03010107 CITY OF CUPEWHNO
BUILDING DIVISION PERMIT CONTRA -TOR INFORMATION:'
...x . ,,.,. ,. ,. .;
BUILDING ADDRESS: HEAD ROOFING PERMIT NO.
883 E ESTATES DR
WNER'S NAME: 1645 S . MARY AVE . APPLICATION SUB DATE
SUBRAMANIAN 01/21/2003
ONE° (408) 737-0170 SANITARY NO. CONTROL NO.
ARCHrI£CT/ENGINEER: BUILDING PERMIT INFO
BLDG ELHCT PLUMB MI!CII
0 0 0
Op LICENSED CONTRACTOR'S DECLARATION
F 1 hereby afnnm that 1 am licensedis ander pdProuss of chalk. .commencing Job Description
<i
with Sc"ion]1KKpof Division3nf the Busincu anJ profcssinnsGdc,anJ my license is
in Inn force and effect. RREROOF
OZn� License Class Lic.X
�,Dam nmtraelor INSTALL 30 YR. CLASS A ELK
� ££� ARCHIJEC'S DECLARATION p
olundcrsund my plansshall he used as public records
c. dU ll YY VV/aa'S� LaC
iL 0 Licensed professional - Q Q �]
1'y' < OWNER-BUILDER DECLARATION ,JAN 2 I 1� [OOJ
A.EQ y 1 hereby alfrm that I am exempt from the Contractors License Law for the
00 following menum.(Section 71131.5.Business and Professions Code:Any city or county
Q which requires a Permit to Construct,alter,improve,demoliab..r repair any.Structure
prior to it issuance,also m ium s the applicant for such permit m file a signed statement
Zscmat heianansedpursuantinthe provisit,nsofthe Contractnr.ucenseLaw(Chapter 9 Sq. Ft. Floor AreaI�tion
(commencing with Section 710))of Division 3 of the Business and Pmfessiams Code)nr
y
but he is exempt therefrom and me Ardis for me alleged exemption.Any violation of $4140
Section 71131.5 by any applicant for a permit subjects the applicant m a civil penally of APN Number
not mom man me hundred dollars($500). 36924 0 21 . 0 0 Occupancy Type
mti
❑I,as owner of the property,or my employees with wages As their sale compen .n,
will do me work,and the swum is ren intended or offered for sale(Sec.704,1,Business
and Pmfestio s Code:The Contractor's Liam Law docs nut apply to an owmr of 305 - FRAME Required Inspections
progeny who builds or improves thereon,and who doessuch work himselforclrough his
own employees,provided that such improvements are not intended oroBercd for Sale.If, 307 — INSULATION
however.the building or improvement is mid within one year of completion.he awner-
buaderwill haw fire burden ofproving chat hedid not Wild n.improw for purpose or 601 — ROOF TEAR OFF
sath')' 602 — ROOF PLYWOOD NAIL
❑L as owner of me progeny,am exclusively contracting wit licensed contractors to 603 — ROOF BATTENS
construct the project(Sec.VW,Business and professions Code:)The Contractor's Li-
censeLawdoesnotApplytoanownerofprogenywhobuildsorimprovesmenton,and 604 — ROOF IN—PROGRESS
who c ommcts for such projects with a contractor(a)licensed pursuant to me Contractor's
License Law.
❑ I am exempt nder Sec. ,B&P C for this reason
water Dale
WORKER'S COMPENSATION DECLARATION
1 hereby aRnn under penalty of perjury one of the following declarations:
I base and will maintain a Cenificam of Consenuo selLinvurt for Workers Compen-
satinn,az provided for by Section 3]11(1 of theM
Iar Cods.for me performance aide,
work for which this permit is issued.
❑ I have and will maintain Worker's Compensation Insurance,as required by Section
37(XloftheV cede,f.r me pe iform++++++ggqqqq��r��rcccccc office,wakfarwhichthispermitisimed.
MY Worker's C tore alien 1 once ant Policy n`hc
Carrico V, .11 Cy No.: 'tel] • t
C RTIFICATEO'EKEM ON FROM WORKERS'
COMPENSATION INSURANCE
(This senlnn need not M completed II'the permit is for one hundred dollars(S bed
or Ices.)
1 ccnify mal i he common of t1I pY�ork for whicM1 this per.........ed,1.,h.11 not
employany r. a any n crst II} ecomesuhjecuo me workers'Compensation
Laws of Calif 111E
Applicant
NOTICE TO APPLICA :If,a ter maker his Ccnilicale of Exemption,you should
become subject to the Wo.kci s Com pre iiim.....Accord the IaWr Code,you must
O z forthwith comply with seeh.rnvixinas this pvmail shall he devoted revoked.
OCONSTRUCTION LENDING AGENCY
[--� I hereby affirm mat mere is a Conswetion lending agency for the performance of
ow the work for whish this permit is issued(Sec.3097,Civ.C)
aW Q Lender's Name
n7 z Icndch Address
U O 1 ccnify mat 1 have read this application and scam that the above iarbonation is
Iy Pcore".l agree m comply with all city and county ordinanms and slate laws relating m
O U building cotuw"ion,and hereby authorim representatives of this city to enter upon me _
LLl able-mentinnedpropenyfor i expenses
hichm.
FCL. (We)Agree ,,save,indemnify and keep harmless the Cityof Cuperonaagainst
rq Iia consequence of
cosUaad expcnuxmit. may in any way accrvc against said City J
V,'� in consequence of the granting of Ibis permit. /
r. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NONPOINT Issued by: Dat
SOURCE REGULATIONS.
fs
Re-roofs
Signature of Applicant/Contractor Dae •.
DA],ARDOUS MA]£RIALS DISCLOSURE Type of Roof
Will me applicant or future building ocupent score or handle hammers material
az defined by the Cu(TTAo Municipal Code.Chapmr 9.12,and the Health and Safety
rode. 0Yes 2553zr ri a All roofs shall be inspected prior to any roofing material being installed.
❑Yes
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
coil ic,7 us air Contaminants AS;defined by the Bay Arca Air
istrict]
DQuality Management Inwin lerlals for insQ1--, n
C]Y. o
I N&SANat m_V,,emus mamnaB myuimmen¢under CM1apmrfi 95 of me Wilding
niallcal &S tyC ,Shan, 5,25533 a'n55JA.l umlcrsmnd mvifthc building
does colW�nh.w cams ma is mY respmsiAilicy he nnmy IMtcxcupanl al Nc
myuirem metpri issurrowOfacerificateofOccupancy. SI nalur o A lieant g PP Datc
Ownromgent `Dale J All roof coverings to be Class "B" or better
Building Division '
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
G 0 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 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 of inspection
We understand the above policy on reroofing and will comply with this policy.
HomeownName:
Address:
Reroofing Company Name:
� a
Applicants Signature: u Date: —
Joe Antonucci
(Chief Building Official)
6/25/01