01100092 CITY OF CUPERTINO
BUtt.nwc DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
22237 CUPERTINO RD JIM KRAUSE ROOFING 01100092
OWNER'S NAME: APPLICATION SUB DATE
VARAIYA ROOSHABH P 2310 DIANA AVE 10/15/2001
PHONE: SANITARY NO. CONTROL NO.
(408) 779-0704
Po O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
m B ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
i y 5 o I hereby affirm that 1 am licensed under provisions of Chapter 9(commands, Job Description
„F withSaion] 00)ofDivision3oftheBusinessandProfasinmCode.admyliccnX REROOF.
ixf5 is in full Come and<R
Is
e Lim.a en T/O PLY, FELT, INSTALL FIRE
m Licens
Dam _ S DECLa
�jzs 0:5 ARCHITECT'S ECLARA oN f FREE STATE .
I understand my plans shall W used as public records
1���
r d o Licensed Professional
OWNER-BUILDER DECLARATION
1 hereby alEnn that 1 um exempt from the Comranor i License Law for the
follm
C?a which imports
mown arri to
7031.5.Business and Profess ons Code Any city or county
O which q pc a trot,altar,improve.demolish, repair
any structure
w poor( 1 I 9 theapplicantf r chpermit
ctors is g edinstrument. - __.. _ _ _ _ _ _.. .. _ ..._.._ ............... .... .._ ..._
n.3— (liar m 1 ud p e-ant t0 the p on. f the t Contractor License fa (Chep( 9
S Ft Floor Areay l•r- ation
(commencing ms ea ]000) rD '.n 3 of the B�abXs9 pdnpreea nacmel' iQ� =. rLr..t�9�Ve...v _„• �.rT1.,4r,11' .�. $270 `
or S (he is cxrmq themrrom and the bas for the subjects
the exemptron Any violation - 1
-of Section]031.5 by any hundred
rot for a permit subjects tM1e applicant to a civil penalty
or not mom than Ove nmama sonars asoo>. 3 2 AP tfttb ft I Occupancy Type
❑I,as owner of the property,or my employees with wages as Chair sole compensation, 1
MCI do the work,and he stmctare is not intended or offered for sale(Sec.9044,
Business and Ponections Code:The Contractor's License law does not apply to an 305 - FRAME Required Inspeetionsi ” • '
owner of property Who builds or ine mors themon,and who does such work Himself
or through his own employ«,,provided that such improvemrms are not intended or _ 307 - INSULATION
offered for sale.If,however the building or improvement is sold within oneyemor -' ' ' ' ." _. - -
' 601 - ROOF TEAR OFF I'
nmpletion.the owner Wilder will have the burden of proving that he did not build or
01.as far owner
of oX of.vie) 602 - ROOF PLYWOOD NAIL -
❑I,asPwner rojecproperty,ranBusinivelyc Polfa ores licensed contractors to
603 - - ROOF BATTENS C
rostrum Law
project(Sec ]044,Business and Property
who b Codis)The Contractors r '
Bund whlawdoes not apply roan ownerof a costo who builds prove:t.m.th 604 - ROOF IN-2ROGRESS
❑1 em corm i under Law.
proleas with r(s) p s to the .. .. .. .
. L
and who comvnx far.such reason I � .. ,I . . ...... ...... ..
e romvna licensed rsuhis
contractor's License taw.
. „p _ BA PCfonhi /
Owner Dare
WORKER'S COMPENSATION DECLARATION
I hereby aRmt under penalty of perjury one of the following declarations:
❑ 1 have'mr! will maimain'a Cenifiam of Consent to aelf-insure for Workers t/
Compensaion, as provided for by Section 3700 of the lobar Code, for the
fieff arm of the work for which ibis p[mti(is issued.
ove
land will maintain Workefs Compen mitt Insurance,as required by Seaton
f the labor Cade,for(he perfotmame of the wank for which this permit is
issued.My Writes Compensation Insumnce tamer and Pa
265 S13 til l
eam t. CERTIFlCAT NOF,EXEMPTIONFKOMWORKERS - t..Y-Yv51 tiPolicy
f1t.I T;,i slY Ca� l..ii?`:, I . - •.�. 1'.
COMPENSATION INSURANCE _ -_ - i.., _ ^- !
' (Th smbe i n ad trot pl Sed the if permit is for hundred doll
11100)o 1 )
Jy Oct
1 certify that m the perf ur it ort fm come Rus t i sued,I JJJ 200;
shall t ploy any pc y mann as m become subject to the Work[ii y
La s of California.Dam
Applican
Q forthwith comply with such provisions I
NOTICE( ing
NOTICE TO APP lux Wor:IaComm matt thtsrmiioso the Ldsptiode,you
z become subject to the w'orkefs Compcnvdon provisions of the Ubor Code,you mus( '
Q p y wi p ions or this permit shell be learned revoked.
i
i,y - ...... . _.
_(~ ti here.
CONSTRUCTION LENDING AGENCY '
K.y I Afar affirm Rut Perm is a construction leading agency for the per(ormana
W
of Under',
work for which Nis permit is issued(Sec.3(19],Civ.CJ ��•�J "
.d Q Lender's Name'
z 1<nea'e Address
V `I amity that 1 have read this application and state that the above information is
comae(.I agree to comply with all city am county ordinances and state laws relating
U oto building ronarocdon,and hereby authomw representatives ofthis city to enter upon
the above mentioned property fm inspea ion purpoua.
(We)agom to save,indu mify and keep narmlcis'He City of Copenino'st rim t,
W liabilities•judgments,costs and expenua which may in any way acerae against said;
V ti City in conamiueme of the granting of this permit. i
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
D CIO= 1200. Issued by: Date
dt' ✓� �o-l�'ol
amm of Awho—moracnor Data Re-roofs
HA
HA RDOU-1Comm hMATERIALSDISCLOSURE
Win y t e Cu[m err rumor vending e,Chapter pare er nadm[naealth an materiel I Type of Roof
as def ed by t25 Cupen'rw M nicipal Code,ChaPmr 9 12,and the Health end Safety F YP - i-• -- - - . . _ . ._.
Coda sato 2553200 ' S. .Y•tIi. j 5,7 k.l)`ay• .•
mra, ',-Sia . .'' ! . :fit All roofs shall be inspected prior-to.any-roofing material.being installed.
wntne appu[m(t miter eadam [nNo aX equip (arderrcerabrn. If a roof is installed without first obtaining an inspectioli,'I agree to remove
emit nmardous w mossom in I as d ed by the Bay Area Air Quality Management
6. °iSn all new materials for inspection. Applicant understands and will comply with
or« , , ❑Na .t, . all non-point source regulations, -
'1 have read the hazardous mmmdals mmiumems under Chapter 6.95 of the'
Cilifomie Health&Safety Code.Sections 25505.25533 and 25534.1 understand that
Brim building docs nm curtently have a renanr Rim it is my resporuibilb,m notify the
occupant of ted requirements wMch..at be me prior to issuance of a Certificate or
Ocmpanr¢AIA Signature of Applicant Date
-' aamor;rra agrm . Date All roof coverings to be Class "B"or better
.. ,'� OFFICE - ..
Building Division
10300 Torre Avenue
gF {' 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 1/a" 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: I 011l_Cl l t/ICL K�93�t�G P J.
Address: .22 23-7 Cikd
Reroofing Company Name:U l lY�, Vu � ji�c,Y�c i JnC
Applicants Signatur Date: 10- 14,C)
Joe Antonucci
(Chief Building Official)
6/25/01