02080119 OF
' CI BUILDING DIVIISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20833 FARGO DR. JIM KRAUSE ROOFING 02080119
OWNER'S NAME: APPLICATION SUB DATE
An EDDIE CHIE HWA YUAN 2310 DIANA AVE 08/21/2002
f§ PHONE: SANITARY NO. CONTROL NO.
(408) 779-0704
O ze0 Z ARCHITEC iENGINEER: a BUILDING PERMIT INFO
m BLDG ELECT PLUMB MECH
LICENSED CONTRACT'OR'S DECLARATION
5 y 1 hemb affirm that I am licensed under fcha ter 9(commencin Job Description
o z_c , provisions n v g REROOF
so
i-st SiN Section 70011)of Division J.f the Business and Mesvons Cade,and my license (� r\p /Jp n
a in ful�_2ARC,1,1.1�CT'S
�C/S� r YWI!I'glL
c < LiccnuLic.k
0 d O DamComn<t dS
to3a, DECLA TION / OCTato-.05 used as Public records (,� 0L I 0 2 2002
remY
aaz O O Licensed Professional
ria OWNER-BUILDERDE CLARATI N UILDI�G
rNil �` 1 hereby affirm that I R-exemptLicense Law Contractor's License for NB
e YFF
t-
Fc S< following reason.(Section 1031.5.Business mad Pmfessiens Code Any city or county 2000
se F D which requires a permit m construct,alter,improve,demolish,or repair any structure
i 3$ Pno to u'sa tt.al q Oac PPlicam for such permnt fl sencd
lwt rte sl frd w!saum io the ymvts ns er the connact« Ltt:<LavfCb.pm,9 3ABbtI�20r a 'M1 . d{y( i Valuation
(<0 8 'th5ecto ]1%11)) fD iowh Softhe B.ein rIPr f.. Code) 7„{/ :4 4� `t II
ordinal he is eeempt therefrom and the loois for the allrgldexempalon Any violation
of not
e than v any hundred
for a pamdl subjects the applicant to civil penal 3 0 5 )412�(M -' Occupancy Type
.of not more than five hundred dollars(SSW). d AQN
❑L as owner ofthe propany,ormyemployeeswith wages astheir macompensation, 307 — INSULA ION
-win do Ne we&:"and,he stmeurt is nor intended or offered tor sate'(sax.'184. 601 - ROOF TEA�egC1I@E Inspections'
Business and Professions Cade:The Comoselin's Liceaue Law does not apply to an +
own«or pmpenr rouse baud:m improves Nne.n,and wn.does such work himself 6 0 2 — ROOF PLYWOOD NAIL
or through his own employees,provided that such improvements art not intended or _.._
._. ..._ .. ._- ..-
cam or sale.If,owner-Wilder
r-Wil r,the building e improvement n sold wanm one yew or 603 --- ROOF—BATTENS - - I -;
completion,for pu pose of
will have the burden of proving that he did not Wild or
improve parpuse. 604 - ROOF IN-PROGRESS
as owner of me progeny am exclusively containing with IicenxJ co^tmewts t, -
construct the project Iger Ito a,Business and Professions Coded mp Comraeto n,
- - License taw does not apply to an owner of property who bailee se improves thereon,
_. apd nalwa treats for aucn.pmJttts,with a-connactortsl licensed pursuant 10 Ne ... _-.._____..___.._.. __-. -_ _._ .___..._.............__.___...._....
Commnors license law..,.
❑lam exempt under Sec: '' ';B&PC for Nis reason
Data
WORKER'S COMPENSATION DECLARATION
I hereby tiirm anon penalty of perjury one of the following declarations:
❑ 1 have and will maintain a Cenificam ef'Consent to ulbmrure for Worker's
..•a; . `Compensation as Provided for by Section 3100 of the Labor Codc, for the
performmace of the work for which this p<,rmit is kwmd.
111 have'and will maintain worker'.Cmicint tion Iniurance,as required by Section
3700 of tl Lotter Cade,for the performance of the work for which this permit,is
issued.My Workers Compensation Insurance carrier and Policy number arc:
.. 'Carter” sI��.✓NOFEs list 'i -_
t . tC6RTIFlCATION OF E%F.hIPTI 1W RKERS, t:. s 14.'1•_ 9 t, a \t I-.,..,'t 6.!,. •.] �:
. . COMPENSATION IN RANCF. _...-.. ._..__._. _ ......._ ............ _...._-...._ .. ....._. _
s 1 (riassecfon'nead not be completed if the permit is furor hundred dollars ` I ( 1 ` \ :
(SI00)or Ices.)
tora
S.
n'. Ic nfy iM1ai in lh pert ren eofth' hrh'ch Ns t - -• .••...• . ••.� - _ _:..
sha11 trot employ any parson in any manner so as to become subject to the Worker,
Compansotion Laws of Cilium,Data
'A '
. pplicant _ ,_. ... .__ ._ . . . ...
dNOTTCEgo APP LTCAorkers Compensation
thisovisio ,o of Exemption:you should ,
become subject y the workers.mor,or tion Previsionsll b he Labor Code.youmust
O O forthwith comply with mch'pmvi.cinns or this permit shall be deemed revoke,,
F'71 1'c1 CONSTRUCTION LENDING AGENCY ,
a-7 ' I hereby affirm Nm,hem is a mode lion lending agency for the perfotmance
n
a"D -Leader's
oName
r which Nis permit is issued ISee3119) CiCI
...... . . ..._ . __.._ ._.. ... .
— — — — —
.J.Z Lehdcr'.a Address,;... .. .. ', ) o-. 1,Y•,
I Ill:
I certify that I have read this application and state that the above attenuation is
V U context.1 and agree 10 comply with all city county ordinances and state laws relating
Q. to Wilding construction,and hereby authorize neweunmtiva of liken,1.enter upon
ry the aWyomenaoncd property for Inspect..pmpnses.
O. -(W), ems. de fy and keep hamlis the City fC 'mono ag.last
01 .14
z Cliabilities.3 judgments,costs ttl genus which may in any y <against said
yy q of Ili g ting f thisperm t
ON-
AP P I UNDERSrA`1DS �D WILL COMPLY W LTH ALL SON P 1pT'
so L GULn Di //&
kfs_ye Date
PP S O
ig t rt fA I cHAZARDOUS MATERIALS DISCLOSURE - Le
1,' Will the appl'cam M town building oc[ is nt sant handl haaard«te matenalRoof-
as u cf db th CHealth
yl pame961 e c Pel Cod Chapter 912 and the nd s f ty
C a,Section
Y 25532(a) r f . i p I eas I .
n
All roofs shall be respected prior.to any roofing material being,installed
rose m it applicant o e ubuilding e m use equipment t devices ntn If a roof is installed without first obtaining an'inspection,'4'agree to remove
,lharard it mm ri x Jefncd by Bay Area Quality Manage m
District,❑Y' _ _ all new materials for inspection. Applicant,understards and will comply with
all non-p C source regulations. ,
ve read the hazardous materials-comments under Chapter 6.95 of the `
California Health&Safety Code.Sections 25505,25533 and 25534.1 understand that
.iryn bail sd es nel<nrrenny Wyeate 1 bar r. yrep .-hiury 1.nuurr he - ' .- .-. . (� r1 -
OeP [ th cquiremrnrc wh ch must W t prio to iso e f a Cenifcmc of p'l 6 A/, Q
v gn ture.of.Applicant ., .
or or itumw^zod agent - ate All roof coverings to be Class "B" of better _
'"`•�' 'OFFICE"
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
4cnnyo Fes: (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
Wand 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.
Homeowners Name: gaff
Address: a �� �ifK G o '&L CU
Reroofing Company Name C
Applicants Signature: '� Date: g a o Z
Joe Antonucci��_ .
(Chief Building Official)
625101