02070124 CITY OF CUPERTINO
BUILDING DIVISION PERMIT LCQNTRACTOR.INFORMATION:
' BUILDING ADDRESS: PERMITN
7571 ERIN WY WESTSHORE ROOFING CO `62070124
Ow,gEa'S.NAMPkAO 5869 WINFIELD BLV APPLICATIaNfMflJ 2002
NONE
(408) 629-2100
: SANITARY NO. CONTROL NO.
O z zARCHITECIDENGINEER:
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O O BLDG ELECT BUILDLNG PPLUMIB INTO MECH.
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;SvP 2 LICENSED CONTRACTOR'S DECLARATION Job Description
o IhertbyaremrmNlamran,ednnderpja :ion.arenapt«9(Nmmendng REROOF p
w!-u with Seni ] )of Dkision3ofthe BusimerP ld Pmfessions Code.mdmylicense
m E: is in full fo n e cLM/_
:O a U Liccn Cl _ Li 7 )_Z
at,
Com
u Ov,g ARCHITECT'S DEC o TION
1 undcnund my plans shall healed.,pu lic rtrarda
'x� OLlansed Professional-°C OWNER-BU rapt fmm Ce ComraON
p.a
1 hereby.(firm thin I am exempt from the Cocoons Co License taw for the
C 3< following reason.(Section 7031.5.Bulinus and Professions Code Any city orstcwmy 9 5 0 0
a.F o whir to
rtquirts o permit m Nmauca alter imprme,demolish, file.
rtpair ica nroaurc
a.w 3 primnols issuance, q t s neappr ant sof o uch onp tool flea g (t¢mem. 1n. _ _ ...__._...�___
Dial he'll ttnsedp is LN to Ula pro sof the Contmcmrs sec uV (Chap r9 +3 gt0�1W1Y1'f��
(<mmmrnc g th Salo ]000)ofD maaof the Bmmeue dPro(ess ono Code)' i,�11s f(];. _5 _ T -'�", Valuation
or that he s u m nhcrcfrom and the basis for the alleged exemption.An
e 0 g p iv`i ximir,
of not Section thin v any hundred
[]for a pemdt subjects the applicant too civil penelry-
bf not mort then five hundred tlollers 13500>. r Occupancy Type
_ol,asowner°(mc pmPeny,urmyemploYe«with wages as lheirsom compan:ation, 307 — INSULATION
will do the work:and the souco c isnotintended at offered for sme-(See]044;' _
`Bosiness'atid Professions Curie:The Commit.a License Low docs no,apply,.an 602 - ROOF PL
owner of progeny Who Wilds or improves thereon,and who docs such work himself
or thr"T'his own employees.provided that such improvements am not intended or
offemil for uld.If.however,the building improvement is sold within one of -__--'- -,---6 0 3'- - -ROOF -BATTENS- ------------ ------- --�; ..--.
g or i v rear
iimpletion.the m..Mr-Wimerwill have thebrdenofProvingthathedidnorWild°r 604 - ROOF IN-PROGRESS
mprove purpose of
_
P Deny Y 8 __ ___.___-.... —_ -__.____-__...... ._...
I:as owne pr the ro •am Business contracting with licensed contractors Ia - - -
License
the n(Seel]044,Business and Professions ills or The improves
Contractor 'I "I
pfOfC
itrad n Low dos not apply man owner h a contig worm builds se improve thereon, `• '- --' -.
Commem contmcu!or svch.proj«n.wiN a.rownemr(s)licensed Pumant.Io the.. --. _.__-_..... .. ....-_ __....... . ................._ -
"- ❑Iamexemptunder Sea ' " '!'' '
/ = ., 'B@PCfor this reason � �;�;��
.
"
WORKER'S COMPENSATION DECLARATION A DA
I hereby affimn u der pc. Try f pr0ury°ora of Ne following declamations: IllarraN
-
❑ 1 have and will moimahra Ceitificate of Consent to self-insure for Worker's )�
Compensation. as-provided for by Section 3700 of the labor Code, for the AUV 0 2 2002 k
performance mf the work for which this permit is issued..
7. ❑I have otM'wilt rtioinmin Workers Compcnsatum Insurance,es required b Section BUIL,D'NG
3]
W of ror Labor Cafe fo th jambrena f Na work for h h Inis pcmdt is
seed My W kc s Co p�'t on I suk nc 'arae d Policy Wr a2 (G�j
e t (ylr;i NP tr1'ol
M1'���Q�'d 7- -_'.5 _ __ _
y 1 CERTIFlCATIONOFEXEMPf10pT}ROM W00.KER5 < <v�' a a'. Tt` I� rt"iF_j1I•� ra:q f�4• J.I'..v .�'-
V COMPENSATION}MSURANCE 1 °
p. ... .._.... __.
I IlTh soon tied not ore Nrnpleietl if the permn is for one hundrtd dollars
SI •' - - '- 's t- -'JIi: s �
15007 or less.) t
r .. ...,_.___...,..._. .._. .. ..
shot)
I n,1 th t the pa in. to a .(Ir. or to me subject
ct i Is ucd'1 .— _..
shall of ploy y f ws y manna to become x b) to the Work n '• .• ( t +_ !I Rr8'r
Compcant " sews of California,C . Dora
.Applic
NOTICETOAP sthe W T ?a C.mm�ktgthis U�fienfExe t° - -- - - - - - --
p you should
becoml ubf nl the such provisions
rC pc rtmnp mons oRhd em Code,you must
Z
0 fonhwM Damply with such grouts ons or this permu shall bed deemed rcvake4.
F
CONSTRUCTION LEN DING AGENM L .-. ✓;+t .t _. -. .
CYi , 1 ore by alTrm That theres e con wn n leading g cY fo the rm
peR ance' _ ,L •I r
W (� Lenders Name'' ')
ed(Sc 3W] C C
(carat that DuE this "'-_._ .._.-----
Lender's
m e ww hmh N s u s ssu
Z Lcnde tAdd<ss
U _ _ .. -J,: it 1
Y 'cation and that the above information is
[r correct 1 clime m comply with all city and county ordinances and state)..a relating
to.F.I gconstruction: hereby tc ieDrc
tatvas of thiscity to mer upon
�- theidboa ma t d proper,for inspection purposes,
d (Weagctolave,mshrm and keep bamJess the City ofCupWmo
egalmt
h liabilities,judgments.costs eM expenses which may in any way ottme against said
V,z City in consequence of the g' rang of this pe u
APPLICAVi IA?lER$T�.\DS' DW CONPLVWTfHXLfN -'-poiyr` 1
S REcuLAr 7,.Z= t Issued by: Date
a uo/A Iran t - - Dat i ; - Re-roofs Y
Cetlel H RDOUS MATERIALS DISCLOSURE
gn,
wn to a cape t f N Wading wNpmt stort o hol fthaaardoand Safety T e,of Roof _
as def d by th Cupcm o Mumc P I Ch pt 9 12 aM the Health end Safety YP - ...__-�.__.._
'S a 355J2(a), � I ':` r - .- ..
t 1 L u l
' rtpY r NO 1 I ) -
AMkAll.roofs shall_ a inspected. rior.to.any roofing,material being costa ed. ..
t wn m ppl ce t f w b Ild g«c p t a pp, t as s win h If a roof is installed without first obtaining an inspection I agPee.to`reinove -
mit heurdous a c nt6m n is u di,It by the B y A q QuJ it M rgeme t
sa'c' all new materials for inspection, Applicant understands and will comply with
r.O Y o p
a all non-point source regulations, I, ,
1 ha a rtad the.harudous marcrieli qu rcments under Chapter.6.9S., the `
fthe bultl doe nm cu y understand! _
cs
«N N fthe hemms h C IC - p YRS responsibility �(y the ._ _ �7 �.
0 P y a�mdhave o u,in,th it
a C/ Z:�'.
&IiA
W ant that tIs po y _
i 0cparHoroNz eSa<n nc raC nSc
Da
. - 7 .9 ignature of Ap ILca
Da ..- All roof coverings to be Class' ' ortbetter
. _ .: . ,�. - - OFFICE-'
Building Division
10300 Torre Avenue
' Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF 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.
IMPORTANT:
1. Flat roofs must have a minimum of I/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,:_- c c— (�
Address: `7 S7 G�l✓1 N (,(/ at �,
V.
Reroofing Company Name: AlC
Applicants Signature: Date: 'Z Z
Joe Antonucci
(Chief Building Official)
6/25/01