03120087 CITY OF CUPE �CONTRACTOR.INk'ORgATION: �
BulLuwc DIVISION
PERMIT swry
BUILDING ADDRESS: _ FOUR SEASONS- ROOFING PERMIT NO 03120087
' ,ERPS NA E: - PERMI'C L59UE DATE
ONE: SANITARY N0. 9 CONTROL NO.
ARCHITECflENGINEER: BDILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
000 LICENSED CONTRACTOR'S DECLARATION
ZC 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing Job Description
<U with Section 700(h.f Division 3 of Me Busincasand Profcssima,C 5y,and my license is
InmBmmeand if f.�a,�l ptj REROOF
a vOi z License Class ^iR Lic.M
n
s,O Dem V 7S DECLARATION jg ARCHITECTS DECLARATION
HH 1 uMcrsund my plans shall M used as public records
aLicensed Professional
S - OWNER-BUILDER DECLARATION
�<X 1 hereby affirm that 1 am exempt frum the Capt.,.,'.License Law for the
00 following reason.(Section 7031.5,Business and Professions Code:Any city or county
K m which requires a permit to construct,slur,improve,demnlish,or repair any structure
Ptia
pool nits isuance,alw acquires the it,lieamfar such Permit to file a signed statement _
££ that he is licensed pursuant to the previsions of Me Contractor's LicenseLaw(Chapter 9 Sq. Ft. Floor Area Valuation
z a (commencing with Section 700(r)of Division 3 of the Business and Professions Code)or
y .. Nat he is exempt therefrom and Ne bots for the alleged exemption,Any violation of ,A.p�i.�g�,v,}v
Section 7031.5 by ary applicant for a permit subjects Ne applicant to a civil penalty of 3'f15 fJr6`2'Y'l9f;r00 Occupancy Type
not more than Bve hundred dollars($500). P Y YP
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and Ne structure is not intended or offered for sale(Sec.7044,Business
and Pmfmsions Code:The Contractor's License law does not apply to an Owner of Required Inspections
property who build(orimpowas thereon,and who doessuch work himself orthrough his
wn employees,provided that such improvements are not intended oroRemd periodic.If,
however,Ne building oaimprovement is sold within one year of completion,the owner.
builder will have the burden of proving that he did not build or improve for purpose of
sale J.
❑1.as owner of the property.am exclusively contracting with licensed contractors to
consmet the premed(Sec.7044,Business and Professions Cade:)The Contactor',Li. _
come Law does not apply to an owner of property who Wilds or improves Moment.and
who contracts for such projects with a commotor(s)licensed pursuant to the Commers's FI NAL�D
License Law.
C]1 am exempt under Sac. B&P C for this reason
owner Da1e JAN -�. 3 2004
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations: BUILDING
,1 , .w■
I have and will maintain a Certificate of Consent to selGinsum for Worker'sCompen-
smion,an provided for by Section 3700 of the Labor Code,for Ne Performance of the BUILDING
work for which this permit is issued.
have and will maintain Workers Compensation Insurance.as required by Section
7(10 of Ne labor Code,for Ne performance or Ne work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy number am: -
Cartier: IPolicy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not becompleted Ellie permit is for one hundred dollars(51 W)
Ie.)
I comity that in the performance of the work fir which this permit is issued.I shall not
employ any person in any manner an as to become subject to the WorkerCompensation
Laws of California.Dale
Applicant
NOTICE TO APPLICANT:if,after making this Car ifcate of Exemption,you should
became subject to the Worker's Compensation provisions of the Labor Code,you must _
., ,Z forthwith comply with such provisions or this Permit shall he deemed revakcd.
yO CONSTRUCTION LENDING AGENCY
(-s I hereby affirm that there is a construction lending agency for fine Performance of
W r7 Ne wank fur which this permit is issued(Sec.3097,Civ.C.)
WA lenders Name
Z Lender's Address
U Q 1 certify that I have read this application and stem that the above information is
Hcorrect.I agree to comply with all city and county ordinances and state laws relating to
L7 V building construction,and herchy authorise representatives of this city to enter upon Ne
{17 above-mentioned property for inspection purposes
y
(We)agree to mvc,indemnify and hick harmless the City Uf Capactins against j
y Iiebiliti( j)grents.o cos,indexpenses nifyand keep
may inanyway eCity Or
City L(/
V z Ag CAN Uf DEthe RSTAN f his ILL COMPLY WITH ALL INT Issued by: Date
5 CER U TIONS.
17= Re-roofs
SignathrcAPplicanV rte etor Dole
HAZARDOUS MATERIALS DISCLOSURE Type Of Roof
Will th applicant or future Wilding Occupant store or handle hararduus material
as dcMed by the Cupertino Municipal Code,Chapter 9.12.and the Health and Safety
ode.Steil
2s53xa)?
Y.
'49N. All roofs shall be inspected prior to any roofing material being installed.
❑Y
Will the applicant or future building occupant use equipment or devices which -If a roof is installed without first obtaining an inspection,I agree to remove
it hazardous ar contaminants as defined by the Bay Area Air Quality Management a new materials for inspection.,
strict?
El Yes We - _
I have mad the haraNnmmaurials requirements under Chapter 195 of the Califor-
at,Hcai &SafctyCodc,Scctiom 25505,25533 and 25534.1 understand Not ifthe building
dress "Ly
nJyhovca t' my rcsponsihility to nndly the cecupont
myu cn whichm rnrwiasuanee Ofa CcrdOca of occupancy. Signature o Applicant Date
u2415' fly
owner art autha'� as rat Date All roof coverings to be Class"B"or better
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
Fax: (408) 777-3333
U P E IST I N O
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.
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: Gaw-Qk Wtd -t'09Q&6
Job Site Address:
U
�a
Roofing Company Name: t 4✓w -1—K,
A phcant's Signature: Date:
Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO 3 Z C)
REROOF
= CUPEZ°TINO PERMIT APPLICATION FORM
APN# i Date:
Buil 'n Address:
Owner's Name: Phone#:
r q% —pct
ntractor• Phone#: License#:
tAv2�g alo<K
Contact: Phone#: Cupertino Business License#:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ ,Built-Up roof
❑ Asphalt Shingles p Asphalt Shingles
VI-lood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ 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: `z�
JobDescryption: o � Il�t'COVE- to v t�
Residential\ Commercial ❑
Fire Zone: YesEl No Er Confirmed with P n Dept. if
there are an strictions: U
Co of Project: Type of Co tructi Occupancy oup:
ra '
Q
Applic le 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
S' .�
FOUR SEASONS ROOFING, INC.
JANUARY 9, 2004
TO: CITY OF CUPERTINO BUILDING DEPARTMENT
REGARDING: 2252?-22&37 slLVER OAK WAY, CUPERTINO
BUILDING PERMIT # 03120087
ON DECEMBER 12, 2003 FOUR-SEASONS ROOFING, INC. REMOVED
THE EXISTING ROOF AT 22527-22537 SILVER OAK WAY. LATER
THAT DAY WE RECEIVED A TEAR OFF INSPECTION
DUE TO WEATHER CONDITION AND THE HOLIDAY SCHEDULE WE
HAD AN OVERSIGHT IN REGARDS TO THE INSPECTION PROCESS.
FOUR SEASONS ROOFING, INC. HAS INSTALLED ALL MATERIAL TO
CURRENT CODE REGARDING THE FOLLOWING DETAILS:
1. THERE IS A 30LB. FELT UNDERLAYMENT UNDER ALL OF THE
VALLEYS.
2. THERE IS A 1" CLEARANCE AROUND ALL "B" VENTS.
3. S D FASTENERS WERE USED ON THE PLYWWOD SHEATHING.
4. ALL PLYWOOD IN NAILED 6" 0.C. ON ALL VERTICAL SEAMS.
5. ALL PLYWOOD IS NAILED 12" 0.C. IN THE FIELD
APPLICATION.
6. ALL PLYWOOD HORIZONATL SEAMS HAVE SUPPORT AT THE
EDGES.
FOUR SEASONS ROOFING, INC. IS RESPONSIBLE FOR THE WORK
PERFORMED AT THE ABOVE MENTIONED ADDRESS.
THANK YOU FOR YOUR ASSISTANCE IN RESOLVING THIS ISSUE.
r
AL WAZ
PRESIDENT, FOUR SEASONS ROOFING, INC
PLEASE FEES,FREE TO CONTACT ME DIRECTLY WITII ANY QUFSTIONS 408-593-2136
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