02070166 CITY OF CUPERTINO -
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BCMYDI{Fsq:IFFORD DR RESPONSIBLE ROOFING INC PERMIT Nlb2070166
Alk°WkIk"NORMAN 2882 SPRING ST NONE: U �/ LAPPLICATIBN rY80 F/2002
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(650) 969-6151 SANITARY N0. CONTROL NO.
O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
z fi BLDG ELECT PLUMB MECH
;Z=ss..o i LICENSED CONTRACTOR'S DECLARATION Job Description
I herebyefftrm has Inco littnsedund rprovisiam of�hapur 9(commencing REROOF p
:m(_u9 wish Section] sof DirisionJ of she Busi ,vntl Professions Code.vntl my license
is in fu o And s. ��
�3" $ ARCHITECT'S LA ATI
,�-� g 1 undemm�d my pions shall be used as ublic recoils
JM/n N .2 8 2003
p O License)Professional
OWNER-BUILDER DECLARATION
`4-w I hereby Affirm that 1 om exempt from the Contractor's License law for the JQ�g1�® $6220
C?Q fallowing reason.(Section]031.7,Bmm
insand Professions Code:Any city mcoumy Yom' '(�,
4 S❑ which requires a permit to construct.alter,improve.demolish,or repair my swcmn
pilo ton issuance,also requires the applicant for such permit to Ole a signed statement. _ ._.__- ..,_._._.__ ...._�_...._.-... _ _
Nat ha is hr<asd pursuant Ip the pia idom of the Comrumri License Law(Chopur 9 y _
(common ng 6t Section)00m)of Division 3 of the Bu rLaor and i...Any, Cede) ', t l+s k s :;4 h w C V L..S i.�s.r.l l.'J:' Valuation
Ar Sam he is 315 b tbcrefrom and the bons far the eethe c pliant A Any violnion t
Of Section n thin
7 iv any applicant for o permit ubja(s the applicant to a civil penalty-1
t
of m(mbre NAn Rwe hundred amlm lssoB). PN NMHME Occupancy Type
ml,as owner of the propeny,or my employees with wages as their sole compensation,. 307 - INSULATION
";will"do the work:end the structure is obi Amended or oRded'for sale'_.7—.
B.Ineu"and Professions Cade:The Comnnor's License law does not apply m an D$t1P�GOn$ •' '
owner of property Who Wilds or improves thereon,and who docs such work himself 602 - ROOF PL NHl L
_or Through his own employees,.provided Nn such improvements arc not intended or
,offered forAle.1(howevcr,the Wildingwimprovcmcnl is sold within one yam of - -- -"603- -"--ROOF`-BATTENS '' ---
S-sR'
completion.Tumpos .fruslaerwillhavesheWrdenofprovingNeshedidnmWildor 604 - ROOF IN-PROGRESS r
improve for purlme of sale.).
.ml:asownerof Ne p S..7 am Boston voly Protests
Ccoucmnt'. .'rt(„ r• ,
- _ comsrvd the Pwlen(Sec.]Oda,Business aril Profenions Codeq The Comrurori )L -.i rt.
License Law dos eat apply to vat owner ar property who Wilda m impmves,hto carthe '
+: - _co who conuacu(Law.. pmjau with a corssractor(s),Ikenud-pursuan,-w.dte - _. .-_...
- - ClI m,xrt Littnu law..
i ❑larii exempI under See- + B@PCfor Nis reason .',•.' i..,-:li !tl'§i
Owner' Dote ,. •••-•
,WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of
prjury one of the following declaretiom:"
d m I heve'and will'mvimein•e Cenifiavm of Coment to ulf-insure for Worker's
Compenudan,-m provided for by Section 37OO of the Labor Code, for the
performance or the work for which this peemit,is issued.
Cl 1 h ve'ttid will maintain W rker'�Compensnion•Inshmnce,0 required by Section
3700 of the Labor Code.for the performante of the work•,for which this pemdr is
71flCAT10mfoOFlnsurece cud olid Policy
t uetl My Workers pe
s p -
eviejr CE�� p,EXEMP770N FRO W RKERS ?l '.
_..,..-....•p•-;,:.,.. ,COMPENSP ON..NSPR�NCE _.. ..:...... . ..._.. -,.._._....__.___-._........._- .-_.._.___..._f_
..-a' i. n, ..,.,r�:I:Lt•'•JI :;:..• ,�. 'Trill7
"
ISI0•t?(rulesses iect�on need eat be cont Iced if she fm one hundred dollen - -•
0)or ] tsl
„ '
T - ..-.. .... «..�._.._��-___..._.._.._
ds'•+ I c %that in,he m
piRmance of Nthis work for which s perm(is issued;l
an
shill not employ any person in any manner so is n become subject to the Worken' t, t 11
Compensation Laws of California.Date
'
NOTICE TO APPLICANT:If,After making This Cenifimre of Exemption,you should
Z bceome ..b toNe Workefe Cdionsar dohs itAanf Ne=W Cotte,you mus,
0 fohhwiN2omplj hiN wch provisions ar this permit shall be damrd invoked.
~ Ihert aRmi that Ne is . . lending
.. _. ..._ _.. _- -._.__ ___ ________ ___ _ _. .i. _ ____. .. ...
I
CONSTRUCTION is ri ONLENDINn AGENCY pe i f:'+G
by coiisiiABi n lend g agency for Ne per(omiantt
;4,s c of Ne work for which Nn pertains issued(Sec.3097,
..:.•_,..-:,_.... _ ._:__: .,:.'.. -
D;Z .. i ..a,;.v i,;-.0_ ..,
V 1 certify(het 1 hove read this application and sun Nat the above information is
carted.I egtee,to comply with It city and county,ordinances and state taws relating
0-U to Wildingconsvucti6n:And hereby amunAzi'mpun
seativeserthis city to enterupon
,>.-la1 ih<st ".mcmioned TAAK far inspection purposes.�,,; ,.
Fr• (We)agree to sem;indemnify end keep hemdeu the City of cupetttno'egeiast
fr h liabilities,judI art..costs an expenses wh cit may m any way¢cine egeimt said
t), City m conses}uende of the qq"A�tmg of Nis perhila "+ 1.
-
'APPLICANT UNDSIT$LUND,S AND WILL COMPLY WITH ALL NON.POSNTr' Issued by: Date
.. IhA." ,
gnarvrtlOfQppIaNAYARD0U5'MATERI $DISC $URE Re-roofs
LD
'defined WIby Ote, llcehl dr furvre Wlldm put n9.12,A the Health and eteeel Type Of Roof - -- _- - - -.— -
C so,ju 25 Cupestmo M meiPe c Chep( 9 13 red the Health red Safety r • -
Code Scnio SSRP 7 .t.- .. -
❑Yns ° No, F;^ All.roofs.shall,be Inspected Is to,any roofing.material being installed.,
ir.Allrdom,it,comit rfumn Wdtling pent seequipment o devices which If a roof is installed without first obtaining an inspecnori,-l'agree to iemove
hneNoua elr contemtrients udeft' Ne Bay Area Au Quality Mean imt
Danict - all new materials for inspection, Applicant understands and.wlll comply with --_
r Oyes}s :i( �H o, rt :!.i ,,- all-non-point source legnlatlODs
�l 1 hive reed N do-amareritls rtquiremAti undirChapin 6.9j of the:
CJI(cora HUIN a:S y Cade Sea a le 2nt.that
2x533 end 25534.bl uidram d that ( / `�A —�
A cu Wtldt gdasumemnendyha most be rt hems to rmpomibtbrymnoufy Ne V]V �/( /
oexgpem of he requlrtmenu which most be met poor to Issuenu of a Cemfinteb(
• YPanaY i .. n .
_2T
Signature-of Applicant Date
weera Asad:aAAgeni .r All roof coverings to be Class"B" or better
2.
'OFFICE --'-•--" -'- --- "--....... .. . .. ... . ...... __.. _
r .
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
Fax: (408)777-3333
UPERTINO
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.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: �"�ctyy— wo rrriCxy)
Address: to733 G t f&1-0( a(
Reroofing Company Name: IZPSCX�vi�l b�2 1Znn Fin��
Applicants Signature:
Joe Antonucci
(Chief Building Official)
6/13/00