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04070161
CITY OF CUPERTINO BUILDING DIVISION PERMIT CCINTRACTORINIFORMATJON �" BUIIDINGADDRESS: CASTO ROOFING Pr'aMIT"'64070161 0263 CARTWRIGHT WX OWNER'S NAME: PERMIT ISSUE DATE GAY FISCHER 1938 OLD MI ONE: - SANITARY NO. CONTROL NO. (650) 961-8922 7AR=CHMCT�GINE�: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH cLICENSEDCONfAALI'OR'SDECLARATIONJobDescrip[ion I hereby affirm tion 1 am licensed under provisions of Chapter 9(commencing ioSec'on]IBJ)ofDmBm elrec ' I Z2 REROOFcense Lic.gale Canlydebf 1 A CHITECI'SDEAUG 1� 2004 U Ion d An'...shall he used As P"10= eco N Licensed Professional A� t�a -12 OWNER-BUIUER DECLARATION �'kla��®�S♦,d�'4 I W-by afrom Nes 1 am exempt from Ne Coormaor's License Law for the ltl la p a following mason.(Section 70313.Business W de:Profession CoAny city or county K m which requires a permit to construct,ager.W prose.demolish,or-pair any auuclure poor,is issoancc.a)m-quiet Ncapplianl fofsuch permiuo fileasigncdatatumcnt �Za that he is licensed punuanl to the pmvisioas Of the Cmnlrumri License law(Chap¢r 9 Sq.Ft. Floor Area Valuation wI a (commencing with Section 7000)of Division 3 of NC Business And Pro(nssinns Codd)of i — that.he is exempt d-efrom and the basis for the alkgc l exemption.My violation Of Semon 70315 by airy applicant for a permit subjects the applicant w a civil penalty of J ifidilt,�N&hibcP U Occupancy Type not-ort than five hundred dollars(5500). r I.zs owner of me propcny,or my employees with wages as d-it sole cnmpenation. will do one work and the avucrete is nmimmraded Or Offered forazle(Sec.1014,Rusin— Required Inspections And Professions Cade:The CoWeemes License law dons rut apply to an owr-t of q P proper y who buil ds m improwa mereon,and w ho does such work himself Or through his son employees,provided that such impmvemenu are not imended araffered forsale.If. however.the building or improvement us sold witism one year of completion,he own.. builder will haws u-burden of proving that W did rot Wild Or improve for purpose of sale.). ❑ I.ps owner of the property,am acloswely contracting who licensed..."cmax to conswm the project(Sec.7014,Business and professions Code:)T)m ContracmYs Li- cense Law docs not apply m an Owner of property who Wilds or improwsa d-mmn,And, who conmms for such pmjcas with acontraemRs)licensed Pursuant in the Contrarwls License law. I am exempt under Sec. ,B&P C for this reason Owner Dam WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty Of perjury arc Of the following declaraumnr. Fl I have and will maintain aCcnificamof Consent to selGinsum for Workers Compton- work for provided for by Scotian 3]OO of the labor Code.for the performance Of Nc Compton- work far which Nia .it is issued. ❑I have and will maintain Warker's Compensation luxuriance,as matured by Section 3700 of me Labor Code.for dm peRotmance Of due wink for which this permit is issued. My Work,e COmp�ens/an/oIn Be,carie,and Paltry number are: OFEXEGrocr. `�-jtsta's`l` Policy No.:�_ CERTIFICATE PENSAn MON FROM WOR S' COMPENSATION INSURAN'Qad (hmsectimn need not W completed Uthe permit is fortune handed dollars(5100) kat) 1 certify dust in the perfarnarce of d-work for which this permit iv is ed.l shall not employ any person in any manner se as to be.me subject m the Workeri Compensation Laws of Cahfomia.Dam Applicant NOTICE TO APPLICANT:If,Aller making thus Ceniftcam of Exemption.you should become subjem to me Workei s Compensation provisions of the labor Code you most .J O forthwith comply with such pmvision or this permit shall W deforms revoked. Z CONSTRUCTION LENDING AGENCY 1 Weby afliren Nat then is a conswcunn leading agency for the performance of a Ne work(ser which Nis Permit is Named(Sec.3097.Civ.U (g) QLem Ices Name G Lend,ra Addles, U 0 1 anify mat I hint,read this application and sate that the a Wve information is U. P cortin 1 agree to comply wide all city and county Amid.and sate laws relating of 0U Wilding construction,and hereby audomim representatim Of this city to enter upon dee W aIvcmcmiontd propeny for inspcmmn putpous. F (We)agree to save,indemnify and loop harmilcss the City of Cupenino against raj Imbilides,jidgmcnu.cosa and e.,.which may in any way acsom.,instsaid City U z APPLIC Ni UNDERSfAN of NrN MILL COMPLY WITH ALL NON-POINT Issued by: Dat SOURCE REGULATION 16� Re-roofs S t RDOUSM IAISDISCLOSURE 0>te Type of Roof l mea and ar forum bis' ng ottupanurore or Wndk havarduus material •,\ Ax 11 cd by Cupertino Muni'al Code.Chapter 9.11,and the Health and Safety Code.Secumn 25531(il] All roofs shall be inspected prior to any roofing material beifig installed. CYa 1J No Wit]Ne applicant or future Wmg Occupant use equipment or device,whim If a roof is installed without first obtaining an inspection,I agree to remove emit hmuardoor is cmnmminana as fined by the Bay A-a Air Quality Management all new materials for inspection. Distfla] Yes Ihave real the by smaterials requirements under Chapter 6.95 of the Califon ria Health&SafeyCode,Sections 15505,25533 and 15534.1 undersand We if the Fuildin (/ V docs no urronuy have a len L At it u my fesponibdiry m am ily the a:cupam of the m -men whit arm' mncrsa(aCesufinteO(Ccc anryre 0.llo [ppplic t ate All roof coverings to be Class"B" or better m .o. d sg m s can, g .k, Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY Of Fax(408)777-3333 W'UPERTINO Building Department JOB ADDRESS: ERIMT # 2ozcp3 90O Q OWNER'SN �� (`Psc(nci ONE # GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting • Linoleum / Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing �esto (Lo,{ �LvL Septic Tank Sheet Metal Sheet Rock .' Tile Z U /Contractor Signature mate �QS� {�ook••^'S 1 rte. Community Development Department Building Division j s f j City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 CM OF Fax: (406)777-3333 IUPEkTINO 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. nstallation5. 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: 1--7ItU job Site Address: CA4 �w^-f� � " "� �` Roofing Company Name: ��� ©C4 `� IN 7 C A licanf Signature: Date: I04 Greg Building Official Revised 1/30/03 CITY OF CUPERTINO REROOF o 7OF CUPEtTINO PERWT APPLICATION FORM APN# 916 _ QO Date: Q Building Address: 6 / : 62:3 ( ,�J rt Owner's Name: / (/ �lPhone Contractor. C Phone#: License# 56 � 6.V ���&q� 7oa3 Contact: .1( Phone#: < < Cupertino Business License# Type of Roof Covering: Existing: Proposed: Q Built-Up Roof O Built-Up roof o Asphalt Shingles 0 Asphalt Shingles A wood Shakes J' wood Shakes o wood Shingles t] wood Shingles O Other(Specify) U Other(Specify) Number of existing coverings O Provide I.CB.O_Report# o To be Removed O Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cu o's Tear Off Policy: 01 Job Description: R-o,�o-vim ,moi W/ CP0ao 8 ti�.rLp� Residential Commercial ❑ v C/ Fue Zo Yes ❑ No ❑ Confirmed with PI if there are an coons: of Project\ Type of Constntctio . . Occupancy up: Qt t e Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Fnergy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLICZ , Business License BUILDING