Loading...
02010122 CITY OF CUPERTINO CONTRACTOR INFORMATION: BUILDING DIVISION PERMIT - • BUILDING ADDRESS: PERMIT NO 21816 ALCAZAR AV 02010122 OWNER'S NAME APPLICATION SUB DATE SHAH BHUPENDRA 0 AND URVASHI B 01/30/2002 SANITARY NO. CONTROL NO 110PHONE: p z ZI ARCHITEC(ENGINEER: BUILDING PERMIT INFO MECH u00 BLDG ELECT PLUMB ZO S8 Z LICENSED CONTRACTOR'S DECLARATION Job Description vmi_ 1 hereby aRrm that 1 am licensed under provisions of Chaptt 9(commencing RE-ROOF Ht-w wnh Sah,m7000)of Division 3ofthe Boamess nil Professions Code.andmyhcense puf< LmimllfoNled<f a 755363 AI�aE® z 6 a Lmcnse CIaS� L¢ FIN A u a pap - SDECLA l� D( R shall W use DECLARATION !-=O; I an emmnd my plans[hall t<used as public records o o Licensed Por m as fecoal FEB 1 4 2002 is. Ell OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt form the Conrmemr's License Law for the following reason.(Section 70315,Business and Pmfeerions Code Any city or county - BUILDING 9500 Fa D whsch regmrca a pcmw to conawct,aher,smprov<,d<malrsh.«rtpau any atucrose poor to its ssuanec,also requtms the applicant for such pemut to file a signed statement . thathen ECCn{cd pursuant to provisions of the Comractor'v License Law(Chapter r• a Valuation tat be Secant to Division 3 the Burnes Lice se La (Ch Code) }l, ,? or that he d exempt thereftom'and the bass for the alleged exempgon Any violation Of Section 70315 by any applicant for a perms subjects the applicant m a civil penalty Iof not mom than five hundred dollars(85!10) 3 0 tg1PN Occupancy Type 0 1,as owner of the propenY,or my employees with wages as their sole compensation. 107 - TNSTTT will do the wark,-and'the structure is not intended or offered for sale(Sec-7W, — -' "'--- - - '- ' ` -atowess nd plo peWons Code The Core ra<soi,Licenu law does,Bros apply man 6 01 - ROOF TE�k�ti nspeettons' " ""'•` Owner of pmpeny Who builds or improves thereon,and who does such work himself 602_ - ROOF PLYWOOD NAIL or through his own employees provided that such impmsements are not intended or '..1&red for one.IC Wasiol.the buddm -improvement is:old within fine"ear of - "-'-"-""-" completion,the....builder will have the burden mpmvmg that he did not build or 603 ROOF BATTENS ina,mmforporposeofsule) 604 - ROOF IN-PROGRESS 01.a'owner of the property out exdusivdi'comracung with bmnsed contnaars ro 1❑ 'i✓' " construct the project(Sec ]Daa.Business and Professions Code:)The Contrast ,it License Taw Ewes not apply tom owner of property who builds and whose metros, } C ".azrd.woa rx License awch prolecu wrth a coastanor(s)licenud pursuant to tM .. _ _—__— ..._... .____._ __ - _ ._. _._ .... ._. .___ ___.."_ 01 son mr's I mail Law. ❑lamcxcmpt under Sec r"" ''"-" "`•'�.B&PC-Nis maven Owner . .,'• nat2 . . WORKER'S COMPENSATION DECLARATION I income,alRim under penally of pcijary�one of the following declum.m. 1 have'and will maintain a Cenrfcatebf Crouch a self-insure for Worker's Compensation, as provided (or by Secuaa 37W of the Labor Cock:for the _ - - 'performance of the work for which this permit is issued ❑1 have and will maintain Worker's Cumpcnsa and insoran<e;as required by Section 37M otitis,Labor Cndc,for the perlannasom of the work for which this permit is hewed My Worker's Compensation Insurance'canner and Policy number arc' ti . I's... CC....a. : ."„•., v. .. -.. .. ..t. ,t - --.._. ., ._.. .._._.....-._.-_. _ ..,....,.n_ n. ................._. 0 ._. .... Camel r+'CCRTIFI A .''7 r'::Pohe No:. Iz .... Yr� s ar ]] 1. TIONOFEKEMYnON FROM WORKERS' •• i�:x.•1 y r. ' COMPENSATION INS URANCE _ i,.,.(TM1is'wnion need.,........ .i..._.,.,. .,..._.. -. ...:.:_.. A not be completed if the permit is for one hundred dollars fE 100)or less) .'I dmf mat 're +. —o” .• _ _ _ ._._... T._.,_.. .. _ .."- ., . .. . ._____ e y in the performance of the work for�y'hich this permit iz rccucd,1 e - i! i;•," Q T. 'shall nrn employ any non in Y manner$o v{o be/pmeebjer,to the Workers' " - Campensati o Cali rtM Da _ / J U `? UNOTICETO Llafter.1mg Certificate of Exemption:you should i `h become subject to the Workers Compensation pmsisions of the Libor Code,you must C 0 forthwith comply with such pmvhdons or,h,s perms shall W deemed mocked. f^ -- '" r''• CONSTRUCTION LENDING AGENCY , . . i . a. I hereby affirm thin them is a conswnhon lending agenry for he pfrformantt of the work far wb¢h this permit Is issued(Sec 3097,Civ W�-Q C) Cendi Name-- _s . __ _ _:_ I . _. ' .a Lendds;Addrcas f..)-O ,1 cMdy shot I no read this ap,lwri i rx and sail that the above mfnrmauan is : ti'(••r 'correct 1 agree to comply with all eny and county ordinances and date laws relatrag +-0 U to bmldinB construction:and hereby authorize mprcsenmtives_of this city to enter upon }-W4 me above-meni oned prope y for inspection purposes . _ ^.06 (W'c)umcsm sme,andimary and keep hamll,sme CUyof Cupimmoag3mn 14 Z Co,io s,jllinen e,cores end expenses which ermit. y m any way accme against card C.1 Z Osyineonsequniceof she Rmnimgof inn permit' 1 R ! 'APPEI N'k UNDERSr�t'.. DS A.CU WILL'COMPLY WITH'ALLN�``P INT Issued by: i /" OU RP LATItpJ$I ' r `y/Z mreill theP IHAZA HAZARDOUS budding v4 Dm< R LOOTS � 1 'z me Re- roofs � pa MATERIALS DISCLOSURE"' f f Cade W 1 tole or handle hazardous Safety, ,.�„ _ ... .. i8na / ' 'vp its«<apml. ...Type o Roo dcf d i the Gu Mina Muniu Cole.Chaplet 9 13.and the Heahh and Safety, se<tian2.753'-wk'"'..• ' ; 'd3AyrONO "er:g ,., 9 a, rior.t l e e h All roofs sha.1 be_ins pected,pgor-to-any"roofing material be ing.installed_• Wll the.applmanror fuwre baW g c p i usecgmpment ordev M1ch If a roof is installed without first obtaining an inspectlon,'I agree to remove eoi t luminous an eonmminints as definald by roe Bay Area Art Quality Management D r <t all new materials for inspection. Applicant understands and will comply wnh_ r:n _. -❑Yes ❑NO - regulations '- "` ill -point source 1 have read the`hararems maamals m uiretnents'order Chapter 695 of the /T California Health&Safety Code,Sections 25505,25533 and 25534.1 understand that ,`the budding does oat cunemly have a tenant roast is my responsibility on notify the (V�>///j� -- 6ecu t of me re menu which must be met nor to issuance of a Cemfi/cp to of ✓/ p- $s Ju Z,_Signatu of Applicant _Dat� 'owner�hcum agent .,Bete„�./ All roof coverings to be Class"B" or better : - OFFICE at 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: r' ©, 57R /� Address: (_4-2-4 Reroofing Company Nam7e: L0, /6{ M a"Op,/ Applicants Signature: 12, - re Date: ell.- 30 -0 Z Joe Antonucci • (Chief Building Official) 6/25/01