for this reason Own r D i at n WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: $ ° 1 have and will'maimain a Certificate of Consent to self-insure for Worker's . vas.✓ Compensation, as provided lot by Section 3700 of the Labor Code, for the performance of the work for which this Pamir is issued. �lhave and will...imain Worker's Compensationlnsurance,hs requited by Section 37M of the Labor Cade,far the performance of the work for which this permit is I ssued.My Worker's Co pe smion Insurance currier and Policy number are: .. ''11 II 'ggq Carrico Na`.ck I-'�Policy No.: WC?J'I „! RTIFICATION OF COMPENSATION IIS FROM WORKERS' - t. f” .- • f, s ' ' COMPENSATION INSURANCE (Tli sscet on need nh he rompleled tithe permit is for one hundred dollars ($100)on let .) 1 " -1 certify that in the performance of Ne work'for which this Permit is.iuuad,I _.:..- shall not employ any person in any manner so as to become subject to the Workers Compensationlaws of Califomia.Dam' Applicant •. � .NOTICETj APPLICANT It,rs Co making this Cenificate Labor Co,youshould - - Wcdmchconipy it Workers Compensation provisions afire Luber Cndc,you most Q forthwith comply with such previsions or this permit.hull W tlttm<d revoked. "mthat CONSTRUCT]ON LENDING AGENCY work which that Here is a'roded s on lending 5genp for the pirfortna r Len o k f h h N perms seed(5 c 109]C v C) - Wr . Led Na ' t.:. ,_ .... . . _.. .. _ Ekt Q z Led Add .. . .... .. o' C.7 � I carrify that i have read this application and state that[be Above information is W F.. corms I agree to comply with all city and county ordinances and.state laws relating 0 U to Wilding ronswaion,and hereby emhmim repm-semaives mints city me mer upon �,,,W the above-mentioned property for inspcnion purposes. yG. fwe)agree to sa,ima innify and keep harmlen the Ciiy of Cupertino againad CO) liabilities,judgments,costs and expenses.which may in any ways eceme again.said V, City in Consequence R the granting of this L CO SOUVAN'rt aDERSTAP05 AND WIDL COMPLY WITH ALL NON-POINT- I ' sou�yeRZF ,uLAn�'' '°'.t �- ��_0 Issued by: Date StftihollsTe tiftApplicartsComeactor. ••. " . - '.Dam Re-roofs HAZARDOUS MATERIALS DISCLOSURE' Wlythe Applicant a'future building occupant saame or handle hash dons motion as defnbe Cupertino MuAiripal Code,ChApte 9.12,And the Health Ad Safetyl Type Of ROOF. Code'Section 25532(a) E]Yes All.roofs shall be-inspected prior to any.roofing material being installed___ _- Win the Applicant or future building eacp t use equipment or devices which If a roof is installed without first obtainingins ection, I agree to remove man baamd m air cont m As defined by the Bay Area Air Quality Management an P g District? all new materia inspection. Applicant understands and wil o ,ply with p °Ye all non-point a re ' ations. 1 live read the lisous materials q ttemeids and Chapter 6.95 of Ne Calvo .Health&'SfetyCde,Sections 2550525533 and 255341 Ade and that ifN Wildmgd«snot ren0yb.v .l. Lth t t amyrcspons tyt otifytW - «cupam of i req esu cab' at W'met prion.F'..i m f er ridicule of Occupan / ©Z Si nature f Applicant D e caner oro andmd.,air Date All roof coverings to be Class "B" o better " r- - OFFICE. .. .._ ._.. Building Division 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: (408)777-3228 Pax: (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 1/4"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 Nani`ir ^�z /� (� n S 6 V1 Address: aqQ�bc.. Reroofing Company Name- 1;,S- Applicants sApplicants Signature: Date: O Z Joe Antonucci (Chief Building Official) 6/25/01