02070120CITY OF CUPERTINO
BUILDING DIVISION
,
CONTRtfCTOR INFORMATION:
PERMIT
BUILDING ADDRESS:
19706 ALDERBROOK WY
KEITH ROOFING CO INC
PERMITN .
82070120
0 11 E BETSY K
920 LINCOLN AVE
APPLICATIO<0.S ff
/! ¢2002
LL /CONTROL
PHONE:
(408)295 -8616
SANITARY NO. NO,
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 'hot l am licensed under pmrisions of Chapter 9 (commencing
Job Description
REROOF p
with Section ]000) of Division 3 of the Business and Professions Cade, and my license
in toll torte and e <ct
Licenx' [sty Lich 7SG
L.mr
—
Commit
ARCHITECI"S DEC
I understand cep plans shall be used es public «cords
Licenxd Professional
OWNER-BUILDER DECLARATION
I hereby affirm that I am
1. exempt from the Contractor's
ssionr rs License law for the
following rtason. (Section 7031.5. Business and Professions Cade: AnY cilY or county
$7800
which quires permit constmn, improves demolish, ore pair any
_prior tot ss c also q the p
n re applicant for statement
gdstammem.
, o
Nm h<ilttnxdp nlotA'provisions ot me ContmnorsLCrnse Ww (Chapter 9
Contractor's License ice
csa NS t rnoo> fD
Bjed
36q 21,.Ulbdr.Aa8a
" )., (co`l`a \j1^ ),s. s,IF. �'.
ValUatlOn
or that arise tthe
or that is exempt Ncrtfmm and he bans fee the alleged a.andimi.A, vi
Any violation
io l
-of Senione[ban iv anyapplicantfara permit subjects the applicant toacivil penury'
applicant to
ardl more [ban five nanarca sonars (stroll).
'
305lPN PIttl@q'E
Occupancy Type
111. as owner of the property, or my employees with wages us their sole compensation.
307 - INSULATION
'wilt; ao the work. -and the structure is not intended or offered for Tale -(Sec: ]044,"
_
CIIIOnS'
`Business and Professions Code: The Contractor's License law does not apply to an
owner of property who boiler or imprmes thcrton, and who doeauch work himself'
602 - ROOF PLYW yL
or through his own employees provided that h improvements rc not o nded or
,ogesra for sale a nowaver me building year o
g p amt - -le lhom f.
.6.03-...- - 'ROOF - BATTENS _.... . - ._. -_... _- _...._..- ..__..
BATTENS-,,�.,
completion, the owner builder will have the burden of proving that he did not build or
improve red purpose of salej.
'
604 - ROOF IN- PROGRESS
,Qi.asowncror thepmpeny.amcxclusively gwmlimnxdcontramorslo
aommcun
--
canswn the proven Lapp ]to 6, and Cone) The Contractor's
law dos nor man owner or cny whob
owner who builds
and who r, such
.nndwhoconuadse a,acnaY
wch projars wlN e.camnaor(s)liunsed pursuant ao Ne.
seimproves t.to the,
._.._. - -.... ___... .. .._._
Contractor's La
la
-. -_.. _. .... _.__.._. ...._. :...______.. .. ., -
pttlde
D me empo ndcrSc 'l'- ' ''BAPC for this mason
Owner : J t
Data
WORKER'S COMPENSATION DECLARATION
. '
2002
1 hereby affirm under penalty of perjury one of, the following declarations:
AU G 0 5
'and will �ommtiio a Certificate Hof 6insenl no self-man. for W.A...
Cumpcnvlion, u Imvided-for by Section 3700 of-the Labor Cade, for the
performance of Ne work far which his memo, is issued.
t�a �y
u �1 VV G
BUILDING
914-Y. mN'will endrum, Wodzr's Compamm oon lastni nee, Ls rcquimd by Sccoicn
Labor Code f perfo red of the k'f h ch a pemul is
lain My Workers ,o pc uo Insuna (ceder end Polity u be aie 1.
..,
Come •"
_.. .. ._ - r.__.....
EXNO
ERTIFlCATION OF EXEMPTION FROM,WORKERS, -
.1 � . (
.rt phis sees nneed not be rompleieddNe permit is far one hundred tlollus
O'..; ' 141,e
ISI00)or lcssJ
'
. a Nat in pert imamsnn r Wants for permit s Issued 1
'shall
- -
• "--_
a
na employ any pc any moon so as to become subject m the Workers'
a ct to
� C ., ,
on laws of Cahfomia: DOm "
Appli�amt
NOTICE O APPLICANT If umr making N Cent roof Exc ptio
becomeh
come to m the Worker s Coroprn the Labor Cade. you must
de. you mulct
cOur r this Permit shaof
forthwith comply with Such Provisions this Permit shell be deemed revoked.
.
'' " 6, mCONSTRUCTION LENDING AGENCY
'
Ihkria"hired that Nea s'a continuation landing egcnry for the performaiam,
of Nc ,. �
work for whrth Nis permit is issued ISce. J09], Civ. C.),
`
'Cender'i Name "' """
Londe Address - -.
1 c m(y Nm I he read N pplic.. o d m« that he above information s
Boric o 1 g e t wmply oh ll city - d co ty tl nances laws
Ili
'
and state ralnt ng
toe building st o n and hereby e N z p s2 mow of Ned coy to corer upon
a
Iht ebooe memmew property form, Purposes.
and keep har ss _ ,
Is. aagme to cost indemnify and keep harmless the C of Cupertino eg
liabilities, judgmenty, costa and expenses which may in any cede against stud
Way.., laid
City n rocs'p6f N g nt ng o(Nii Perm t -' '_ ' -
i
'APPC T +DERSTA. \D p!b WD,i \1P 1\7TH ALL To'
S cE -
z'�
1
Issued by: "
to s INC a
vJ�
1 Date
' - xAZn DDUSMATERIALSDISCLQSVRE y :.,
Re -roofs
WII the 'ppilcanl or f m« bu Id ng « upam some or boodle houNOb metenu
,Type Of ROOF
cedefined by rh Cupen Mu I Cod Ch pt 913 and the He IN d Saf ry
_
CMe Sam on 25531/eI I -
❑Yes tr o
`' '_ .. "' : -+ "" °- — -
_. l• .
s �
;' - -
`.b �;
...All roofs shall: a nspected rior.to,any roofing material being.installed..._..,
p
Will the appbcont o f w building oc pent u equipment o devices which
ion harmdous av coned cants d ea b) NeIB
' + '
If a roof Is mstalled'ivithout first obtaining anlnspection; I ie'move
' yArc Air QualryMwg teem
District?
agree to
all rte aterials for inspection. Applicant understands and will comply_wlth
_
r :,
"
_
all- n- olnfsource eglatJons.- ' -
1 h e read Ne harudou m mriels m',
requirements uMe, CTan6i 69S'of the
i7_
Callfturni He & Sefcry Code Scinsons 35505 35533 and 25534 q understand Net
(the ed snotcurrently have nine l :d I I ii my forme b,l lY to nif"Ne
oar N .rcquirtm inch 'mall be met pho to issuanc f uti ae of
u . -. .. ,:
., i
�Z .g
t _e . App] c t ... .. "ate
A roof coverings to be Class °B° or better
Na a age t Date.; -
......—OFFICE.
acloF
r .r ,
Building Division
10300 Torre Avenue
Cupertino, CA 95014 -3255
Telephone: (408) 777 -3228
Fax: (408) 777 -3333
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 Y" 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
n 1
Homeowners Name:
Address:
Reroofing Company
Applicants
Joe
Antonucci
(Chief Building Official)
6(25/01
will comply with this policy.