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05060145
;BUCILDING ITYOFCUPERTINO BUILDING DIVISION PERMIT CONTR>OR,INFPS''M�ATIONiS ADDRESS: FOUR SEASONS ROOFING PERMIT ND05060145 NER'S NAME: PERMIT ISSUE DATE DAVID CHOI 502 HORNING ONE: SANITARY NO. CONTROL NO. 408) 278-0330 ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDGO PLUMB MECHO X00 LICENSED CONTRACTDR'S DECLARATION lb Dcri tion 1 ^ f1 0 1 hereby affirm Nat 1 am licensed under phenomena oes of Chapter 9(commencing IP l ern`, )7 ff with Section 70DB)ol'Dividan 3 of an Business and Professors Code,and my licenmb u �. - '•t�, ,F in full mice and` y72ro ` REROOF W/ COMP. I�J MV1 Z License class Lk.g , nF Dam —ZZ jpt Canlraetof ol- ARCHITECTS DECLARATION 1. ll a i understand my plans WII M used u public mconli 2�U� DO i�xn Licensed herebProfessional efl fl n( LL \� OWNER-BUILDER DECLARATION LUV[U tUl Iljll J\jO i I 1 hereby.(fere that 11. exempt from the Pr Conmcmr,Code:Ac law for Nc o D fallowing won.(Section 7 construct, Business and w. etimm Any city m enemy K$ which mquirea•ccmtit recons the alar.Mpmw-demolish.I m e a sig ed tWment ?t'irn poor M i u i,smW psi l anito pmvisi applicant for such Permit Lt le a,iLnea statement Z< Natharlimmed pursuant m Ne of Division of of n Butecteracust nd Pelt is(Chapmr9 Sq.FI.Floor Area Valuation i€$ that(comW is exe with therefrom And deDiaisian 3 of Ne B d came d on.m lav Code)of Nat io u exempt b a m(mm antl er aper it bj alleged cumptiw.Any it Penminalty of A.mmome0d3nn rias hundr ed ed doibu(anssW).permit subjects the applicant m a cavi pen.Rr or er0 0 Occupancy Type 0 1,pe owner of the property or my employees with wgcs pe thkmk compemdon. wi0 do the warm.and the suuctum r trot rounded er iew does sea A(Sec. BudmPof And arty wh Wild,Cutic:rn Contractor, nd wW law sacs ort appy lf rt awwr m Required Inspections propertywye s,pro i imams,Neiman,sedwho AMAsuch work Mmaelredthrough hr howe erlayvs,provided that ver impmvemano a=ret year o ed mo@red forO mer. however,the building or caof provinisen,Iwithinoroyear of mpove for tha orae of builder will hew Ne aurden of proving Wt k did rot build or improve Ire purpose of akJ. f 0 1.as Owner of the property,am exclusively contracting with licensed conummrs An comtmct the project(Sec.7041,Business and Profession Code:)The Contractors Li- ceme law docs not apply m an owner of property who builds or Improves demon,and, who convects for such pmjem with a mmrmmr(s)licensed pursuant o Bre Conuactors License law, 0 lam"emit under See. .B h PC for this won Own" Data Adk WORKER'S COMPENSATION DECLARATION 1 hereby an under penalty or perjury one of the following declarations: 1 haw and will meinuin eCeNOmu ofConsem m Olf-imam for WorkcraCompen- Oion,as provided for by Section 3700 of the Loam Code,for the performance of the work for which this permit is issued. 0 1 Mw and will maintain Worker's Compensation Insurance,as mqulmd by Section 3700 of NC War Code,for the performance of be work for which Ni,permit i,issued. My Workers Compensation InsurancenmNcr and Policy number are: Caricrra.2-.a+SUnk. e4iva e IPo iry No.:esu/ptn*A j/VO aLt+n CERTIFICATE OFTEXEMPfIONFltOM WORKERS COMPENSATION INSURANCE Transection wed notbecompleted if the permit Is torose Monod dollars([1011 or ksa) 1 coolly that in the perfmnaneo of the work for which this permit is iaucd.l,hall not employ any person In any manner an As m become subject to the Workers Compensation Laws of California.Dam Applicant NOTICE TO APPLICANT:If.after making this ceni0mte of Exemption,you,hold become subject M the Worker',Compensation provisions of Ne Labor Cade,you meat 3z forthwith comply with such provision or this Permit hall be deemed revoked. zCONSTRUCTION LENDING AGENCY (r I hecbyafOrn that Nes Is a construction lending agency for the performance of ai r� the work for which thin permit Is issued(Sec.3M.Civ.Cd Wa A Lendcra Name , z Leda'.Add. U Q I ceNfy Na 1 have read this application and rete that the above information r IL (~' correct.1 agree M comply with 411 city and county manarm and one lawn mlating to O V building construction,and hereby authorise mp.nodvea of this city to enter upon Ne G17 above-mendoned property for inspection purposes. (We)artme to saw,indemnify and keep harmlea the City of Cupertino against ti fah liabilities,judgments,costs and expenses which may In any way accrue agalmuaid City in V s ork. APPLLICANT UNDERS VDS Asequance of the SMmflm9 Of mND WILL COMPLY WITH ALL NON-POINT Issued by: Date B EREGULATI —27—0 Re-roofs mgmture Appli ser Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof dl tic applicant or rum=building occupant sort arluMk havardous material As Rwd by tic Cupertino Municipal Code.Chapter 9.13,arced the Health and Safety O ne.Section y5532(a)? All roofs shall be inspected prior to any roofing material being installed. Oyu 0 N Will tite applicant or future building Occupant use equipment at&vim+which If a roof is installed without first obtaining an inspection,I agree to remove it haatdom air conumina,a dcflmd by the Bay Area Air Quality Management all new materials for ins tion. uict7 0Yes ON. I have rand NehaSecwmam05,255rials ui sent 5334.1 rClupmr695 iof rhe Calif Hglthd Safct Code.Satiau ZSSOs,]5373 anal LSS3/.l undcmand thulrthe buildingt/fi/a cs Out covertly have a tenant N my respeembillty us notify the oecupant of the i uwhichmunbemet o(aCmifuupro= z06 IgnageofApplicant Date wnc, .atWdsm1 ant Dam All roof coverings to be Class"Bo or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 C Fax(408)777-3333 �UPEI�TINO Building De artment JOB ADDRESS: PERMIT # 228i G & ©sd o � y�— OWNER'S N PHONE # GENERAL CONTRACTOR R. FAX# I am not using any subcontractors: Signature Date Please check applicable subcontractor and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date Community Development Department Building Division City of Cupertino 10300 Torre Avenue CITY.�F Telephone: (408)777-3228 UPEI�T�IV� Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 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 re-roofing 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) Pre-inspection 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 a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. 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 on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: Oval ( /1OL .So e,"'V Job Site Address: ,.2- 2 ,1119 /J12 4� Roofing Company Name: sE Applicant's Signature: Date: -dam Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper CITY OF CUPERTINO REROOF CUPEI�TINO PERMIT APPLICATION FORM APN#3LI2 3302 Date: — — 5— Building Address: � G ner'same�:, Phone#: �d L WFIC cS oo :t/ C tractor: n Phone #: 4og License#: (r( z78-037 0 Contact, Phone#:40 Cupertino Business License#: R Z —6770 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles 3d—Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: kfrkLq Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are anrestrictions: E Cost of Project: Type of Co ction: Occupancy group: Q�0 f7' ERo Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING J � 3u G � •