02060045 (2) CITY OF CUPERTINO -
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10158 RIDGEWAY DR FOUR SEASONS ROOFING 02060045
OWNER'S NAME: APPLICATION SUB DATE
GOWER GRANT H AND ELIZABETH H 645 HORNING ST 06/10/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 278-0330
700 ARCHITECP/ENGWEER: BUILDING PERMIT INFO
ty FF BLDG ELECT PLUMB MECH
O5.i LICENSED CONTRACTOR'S DECLARATION r ��,I]�tlncr.rira�
OL O Section
7000)
y0)of Division
of
IJeucer provisions afn,Costrq(commencing REROOF {��P ® "yde'e✓L'
ry with S<mion 71X101 of Division J of the Business and Professions Cadc,nnd�my license
Y t is in full force til eRf 1 �z/� r/
z z a License Class CC —` Lic.at d '3 0 2003
Data Cammntm _: JAN
3 a G ARCHf1ECT'S DECLARA ION
E g ON g 1 understand my plans shall be used as public rccoNs
-8 LicenxJPmkisinnal BUILDING
a.a. OWNER-BUILDER m the RATION
iz^ 1 hereby.(Arta that 1 1. exempt from the Cessions a License taw for the
h?C following rcasoa permit to 7031.5.Business and Professions Cade:Any city or county' $8000
F❑ whichrtq to permit re construct,sher improve,demolish,ore asranystrunorc
M 3$ that
her to t. ensied purl requires theapplicant for Conanuch permit Liomm Lowned
- a
MatswitpulelinttplImof Divisiof the Conant l.ndprlaw(Chager9 �, 4o [ 1 C:A r t vt,a' ValIlaIl00
continental,emptthtonem and the visas or the
swttl professions vi COJe) {;q�'R !'• 1:34241OF1°�l.;iU yr°f„1,14; r +
on that he t7 31.5 b meiefrom and the bass far she subjects
hal exemption.Any violation
I
of Sesnot
]than byan,
undredi dollars($for a 500).
subjanthe applicemaacivil perelry p y,Typ
.root marc man eve hundred sonars essW). 3 0�PN LYIlIDI]C` ' � <:�.” Occu ane e
❑L mow a,,of me property.u my employees with wages as tbeirsole compensation, I,,���f i'�
r �s�.�J.,
'Butimll o'Ne work;and the onsmrc is not intended Li or offeLicense
forfee sale(Sec. to. 6O 1 - ROOF TEf ln$ ectlons,
new er o pro Professions Code:The Contractor's.and w law does nos apply to an q P
owner ofpropertyhis ow Who builds or improves thereon,and who docs such wink himself
or mrongh his own employees.providedWilding
that such improvements oa not intended or - 6 0 2._-....ROOF. PLYWOOD NAIL—.... .... .. .. . __ -_
;offered-'comple for shelCho buildi she Wilding or urden ccmeni n sold within oanycei of -'- -' - -
cnmpletlon,the ownerbuilder will have me Horden cuproving that he did not build or 603 - ROOF BATTENS
improve tar parpox of xlc.) 604 - ROOF,- IN-PROGRESS„
..�1as owner of the . .. -._ _ . ... - .. .. _.. ................
propertyy.mo CXCImiVCBusiness a cnmmcung with licensed n contractors .:
ito
cosecs she project(Sec. to a,Business and Professions Cale:)The Contractors _
License law does not .huc m an owner th progeny who builds se improves thereon '
,and hecommentkens fLa such projects with n comructor(s)licensed punuant mlhe ..___ -. .___ ...._...._-. ___.._... ___._.._.. _.. _r..Cmura
01..exempt
License Law.
- ❑1 am exempt under Sce: ,B&P C,far Nix raison
Date
_ owner " ...,,. _ \
•' WORKER'S COMPENSATION DECLARATION
I hereby Pfrimt under penalty of perjury mie•of she following declarations:
S
01 have and will maintain a CertlBcaie of Consent to self-insum for Worker's /
Compensation, as provided for by Section J'/W of the Labor Code, forme
performance of the work for which thix permit is issued
oad will maintain Worker's Compensation Insurance,as required by Section
'rare
of the'Labor Coale,for the farm nice of the work for which this permit'is
i� issued.My Worker's Compensation Insumnee carrier and Policy number me:- \1
....' ..r'. . Oft
CariierM^14i Nd''lp'T/�'t Policy No:: D /6Z.. s...a. ... .i' l��v...,k. .._._.__....
_ 1 '!;CERTIFICATION OF EXEMPTION FROM W0 KHRS'
COMPENSATION_N INSURANCE r":t'1=, L
..•, °' (This'section need not be completed ._._
t tM if the permit is for one hundred dollars
($100)ar less.)
',.I cemployhat in the perfminy ma n the as
forco eh subject
init res Issued,1
ompent employ wanya i person it any manner so as to become subject to the Wohers'
Compensation Lawx of Cali(omia.Daren
...Applicata:
NOTICE subject APPLICANT:rxager making this visa n s o of Labor ian.you should
become ttoro the Worker's Cominnmthis provisions of the deemed
Code,you must
z 0 fdnhwiih cmnply with such provisions or this pemtit shall he Jeemcd revoked.
F.�
' CONSTRUCTIONLENDINGAGENCY
ry 1 hereby idlima Ilim them is a cnnstitictwn lending agency to,the perfumiana -
�;,ti of the work far which thispemmilis I...ed(Sec.JWl,Civ C.)
Q - nd r. Nam .. _. _.
Le .. -.. __..
I I-c tl Address' t
V Q a I certify that 1 have read this application and state that the above intormation is
correct.1 agree to comply,with all city and county ordinances and state laws mining
? O.0 to Wilding consubction.and hereby authorize repreeatmlva of this city to enter upon
gy] ,he obovennentioned property foz�in,pcmion purposes.,
(We7 agreerocare.indemnifyand keep humlesdthe Cit)'of Cupertino against
Vi
liabilities.;judgments,costs and expensewhich may in any a,n,.o.gain,,said
u.z City in cuma,cliatnur ohs griaing ofthc perm,
APPLICANT 'VDER TANDS AND WILL COMPLY'WIT LL 'ON PO,
Soca ) f�_rp Issued by: 12 , Dale
rcif'Applican/Conwcor, ' Dam;', RB-COOfS -
HAZARDOUS MATERIALS DISCLOSURD I
,;,,• wlNe pplicant or future Wilding Occpant store orhandl haraN ,mmrnl Typeof.Roof. ,._ ..,. .�.
u deficed by thirClushounto Municipal Cole Chapter 9.12.seethe Health end Safety,
Code Semoo'255J2( )
❑Ys ` 11ty tl7 - .
All roofs sh_all be inspected.prlor,to,.any-roofing.material.being.installed
Will the applicant. future bilding Occupant use equipment or dsvitts which If a roof is installed without first obtaining an inspection;T agreeto remove
imli,hariand.ovituroantamtnantsa5aennedn he Ba VeaAr Quality Management
Di Vt all new materials for inspection. Applicant understands and will comply with
.g
anon=point s - ce regulations . .
`
In r n&S ety Caoas ecom rcy 25533. u d CI Pmr 6o5 of the
'CII, Halm&Safety Codes siotts"'LEQSSII and SSJa IunJersta d mos
III, bmltlm Vas o,c I h a¢na t th tit
8 Y y.urnm of a Certificate
e nos fy the
oc p til me ul �tich must be tact poor, ice ofa Ccrtif ra of - - -
Oc P cY , /--rte y^�
[� '��_ Q�. Signature of Applicant Date
"Davial,or hithmiled agent Date All roof coverings to be Class `B" or better
r
OFFICE
.l
Building Division
10300 Torn Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
OCIOF'
Fax: (408)777-3333
CUPEkTINO
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/a"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 com�pl.y with this policy.
Homeowners Name: _ PFJ Za.4-- � � SCI "k--
Address: i
Reroofing Company Name:
Applicants Signature: Date: �
Joe Antonucci
(Chief Building Official)
6/25/01