01060132 CITY OF CUPERTINO '
nuanwc DIVISION PERMIT .CONTRACTOR'INFORMATION: .
BUILDING ADDRESS: PERMIT NO.
10511 DAVISON AV EXTERIOR SOLUTIONS 01060132
OWNER'S NAME: APPLICATION SUB DATE
SINAR ALEXANDER AND ANETA 1771 SMITH AVE 06/22/2001
.PHONE: SANITARY NO. CONTROL NO.
l- (408) 358-1233
i
Q Z —i
O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
❑❑ - BLDG ELECT PLUMB ARCH
LICENSED CONTRACTOR'S DECLARATION
0 Z L-0 I herebyaffirm that I am licensed under provisions of Chapter 9(commcneinr Job Description
p Z-❑ Prov'si po g
p:dwith Senior]WO)efDivision3oftheBusinessandProfessionsCde,andmylicense SHAKE TO TILE.
is in full force and effect. '
6 License Chis. Lia.lo 1
u Dale rte — Com CL / t
pa c.H ARCHITECT'S DECLARA N SQL MS
understand my plans shall be use)as public records �i✓C
or a
w Ei pLicensed Professional
°'°i OWNER-BUILDER DECLARATION 1
- �� . I hereby affirm that I am exempt from the Contractor's License Law for 0e
gi z a 'which ng reasoa.permit t 7o31s, t,alter,improve,
demolish,
m li endo:Anr city situation,amnr $14529
S i❑ which requires a pertnil m construct,alter,improve,demolish,br repair any .an
wpm ..p t t on al c9 Ih PI' IC Ipv Il fl 'g dtncneu,
' (Ch9 '..3 r6_kfb 9�- ., Valuation
(o m.ani with 5 li ]000)of Division 3 of the Business and Propulsions Code)
or that he is exempt therefrom and the basis for the alleged exemption.Any violation
-of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty
4of not more than five hundred dollars($500). 305 AFN � ,., Occupancy Type
❑I,as owner of the property,or my employees with wages as their sole compensation. `
or through his own employees.provided that such im 6 02 - ROOF PLYWOOD NAI
will do the work,and the structure is not intended'or offered for sale(Secf7044, ---
Business'and'Pmfessions Code:The Contractor's License Law docs not apply to an 601 - ROOF TEARe FO Inspections
.
r of property Who builds or improves IMreoo,and who does such work himself
v met t intended d or L
.��olTe ed fo 'I�If hoevr.the SuJd' - P '- 'r of
t " Improvement asuld m nay 603 - ROOF BATTENS )'' '
'completion,the owner bu lJerw 11 have the buNen of prov ng that he did not bli ld or
improveforPurpose Of I ) 604 ROOF IN-PROGRESS
_...._.
e - 01 - .er of the PnP nYexclusively --------
. lu IYcot I g withlicensed contractors to -Li I,_';: . ._ ...._.
construct the project(S 7044 Business and Pmfesso Code:)The Contractor V
r f •I'.
andaLicense Law does not apply m an own f property whobuildsIds Improves thereon.
I,
f and who.cnntian,.foe such Prolcets.wnh n comrndor(s) licensed..pursuant to the -T 1. ....,/.._..__._.. ...... .. _. ._ --- _. ---- - .. _..__
Comractor s license Law _
❑lfin cumfit under See. Bl&PCfor this rwsoo
0 IwrI 1.11j . Data
,..
i
1 + WORKER'S COMPENSATION DECLARATION C e /�
Ihale bY ff d p hY,ofpernry fthefollawinBdeclarations: FINALED
❑ I hav and will ma ntam a Cenihca¢of Conserv to self insure for Worker's
S al Compensationm ,-asp idd far by Section 37W Of heLabor'Code. for the _ OCT 15 2001
�p /fo� eof the rkf,r h'bth Perrotsi"Id.,' ,
9, ®'I to a aad will nolimadin Workers
.e ' Cn pe e[ n lnsu._aOOh as re
quireaby
yScmro
n _
37W f Ihe'Laby C de,f IM1 pero fine wbkfr which this p '
i J M W r Con 7 r and Policy mre.eBUIL
DING.
C ,.,..
_..,_. ..... _,.. .. _..
Policy No:
,,i,jCERTIFICATIUo Ub LXEMPTfON FROMWOZKERS"" '
( .,: p Perrot .._•-_.__.
COMPENSATION INS CE
0 e.
'as Thssen on dnot tie cool lined fthe ti 1 ne hunJeWd II 't ) - '`')
(SIW)or less) -
i `Icnfy;that 'hefa fma fth 'k for which thepermit s issued,'[
1hall( of employ any person in any ma n r w ;to beta subject to the Workers'
'yf '
Clompiammawn Laws fCalifornia.Data
-Applcant ._. .-.. __ ..._._.._. ._...... ... ._ _.. ___...
NOTICE TO APPLICANT If,after makingth Cnfcare ofExemption,you h Id ---) ,
b e - bjar,m the Wo kers Compensation v p o s If h I n C J y u trust 1
Q O
forthwith comply`with such prov isions or this permit shall be deemed revoked
CONSTRUCTION LENDING AGENCY
ry
1 hereby afthim that there is a coutionation lending ag 4 for dheaffrommea -t I
F4:
-ofd work far which his pe iti,"ss d(5 30 Ci C)
...L d N ... ..... . .. . . . _ ._.., _ . . . .._.._.... .... _ ..... .. _._._.. ..__._ _. _..
L nd Add
- Jaz s.
V I t I.ecru fy that I have read Ih s oppl canon end smte thin 0 oho a inform tion is
-�ga.c ., conecc 1 ag'earn
u-na .with all city and county,ordinances and state laws reading
4 [) to building cumulattion:and hereby authociu'rcpneartaniee ofthis city to enter upon
[]] the bove atemicand pr p ny for.
in.vpe u n pu oses. ,.-
(We) y to e indemnify idkee Cty c peninoagainsl
'r-(q
liabilities meats c is and pe w e against aid
tt, U'Z City :b mree the g g 1, c n
souu AN urvgEce c- u' L-'-oN-P Ivr' I Issued by: Date b ad
5 gact Apphla tAdifiacmr; ., . : Date Re-roofs
.✓HAZARDOUS MATERIALS DISCLOSURE f Roof it11 the appl t future b Id nB occupant t b handle hazard us main pe O o0 _ ..... ., _ .,. _.._. ..
def ed by he Camino.Mur c'P I Code,Chapter 9.12 ad the Health and Safety
Code
Section OYs 2553 {v1 fx[]No ) .1 •kx h- An�'
All roofs shall be inspected pnor_to any roofing,material being installed._ _
• Will the upple t funrebuilding occ p t use equipment rdevices,which If a roof is inslalled''*it out first obtaining ah'ins eetiou;Filigree remove
e thaz rd uw t Ivan¢as def db the BayAreaManagement g I p
Y Quality - 'N
District' P _ . PP - and will comply with.-.-,__
_.
a new rials ort s ec bcantunderstands
,f7rvn, .( all no po •I sour r.gul - -
I have' 'the h m i male I req ens d Ch pt 6.95 Of the
Cal fo a H It &S fety C d Sectio 5 0525533 and 25534,1 understand that
"if lh b011 g es Ic rteml he a hews my esponsb Ity to notify e
ccppa oft requirements h' as et ufa rf fiat of '
- d.aL i. .�', .g .---eo . pp._cant .. ,- - -.__ ..._ — - �--- Dae_. _ _.... . _ _
nature of li t
o oramnoriaed g t .,_ ,� DOe All roof coverings to be Class B"of better'.' '
OFFICE -
':�:F "'. r,': ',x,,.' .. . . .. i.,,.e..-:. . :: e e' ;,.fit i•,,
Building Division
i 10300 Torre Avenue
Cupertino,CA 95014-3255
•
Telephone: (408 777-3228
8
acllyolli
Fax: (408)777-3333
~CUPERTINO
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: AG2xAwD e/L �iN.q/L
Address: o51,2 D/At/1-DsC)N Ave,
Reroofing Company Name: "Ex 7-e 2i 2 Lg e-v97dNS I AJC
Applicants Signature:
Joe Antonucci
(Chief Building Official)
6/13/00