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02060046`' BUILDING DIVISIONPERMIT SION U I CONTRACTOR INFORMATION: BUILDING ADDRESS: TYIT AA AT OWNER'S NAME: CAMUSO CARMEN J AND CYNTHIA PHONE: ARCHITECT'I NGINBER: Z O N Z LICENSED CONTRACTOR'S DECLARATION O Z — _ 1 hereby aRmr that I am licensed under provisions of Chapter 9 (commencing F EliE with Semlon70fKoof Division3olost Business an P�"fe'luns Cade, apd my license a ex y is in full force nn e���� � O`Ji O w U Demnx lass Cc has C— RCHITECT'S DECLARATIO g + 1 understand my plans shall be used as public retorts �N wO O Licensed Professional m� OWNER-BUU.DF,R DECLARATION — so , 1 hereby from that 1 em cmmpt from the Contractor's License Law for the Z < following reason. (Section 7831.5, Business and Profeuiom Code: Any city or county Z O which requires a permit to construct, aIle, improve, demolish, or repair any structure 3 -:prior m its issuance, also requires slit appliwns .... ch permit to file a signalm smmenr that he is Emanated pursubn( to the prrovisions of the Commoner License Law (Chapter 9 (commencing sun Section 7000 of Dw Winn 3 of the Uysinces and ProfFaions Code) or that he is exempt therefrom and the basis for the alleged e4emp lc h. Any violation of Section 7831:5 by any applicia l for a Permit subjects the applicant to a civil penalty of not more than five hundred dollars ($50,. ❑ 1, as owner of the property, or my employees with wages as their sole compensation, " will do the work, and the sacrum is not Intended or offered far .In (Sec. 70,4; 'Business and Professions Code: The Corrector's License Law does not apply to an caner of pm,my Who builds or improves thereon, and who does such work himself or through his own employees. provided that such improvements am not intended or 9 —bRned for sole. If, however. the building o7 improvement island within one year of omoletion, the owner -budder will have the burden of orovina that he did not build or improve for purpose of sale.). O 1: as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 704, Business and Professions Code:) The Contractor's is License Law does not apply to an owner of properly who builds or improves Charms, t. ^: 4 and who contains for suchprojecm.wOh a.contrucou(s) licinsed.pursuanuo the Cot r rs License 4 ❑lamexempt under S c'tj,BI& P C for this mason Owner :.; •., "�•—.Dare WORKER'S COMPENSATION DECLARATION :.- Ihereby M. made,pc ally of pea ry rte of, the fallowing declarations: ❑ 1 h and wiH modules .'Caidfikriaa of Consent to self-iname for Worker's 2pcnsat.on: as provided i r by'Section 3700 of the labor Code, for the pert a fthe work for which the fiction lsissued ❑ 1 havemod'will man talo Workcr s Compc t 1 ranee us required by Sabon 3700 of the Labor Code for the performance f the work for whch this pemdt is lotted My Wok S5aC psaxacion Inscrame Carrier andPolicy nuoulmc, are r FOUR SEASONS riCUM 1[0 00x4 em" -Tial (408)278-0330 REROOF 305--= 601 - ROOF PERMIT N0. NG ..-_. ROOF. 02060046 603 - ROOF APPLICATION SUB DATE 604-.- ROOF 06/10/2002 SANITARY NO. CONTROL N0, BUILDING PERMIT INFO BLDG ELECT PLUMB MECH = Job Description $8000 _,Valuation tT.�.�'.ih; i Occupancy Type 601 - ROOF TEA&tIdTtInspections "" ""• " 602 ..-_. ROOF. -PLYWOOD NAIL._._ __._.._.. ..__.___... _...__. 603 - ROOF BATTENS "r 604-.- ROOF IN -PROGRESS JAN 3 0 2003 BUILDING COMPENSATION INSURANCE t il ' °(This action need oat be completed if the permit o foe one hundred dollois- (Sloo)ones:.l Nii th perform ace ofsh ok'for wh¢h ih pc- tis i.uued I -- Y shall t employ ady pervd y man . to become subject 16 the Workers r...,,......�.,,:....r...,...r O O fodhsOitE comply with such provisions or this permit shall be deemed mounted. rc� ' 6I CONSTRUCTION LENDING AGENCY I thereby'ffrm Iturdth 1s aconswcuon lending agneyfr theperfortimnce ; iL�.t of the war, for which Nis permit ra ossuW ISec. 7097, Civ. C.) r Tis Q.•Landau shame::.-• r's ...• •,.••-.:•.•_ ,•. _. .' _..c _.-.. _ :: _. _.: LendeAdda •. tes". .• , +' + ... U .0 1 certify that I have read this application and state that the above information is cbriect. 1 agree; to comply, with all city and manly ordinances and stale laws relating 0;V m to building naraciion: and herebyaihmin, ispresrnmis tives m ciiy,. enter upou the above mentioned pmperry for inspection pur,d es.. F`fye, 'IWr)agree,. m save. indemnify and keep harmless'Ne Ciiyof Copcninoagainst car W. liab t judgments, c t d a p ism h ch y m any y ccr m ngain.vt said V. z Cirymc nequc edf she Bio tog of thispc t' APPLIC NT t' OERSY AND WILL eoMPLY TI'H ALL NON-POLNY ` SOURff/. R6 LATIO a p ^ v Si,marUtrIct'ApplictunfiCorturactio Data ,HAZARDOUS MATERIALS DISCLOSURE Wllnh upplic tin romme building ra,n, unre or liandle haotmouvi mmadal m defnW by th C pen M I CoaCh pts 9 12 and Ili Health earl CodElye $act o 25531( 7 n•. Will rhe applie.,or future builiimgoccupant use equipment or devices which emir haanrdous air continuous s,ydefired by the Bay Amo Air Quality Management Distto ,I / IY<s .[]No - •- 1 baiit"read'am htaxanrn.s marenals requ mammos under'Chapmr fi 95 of the California Health & Safety Core, Sections 25505 25533 and 15534 1 understand that if the building does nos curter ly have attention. that it is y responsibility m notify the p'ccup m of the ireemme'ms which must be m1 1,et prior to issuance of a Certificate of e 0�rf I Fe 'L. % nrthonmd agent ,, ; Ume Jill Issued by: r Date U V ,- Re-roofs ' Type of Roof) _ ., . ars �7 rt f4^i 4�'t All roofs shall be.inspected prior to -any roofing material being Installed._ If a roof is installed without first obtaining an-inspectioti,' I agree t6 remove all new materials f r. inspection. Applicant understands and will comply with - all IT point so ere ulattons Signature of Applicant _ Date All roof coverings to be Class "B" or better' i OFFICE c ,. s 0 t 11 man CITY OF CUPEkTINO Building Division 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: (408)777-3228 Fax: (408) 777-3333 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 YV 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: //-P fav 7w.d d e'kS' Address: Reroofing Company Name: Applicants Signature: ��--- Date: & �//25 ' Joee Antonucci (Chief Building Official) 6/25/01