02080058 OF
CI BUILDING DrnSSIONVDPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10190 CALVERT DR. EASTMAN CONTRACTING, INC 020}
80058
oG RRALD BLOCK 1418 DOUGLAS ST APPLICATION
1SB 22002
PHONE: SANITARY NO. CONTROL NO.
k (408) 971-9000
O O ARCHRECr/ENGINEER: g BUILDING PERMIT INFO
U BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
�5�z I thereby 1Erm Nat I am licensed under Job Description
of-o ya provisions of Chapter REROOF
p_C w with Section 700D)of Division i mine Business nd Poc curric,Cwe,and my liccnsc
6 �� is in full Tura gp effect.
�K w 6 Licen I s Li
0 6 V Dplf� (,'On Or
ARCHITECT'S DEC
C°'O I undemand my pians shall W used m pts II rtcmd,
wa 6 0 0 Licensed Professional
u.
y�
!2, OWNER-BUILDER DECLARATION
I hereby ai that I am exempt from the Conacr's License Law for the
? millionvmfollowing reason.(Section 7031.5.Business and Professions Code:Any city or county $7700
D wM1 ch requires a permit t .t t alter.improve,demolish or repair any structure
n 3 se-prior to its imusionce.also rec,uires me applicant for such pemduo file a signed staement-
- N.th :r kdpuis tiodieprov nsorNecontmet«sLicemelaw(Chaper9 r 3'�91F9 .�!''AI4a 7 . • Valuation
(commencing N Sect 7")7 ) f Division 3 or the Business and P'Cocistans ewe) ( {).� a ... 1�.. 1 :0'
°r that he is exempt therefrom and the has s for the allegN excaptimi Any violation
-of Section 70315 by any applicant for a permit subjects the applicant to a civil penalty
•of not mare than Eve hundred dollars IS500). 3 0 5AP.N 4d'WAME n:: " Occupancy Type
01,as come,ofNe property.or my employees with wages as their sole comlewtion, 307 INSULATION
will do the work;and the structure Is not intended or oHered'fm'sme(sec..
:'asio '70a4, 601 ROOF TE
'11minesnd Profesns -Code The Contractor's License Law does not apply to an ARCI fila UInspections •s''
owner
of property Who builds or impmves inerton,and who does such work himself 602 — ROOF PLYWOOD NAIL
or=this own employees.provided that such improvements arc not amended or
oIT for sale If.however.Ne Wilding m ifiipmmoreut issoldsvithin one year of - __.._.....-603 ----ROOF -BATTENS ... .. .. . ... ... . ..
completion,the owner-Wilder will have the burden of proving that he did not Wild or 604 — ROOF IN—PROGRESS
improve for p of of ,c.lef,
_ 1.nsm..._. _ .__.___..._____..___ ... ctor
1:as owner of Ne property,am Business a convecting with licensedtiTi contactors m ,;--_ -� -----`-'-
p conewct Laduew
does
(sec.7001,Business and Professions Cwea The.e,tmorom, - I I
and who
Law doer.not apply wan owner of property who builds se improves .to dre "- '
..and who contracts forh Projects with•.comra<wr(s).li¢nod pursuant to.th<. __.. .__...._._. _
Convacmr,s Liana Low. . . ..- _. _. .._._. .......... .._.__. _.
0 l am exempt too<rSec.
Own Da¢ ' ' - t>•cad
cr WORKER'S COMPENSATION DECLARATION AUG 2 9 200
1 hereby affirm unser Penalty or perjury one of the following dahvations 2
A" O 1 have'and will maintain a Certificate of Conant t0 self-amore for Worker's BUILDING
Compensation, or, h
s provided fill by Section 37W of the Lar Cook, for the
perf°riiance of the work for which this permit is issued. \^7
❑1 have and will maintain Worker's Compenation Insuri nce.as required by Section
37W of the Labor Code,for the performance or Ne workfm which this permit is
issued My Worker's Compensation 1 sum carrier and Poly umbo are:
Y.' 1 .;CE CAT Es'
FROM WORKBRS i l:'" 1 Y{ it i ii it: s'i^sSy{\t\s L-1 -
..� ___ION INSURANCE a ,
COM-, .,,.s^ -- ._..,.__ _.._____. _. .._...._
miis seams need not he ccmpleed if the permit is for one hundred dollars -' 1"i - l
(S IWl or less.)
.• 1'ceftify that inNe performance of the kf hchN pcmdl- ssued,l ._.�. .._.: _. .1. a`'.
shall'of employ any pets°,in any manner as w become subject to the Workers . s i
Compensation Laws of Cali fomia.Dale,
Applicant '. .
NOTICE• APPLICANT this ofExemption,
should
Z become subject the rkeess Compensation provisions of the LibiurCwde.youmust
forthwith comply ith suchphis permit shall dimmed invoked.z
i
F n�a `' 'CONSTRUCTION LENDING AGENCY na :•.
7 ' ' 1 thereby hi that the conewct on 1)97.C agency f«the performaritt
ofusework for which Nips t issued(S 3097.Civ.C)
L Q 'Lend, Address
.. .....
�'Z Lend,, Add s '••i' IL
U I certify that 1 have read this application and one that the above information IS
correct.1 agree to comply with all city and county ordinances and state laws miming
U w building construction.and hemby aumoiire rePresentativee ofmis city m enter upon
'., W the M tined p pe ty for inspectionp m
F.-0. (We) gmetosa d ifyemd keep h yinles;any way
fC e gain said
V Z C m c dg cots.costs d expenses hch yin any y acme against said /
in q ea. g f L a
APP CA UNDERSTA\ S 1° LC N LYWITH ALL NOM1P NT Date
S I + a love. 611>h
Issued by:
re ofApplica ocan actor.. Dfil" Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
i.Will the applcant o.future Wilding occupant t re 1 hourefle haardone riieerldl. Type.of Roof.
as d f ed by th Criterion.Municipal Code,Ch pt f 9,12,and theHealth d Safety { -
Code Section 25532m) �`,,..JJ I ..' f 4 ) I', (
❑Ye -�3µNo s. 9 - !na ( t r .v .1 yt. ..
_All roofs.shall.be.inspected.pnor_to.any.roofing material.being,installed... _
Will thapplicant or ft re buildingoc p t use compactor or devices.which If a roof is installed without first obtaining an-inspection; I'agree'to remove
emir hazardous air contaminants asdefned by the Bay Area Air Quality Management
Distr"'? all IT materials for inspection. Applicant understands and will corn l with-
oY - / -- -
all
,ori-point source reguplations. . pP "ll.; - - p y
1 have read he h aN conal requirements is and Ch pt o95 of the /�-(a j�,(/
forma iii H IN x,Sat se s le S t ns 25505 5533 and once d rot d Nat C/ l b -
i t ld g does nn tly have- e that t y rc po '61'ty t notify the - -
cup t fifth cq rcmems ch tprio t t iianc<ofa enifa¢of
e' up c. ss ,
__ __ IZO� Signat_ureofApplicant Date
All roof coverings to be Class "B" or better
amWdred agent' � . . .. Dam '
' OFFICE
17,
Building Division
10300 Torre Avenue
i . Cupertino,CA 95014-3255
• Telephone: (408)777-3228
Fax: (408)777-3333
= CUciao
ERTINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing.
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 reroofing 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) Preinspection 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 that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of Y"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 of inspection
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: �—/1 Pity VIA .
Address: �(7 i 6)O l r-J AWA -t— �1�• c �Xil,{Z YLc�-
Reroofing Company Name: (::�OJD7 MOku. Il" O chy,A— �Vt'G
Applicants Signature: � G.j (7r Date:
Joee Antonucci
(Chief Building Official)
6125/01