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04050089 CITY OF CUPERTINO BUILDING DIVISION PERMIT �CONTRACTOR I,N , iRMATION BUILDING ADDRESS: R E ROOFING & CONSTRUCTION TtItNO14-050089 II OWNER'S NAME: PERMITISUBDATE JIM LENTFER lip ONE: SANITARY NO. CONTROL NO. (408) 925-999S ARCHITECUENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH rrtt 0 0 0 5 LICENSED CONTRACTOR'S DEsionof + -r1IlU 1 hereby affirm that l em licensed under provision of Chapter ode, 9(commencingCHa— ON im with Section]O(p)al D' i 3.On Business andAy(<spons Codednd myliccfus is N R' Cho Cllr"L/, REROOF jpz li' C ` tie 11 _ NOVAga g�[s pro DamAR HI / V 4 ?00 last CTS DEC 1 as U 1 u rZ2-11lana Seal C used ta p eli Ns 3t7 Licensed Professional B Q �I L D I OWNER-BUILDER DECLARATION ■■Ye■ e iF 1 herehy affirm Nal 1 am exempt from dm Comma or's License Law for the i 10 following reason.(Section]N 1.5,Business asb professirm Code:Any city Or county $ which requires a permit to construct,altar.improve,demolish,or repair any structure HZY prim to its issuance.also requires the applicant for such Permit o file a Signed statement ss< that he is licensed pursuant m the provisions of me Cmunatur's License Law(Ch.mr,9 Sq.Ft. Floor Area Valuation ns '8 (commencing with Section]OOO)of Division 3 of be Business and I'm(eaiam Code)co '52 5 3 Nat he is exempt Ne¢from and dee basis fm the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of 3 560aQtatibe10 0 Occupancy Type not tame than five hundred dollars(M). P Y YP ❑La sownerofthe prwroc or isnot moycedwiNwegesuthei(See Business and Prthewalk.endtheumcturtisnots LMed Law sale(Sec.]ON,Business and Professions Code:The Contractors License law darn not apply m an owner is Required Inspections propertywho buildsviireproves Normo.andwho are ssuchwnfth roffredforage his man howevemploy=.On building., Natsuch improvements are mYear oedmoffered for salt,if, Wild., .Ne building or i en of proving vinu sold within tare Year or mprove for Ne owner- Wilder will low the Wrdm of pressing that he did not build or improve fm puryose of sale J. O I,es an,of the property,mo exclusively contracting with licensed contractors m construct Ne project(Sec.l(taa,Business and Professions Code:)The Contracmri Li cerise law does not apply to an owner of pmpeny who builds or improves daemon,and who contracts for such projects with a conlactor(s)Ifcemed pursuant o doe Contractor's License Law. O l am exempt under Sec. ,B&PC for Nis msson Owner Dam WORKERS COMPENSATION DECLARATION I hereby affimr under penalty of perjury one of the following decimations: I have and will maintain a Cerufrcom ofCm mra to calf-home for Workee.Compm- ation,as provided for by Sm.37Mof Ne labor Cade.for do,perfoorm.of the woe for which Of.permit is issued. 1 have and will maintain Worker's Compensation Insurance,at inquired by Section I of the Lmor Code.for On p.rfmmancc of the work for which this permit is r. My Worker's Compenationl uasacanfm and Polity number tic: Canter. Policy No.: CERTIFICATE OF VEMP1ON FROM WORKERS' COMPENSATION INSURANCE (Thd section need not W completed Rthe permit Is furore hundred dollars(SIM) or less.) I cenify that in the performance of Ne work for which this permit is issued,I Nall not employ any person in my mannerso,at m become subject to dee Wrrkcrs'Compenadoo Laws of California.Dam Applicant NOTICE TO APPLICANT:If.after making this Cenificma of Exemption,you NouW become subject to the Worked Compensation provisions of me Labor Code,you must .J 7, forthwith comply with such provisions m this permit shall be dcemW revoked. Z O CONSTRUCTION LENDING AGENCY V F-e Iherebyich thi NU uti its issued(Sec. Cil agency for the performance of �r Ne work fm which this pcemit is issued(Sec.709].Civ.C.) 0.. Undr'.Nun. Z)Z 1<nderi Add. U0 1 certify that I have rod this application and scam that the above infatuation is - [y F correct.I agree to comply with all city and county ordinances and state laws¢hung to p W move-mentinmetfon.and here by euNodm¢prescnudvrs of Nit city Sartre,upon Ne ahovlide,j igm property forinspection sen whilwes. ('20 J F y (we)agree to ave,indemnify and keep emtlecs the City of Cupertino against VI liabilidu.judgmentse granandofpmsaamt. may in anY way accrue agaimtsaid City CJ z m areae of thegmnangr(mus pemail. Issued by. Date PPLI ERSTANDS COMPLY WITH AL NON-POINT S LA S. Ir Re-roofs Si' ApplicendContractor Dam H ROOUS MATERIALS DISCLOSURE Type of Roof Wr enm car fu u.Wiltli gaecupem arum or handle hvartlouimme as defined by the Cupertino Munici Cod,.Gaptar 9.12,antl the Health and Safety Adikode.Seeuon 25532(x)? ❑Yes Nn All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,I agree to remove Will the epplinm or fuwm buil 'recupant use equipmcm or devices which g P mit hvardnus air conlaminana metl by I Bay Arta Air Qmdity Management mg1==: District? ❑Yes Nu / I have read the hvardous materials-quiremenu under Chaptar 6.95rfth,Calif.ria Health&SafetyCade,Seen.255B5.25533 and 25530.1 undertand Nuifdc Wildine haws Citi my mspoosiM1ilitymnnuly dm ac tnf Ncrequire or ecof.Cemilcm,of apanc. Date Owner thmircda a All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue j .,� ' ✓° Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 �UPEkTINO Building De artment JOB ADDRESS: 2 � LL� n � PERMIT # OWNER'S NAME: V Nl L�v T YtPHONE # GENERAL CONTRACTOR FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock -Tile � L 0 er/Co ctorSignature Date Community Development Department /f Building Division (��`.. City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 U P E T I N O 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 'fh1the,above stated po icy on re-roofing. Homeowner's Name: job Site Address: �1AA1� Roofing C Name: 1� Iv 5 TRt� l OW A pli ant's Signatur -� Date: �� I Greg teel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO REROOF © y CUOF PERTINO PERMIT APPLICATION FORM APN # � D 6 62 Z. Date: Building Address: 2 /,2024 BALL- Owner's Name: �IM LNf�/ 1X11 Phone #: Contractor:/p �l N Phone#: (P License#: q h C�n��. K" 20 �12�1 1 Contact: LPhone#: Cupertino Business License#: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof XA_sphalt Shingles -Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ ood 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: Job Description: "jGK (s C"701"( 1 I.KWA_ * woov Sl{kKt l INFtMti Klcw 2 CDX .10 - Tn Residential Commercial ❑ Fire Zone: Yes ❑ N Confirmed with Planning Dept. if there are anrestrictions: LJ Cost of Project: U Tape of Construction: Occupancy group: U Qty. if A is bl Fee ID Fee Description Fee Group WBSEISMICIOM E BldgPermit Fees BUILDING Ener BUILDING RE Seismic Fee Res BUILDING Seismic Commercial BUILDING K Plan Check Fee BUILDING Business License BUILDING 2,Ssr- _ I