03030052 CITY OF CUPERTINO M > 'x � '' "'• '"`�%'' ''° `�"�
BUILDING DIVISION PERMIT
au1LDINOAD°RESS: WINTER ROOFING INC result TNO.'
OWNERS NAME: 151 WYANDOTTE DR PERMIT A
BRENDA CT. HOA
"E: X4083638052 SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PWMB MECH
300
LICENSED CONfRAC IOR'SDECLARATION Ib Description
vd 1 hereby affirm that 1 umva .
n Reacted under poof CluO
pter 9(Commencing P
wllb Section 70011).1'Division Sar the Business N
and Profeana Code,and my If"=is
m menu force and If REROOF
Llcenso Cl t I
g 0Be IEcrsDtroular,l.kaAn REMOVE WOOD SHAKES, INSTALL 1/2 OSB & 30 YR. CO
I command my plana sball a.sod as public=,do
h� Licensed Professional s OWNER-BUILDER DECLARATION �cep
LED
I thereby mean affirm)hall I.S.exempt from ate Cevennes :A n c taw for IM
o o
following Migrant0. (anis in
7(171. Business and Professlu.Cmk:Any city u county
$� which rcquims a permit m m.mmL ala.Improve.demnlW,or epalr anY struuum
1111V n
prim to its issuance,also requires the applicant for such permit to file I signed statement
gg5xq< to he is licensed puraant W The provision ofdm Cminctm'Llcane Law(Clepa9 Sq.Ft.Floor Area nation
(c.mmemcinS with Section 7000).,Division 3.f lM Bualness and Professing.Code)or
e
that he is exempt tMmfrom and 0e basis for the alleged extmption.Any violation of
Stations 7031.5 by arty applicant for a Numb subjects the applicant a a dull penally of APN Number ancy Type
.1 mom then rim hundred dollars(55001
❑Laaowncror0epmperiy,ormyemployceawllhmpsut irmlcmmpenuRon, 36943005 . 00
willdo ft work.and thestmcme is not lntmded or Offered(music(See.7041,Bminus Required Inspections
and ProfeWom Code:The Contractors Lt.=Law dap ml apply m an exactor e q p
property who builds or improma demon,and who dneumh work Mmaelfm through his 305 — FRAME
own employer,provided that such Improvements art not intended m offend fm sae.If. 3O7 — INSULATION
however.the building m improvement is sold within one yew of Completion,be Owner•
build.will ban the burden or proving dent he aid not build or improve fm p rpue of 601 — ROOF TEAR OFF
ext)' 602 - ROOF PLYWOOD NAIL
❑1.as owner of the property,am exclusively contracting wide 1iee.ed mntramem to
Co.".,the ptajml(Sec.7044.Business and Profession.Code:)The Commuters L6 603 — ROOF BATTENS
came Law dap not apply m an owner of property who ansa or lmPomma tbermn.Md. 604 — ROOF IN—PROGRESS
who contracts far such pmja.a with a mnmactorts)Ilce.ed pursuant a Ne Contra.oM1 -
Lt. Be Law.
E3 IM eaempt and.Sec .B&PC fm No,won
Owner Dam .
WORKERS COMPENSAnON DECLARATION
I hereby al0mr under peulty of Perjury ane of the following dmomaterm ,
ban and will m roan a CcNficam OFCO=M to sel4lnsum fm WakesCurnPen-
1;V7'y01D
n,u Provided fm by Su.4on 3700 of the labor Code,for the performance of the
which this permit is issued
and will maintain Workers Compensation Insurance,u required by Sagami,
he tuber Code.fartie perfo rennce of the work fm which this permit is Wmd.
Wakens Coope noon Ins some nme aM Poliry number ate:
ier. Policy No.: G '
C RrIFIC OF me
FROM WORKERSF
COMPENSATION INSURANCE
(This sectimnmd not Mcompleed little permit is forone hundred dolhn(5100)
I unify that In me perfarma.o of the work far which this permit is Issued.I shall not
employ any person in any manner an as m become subjml to the Wodxrs'Compensation
Law,of California.Dam -
Applicant
NOTICE TO APPLICANT.If,afa making this Cenificalc of Exemption,you should -
become subject to the Workus Compensation Prov a .of o m lather Code,Y.moss
0 O forthwith comply with such provisions u this permit that)he dcamed evoked.
rCONSTRUCTION LENDING AGENCY
,4 1 Mmby a1Rrm that Nm Is a construction lending agency for the performance of
the wok for which this permit is issued(Sm.3097.Civ.C.) '
W Q Lenders Name
7 z Tonder,Mdmss '
L)O 1 cenify that I ham mW this application and scam that the above Information 11
D.U conal,l at=m Comply with all city and county Ordinance,and sae lava Mining to
0 building construction,and Mmby aumodm mp,e,entatimes of this city to enter upon the
W aMve-memioned property for inspection purpo¢s.
(We)agree m an,indemnify and keep harmless the City of Cupertino gain
zy IlabilitiM judgments.costs Md expenu, Ich may In any wry am.e against sold City
in ICCA T -
U^ APPLIUNDERSTANof Ais WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR EOULATI
Re-roofs
Sign 9ANHOVOM Dam
HAZAR OUS MATERIALS DISCLOSURE Type Of ROOF
Will the applicant or
fume building=up.[nom at handle harudm.material
as eRned by the Cupertino Municipal Code,Chapter 9.13,and the Health and Safety
ala,Section 25532(a)T Jf��Nyy�'' •' All roofs shall be inspected prior to any roofing material being installed.
Will the applicant.Blue allding occupant use Compment at dukes which If a roof is installed without first obtaining an inspection,I agree to remove
It Imeso m air conmminanu u de y the Bay Am Air Quality Management all new aterials for inspecti
n n7
❑Yet u
Iba.madthebamrdmsonyeHalo equimments under Chape,695 Orion Califon —)�
rah Health&SalcryCede.Seedonk[.550.5,25533 and 25534.1 mdersmnd does ifine building / (/
doe,n/kurmm r Mm a a ((Nu it u my r. iNllly m nodfy N occupant of the
req. mento whe me e it poor m issuance or a Cenl0cate of Occupancy. $I 8ture O1' pllCa Date
2=01A—07
.r. rim agent Dam - All roof coverings to be Class"B"or better
Rif�
Community Development Department
Building Division
� a- City of Cupertino
µ> 10300 Torre Avenue
CITY OF Telephone: (408)777-3228
C U PE kT 1 N^ Fax; (408)777-3333
v
f 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: G� /✓-
Job Site Address: LGV01
1 / CV
Roofing Company Name: H
A plicanYs Signatu Date:
Greg eel
Building Official
Revised 1/30/03
Printed on Recycled Paper