01100068.CITY OF
BUILDING IIPERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO,
10315 EL PRADO WY
CALIFORNIA SECURITY ROOFING
01100068
OWNER'S NAME:
APPLICATION SUB DATE
ROSS KEISER
90 UMBARGER RD
10/10/2001
'HONE:
SANITARY NO.. CONTROL NO.
(408)363-6400
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
C
BLDG ELECT PLUMB MF,CH
LJ
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hereby all Ila, I am licensed under previsions of Chapter 9 (commencing
with Station ]000)of Division 3 ofthe Business and Professions Code. and my license
REROOF.
iin full forte and caw,
sal,
sLulopaClass Lie."
REMOVE WOODSHAKE, INSTALL, 1/211
��
Dat`��•Lr
CDX PLYWOOD & 40 YR. DIMENSIONAL COMP.
r' AITCHIIECI"SDEC`LAr ON
3 I understand my plans shall be used as public records
-
pLicensed Professional
OWNER -exempt R
1 hereby affirm that 1 m the CoATION
License low for the
exempt from the Cessions
following noon. (Section ]omm Business em Professions Code: Any city or
1 o
ucowry
O which requires a permit to consvuct cher, improve, demolish, or repair any swmurt
$- prior to iss isarnv. alsorequim lheapplicam f« treatcrmx pitfar. signed uatamem
S -Ft Floor,A4eap Y
' ', 36 ' q' ♦ \ ! ! �1t,
l.f rlJ, e_xs. L„1, Y! `:
C uation
— Out ho isaubdued puleuant to the provisions of the Contractors License Law (Chapter 9
(commencingwith Sxlionv000) of Division 3 of the siness professions Code)
Bit! e
.
and the tesla for the alleged Any violation
or Nm he is exempt zany
s1�'sk -.:i9'1
I'
Y lI
14 0
applicant to
- of Section ]031.5 by any applicant for o permit subjects the appliam m e civil penalty
applicant
of mare than five hundred dollars (s50).
34 AP�N1 �mb�r0
” r Occupancy Type
° 1, a owner of the property, or my employe with wages a Weir sole compensation,
23
,
will &-do, he smuemea is not intended « offered for ale (sec. ]ora.
`Businea am'professions Cade: lbs Contractors License Law does not apply to w
305 - FRAME Required Inspections '
owner of property Who builds or improves thereon, end who does such war, himself
sur through his own employees. Provided that such improvements an« intended Or
are
30.7 — INSULATION
loffered for ale. IL however the building « improvement is sold within one Year of
-
completion. the owner -Wilder will ham the burden ofupproving that he did not Wild or
601 - ROOF TEAR OFF
improve for papers: clale.).
602 - ROOF PLYWOOD NAIL
❑1; es owner oldie property, assn exclusively contrating with licensed convectors to
603 - ROOF BATTENS
maxima the prujeet (Sec, 701 Business am Profen thus Cme:) The Contractor's
License I doss wi apply I owner of property who Wilds a thenon,
d
6 04 — ROOF IN -PROGRESS . .
S
pan
cm a
for such Prvjav with a.convanorfx) licensed ponuam to the
par
who roLice
Co s
ContrettoPs License Lv,v.
° I imexempt under Sec:' - 9&PC f«Wim assert
'. owner'ira
WORKER'S COMPENSATION DECLARATION • .
' F0rV ^ L' D
1 hereby affirm underpenalry of perjury one of the fallowing declinations:
have and At mainwa a'Cerificate of Caren; m selfimaa far Work,,',
'ompensatiw,
OCT 2 6 2001
u provided fee by Section 3700 of the Lather Code, for the
Performance of the w«k for which Wis Permit is isxed.
01 have am will maintiin Worker's Compensation Insurance, as required by Section
BUILDING
3]00 f the Labor Cm [ the parfonteme of the work for which this parts
V
d Myth rkkF/s[� u� n�Jnsuancec dPolny numher,acra ,•
Ciss y'pe-n
ard( L-YlaY 'kficy No. /3J3 >/3�
CERTIFICATION
1;':''a. t F' f '=.kti ''t.4F`'i", - •u.11J;llwl,..
t t [ !
„ OF EXEMPTIONOh�RSI
COMPENSATION INSURANCE
s •..)
'mris'anian need alt M mmplmed if the permit is f«one hundred dollars
t l �' - -�—_ __-- - ` ,`li'l , i'x !-'___ - -
3100)«lea:).. _
t
I e in We of the ork ashich is iss ed, I
shell
' `?
plothat
I. say mo fi
note ploy any rill m any msnncr . a m become b t m the Wo�eis'
u el 10
Comps ii n CeGfom,e Dex "Qi
Applicant �•,
.. _. _ ..
-
NOTICE (CANT. If. after basking emB tmphoon you should
baome subject tothe Wor,els Compensation provision 44MLM, Code, you must
'
fonhwlth comply with such provisions or this Permit shall W damcd revoked.
- .' CONSTRUCTION LENDING AGENCY
1 hereby affnd that Nene is a construction lending agency for the perfonrmce
.. ,,.
of the work for which this permit is issued (See 309]. Civ. C)
a.
-. Lender's Name - .. ,. ..., ......._.,
.. ,
-. —.. -. _ . _ .... . _ ... _......... _
Lender's Address'
I Mnify that 1 have read this application and state thershe above information is
empect.1 agree to comply with all city and cowry, ordirwra am state laws elating
to Wilding ansmucrion; am hereby aWodae repaxnutiva of this city to enter upon
the above-mentioned! pmpmy for inspection purposes.
•,
(We) agree to Ism: indemnify am kap hannlrn the City of Cupenino against
1 liabilities, judgments, cents am upeaes which may in any way accede against said
J City in consequence of the granting alibis permit "' .I
APPLIC RST/ DS AND WILL COMPLY WITH 'AL NON -POINT
so GUUTo_S r
Issued by: k, Date
'. Sigaartaf Appicwucanuamr. - :!' Dan •1`
"'. HA2ARDOU ATERIA CLOSURE".
Re-roofs.11 .
Q.
,. :xin'd,eapCuprt«f amre Wudmg«capal yore«Mr We nsa
Type Of Roof
p a Safe,
udefined by the Cupertino Murdripal Code. Chapmr 9.12, and the , and Sefery
Cm S t 25572(x) -. ,. _ d,, 1.
t, i H
;,(; .� t {s; 4"� 11�[a Fi ,-l} M1I't')1`s•K: di
°Y , ." . :.1 ?:
x.
..All roofs shall be, inspected pnor.to any, roofing.material,being installed.
' Will the applicant or future Wilding occupant use equipment r devices which
hazardous defined by
Ifaroof isinsialled:Without first obtainin an ins eetioti;"Ila ree'toiemove
g P g
emit air contaminants as We Bay Ana Air Quality Management
District]
all new materials for inspection.Applicant. understands and will comply with
°Y" ON.
all non -point source regulation:. , ,' ; ,
,.
1 h sand the haaN - s'marmis requ r inents mMe, Chapter h 95 of the
1.,,,_
' Cal fano Health & Safety Castle. Sections 25505 25533 am 25534 I americium Wet
. if the building doss not currentlyh e a reruns that is my reaPensibilityr notify the
«cupant f 'he"m nwhich must be' t p to issuance f C ni0cate of
ti A o G .�1� ^! O �—m✓
q P ..
Signature of Applicant � Date
-�-,�o
_.
- - - - - - - -
All roof coverings to be Class "B" oi'beIter'
or atuthonaad agent' Date
•'
OFFICE ._ _.. ... _
I