03030059 CITY OF CUPERTINO e'Yw*y" �}iyrc���k*7 "ry+y 7 ^?yam
BUILDING DIVISION PERMIT �',� .. ., `+"v�„ 1\.,IC YK
Bu1Lo1NGADDRESS: WINTER ROOFING INC PERMIT NO.
1
OWNER'S NAME: 151 WYANDOTTE DR PERMRL'S A
BRENDA
ryE' 4083638052 SANRARY NO. CONTROL NO,
ARCHI=IENOINEM: BUILDING PERMIT INFO
BLDG EL ECL' PLUMB MECH
30o LICENSED CONTRACTOR'S DECLARATION Job Description
(� 1 he
air
that 1 em licensed under provis of Chapter 9(commencing P '
pl with Section 7000)n Dlvitlon SOf the Busneuand Profculnm Codd.arM myllecnm4
^p (nfullforce and art r REROOF'
p N Llcena Class
'� LIG.B'
Ls
Date
conumvor REMOVE WOOD SHAKES, �.`jTl'-�'`.�LLLL 1/2 OSB & 30 YR. CO
RcxrlEcrs D em, „°`W
1 understand my plans shall be hand as public records �®
555 Licensed Professional
5 OWNER-BUILDER DECLARATION MAY O `x 20000
ffint,
cense
jf 1 herebynaso.(Smile.
tort 1 1. exempt form the lemns Cc :Any c ty O for the
p o following mason.(Saito 7onsu Business and Profetamu Gede:Any Ary or county
S�+
which requires a permit re umatmA,ahr,hnpmsu demtllalt,or repair any awmen
prior in las Wumceossmarr in resft the applicant of forthe Cohpeurnill tar's och.Irile a .(Cha mem u p,
(doll he comate licensed pSectam mOe of Division
of dmee usinam uanml,ons Cole)or Sq.Ft.Floor Area r,tlG Valuation
.�
(commencing exempt
pthheeion rom and Our ba1xlwynf the BuAnxsmut ton.my violation
or Vg
mw he h exempt oem(rom and the bels for the alleged exemption.My violation of 82381
Section
mcoo NSen(Ibby n�a2AHda t for
oiiso Permit subjects the applicant to 9 Anil penalty of APN Number Occupancy Type
❑I.as Ownerofoepmpeny,mmyemploycu with wages Uebwle chmpena0on, 36943012 . 00
will do the work,and the swclure is notintended oroRered forsale(Sec.7011,Business Required Inspections
and professions Code:The Conhmn hies License Law denot apply lo e an owner of tl p
property who builds orhemons thereo^.md who doeauch work blmmlfw through his 305 — FRAME
ownemploycu.provided that such lmprowments ase not intended orolfued for ala It, 307 — INSULATION
however,the building or impnvement is sold within one year of completion.the come,
Wilder will hale the burden of proving that he did not build or Improve for purpose of 601 — ROOF TEAR OFF
sale,), 602 - ROOF PLYWOOD NAIL
❑1,as Owner of the property.em exalt inly contracting with licensed cortuacom to
comtmn the project(Sec.7044.Basimas and Profession Code:)The Contraetm'e LI- 603 — ROOF BATTENS
ceme law does not apply to an owner of property who Wilds or improves themon,and, 604 — ROOF IN-PROGRESS
who contracts for such pmjcets with a convacror(s)licensed pursuant to the Contractors
License law.
❑I am exempt under See. ,B k P C fm this mason
Owner Dae
WORKER'S COMPENSATION DECLARATION
1 hereby tMon under penalty of perjury one of the following declaration:
haw and will m humm.CutlMaof Cmsent to selFlnsme fm Workers Cumpen.
don,u pmvlded fm by Section 7700 of the labor Code,for the performance of the
work for which this permit Is Issued.
aw and will maintain Workers Compensation Inunnce,u mquked by Secow
00 of the labor Code,for the Performance of the woo for which this permit Is issued.
My WoherlC supe salon lnaun acarian and Paltry number�am-
icy No.: WORKER—"'7'-
R °ICA OF ON PAA WORKERS'
COMPENSATION INSURANCE
flbla sect)as necd nm On completed lithe Permit Is for ons,hundred dollars($1011)
or lest)
I certify That in the Performance of the work for which thls permit is land.I shall not
employ any pecan In my summer an as in became subject to the Wehcn'Cmnpewdw
Laws of Cahfiumma Date
APpllcnm
NOTICE TO APPLICANT.If.after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provision of the Lxbor Code•you most
0 O forthwith comply with such provision or this permit shall be doomed mm W.
CONSTRUCTION LENDING AGENCY
I hereby allhm mut them h a construction lending agency for the Performance of
the work for which this permit is Issued(Sec.7097,Civ.C.) .
W Q Lenders Namc
=z Lenders Address
V Q 1 certify must 1 be.rad this application and rete Wt the above infomn0un Is
U. "U Goren,l{gree to comply with all city and county ordinances and sou laws minting o
p Wilding construction,and hereby authorise repreauumbcs at this city to enter upon do
W shove-mentioned pronmy for Inspection purposes. y)
(We)agme lo aw.Indemnlry and keep hum the City of Cupertino agsint GO
y IlebilWu•judgments,eostsandapenanwhichma my my wave against said City
6d in couequ aofthOrsaningofthispermit.
APPLI UNDERSTANDS A 1 OMPLY WITH ALL NON-POINT Issued by: Date ►(
SO EGULATIO S.
tQT Re-roofs
Signa o Lica . n Dam
H DOUS MATERIALS DISCLOSURE Type of Roof
Will me appliam or future building Occupant stom orhandlc hardou material -
fined by the Cupertino Municipal ode.Chapter 9.12,and the Health and Safety
0Yessss5:(an All roofs shall be inspected prior to any roofing material being installed.
❑Yes
Will the applicant or future building Occupant on equipment or devices which If a roof is installed without firstobtai 'ng an inspection,I agree to remove .
It handous air conurninmu a de by the Bay Area Air Quality Management all new m rials for inspection.
ict7
❑Yn u
I theha no dais qui me under Chapterli.95 tithe Cali r.
MAHnbh detyCode.Sm9 25 an 31•I undcnmul ft lithe building . i
don n fitly hew a t is ry or comfy on,occupant or the
to u or oft Certificate orocchpanay. Ig ur &Appliofit ate
w to aured.gemt - Dem All roof coverings to be Class rB"or better
t1
i Community Development Department
it
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEFLTINO
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: — n L
Company Name: hl1►t ✓h
G r &Cvt NG (_J—
Roofing .
A vhcanYsSignatui Date:
Greg eel
Building Official
Revised 1/30/03
Printed on Recycled Paper