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03040026�z 0 a� az UO CITY OF CUPERTINO I»'uRh3'_n ' 'Ax'>" e'F0 I,TJy{QGNf BUILDING DIVISION PERMT cUV '""' i$ BUILDI ADDRESS: p1460 PERMITNO. CUPERTINO RD KEVIN SULLIVAN ROOFING 03040026 OWNER�Sg MEIE UEDATE PERMIT�04/04/2003 ,FAWCETT 1696 VALLEY OAKS DR. ' .NE SANITARY NO. CONTROL NO. (408)842-1057 ARCHITECVENGINEER: BUILDING PERMIT INFO EIRCI' PLUMB MECH 0 LICENSED CONTRACTOR'S DECLARATION CMpl 9 Job Description I hereby affirm that I un licensed under Novmons of , (mmmcncing ..Codc,skeletal. in full farce IT wSatin7")ofDNion3afmBLuk.i Yn9#_S REROOFLicaacl Data CHITECTSDEC RATION 1/0 COMP., INSTALL 30LB. FELT & 30YR. COMP. 1 understand my plans mall a and as public ncnrds N A L E® Licensed Pasfesaimul OWNER -BUILDER DECLARATION 1 hereby affirm that I em ewmpt from the Conbators License law for the APR 14 A`1 following moan. (Section 8013, Business end Professions Code: My city m county L 2003 which n rubes a permit to co mrucl, filler, wProw. demolish, m repair any abaelure prior W its issuance, also requires la applicant fmsuch Permit to file .signed statement Nat he Is lcensed purl to the provision, of the ConBacmr'aLcense LAW (Chapter 9 Sq. Ft. Floor AreaB Valuation (commencing wife Seclion7plo) of Division 3 of Ne Businessland Pmfessla s,Co ole( ILDING Nat he Isconcern therefrom and fee basisfm the alleged exemption. My vIalmia of APN Number% ane e p y Type Seedon 7031.5 by any applicant fm a permit Subjects the applicant W a civil penalty of not muse than Rw hundred dollars ($500). 0 1, as owner cribs property, or my employees with wages as their sou rompewtia, 'A9rc;nnr'A nn Required Inspections willdo feework.andthe awctum is nmimmnded oronemd rmsalo(See.70a4,Bualmu and Pmfeadans Cade: Ta Cmoramon Licenn Law deal not apply be an womb r of property who builds, Wprowstiura0.andwhodaeasudemrk bimalforfecarib his 305 - FRAME ownemployw, provided lhmsuch Imprmemmuau not in¢nded mortend fmsaie. If, however, the building or improvement hisaid within ane you of composite, the owner. 307 — INSULATION builder will ave she burden of passing that he did no, build or Improve for purpose of 601 - ROOF TEAR OFF 0 1, as owner of wo property. am exclusively contracting with licensed ..rumm rn m 602 - ROOF PLYWOOD NAIL consumer the, project (See. 7044, Budnaa and PasRsdons code:) The contractor, l3' 603 - ROOF BATTENS ft. LAW deal not apply m an owner of property who IviMs or Improves Newan. and who contracts for well projects wish •commitments) licensed pennant W all Contractors 604 — ROOF IN—PROGRESS License Law. ❑ I are exempt under Sec. . B k P C for this mason Owner Dam WORKERS COMPENSATION DECLARATION 1 henhy aRlm under penalty of perpay arc of the following dalustions: haus and will maiable. CenlOawofCa scat ro elf-iasum for Worker. Cession. on, es provided for by Seldom 3700 of the labor Code. for the performance of No wart for which N4 permit is Issued. 0 1 have end will maintain Workers Compensation Illusion, as required by Section 7700 ofthe Labor Casio, lm the performance of Newest forwhlch this permit is Wised. My MM,pp\\rte s Con emu on Nal a u end Polity n w r rs r n Poll o �� CERTIFICA 8OFEXEMFf10N WORKERS' COMPENSATION INSURANCE (This action read trot he cam plead if wa Permit o fm one hundred Orleans ($1 oo) M Ins.) I entfy that In the performance of she work for which this permit is broad. l Nil nor employ any person In any manner an u W t aorne Subject to the Wariness' Compensation Laws of Callforow. Dfim Applicant NOTICE TO APPLICANT: If. tar making this CenlRam of Exemption, you should become subject to the Wallace. Compensation provisions of time labor Code, you mull forthwith cnmply with such provisions or this permit shell w deemW ranked. CONSIMUC170N LENDING AGENCY 1 hemby affirm that Nen is a contraction lending agency rot we Performance of the work for which this permit Is Issued (Sec. 3097, Civ. C.) Lenders Name latalce. Address 1 certify that I hove read this application and suss that the above Information Is corset. 1 agree to comply with all city end county ordinances and muss lows seising W building contraction, and hereby amhodn representatives of NH city W cram upon the shove -mentioned Property for Inspection purposes. (We) ague W save, Indemnify and kap harmless the City of Cupertino against Iobilidau judgments, calls and expenses which may in my my secret against said City In comwgmme of fee granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURCER U TI Re -roofs Type of Roof {naluro ofApplic HAZA_RDOUS MATERIALS DISCLOSURE Will she applicant or future wilding oceupau tom or handle holudom casuist as dc0ned by she Cupertino Municipal Code. Caper 9.13. and we Hearth ad Safety Code, section 75533(.)7 All roofs shall be inspected to any roofing material being installed. prior If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future wilding occupant we equipment or devices which alt huardous air aonnminam s a do0ncd by Ne Bay Area Air Quality Management all new materials for inspection. outlet? 0Yes gr1u I bac mad fee haandom materials mclummcnm underCapm 6.95 of the Califon \y� nth Hot" SarelyCode, Secliau 35505,35573 and 25574.1 uedemaM tial little wilding doss (rot cmwndy sew a moat. dui ii o my mtpomlMlily m nodry N tan Sul of she �/ "er ti nu—whic miles e yuim tprimwinaancetnCenine.m r lap. Q Signature of Applicant Date All roof coverings to be Class 'B" or be ter 0 tar mLhorind agent Dam Community Development Department Building Division City of Cupertino 10300 Tone Avenue /'+ CITY OF Telephone: (408) 777-3228 L U PE kT] N Fax: (408) 777-3333 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. 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 Y4 " 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. Homeowners Name: 0 42 /? n /.e ra w C2 �7 job Site Address: Roofing Company A plicant'sSignature: A&46"Date: � 03 i Greg eel Building Official Revised 1/30/03 ICUPEI�TINO CITY OF CUPERTINO 3 " Z REROOF PERMIT APPLICATION FORM APN #�� , C7 , 6 y Bldg Permit Fees Date: BENERGY Energy O Building Address: Seismic Fee Res 2_Z 6 BSEISMICOM r BUILDING Owner's Name: Plan Check Fee Phone #: n i e i.✓ c P 74 Business License Za 9 xZ4 Contractor:^ hone #: License #: 1/4 17 oa* 0 / Contact: 41 hone #: Cupertino Business License #: 629) -0 i Type of -Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof X. Asphalt Shingles 13 Asphalt Shingles Wood Shakes ❑ Wood Shakes Wood Shingles Cdr Other (Specify) 61 �7�� ❑ Wood Shingles Qr" Other (Specify) /' 1 i11a n Number of existing coverings ❑ Provide I.C.B.O. Report # m� To be Removed Cl Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: rA% 0 ; / 30 r G m Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed w' Planning Dept. if [here are an restrictions: LJ Cost of Proj Type of Con c 'o Occupanc group —Y 5 00 Qty. if /'*� Applicable.) Fee ID Fee Descrintinn Fee Gmun BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING