01080018 crof cuPEN
BU CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS. PERMIT NO.
21230 HOMESTEAD RD PT A ALL SEASONS ROOFING SERV CES01080018
OWNER'S NAME: APPLICATION SUB DATE
VILLAGE GREEN ASSOCIATES 2640 PACER LN 08/03/2001
PHONE: SANITARY NO. CONTROL NO,
4089724455
R.O ZO ARCHITECTIENGINEER: BUILDING PERMIT INFO
icc BLDG ELECT PLUMB MECH
LL LJ LJ 1-7 GI
Z i LICENSED CONTRACTOR'S DECLARATION Job Description
OZ-C l herehyaffirm that l am licensed under provisions of Chapter 9(commencing
F=hso with Secdon ZDDh)cf Divisi.m3m the Businessund Profe.W.ma Code, minnyliccnse REROOF.
is full force and effect.C- S 1 T/O & OSB COMP.
ce License Cles Lic,k
K O i Date Co.'—
w 3 w ARCHITECT'S DECLARATIO.
t t O S 1 understand my plans shall be used as public records
i r
6 c Ozi� O Licensed Professional
o OWNER. GILDER DECLARATION
I hereby offra that1 am exempt from the Contractor's License Law for the
i-Z a following reason.(Section 703 1.5,Business and Professions Code:Any city or county
ce,Y ❑ which requires Permit to consumer,tmeralter,improve,demolish.or rep i any structure
-s .pot t.' a I reclaimsthe applicantf r 1 Femur fl a.t ned.tntcment -
.... ..... .
a.3 - thlhcsl ect,cclpu ito)he ruscomis oft Contractor,License L. (Chapter9 Sq. Ft Flool Area - r 1 aluatlon
( mmrting with Section)d(g)j of Di -son 3 of the Business and professions Code) I' LY a..•-. ..1�t•„
.,,but he is exempt therefrom and the busts for the alleged exemption.Any violation
-of Section 70315 by any applicant for a permit subjects the applicant to a civil penalty '
of not more than rive hundred dollars($500). A N umber '..� Occupancy Type
O 1,as owner of the pmpcny,or my employees with wages as their sole ro a,munint
will dothework,and the swcwre'is not intended"or'offered for sale(Sec.7044,'
Buiiness mic Trofessions Code:The Contractors License law does not apply to an 307 - INSULAT I OMuired Inspections,
owner of property Who builds or improves thereon,and who does such work himself 601 - R ..throughimprovements ._._.
:orf if -:ale ILhowever,twbmavingonmprnof rowssolawunnneywror 602 - ROOF PLYWOOD NAIL'
------
icompletion,the owner-builder will have the burden of Prov ng tM1m he tliJ not build or �
mprove for purpose of sala.l. 603 - ROOF BATTENS _
dl:a:r.herof ismic property,am Businivelyc Pvaf'tingruhoda:)no Common�o 604 -- -ROOF IN-:PROGRESS � -
.- c License
the does
no(Sec.]Dsa,Business and any whio b Code:)The wes Comment
s, F U n n A L E M .. • t
License Low does not apply mon owner of with progeny who builds or improves thereon. 11`t
and who contracts for such projects with a rommnnr(t).licenud pursuant.to the ... . . -_.
Commctnrs Licence Law.
❑lio esem tundersec. D"• ,.9&PCfarthismason DEC 1 1 2001
O • - "" "
m: .
tWORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: Bu'LD'pl/?
❑ 1 have aid will maintain u Ccnificam of Consent m self-insure for Worker's NG
Compensation, as,provided for by Section 3900 of the Labor Cole, for the
performance of the work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
37W of the Labor Code,for the performance of the work for which Nis permit is
issued.MyWorker's pe
s Connvtion Insurance came and Polity random art:
Cartter.. 0
h ," ICE IFICAT;IOoffN _ �..1 C
FXMyTNION FROM WORKERSOE
.,. _..:.-.
_Co. FCNSATION INS URANCB._.:.• _ _.- ..__..________._.. °. •. . . .-.._._... ._.______.._._....
IThis action need not he compinM if he permit is for one humlrtd dollars - - -
(SIW)orless.l ,
I I emfyithaiinhe pef antt of thewnk for which In is paten is issued;I
shall ern a npluy any person to o ty manner so lis m iItOrne subject m the Workers'
Compensation Laws of Colifomin'(late
Applicant - - __- t. - - .
NOTI
you shoold
'becoeETQAPPLhe Workers
other Compoomik thisCisions O of Labor Cas .youmot -
become subject to ywit Workers Compensation permit Ihall the labor Cale,you mon
Z
Q forthwith comply with such provisions or this Peretti shall be deemed revoke$.
CONS TRUCTION LENDING AGENCY -
a 1 h aby tifflon drainers no oo.tnation 1 d n6 agency for the performance -
W "ea k f M1i h th:p ct it s s d l5 .tIN].Civ
L Q der s Name
Under's Address
n
='U-� 1 corny that l have read misapplication and state the,the above infomsmion is
E.. correc1 agree tg9ci with all cityand county ordinances and state laws relating
(� (� to built.ding contraction,and hereby authorize representatives of this city to enter upon
the above mentioned property for lmpemiun purposes., -
E.;y IWel agree in.ave,indemnify and keep harmless the City''of Cupertino against
4 Ji.nlaies,juJgments. V
o s which may in any way acme against via
'City in conuyurnce oftris permit.._
APPLICANT UNOERj WILL COMPLY WITH ALCNONPOINT
UR CE REGULATII$$uedby: Date
t enfPppic dDate Re-roofs
HAMATERIALS DISCLOSURE < 1 -.WBPtheappr ild gaap'm Imre handle basudons material Type of Roof \ �as defined by the C peal Cod Chapter 9.12 d the Health and SafetyCore S t 255] W) - S -• -
oY. "" -All.roofs.shall be.inspected prior.to any." fing,material,being installed..._. ._ .
•I will the applicant or future building oes pat use equipment or devices which If a roof is installed without first obtaining an inspection;1 agree to remove
e t h. Ire t ran u set def cd bythy❑ Ar u A Qualityag
Manement
D tritall new materials for inspection. Applicant understands and will comply with
- oYet ❑No , _ I. _ all non-point rice r oulati „ t.. -
I have tmad the hazndoiv materials requirements under Chapter 6.95 of the
Calif.,.[.Health&Safcty Code.Sections 25505.25533 and 15534.1 uademard that _
lithe building dues not ammudyhave'a tenon.that it is my responsibility to notify the
occupant of the re uirtownrs which muni he me,p e of..Cenificme of
Occupancy.
mvtn iseaenc Signature of III ant Date
Owneror xnthorie gent . _ Data All roof coverings to be Class `B" or better
OFFICE
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t Building Division
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10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
� CITY OF Fax: (408)777-3333
UPEkTINO
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 Name:
Addres;.Z Z / a Q
Reroofing Company Name: P1 o&&A fi'
Applicants Signature: Date:
Joe Antonucci
(Chief Building Official)
6/25/01