02080056.
CIBUILDING OFUOPERTONNO
CONTRACTOR INFORMATION:
PERMIT
B/946ADCRANBERRY CL
PERMIT
GY;'W `98bKJA AND KENT
APPLICAT ON �3
OS/ 1GB AT)i 2
PHONE:
SANITARY NO. CONTROL NO,
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ARCHITECDENGINEER: f
BUILDING PERMIT INFO
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LICENSED CONTRACTOR'S DECLARATION
Job Description
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9 (eoml tie ing
1 hereby alum Not 1 am licensed under P visions of ionic
with section ]Qn0)of Division3of d¢Busi aProressinna slid and myli«lie
in full fgcyjand cRecS "
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REROOF
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O1Y 39 Lie. 03
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u.ARCHITECT'S
e -1 2-u t. C°nuam tw.wly
DEC RATION Vy-oozy
F99MALE®
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1 undemm�d my shall be uxd zvc.555
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plans n public records Z
Licensed Professional
OWNER
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AUG 2 2 2002
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-BUILDER DECLARATION
1 hereby o%iect Nat 1 am exempt from the Connector's Law for the
Any
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Ca : c
following rtamn. (Section ]OJ t,5. Business and Pro&cion Cads: Any city or county
$8500
❑
wh h reclaims a pemut to construct. her, improve, demolish. or mpau any structure
1 3
. prior to itsissuance, abso requires the applicant fur such permit to file a signed statement
that be nlicensed pn d 06 Oc inklYiSmao of the ConuactoisLicense Law (Chapter 9
(commencingf Division 3 of le ons Code)
uem SNerelmrOimWaM -nn Professions
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a rf 36�?tOP30��F��a l 'Y
, i f a,z s-..: i. l1.3�i
Valuation
he s the buss for Nalleged cam n
by
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- of Section ]0J 1.5 any applicam for a permit subjects The applicant m o Civil Penalty
of not more than eve hundred d°gan (a500).
3 0 SAP -N pi q&E
Occupancy Type
01, as owner of the property. or my employees with wages as their sole compensation.
307 - INSULATION
-will red the work; and the structure is not intended offered for sale'(Stt: Two;-.
Business and Pmressions Code: The CommcmCs License Law does not apply to an
601 — ROOF TE TA /�Cia+ :.: .
�-ilCq Qk Inspections ,."
owner of property Who builds or improves thereon, and who does such work himself
602 - ROOF PLYWOOD NAIL
o through his own employees, provided that such improvements are intended or
lnoture
- -°frim!- tseniiawde p anentnsellwi,didnuer�or
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- 603._.-. ROOF -BP:TTENS ..__.. r
ve:osHowe
°mol tion Ne owner Wider will have N bard of proving that W did not Wild or
improver pary°sc lir I ).
604 - ROOF IN -PROGRESS
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coLasowner ofthep came I t IYl with c sTh onum
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(Sec. Profession Cade) The
Professions
continues she prosect (S , 9to 4.an
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license law docs owner o property improves hesco
apply m m owner of prooeny who Wilds or improves d¢reon.
2_
fi
_enJwhors fLom. such.projens. with a.contractogs).licenscd.pursuant-to.Ne..__.._..._.__..__
............... .... _..,..___......._ ,_... _._.
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Livens
s License Law,.
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I and ex
❑lamenempt`under Stt:'"" ;B&PC for this reason
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Owner Date -
" -' WORKER'S COMPENSATION DECLARATION
' 1 hereby dared under penalty ofperjaiy afollowing 'One of the follong declarations:
❑ I have and will maintain a Certificate of Comical self -insure for Worker's
Compensmion, as provided for by Section 37W of the labor Code, far the
performance of the work, for which this permit is issued:
❑ 1 have and will mauritain W rke Compensation Intontt req red by Section
'L
J]W f he W Cade f N pert nna f N k fo n ch this perm i s
i,.0 d. My W k 's Comps scat I . ur Policy numbs, me
am r ✓ t/'(faer r4N1�Policy No:
rCERTIFl ;Al ION OF EKEMPrION FROM WORKERS
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. "...,.'.;._ COMPENSATION
v ' es 4dtiodneed 6ui beoomplcted if Nrtn
c pcit is for one hundred dollars
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(SlW) ur or less.)
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fi.. n t.aa_ea,1r,.i
1 c n r. that n N pert Ee pf mk rno perm
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shall nm employ'my person in any manner so as to become subject to the Workers
v
s 1 - •'s
Compensation laws of Califomia. Dale, -
-Appliran .. .. .. ...
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PN O APo IL making Nis Cenifinm of ionic.
oust
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come subject
become the Worker's Cor the Labor you
it Worker's Compenanon Permit Cooked, must
comfy
forthwith comply with such provisions or Permit be decreed evoked.
shall be
nCONSTRUCf10N LENDING AGENCY'
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; '' ' "I hereby aflivn that Vert is a construction lending agency drill performance
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of to k for this s perm i s issued (S 3097. Civ. C.)
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1 sen fY that f ha a read Nis aPPlic on and vme that he above infumrmims is
,
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cunect.-I agree a cOno Ply,wah all city and county ordinances and state laws relating
to Wilding
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construction. and hereby amhonze rtpmsendrive, of Nis city 10 enter upon
the W i ed for'inspection purposes,
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save.
eW) g rasa indemnifyandoh I. anyw fC pen' °zgainst
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liabilities, 3 tlg t costs d es
pe which Y any y g Inst said
y5n� on
C PUCANTgUYturnDERS `g IA.�D WII'mLL`CONPLY W'RH ALL JO rc NT,
uence�- r LLrt
Issued by;
J
Date
Signat a of AppllcanUConracmr - Dae.
Re -roofs
. HAZARDOUS MATERIALS DISCLOSURE
Will she applicant or future W lamg °ttupmt ante or handle nn=araon5 met ,
-T e of. -Roof -
.-Type
as d fined by theC pen Municipal Code Chapter 9.12 and the Health and Safety
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CMe O
Sectioni255326). 1 l ' ...
- , `. l 5' S^l ' I . r' + Y '
ll roofs shalLbe inspected
.Apoor-to an roofing material being installed.
;fill, the fic-art - so future W (ding occ pa tuts equipment odevices which
emit hazard ire m nano Jefned by the Bay Arca Ali Quality Management
__ .._.
If a roof is installed without first obtaining an inspection' I' agree to remove
g
D"' ' are �a -
all new materials for inspection, Applicant understands and will comply with
all non point sou re ations.
-
I have read the hazardous materials requiemens under Chapter 6.95 of Nc
Califomia Health & Safety Code Sections 25505, 25533 and 2.5534. 1 undecamd Mat
in
if he building does net currently have a tenant, that it ism
my tfie'
an, of the requirements which W
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must met prior ro issuance ofCenificase of
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._ec "Pa
-
Signature of App !cant.
All "B" '
Owner °r agent .. _ Date
roof coverings to be Class, & better
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=CITY OF
CUPERTINO
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Paz: (408) 777-3333
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 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 of inspection
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: • Yo u ra wz,1L
Address:��1'� �16�'-0 Y CA,eo-1
Reroofing Company Name: _VOW 6 -• 5LU-4-mAi s
Applicants Signature:_Date
Joe
Antonucci_
(Chief Building Official)
6/25/01