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09040068 CITY OF CUPERTINO BUfLDING DIVISION PERMIT � � � � ' PERMIT NO. BUILDING ADDRESS: 10898, FOUR SEASONS ROOFING 4 PERMIT ISSUE DATE OWNgl'@"g, 10918, 10928, 10938 PMTMANAGEMENT SANITARY NO. 0 o. ONE: BUILDING PERMIT INFO ARCHIT-CT/ENGINEER: B� EO PLUMB MECH RE—RF RPLC EXT RFSYS W/NEW GAF 2129 p LICENSED CONTRACTOR'S DECLARATION G CNYN A S PHLT RF Job Description U I hereby affirm that I am licensed under provisions of Chapter 9(commencfnk with Section 7000)of Division 3 of the Business and Professions Code,and my license is r ra„ in full face and effec j Z Lice" ac Clan �� Lam• :y Date Contractor•Y ARCHITECTS DECLARATION I understand my plans shall be used as public records �yU 4 o H Licensed Pmfessional OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the co following reason.(Section 7031.5,Business and Professions Code:Any city or county 9 which requires a permit to concoct,alter,improve,demolish,or repair any structure prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation that he is licensed pursuant to the provisionsof the Contractor's License Law(Chapter 9 3q.Ft.Floor Area xt--a (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(5500). 0 I,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure is notintended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law dos not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement 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.). 0 1,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. 0 1 am exempt under Sec B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's Compcn- �ation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 I have and will maintain Workces Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Com ensa' n Insurance carrier and Policy Cartier. Polity No.: Q•7 I CERTIFICATE EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J Z forthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY Fr►�. 1 hereby affirm that there is a constructinn lending agency for the performance of pt;> the work for which this permit is issued(Sec.3097,Civ.Q ALender's Name Lender's Address U 0 I certify that 1 have read this application and state that the above information is LL 0-4 H correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building concoction,and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. W (We)agree to save,indemnify and keep harmless the City of Cupertino against c.4) liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. Date r -- APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: C , SOURCE UGULATIONS. S el-0 Re-roofs - Signature of ApplicanVContnctor Date HAZARDOUS MATERIALS DISCLOSURE Type of F.00f ,v Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Cafe,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. C]Yes ite If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which L hazardous air contaminants as defined by the Bay Area Air Quality Management all new n Laterials for inspection. .strict? 0 Yes 4Nu I have read the hazardous materials requirements under Chapter 6.95 of thc Califor- nia Health&Safety Cade,Sections 25505.25533 and 25534.1 understand that if the building -"--- does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which must be met riot to issuance of a Certificate of Occy�cy. Signature of Applicant Date Dato All roof coverings to be Class'"or better Owner or authorized agent CITY OF C'UPERTINO REF:OOF CUPEkTINOc�PERMIT APPLICATION APN # :�) I Date: Building Address: Owner's Name: I�Yf(, �c�t .*�•�` Phone #: (,V0V y �-- �3 � zS HOA: Yes No ❑ If yes, provide letter from HOA Contractor: Phone #: OtAr S �v //'? Fax z, S3 Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles X Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles El Wood Shingles X Other (Specify) �Irt,� ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: /mer Residentialr Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ -applicable, include in plan set & the sheet index. Valuation: 2,0,0 - 1 Have Read, Understand and Will Comply with :�upertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO a REROOF ''UPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B - ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Conmercial B IREROOFRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 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 2007 IBC Standards and manufacturers specifications on z e-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 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 b uilding 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 Ci-.y,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 withou:first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be pe:-formed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fE e 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 U "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 abo,re stated policy on re-roofing. Homeowner's Name: Job Site Address: -- Roofing Company Name: Applicant's Signature: ""- r'��-- ------ Date: Greg Casteel Building Official Reviled 07/30/08