03030053 CITY OFCUPERTINO pr"�^* �,'r"�." I*'' "� �,7r�
BUILDING DIVISION PERMIT '&%Nye NEW, 1�F1101", 1A 101\Nq�,
BUILDING ADDRESS: WINTER ROOFING INC PERMIT No.
I"T
OWNER'S NA Mt. 157, WYANDOTTE DR PERMIT mu
BRENDA
E' 4083638052 SANITARYN OLNO.
7ARC.HrrECTtENGINEM' BUILDING PERMIT INTOBLDG ELECT PLUMB MECH
LICENSED CONTRACTORS DECLARATION JobDescri non
I hereby•form that I am licensed under provWons ofClnpur 9(commencing - Pection 7000)of D10,lon 3ofdte Businw and NofeuiensCode,and my license le
force andett 0REROOF
soCHITECfSDBC11RREMOVE WOOD SHAKES, INSTALL 1/2 OSB & 30 YR. CO
I understan`xZd my plensshaR be used u public records
to Licensed Pmfutlon 1.
Y0 Oat I Am exempt
DECLARATION
Contractor's
1 hereby affirm Sec that 1 1. exempt Business an d r C^nlnnCo :A nso law for the ,v q 007
�Co which requiann.(Seult to CDI3.t.Atend ..demnsh,Ar "itny an orcountyAPR 2 •✓ L J
a which its Isla a Penult re uinc,the
alttt.improve,demolish,ri m a signed atmcture
�^ psiormiulensedp pursuant to
the APPlium for such the Com uctoerefilesA aw(Ch MCM
(Chapter
< Nu he is licenced pussoanUo the pmvialons of the Conlncmrslhrcnse law(Chepur9 Sq.Ft.Floor Area Valuation
(cmnmcucing with Section 7000)of Division 3 of the B.s neamA Pnefessmm Cede)- BU I LDIN
33 that he is exempt therefrom and the halt for Ne Alleged exemption.Any violation of
} Section 7031.5 by any applicant for•permit subjects the applicant W A Civil penalty of APN Number Occupancy Type
( not mean data low hundred dollars(M).
' Dl,a owner of thepmpeny:-myemplores with wageau thelrsokeompensatim. 36943006 . 00 .
will do tax work.andtheatmnure u not Rounded-orsted forsake(See.70M,Budrcus Required Inspections
tab Protestant Code:The Commences Liccum law Aon not apply An ns an owner or 305 — FRAME 9 P
property who bullds or improws thereon,and who deet such work himself or temush his
own employees.provided thatsoeh lmpmwmmu tae not Intended-orfaed Tarsale.If. 307 — INSULATION
howevhowever,rer,the building.impmwmem Is sold within one year of co ri letioq the ow-n-
builder will haw dre burden of proving that he did not build or Improve fee purpose of 601 — ROOF TEAR 'OFF
ale.). 602 - ROOF PLYWOOD NAIL
❑1,as owner of du properly,am uelutiwly contracting with Ilmued contnn-s he
construct the project(Sec.7044.Business ad professions Cade:)The Comractori U- 603 — ROOF BATTENS
cense law does not apply w an owner of property who builds or improves thereon.and 604 — ROOF IN-PROGRESS
who Contracts for such pmjenx with a emtrectort0 licensed pursued An Contractors
Lice..law
❑I Am exempt under See. BAPCfar this meson
Owner Dau
WORKER'S COMPENSATION DECLARATION "
I hereby tlnmt under penalty of perjury one of the following declarations:
haw and will maintain a CuNnu eeof Consent W ulUnsure f-WorkeeAComprn-
sadon,As provided for by Sectim 3700 of the labor Code.for the performance of the
work far hfch this permit is issued.
hew and will maintain Workers Compensation Insurance,u mqulned by sew.311D of the labor Cade,for the performance of the work for which this pandit is issued,
My Work es rep madam In rancee or and Polity number Art: '
Cerner. Policy No.: 0
'RIIFIC :OPE EMPIONFROM WORKERS'
COMPENSATION INSURANCE
(This semimrced nation complied lithe permit uferone hundeddollaran IM)
1 Certify that I^the performance of the work r-which this permit is Issued,I shall not
employ any person In any nummer an At became wbkct to the tVurkrs'Compensatim .
Law,of California Date
Applicant
NOTICE TO APPLICANT.IL after making this Ceninnu of Exemption.You should
become subject to the Workers Compensation provisions of the lahm Cade,you most i '
O forthwith comply with such provisions or this permit that]be domed mwkc4.
q CONSTRUCTION LENDING AGENCY
�.. I hereby alliin that them It a construction leading agency for the performance of
BG the work r-which this permit 1,named(Sec.3097,Civ.C.)
M Q Lender's Nwo
tander'sAtldresa
U0 1 unify that 1 lave mad this Application and mu that the Above informalim is
correct.I agree to comply with all city and county omin•nces and stare laws mlxmg u e
VC building comwction,and hereby•utbodu mpmxnudws of this ity do cnur uPnn the
ITd above-mentioned property for inspeedm pulp=,
(We)agree to saw,Indemnify antl keep h the City of Cupenim Against /
M IIeb11Wu,Ju menu.cesuandexpr.yxwhkhm nany wyarne against said City
U 7 In eonuq of the grmdng of this permu
F7 APPLIC#FT UNDERSTANDS AND W MPLY WITH ALL NON-POINT Issued by:9 D -•- 0
S0117"'WNS.
Re-roofs
Sjgfifi rcppll andComr An ` Dau
HAZA MURSM 41UAIS DISCLOSURE Type of Roof
11 de applicam or future building occupant a=or handle hazardous
msuill
d ad by the Cupertino Municipal Code.Chapter 9.11,and the Health and Safety
e.Section 8531(•)7 All roofs shall be inspected prior to any roofing material':being installed.
❑Yes VV P
Will the applicant or fudum building occupant=equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
rramm nAir conuminsntsudc by the Bay Area AAir Quality Management all new Materials for inspection.
It ht u
t]Yex u
I have mad the huamtmsmeted qulremenu underChapur 6.95.1'the Califor.
rah Hc• ASefclyCade,SectioruB 5533 and 8531.1 understand NBlftie building
does currently haw a lt my .mapomiMlltY An natifY tie attupant of the _
menu 'n uanceofa Ccmfexuor Occupancy, 4igre Appl LC t - Date
nes-. ed a ret D,te All roof coverings to be Class"B"or better
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OFTelephone: (408)777-3228
C U Q E nT'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 with the above stated policy on re-roofing.
Homeowner's Name:
Job Site Address: Q1 15!902 PAP
Roofing Company Name: Wl k b_✓ YLC
A plicanYQignag: Date: U3
Greg eel
Building Official
Revised 1/30/03
Printed on Recycled Paper