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03100115 CITYOPCUPERTINO : BUILDING DIVISION PERMIT t CONTRACTORANFO.RMATION ' BUILDING ADDRESS: WING ' S ROOFING INC PERMIT No.03100115 1022% W T,2TAT�R DR OWNER'S NAME: 561 RUTGERS ST PERMIT LSSUE DATE NE: SANITARY NO. (510) 481-3818 CONTROLNO. ARCIIITECrIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH M 0 ton LICENSED CONTRd under DECLARATION C I hereby affirm that 1 13 licensed under pdir ions o , dc,r 9(commencing Job Description i with Section 7(gIlp of Divisron7 fth B sirtcss and Pmfcuium dc,and myliccrosc is ��..y fu farce an ffcetz; V Lori cls= a �� REROOF F Da¢ Co ltracwT / AR HII=amptl. 1 5 h,u undcruanJ my plans shall M uuYpuMic acaNs n °off Lice sed euional g OW NERBUILDER DECLARATION <$ 1 hereby affirm that I am exempt from the Cnmraaor's License Law for the no following reason.(Section 7031.5.Business and P.fecsiou Cade:Any city or county E$ which require=a remit to construct,alter,improve,demnlish,or repairanystructure pnor to its issuance.also requires the applicant for such permieu file a signed statement a< that he is licensed pursuant othe pmvisionsorthe Connector's License Law(Chapter 9 Sq. Ft. Floor Area Valuation j 1•� (commencing wi lh Section NAq)nl Division J of the Business and Professions Cmle)Or that he is exempt theref.m and the buffs for the alleged exemption.Any violation of 36922027 n Section 7071.5 by any applicant for a permit subjects the applicant to a civil Penally of APNNumber Occupancy Type not more man me hundred unit...(5500). PanC Y YP I,as owner or the property.a my employees with wages u their sole compensation, will do the work.and the structua is not intended or offered No sale(Sec.7014,Business and Professions Code:The Contuaors License law dors not apply to an owner of Required Inspections ,.petty who builds or improves thereon,and who due=such work himself or through his own employ=,provided Nat such improvements are not intended oro@red for sale If, howeycr,the building or improvement is sold within one year ofcompletion.she owner- builder will have the burden of proving that he did not Wild or improve for purpose of sale.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to consumer the project(Sec.71N4.Business and ROlextron=Codc:)The Convactnr's Li. ccue law deco not apply to an owner of propcny who but Ids or improves memon,and who comets for such pmjccts with a eoadaclnr(H licensed pursuant to the Conlrae.rs . License law. ❑I am exempt under See. ,B&P C for this reason Owner Data WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penally of perjury ore Of the following declarations: 1 have and will maintain a Ccnifcue or Crosson to self-insure for Worker=Compem union,u provided for by Section 37M of the tabor Code,for the pefformance of the work for which this permit is issued. ❑1 have and will maintain Worker's COMPrnsalion Insurance,as required by Section 37W.1-the labor COO,for the rforma a of the work hm which this permit is iwued. My Workers Co Ilion In a c ler and P Na number art: C(lTef./ IQ n y Polic CERTIFICA OFF EMPOON FROM WORKERS' COMPENSATION INSURANCE (Thu somian need not heeomplcwd if the permit is Barone hundred dollars($100) less.) 1 certify that in the performance of the work for which this Permit is issued.I shall not employ any person in any manner so as to become subject o the Workers'Compensation Laws or California.Due Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption.you should become subject to the Worker's Compensation provisions or the Labor code,you am �Q forthwith comply with such provision=or this Permit shall he deemed revoked. ZN CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of ]: the work for which this permit is issued(See 3097.Civ,C.) Y Q Under'a Name , Z)2 Lcadcr'=Address 0 1 certify that I have read this application and sate Our the above information is i Hcoaccl.1 agree to comply with all city and county Ordinances and state laws relating to �U building Construction,and hereby authorise op entrui m or this city to enter upon the purpo es W ahovcties,judncdnis cst for inspection which may y (We)agree to save,indemnify and keep harmless the City of Cupertino against rzTz incoidesicrutc rot costs and cabernetwhichmay In any way accrue against mid City J r7, APPLI qucncc ND grant ng ofRSTANDS thisPermit.WIL " SOURCE ULD RSTANDS AND WILL COMPLY WITH N,POINT Issued by: - Date SOURCER LA IONS. J l// Re-roofs arc of r HAZAR c US MATERIALS DISCLOSURE Data Type of Roof Will the applicant or fu arc building occupant core a handle haruduus material ar defined by the Cupertino Municipal,Code.Chapter 9.12,and the Health and Safety Code,Section 25532()1 All roofs shall be inspected prior to any roofing material being installed. ❑Yes WBI me aPPlinnl orfot c building Occupant vin equipment orchvient which If a roof is installe without first obtaining an inspection,I agree to remove tit W/Ardnus air comominents'u defined by the Bay Arca Air Quality Management all new materials f r inspection. [ni.Hoddr&Sabciy trict, byes a Ihave d oho>aNtus imus2505a25is quircmc5534.Icr Chapmn.9t,fthe Califon oM.Secdou 255(15.255]]and255J4.1unJcrsend thallfthc lvilJings not cinoody ase a renam,mat it is my respu ciamy m idly t up tofmelre whit bcmetpriorwissuanceofaCcniffate of ponignature pplicant e a to ty D,te All oof coverings to be Class"B"or better f� l Community Development Department � Building Division �rE 1 City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 U PE kT'NO 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 1/4 " 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. Homeowner's Name: Pte- t, Job Site Address: Roofing Company Name: P V �'N (S AP' icant's S�ig�nature: Date Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO REROOF COf " ( ° " ( � 1 CUPERTINO PERMIT APPLICATION FORM APN # Date: 3 2. Z 027 /p -/-S-- 0_3 Building Address: Owner's Name: Phone#: Contractor: VLicense#: W140/s ; �N� r&4 Contact: U(N o e ItU-A Phone#: Cupertino Business License#: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof A Asphalt Shingles %, Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. . I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ;ioi Job Description: Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are an restrictions: LJ Cos f Project: _ Type of Construction: Occupancy group: Qty. if A licable Fee ID Fee Descrition Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING \ G BUSLIC Business License BUILDING 3� �-2 � z7 7J