02060184 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20327 CLIFDEN WY A L RESIDENTIAL/COMMERCIAL 02060184
OWNER'S NAME: APPLICATION SUB DATE
KON PAGET 14893 E HILLS DRIVE 06/26/2002
PHONE: (408) 729-6100 SANITARY NO. CONTROL NO.
tARCHITECUENGINEER:
w
'02 BUILDING PERMIT INFO
at U BLDG ELECT PLUMB MECH
N<i I_7 CJ -'-I L71
5 ON 2 LICENSED CONTRACT'OR'S DECLARATION Job Description
Q z_O I hereby ulErm that I am IimnseJ under p v sons of Chapter 9(commencing
FmCm wim5emion]oM) fUivision3oflheBusine ruproussionsCode.and mylicense REROOF .
m I. is m full forevfride 1
sews uen,eef>ry a "3 uc.x T/0 EXISTING, SHEET OSB 50 YR. SHINGLE.
sWe 3 o U Da Co. oto
ARC 1TECf'S DE(�A
i I undcmanJ my plans shall be used as pubbc recalls
i p O Licensed Professional
z OWNER-BUILDER DECLARATION
m I hereby affirm that I am exempt fmm the Contractor's License Law for the
following reason.(Section 1031.5.Business and Professions Code:Any city or county
F= which requims a permit m construct,alcor,improve,demolish,or mpair any structure,
aim -prior to its issuantt,also requires the applicant for such permit to file a signedsta¢mem. _ _
hurt hq isliccnscd puhuarn tq the pmvilmor.if me Communes License Law(Chapter 9 S Ft. Floor Area., aluation
Bmmmencinswhm Sedmn.n>ml of Dickina3onne lique,..\and Preftim,Cade) CONT-R-11 ;.ta}t Itvfi ast_':IA�,TiO'
or Out he is cxemprtneicfrom and the basis for the all{gW'eiemption.Any violation
of Section 7031.5 by any applicant fm a permit subjects the applicant n.a civil penahy
of not mare than dive hundred dollar,19500). P Number �,- .. Occupancy Type
01.ismwn pt
rof the onstiY.army employees wi lh wages as their sole compensation, _ FRAME
—will dotheccomic,'andthe structure is not intended'or oFetnd for sale(Set.7ld
Businesk'som Professions Curb The Contractor's License Law docs not apply to an 3 07 - INSULAT IEDNuired Inspections
owner of pmpeny Who bu IJ. .1 billow,domem.and he does such o k himself
or through his own employees.paivided that such improvements are not intended or 601 — ROOF TEAR OFF_
offered for sale if,ho 'm b len .. _._ -._. __ __. ._ __ _ - -_._
g P emts m m db year or 602 — ROOF PLYWOOD NAIL" r
--
completion,the owner bu Idcr will have the burden of proving mm he did not build or
impmxeforputpa,eaf,nc), 603 — ROOF BATTENS
Ol asawner ofm n g 604 ROOF IN—PROGRESS
answet the project(Sec.'yl0a1,Business nd Professions lCode:)The Contractors
pro)cc
— License Law does not apply to an owner of proper,,who builds or improves thereon, + `'
Z and who.contracm,for sueblelljectx with.-conunctogs)licensed.punuart.w.the
Contractor's Licence low,
— ❑lam exempt under sec '','B'&P C for his mosoo
O,vn<i s one
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penaltyof Ircrjury one of the following Jcclimalum':
j t• 0 1 how and will'maimain a'Cemficae of Cm1c.t'm xelf-insure for Worker's
\
Compensation. as provided lot by Section 3100 f he Labor Cade, for he �e^
pert (he work far h hmfrt t .iss' d.
01 how d will mma WO k Compensation 1 arc az eq IM by Section
l]M of he Labor Code f-11 perf cot t he k f which M per n
.. y Com s i 1 m J Pot'y be arc
m J M Walker,
CE Pa
O.
RTIFICATION EXEM FA
N;70 --
COMP NSATION INSURANCE DI G///���
(Th' section neW not be completed f ne permit i,for one hundred dollars ' L 111 y l '
(SIM) les.) -
that
pof he
bp I xs6a1
Comt employ any R na Y ner,o as 1.become subject m be Wcourecd rti
Notation Laws ofCdifom aDoe r
..Applicam '
NOTICE TO APP LIC ANT If aft k
bc&om&subject to the Workers Compensation pr,ov rfR of
the
ELabor
piCurb,you
c
hmouulsfonbw Ih comply with such provcions or this perms shall be deemed d
- ' -' "--- -- -
revoked. '
'Ihr""amCONSTRUCTIONereiLENDINGm"melen AGENCY
�.' I hereby alErm That mere is a niniwnian lending agency for the perfamtance �
r Lethe work me which this permit i<issued(Sec.3fl9].Ci¢Cl ' '
Cinder's Address '• .- .,., ,,. , -
I cenify that I have rtesscoth
'his application and re at the above information is
fir.jF comet I agree to comply with all city and county,ordinances and state lawc relating
V to Wildingcon.ametion.and hereby authentic represemmtive,of this city to enter upon
y W the ab J props ty finspectionP p
F`
liabilitiesJudgments.g -i to penfy d'kttph 1 n- Clay-v.of en ge nv
"V Z Ln coeof N d expenses which n�ny y c cgumst,anid r
City q c of the printing of permit
APPLICANT UN' RST\ OS ASD WILL COMPLY\ 1TH ILL NON PJIV9sf I REGLone
I
Issued by: Date
ib t fA herm,Z Re roofs
HAZARD U'
Wilding
A ISCLOSURE
was pp. ntmM wnamg ptmeo.hdalnaiNasSafe,, T eofRoof _. .
J ,J.f ed i theC pen Mun cipa Chapter9.12.and N Health mJ SafnY YP — _ ' . ' -.
i Caf, 5 to 155] (� y.. h .. t�'�.� . ._' .._..—._ ,.-...—.,—,-
�Y N - f xI
All roofss6a11 be.Inspected prior to.any roofing material
'
beinginstaflled.Will th f t eblaingoccupantu¢cqupr, t at devices which
emit nae d I,coalis nd fnc0by aY All If a roof is intlled without first obtaining an ns etio , I agre.e toremove
°i1nc ,
0y _
all new materials for inspect n. Applicant understands and will comply with.
all It-point sourclati is.
I
have d he b-cfardstill arsollitill1 ' ntx under Chapter fi 95 of th
a H25505,25533
Calif mi. &
lthS Safety Code Sea 5505 553]and 1understood that
ifthebuilding toe, f currentlyh nerant, hat it is my _p _bility to oury the
rainfall of he requ rcme s wh ch must be et prior to Issuance of a Certficate of t
ON. ancy. -
(o Signatu_ of A_ pp icant Dale - 11
- r n.,he iced agent All roof cost ca to be Class "B"or better' -
.. ._ ,:.... .-._ .._ : . .... __ ... -- - -OFFICE
i Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
• CITY OF Fax: (408)777-3333
CUPEkTiNO
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 V"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.
,)cl`iomeowners Name: 6 ti
,(Address: _ :2! -� (I
)ieroofing Company e:
Applicants Signature: ate: L 02
Joe Antonucci
(Chief Building Official)
6/25/01