02060193 `CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
22433 SANTA PAULA AV ALL SEASONS ROOFING SERVIC S 0205601193
STEVENOT RICHARD G 2640 PACER LN APPLICA06/u 7/2002
PHONE. 4089724455 SANITARY NO. CONTROL NO.
0 L Z ARCHITECTMNGINGER: BUILDING PERMIT INFO
W'0 BLDG ELECT PLUMB MECH
S. = LICENSED CONTRACTOR'S DECLARATION Job Description
:z g C I hereby a that I em licensed under p 'cions of Chapter 9(commencing REROOF
v,Fm wish S!1d1dM.!
the dexside.:dej< Lt to n « N q T/0 1 LAYER OF WOOD SHAKE,
'oa Datecame' INSTALL 30 YR. DIMENSIONAL CEDAR BLEND.
I Re u t, ECT'SDECL 'ION'.u 0 be used as public records
1t
i aC5 License Pmfcssional
o a OWNER-BUILDER DECLARATION
1 hereby affirm that 1 oroemfrom the Contractor's Liccnsc Law,for the
C 2 a following fins,(Section tto115 pt Businna andio li Cod,:Any city or county
IE
2F 0 which req permitconstruct, lir improve.
de p 1 xM1 p- y structure
�u3$
poor to itsu 1so requires meapplicant f such permit rile a signed statement
I',be is licensed pt t to,chi p .
o of CormiuctoreLicense L, (Chapter 9f_,n Sq•Ft,Floor-Area y" s 45g4uation
(commencing with Section 70W?of DivisionJ of the Business dP f .ons Cut 'L x A )ils. stfp. G.t. I., l._?, Ivy
or that be i5 exempt thcrtfmm and the basis for the alleged exemption.Any violation
of Section 7011.5 by any applicant for a permit subjects the applicant to a civil Penalty
of not..or than rise hundred dalL,r.(SSW). 3 5 744t4i JT)l8!0 • . ' •) Occupancy Type
❑Lasref be property,ar my employees with wages as their sole compensation.
-will do the work:and the.structure is not intended'or offered for sala'(Scc.70,14: 305 — FRAME-,
'Business and Professions Case:The Contractor.License law docs not apply tom Required Inspections'
owner,tit
of property who build,or improves thereon.and who doe,.such work himself 307 - INSULATION
or creel fM1 his awn W.,v ,t Wilding
m r such impravcmct l arc non immure Or _
e for side.B,However,the wading or tmPmvement n sold he did did year or' ' ' 601 ROOF -TEAR OFF'-
completion, -- ------ --- '- - - ' --- - _.
the
pons of wilder will have the harden of that he did not build or
\ is
rot pumaae arsmn.). pro"ng 602 — ROOF PLYWOOD NAIL
_-_.— . . . .. ._ . ___. _ ...... - 603 - — -ROOF--BATTENS -- -- _.
O 1,as wncr of me ProPenY,am exclusixsly conn¢ting wnh licensed cammctors to
construct the project(See.7(144,Basins.,and Podexsm-Cndeq The Contractor's 604 — ROOF IN—PROGRESS .... ' '
License law does not apply to an Owner of property who builds or improves thereon,
.. :. .-and who mnuac¢.forsuchprojeco.with a.contractons)licensepursuam m..m< -_-.._C'N���® __ _-._._ ....- ....... _.. -.-. .. ..
Contractors License Law. F
❑1 am exempt under Sec. s - ,C B&P C for this Orison .
Owner Date JUL 2 3 2002
WORKER'S COMPENSATION DECLARATION
1 hereby alums under penalty of perjury one of the following declarations:
, O 1 have and will maintain a Cenifate of Conserv to self-insure for Workers BUILDING
V� Compensation, as provided for by Section 37W of the labor Code, for the
Performance of the work for which his pemm is issued.
❑1 have and will maintain Worker's Compensation Insurance•as required by,Section
3771 of the Labor Code for the performance of the work for which this permit is
issued My WorIs c' C pe . i Isum carrier and Policy number an:
_
' ,Ill ldoli ,N wC'`7^�2! / ; t ,'• �j N C l3"2 'I` r:a. - -
�y�[' _ . .. . ... _ ... .
cr CERTIFICATION.OF E%EMI'TrIN PROM,WORKERS't
COMPENSATION INSURANCE
it (This section nee not be completed if the permit is for one hundred dollars
IS]W)or less.)
fondly that in Person
in any dr un the work for whim this [e iu rke,i
shall not employ any person m any ma ea W ad io become subject to the Workers '
COmpenution laws of Calilomia.Damon
Applicant
NOTICE TO APPLICANT:If,after making this Cenifrmc of Exemption.you should
become subject to the W'orker's Compensation provisions of the Labor Code,you must
Q 0 forthwith comply with such provisions ar this Permit shall he deemed revoked.
CONSTRUCTION LENDING AGENCY','
Iherebytifrm that there isacnnstiumion lending agency for this performance
ra of me work for which this permit is issued(Sec:3097:Cie Cd
=.z -Lender's Nater. n _.. _. :. ..-a.....r,
Lcnacr'i Addrtsx', . . .
U'0 1 certify mat 1 have mad this application and awe that the above information is
(1st"U correct.1 agree m m,mnland hereb oiD arta cin,myOMIT urdatives of
nate laws enter
uponQ'W no Wilding amrmction,artahembyutsecti mfaposen[atives of this city mentor upon
04 me aboveme ire,to pro«ny for inspection purposes. •
;p, . (We) to save,indcmniry and keep harmlcssthe City ofCupenino against
h liabilities,judgments•co cs and expenses which may in any way accede against said
U Z City in cansequence of granting of Nis pems[
r . p�
APPLICANT I' {J. fAI AND WILL COMPLY WITHAC:'NONPOINT
Issued �s Date
h'I
souucE RF Lir I' .. ��OL
t attire of li VComroctor' Dme
- Re-roofs
•8n ." PP HAZ RDOUS MATERIALS DISCLOSURE'
Will m licant a f t Wilding«cupant [ Handle hezvdous matenN Type Of Roof
- as def dh Cupertino Municipal Cotl Chapter 9.13 d the Health d Safety , '
Code Set SSi3O J t s [ l f '`. P f ",' t1 .,
_
Dye "° 1 1 e All roofs shall be.inspected,prior in any roofing material being installed.
w71 the."Ii, rebuilding occupant use equipment milevices which If a roof is installed without first obtaining an inspection, Fagree to'remove
emit hazmdm air contammamdrod,firsed by Ne Bay'Ama Air Qualty Management
Dix uiel?- all new materials for inspection. Applicant understands and will comply with
❑yea; - - a - ,- c all non-point source
'1 have mad the s nrtqutrade,Chapter of Ne
California Health&Safety C Ssitenmaterials55(5,25533 and 25534,1understondtha
ifthe budding t rtenI have a temsnt.thmitis my responsibility to notify the
«cupmt of
sm Which most he mer poor to issuance of a Certificate of
Q"°Pan`y' " Signature of Applica Date
AX&�i'• aim a ageni Date 0,1
I roof coverings to be Class"B" or better
ar
-' 'OFFICE
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF 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 1/4"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: P(/2
Address:
Reroofing Company Na
Applicants Signature: Dilt
Joe Antonucci _
(Chief Building Official)
6/25/01