00080016crrr up cur-k6r(kCON'T'RACTOR INFORMATION:
nuu.ntNc DIVISIONN PERMIT
BUILDING A TIH379 N BLANEY AV R E ROOFING Pr:RMI PNO 0008001.6
OWNER'S NAME OAKLAND PL APPLICATIONLL1 GG55// gl/P @@ IL/2000
COX JAMES M SR
OONF: (408)925-9995TRSANITARY NO. CON Mol, NO.
� y2 LICItNSIiD CON'I'RAC(OR S DIiCLAItA'1'ION
y m I hereby abhor ilia I nm license under pnnllionl of Chapter 9 (commencing
F H c to with Sermon RNID) of D'niton 3 of the Bu.m,o and Pre r,oi o Cndc, and my Ileeaa
< is in full force und,fihm.
Y¢ Licen,e Chau Lie, N
O D Date Contractor
te3 c y ARCHITECP'S DECLARATION
I underan my plain chat] be need a, public record,
iy}
u � _ Liccnwd Podoc :awl
Dar I an-hU n,a fir D filo, Co '11ON
v a = w I hereby .flan thin 1 an, exempt onion the ucanmclC s Any law Int me
F y ^ following rea,ot. hour , Rene,u Ihasine,l and ..,. de i iii h, vat Any city nr weeny
P o which if; o,h n permit oc cinema, applicant
nt do—a, damnll, n file
repo, uny smeon
prior m ns i,cuanee. Nen regnim, the applicant ahesuch penin m lite a nigned sammem
i 3 = (co be is (commencing
it Sectio Io the Pm Division
of the C e Ruoitls Licen.a law on%Cae )
rcommeneto contain
Stherefmoa)d heN i, 3atrea❑n,inc'+aa nor lbofAny, Cate)
or that he 7 31 S b tberefmm rano the haeia for tire a , the aeenpnoo Any I ptnti,m
of Section Iran by any do,c] d ff for n pem,i, mhlun, the applicant m v civil pannhy
of not me Iran lire hundred dollen 155fN,y
❑ I. to owner of the property, mar, en,plo cs with wage. m their,nle comlmnsalo n.
will do the work, and the ami ix nut intended ur oftcmd ter sale (Seco 70o,
Business and Profession. Code: The Contractor's Licenw Law drns nn, apply to :in
ohne, or property Who Wild, or improve, Thereon, and who d,w. such work nimceh
in through his own employee,. pron filed that ouch impnwcmenb are not intended or
offered ror,ale. It, however, the building or improvement i, xmd within one ynur or
impletion, the owner -Wilder will have the lanolin of proving that he did nu, build nr
improve fur pn,are, of sale.).
❑ I, m ,rat of th,,m,r,..ar ebachni,ofl, anntoNng with liccncnd nm,aaan, m
Lic.sari the pmjno (Set. RILL Boned, nee Pm1'ct,ine, Cod,:) Me Cnntrucmr's
ense taw doe, no, apply n, an owner of pmpvny who bund, or improve, thrnnf.
and who contract, for such project, w'uh a comramoeq licensed punumn to the
Commuter', Liceme Law.
❑ I am exempt ander Sec. , B k PC llntnix reason
ow aur Dale
WORKER'S COMPENSATION DECLARA'T'ION
1 hereby elfin under penahy of pe juryone of the Ibhow'nlg decblmlin e:
J I huv and l , ,ohnn a Cendine of
nCoadem In ,elGlluum for Wod,11"
4 Conermawd
aon, to, prolld'd for by Seefl.... 3700 of the I.uhor Code, for me
permrma ee of me wad, ter whim, me, PaNnu . nen.
.1 nave and will ntainmin wader's Conmcmnean , ounce. ;c, mgoiavl by Section
3 ,B of me Lunar Code, for me p,,fora na, A the woak for wldelt If prnoit i,
Cused. My Worker, Campco,mhon lnammce earrieraul trolley another are e
arrier l%Rv N Whew Paley Nmwao o uoi25y
Chldl'1171CAI ION OF; B%f!MP'I'[ON PRONI Wr11l KFI(S'
COMPHNSA1'1(1N INSURANCE
ffhi' nedinn taut nil be eam..Ual It ahs paean, ie tT.' Can han la"I dnll:ax
(81011) or Itis.)
I cerdfy that iu aha pc,l'onmm. lo, of,I w d Ian Ahich this pam,il l,'usunk I
,Ia II d y any puma, iu :my auunn1 a t� Jyoiylq stlyrcT7ihc wider:
Z ice ,:
,Uhl"I, ark,IxCou manpn , a til lbe l:11an lodmi
e. yon ll
p aamn
at llter ��ii del he. deemed 1-okol
z°
VJ CONST NUC I ION LIiNDINC A(!ILNCY
aI herby abhor that Them ix a.onsmctlon Iuudlug agency to the porfanuanm
of the work for which eats p,nni, is ns ue l (Sc,. 3097. Civ. C.)
Q Lender', Num,
z Lrndcr's Addr..
V 0 I ormly than l hull notal 0111 111111111011011 unit 'turn ,hat Ilan ohmn heonn lion lax
corrin,. I ag,ce It, comply an all ciay and comay ordinance, are sone law,, Mining
V o,nildiogrun tmcllit, and hereby authorize reprlemnavca if hit ally no enter upon
me.hive-mentioned pmpeny for inspeedan pnrpas,s.
F G (We)again In ave, indemnity and keep bureaus the (.'try of Cuptminnngainol
t, Iiubllitiel, judgancnl.. cab and cxpemcs which nary la, any way I.ttnm again,, ,aid
V ria City i (of he gaming of ,laic pi
ICANI D N 1PLY WITH ALL O POINT
S mirm,.RCE ,,1��-< �2��UJ
Signalua"nL11 S IIaIC
HAn oRutueS MATBRIALS DISCLO. URI:
Will y t e Cupertino
or forum radial,pCh ncahmm stere ur latae hamnman Sm,,,d
Cade. ninny, he Cupcninn Ah,nicip: Cndc. ChuPacr 9.12. and the llunitn and Sola,y
Code. Sermon 255121x):'
❑Yes r Nn
W911 ate Cpphcart it, future building xcupan, um equi,awrn or entero wine,
it, mit hmatdoun airconuminamcn dofnCd Ly the Buy Area Air Quality Management
):Arica?
❑Yes Nn
I hoe read be ha ... dnus mmedal, .,mr-cntems tied,, Chapter 695 of ,he
Cahiromia H .hh K Safety Cult Section, 25505.25533 and 29534. I under, and Chu,
ileing doer nm currently have notation, that it i1 my re,lumslbhily n, notify ,he
cupan ,f ,hS Rj6jSn¢ms whi,h ums M incl ,an to i .... the pf a Ceniacae of
,,, o mn,
h1.DO 6LLCT PLUM(SNIPCH
I_ i 1--1 1_ J L J
Job Description
REMOVE EXISTING LAYER OF
COX PLYWOOD 30# FELT 40
a
WOOD SHAKE,
YEAR ASPHALT
Valuation
JdGCJvjYa- Wet g'uired Inspections
305
— FRAME
307 —
INSULATION
601
— ROOF TEAR OFF
602 —
ROOF PLYWOOD NAIL
603
— ROOF BATTENS
604
— ROOF IN—PROGRESS
Issued by: A�_. Date
Re -fools
Type of Roof
All roofs shall be inspected prior to any roofing material being installed.
If it roof is installed without first obtaining un inspection, I agree to remove
all new materials for inspection. Applicant understands and will comply with
`42I2oo J
ant Date
All roof coverings to be Class `•B" or better
AD
SH