03100035 I.CITY OF CUPERTINO
BUILDING DIVISION PERMIT =C ONTRACTQR,INk'OXtMATION `
BUILDING ADDRESS: , PERMIT NO
JOE S BARRAZA MASONRY INC 03100035
?nGra nr7\nra rm
OWNER'S NAME: 1490 NORMAN AVE FERMIT ISSUE DATE
n u 'rn� .G�
ns1�'
VNE: (408) 727-1148 SANITARY NO CONTROL NO.
ARCHITEC(ENGINEER: I BL00 BUILDING PERMIT INFO MECH
1�Q
LICENSED CONIRd ad., DECLARATION
1�m F 1 hereby a(Brm that 1 em lithe Bo under previsions of Chapter 9 kammen.I. Job DeSCI'I(7tlOn \
i<E4 wiNSection]OgBecDrviaion3of dm Bmineu and Prafcssiuns Code,end mylicenm is
m mu force and mreml REROOF
D w Contractor
i f? Class r
Desk ECL
ARCHITECTS DECLARATION 2 6/
U I understand my plain shell he used as public records O
a O3
'oN
Licensed Pm(esswnal
S OWNER BUILDER m DECLARATION
1<2 I hereby affirm on I L exempt from the Contractor's License law far the
ZOO fallowing maven (Erection]IDLE,al,Business and ave. Hasa Code:Any city m aunty
$ which requires a pains re cnresthe alter,ampmve,hpermit t nrcas repair g any structure S) n n n n
-Ij, pnormats issuance.aim requires the applicant for Such permit 0caaigned stammem
< that heiabcensed pursuant to the pwvuluarlof the ContmctutaLimnsclaw(Chepter9 Sq. Ft. Floor Area Valuation
I mFp (commencing with Section 7")of Division 3 of the B traineu and Prohibitions Cons)or
$ that he is exempt therefrom and the basis for the alleged exemption.Any violation of 326-56S)15 . 00
Section 7031.3 by any applicant for a perrnn subjects the applicant to A civil penalty of APN Number Occupancy Type
not mare than five hundred dollars(SSW).
I,a owner of the Property,in my employees with"gas as their Able compensation.
will to the work and the awcwrt is not intended or offered for sale(Sac.7004,Business 305 - FRAME Required Inspections
and Prefessions Code:The Contractor's License law data not apply be An owner of P
property who buddsor improves thereon,and who doessuch work himselforthrough his 307 - INSULATION
Own employ=,provided that such improvemcnuw not mlended aoRcred(mae.IL 601 - ROOF TEAR OFF
however.the building or improvement is sold within arse year of completion,the owner.
builder will have the burden of proving that he did act build or improve fm purpoe of 602 - ROOF PLYWOOD NA I L
al`')' 603 - ROOF BATTENS
❑L ru owner of the property.Am exclusively confessing with licensed conuacen to Li.
mone,Ltthe notaSec.70nownerof Abdnywhoansdsori The Conhermonsnd 604 — ROOF IN-PROGRESS
cove raw does not apply je an with a of proper(who builds ra improvev thereon,and
whonere LA ts for such projects with a cantrutor(q livened purwam w dte Contnnota
I Lk I ae Law.
�lan nempt under Sec. .BA PC forsrs ssessan I
Data
WORK YCOMPENS IOND LARA ON
(hereby aRmt under pevity of perjury arc of lowing dedantions:
I have and will mainuin a Cevfioeof Covenuo alGivum fm Worker's Compere
iaioy ss provided for by Section 3709 of the labor Code,for the performance of the
work for which this Permit is issued.
❑1 hays and will maintain Worker's Compensation Ivurarm,As acquired by Section
3709 of the Labor Code.for the performance of the work for which this Permit is Issued.
My Warkers Compensation Insurance career and Policy number arc:
Career. PoOcy N-
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
ffhuscetien need not Mcompleted tf the pima Is fmone,hundred dollar(SI W)
or leas.)
I Andy that in the performance of the work for which fhls Permit is issued.l shall not
employ any pc Han inner to Me aubiet]to tM WOrkcr Compensnlon
Laws of CAI If i . '���C
Applicant - - -
NOTICE PPLICA : ,a er Waking this CcntBcak or Exemption,you should ti
became n in the Workers Compensation Previsions of the Labor Code,line must
Z foMwt amply with such provisions or this permit hall be deemed mwked.
OCONSTRUCTION LENDING AGENCY
1 hereby affirm that therc la A construction lending agency lot the performance of
1'> tho work fur which this permit is issued(Sec.3097,Ca,C.)
Q Lender'sNam-
de
z lenr's AtI
Q I certify that 1 have mad this application and sure that the above information is
F marten.I Agra to comply wit all city and county ordinances and sae laws rclwng to
0U building convection,and hereby euthonaercpresentauvvof this city to enter upon(be
a ahovoequenceo propertyforins this Permit.
(We)agree to save.indemnify and keep harmless the City of Cupertino against
r% liabilities,judgments,costs and expenses which may in any way amnam against said City
AAPPLICANT of UNDERSTANDS or this permit.the r� APPLICANT UNDERSTANDS ANO WILL COMPLY WITH ALL NON-POIyT Issued by: Date
SOURCE REGULAy9NS. ,� f,91314 _
(! - f'Ati� !7 Re-roofs Q f
t un,of ApfWeYntica lfactSr U Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future budding Occupant mre or handle hazardous material
as defined by the Cuper inns Municipal Code,Chapter 9.12,and the Health and Sarety
Code.attics 25532(a)u XNo All roofs shall be inspected prior to any roofing material being installed.
4 '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 ho,t,mous air contaminants As thorned by the Bay Arc.Air Quality Management all new materials for inspection.
fact,
❑Yea ;KN.
I have mad thock.SNnuas 25505,25533 and 255 .1u Chapter tand day of the Call
ma Health lk Safety Codc,Smtians 255f1S.2557J end 25534.1 understand thmifthe building \v/„
cunendy w a tevnL that it is my ampovihdity m notify the occupant cribs
my antsw c mualbcmcIpn uasuaccorActurd"eofOcc7% Signature of Applicant ate
( d/ �j�
Owner or milbonced agent �Dat�° All roof coverings to be Class "B"or better
r,
Community Development Department
Building Division
i � City of Cupertino
10300 Torre Avenue
qCliff Of Telephone: (408)777-3228
UPEkTINO 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.
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: v I km&•S /' b�,✓
Job Site Address: X06744 4evAam. CT
Roofing Company Name: M(n S On RY COO I.y "f-L oY . -r-Ne
A plicant s Signature: 1 G11712a� �r�L Date: f
• Greg eel
Building Official
Revised 1/30/03
Printed an Recycled Paper
CITY OF CUPERTINO 6 31
REROOF
• CUPER INO PERMIT APPLICATION FORM
APN# I Date:
� Z 6 6 -- s o i�-— (� o / J
Building Address: 240t74
TCA IAA (�
Owner's Name: Phone#:
TAma.S Pz__�67 I (4�) g96-i9�
Contractor: Phone#: License#:
Contact: p Phone#: Cupertino Business License#:
TAI 2 S. n a Z/42,4 C(*) -77/7--
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
W Wood Shakes ❑ Wood Shakes S��f�
❑ Wood Shingles L3 WoodShingles ��/1�21"
❑ Other(Specify) ❑ Other(Specify) (. � q�
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
•I I Have Read, Understand and Will Comply With Cupertino's Tear Off Policy: ❑
Job DescriptionA
t6 A 0 Vz t`- WoJd C/nkesl P-Wlmce. 6t//`t4 1-l0ry;er LVA.;eiva�,. S/A r"
Residential � ommercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Plann' t. if
there are any res
CosrgJej OV Type of Cons ct on � Occupancy grop:
r
Qty. if
Appltc ]e Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM I Seismic Commercial BUILDING I
I BPLANCHK I Plan Check Fee BUILDING
BUSLIC I Business License I BUILDING I
I I I I