01070056 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDINGADDRESS PERMIT NO,
7864 BELKNAP DR BECKS ROOFING
01070056
OWNERSNAME APPLICATION SUB DATE
GIRODO MAURICE J ET AL 6191 OCHO RLOS DR 07/13/2001
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(408) 365-8979
IC!-2 ARCHITECTIENGINEER
��0� BUILDING PERMIT INFO
BLDG ELECT PLUME MECH
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Ile t�2'� LICENSED CONTRACTUR S DECLARATION
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bz�E I hereby offirm�Ih.11 an licensed acidic,larsoica,of Chapter 9 consul Job Description
h Ed g
r�n L: ,ill SccImm 7000) Business in Pr cs I,is close REROOF.
No fall r....can off
can e Lie It T
ar L
Carl......
Lie,It T/O & INSTALL
D "NHECT,DEC 2 1/2 " PLY, &430 FEL,
LARAT 3
2:C r 5 DECLARATIO #30 FEL, PRES COMPO,
I anclearctiond 111,oamlliall ace,tal."Uhlic records
ace
OWNER-BUILDER DECLARATION
I hereby inufficrin that I am escard for. he Cartmermis License Law far the
t s' following ;".a Secluall 7031.5.Bal,luess and Pooll,ince,Code Any city or county
ce 'inch usellailel I Pac a rumors,dernal,h,marsail-ar,ablears,
or rearas 1�iaaacac.alaa filer,moned,onears,
chat he c;licensed pumuctat to He proo,laun,of she Clincounar"Licla,Law(Charter 9
ing as th Section 70)(1)or D,vision 3 al I lit Business acid Proff,ions Coded
!colmh i came ilmar,therchund and The basis Car he it It, ,S'.q..Ft. Floor Arca
I'd esearridiarb Any tolmon,
of Section 7031.5 by ally appl cand I or a fiction subjects the applicant to a civil penalty
of at am than five hundred dollar,(5500), 3 6 Wif"15 U Occupancy Type
0 1.a,..act at me'wssmy.a,my scropIriver,.ch volow,as their'do erec'matims,
will do[lie work, ad Ile,volcanic is'lot incialed or officard lot sale(See,7044,
Binallicals and Pi-fellanal Coal I he Contractor*,License Law does a.(apply a an 3 05 - FRAME Required Inspections
,,.a,,of property Who haild,an imp...c,themon,cold vsh.due,such lack himself
or through his.,a employees.Pon,tried that such improvements am not intended or 3 07 - INSULATION
offered for sale.fr.however,the building or improvement is cold within(,,,a nor of
culailection,the accularchialcor will have he bullion of pas T,that lie did con budd or 601 - ROOF TEAR OFF
fir"capi sale.). 602 - ROOF PLYWOOD NAIL
Of L as cosmic of'he Proccuricarcl a-aseltalively contracting I I'll licensed ceramic a
larmore,the pa,,in Sco.70c facilities,and Prof..tons loll,:)1,C lact, 603 ROOF 13ATTENS
for,,
License Law does or 1111, oloacroff,croven,who hold,a,improve,them... 604 ROOF IN-PROGRESS
acid"o,kcatlacts for such,rojects with a calculations) licensed pursuard to me
Central License Law.
0 1 a.crounio made,See_B&P C far his reason
[)am
WORKER S COMPENSATION DECLARAl]ON
I hercbv offical under Penalty of peourv,one of$a following declarations:
zl�_�
1 also roof will licalloull a Centlikell it Comeat to Ill anum to,. W for,
Complication, ,, provided far by Section 3700 of 'he Latin, Code I he
ferfornmence of the work for which this p,ami,is come.
0 1 once and will at and a Worker�Cona,us,jan firmamor,a, armed by Set
3700 al [,a Lonal,Code I",'he picauntrainal or the work I.,which this Permit is
issued.M C an ims 11 co,corm,and all, lumber ne:
C Nw: 0Q
CERTIFICAl ION OFCXEMIUIO FIR MWORKERS'
COMPENSNI ION INSURANCE
section need lact be completed if'he mmit 11 far else hundred dollars,
gI00)mhw,)
I ..(it,chat ic�line nerfourcon,a nitric �mk far Iriah do,Permit Is issued,I
,chat 'but employ any Person in any Emmor so as to become subject to the Worken' t
Co. affmL,t.,,dfCmrmma.D.m
Appip,!.11
......thould
z became subject[I)[lie Warlai s Cnialcursation provisions at the Libor Code you trust
C) frathwida consid,with Inch provisions this permit hall Im decimal mouser,
z 2 - - - -
CONSTRUCTION LENDING AGENCY
of'he I 1.1mmov actinic that held is a constrician lending agency har the pla almoner,
all,ta� hieh tha,penal is issued Sme.3097.Co,C.)
Leader's Name
:D z Leader',Addoc
U 0 1 certify that I have read this applicaticarand%lam don the above info....I..is
;c. P correct,I agree to comply arm all city and concry ordinances and state laws aclatione
0 tj to building construction.and hereby authorize representatives oftas city to enter up".
>, W the move-maraimseal prorsern,ficaraii,sadmi. tall
C., Ovidagnact,to iii indemnify anti k,ep harnicsi the City(it Cupertion against
li"ifivic,j Isamu,......1, nal esp.......[,tell on" u cc,vc,ac,ma .,oiroi, aid
City'a comes,race the "a".' ".I.
APPI 11AN-V U ERSTAI' XS' Lj.0091% "cITHA `1?7, Iss
SOURCEREG AIION Tied by: Date
Silga,lice it Ap,fli,,rt/Coul....to, Dan, Re-Doofs
HAZARDOUSMAl ERIALS DISCLOSURE�
Will me applicant a,future building.,.W,act an handle hicandmin oncomad T pe of Roof
as defined b,,hc Carioca.Mma,qal Ceds.Chapter 9 12,maddhe Health and Safe,, y
Code.Section 25532(a)?,
I I Iyl 0 No All,roofs.shall be inspected prior I.o any reefing material being installed.
Will the applicant or lot=building occupant use equipment or devices which If a roof is installed without First obtaining an inspection. I aEree to remove
cault hazardous air communication,as defaced by the Bay Area Air Quality Management t,
Donn,c� all new materials for inspection. Applicant Understands all([ will comply with
0 ye, ON. all [loll-point so cc rcgulailic<Rn�
I have read de,harsoffics materials requirements under Chapter 6.95 of the 7 -
California Health&Safely Cade.Sections 25505,25533 and 25534.1 andeadard,lan,
it the building does not courroul bar it I,my ow,ar,imlil,to cruld I the
�4 mooment, v I ,I i he met to 1,,,1.oliciame af a C it I Z
Signature of Applicant Date
All roof coverings to be Class "B"or better
occur"
OFFICE