02030156 CUPERTI
• CITBBUILDF G DIIVISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
950 FERNGROVE DR ABLE ROOFING INC. 02030156
OWNER'S NAME: - APPLICATION SUB DATE
RAFFAELE SENA 1420—B CONCORD AVE 03/26/2002
PHONE: (925) 689-8558 SANITARY NO. CONTROL NO.
O C ARCHITEC rENGINEER: BUILDING PERMIT INTO
ke BLDG ELECT PLUMB MECH
r -t LJ L= L=1
S v=y LICENSED CONTRACTOR'S DECLARATION Job Description
i Z-E I hereby aff un that 1 am licensed under provisions of Chapter 9(commencing o
(_co with Section license REROOF.
yl= ismmnrarte,na�alreT9 uca (e zT T/O TAR & GRAVEL, ADD POLYURETHANE FOAM &
It
aac si License la s
'aw Dale �e� ,Can.one,ar ACRYLIC COATING.
to ARCHn'ECI"S DECLARA ION
O I understand my plans shall b<used as public wcoms
1 act p O
, Licensed Professional
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor s License Law for the
C?< following reason.(Section 7031.5,Business and Professions Code:Any city or county
ISO which requires a Permit to construct,alter,improve,demolish,or rtpav any structureIwj3 .pnw ra,its resonance.also"trims be applicant fh pemm to file a signed
that he isl sed withSsionoNepm n fNC Barin%wensclew(Chapter 9onsCoe) Sq.-FtIs Floor-Area- , i,
(commencing:resat ]drk])of Division 3 nhee naapnePraressmnacode) L:',A`� f•)ti.ij, e ;.'ka a..t; s;,,' x�_Y^r,;. . $12 �a[ion
or that be is exempt therefrom u td the basis for the allagcd dempled Any violation
of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
ornatname tha"five hundred dollars(s5oo)., 375AT� 1 160 "T',.! Occupancy Type
❑has owner of the limped,,or my employees with wages ae,heir role compensation. 1
will do'the work,`and'the structure'is not intended or offered for sale'(See.]044,'
'Bunineds'and Professions Code:The Commetnrs License Law does not apply man 305 - FRAME Required Inspections"' a'
caner of property Who builds or improves thereon,and who does such work himself
.4 thm for.)own empmyees.provided that such imp ro t in sol are not ime,Wed or 307 - INSULATION
coned for role If.however,rhe buuvret or urden o<ment ri mrd Nim one Year of- - -- -' --- "---.. .. . ----- -
completion,ret owner harmer will have me hareem arpro.,ngthat o ata mol build or ROOF TEAR OFF_ __ _____
imp r..a for parpasaaraale.). 602 — ROOF PLYWOOD NAIL
v t7l,isownero(Ne pmperty,am Business it Profein n,Candenscdcommme....s -....__... ._._
,. r g 603 — ROOF "BATTENS _._._._....-------_,--_._.—._.
License
the project(Sec.]1334,Business and property
who to Code)The Contractor's r ""
imenah amtrocaw amot -stich ejects orpmanywbawucensedd,tor pro...I the 604 — ROOF IN—PROGRESS"
and who s Lica a(oLsoch Projects with.a.coniwemgs)licensed pursmm lo.me. _...._.......__......_....... .. .... __. _...
• % Comrtcmr's License Law. .. .._..__...._._.___.1..---.-------------- _.__....._...... -
❑Iamexempt underSer, ",B'&P C for this wawn I,,1,� �Qko c ---_ ........_. ...
'WORKER'S COMPENSATION DECLARATION
Ihereby affirm under penalty of perjury one of the following dcclnretlons:- MAR 2 9 2002
❑ 1 have and will maintim ,Certificate,of Contin,to self-insure for Worker's
A Compensation, as provided for by Section 3700 of the Labor Code, for the BUILDING
performancew
of the work for hich this permit h issued.A7 have'"it will maintain Worker's Compensmion insurenc<,es required by, mi
Section
] of the Labor Code;for the performance of the work for which,Ids pert is
ssucd MY W&-"core aauon I-.a. - and Policy be aw
Cam' ,`,'Policy No
ERTIFICATIONOFEKEMPTIONFROMWORKHRCCM1' � )..'.:.'< dy.,.S,4 Y1 {h 1f�+S.t h.12h;� S., 'eF °',t1: •a ...'' .
'P" COMPENSATION INSURANCE'°"'" r '
'rflu - cimv need iudbe completed iflhe pe i,is for one hundred dollars "•3 ):•_r' T-s i�c' -- — ---
(5100)or IcssJ --
(
. ...1 .. .. _ _. ....:.- _.__ ...:..
s 1 cempl that b Person
performanceanyhnf,h M1 f which Ili permit -
` .sued ) ..,._. ....... .. ... ... . ...
shall no,employ any person n,. mariner so es m become subrcci to the Workers -
CompenamionhawsofCalifomi. __
..APWiunt"' '.. .. .... .. .
'NOTICE TO APP LIC ANTIf ft making this Caff roof Exe pi nyoqu must
ticcome subject to the Workers Colons or thin provisions of the erred Code,you mus,
'� � forthwith comply with such provisions or this permit shall be deemed rtvoktd.
1•,1,H "!i CONSTRUCTION LENDING AGENCY -- - - -- " - -" -- ' '
I hamabY WTrm that Benfis a 6irstruction lending agency for the_perfcbha ce' t•
of ih< okf "hich th p I,.'ssued(S "'309] C'v.C) ? r
Inde s N me .. u.. ._. -.. .
Lendars,Address...
vti I«grey that 1 have with all city
and
and stain that theinaws mioo is '
0L� U c builds agree ro comply with all city and county ordinances l h stem laws relating
.U to Ueab above
entionedpropnhy for
aumoomaprescmatives ofthia citymcn¢r upon
�,,, [T. Ne eba e e) i onto property r penton puhar
L 0.' es.judgments.ge tom ride mpensesfy and p h y ss the Cny or ecce,I o s S ad
L. V1 li try t unace costs M expenses which may n any way accrue eg'nxt said
V_Z Airy o s` rice R the gra a ge Nis
SOURCE REUNDERSTSN,: 'IL CL CL OI\ YWITH ALL YOP:PO] 1
' sovacEREculanoNs r' �-'� 3� Issued by: Date
Srgmamwof APPlaam/Comncmr '� .:"' :;"":''+' -` ",Data?" Re-roofs
HAZARDOUS MATERIALS DISCLOSURE t;�,,
',,;!` W Il enc applicam or f tort bum g a p I store di handle I"s no-nd -Type of.Roof_.
as defndbylh Cupenn M 'pal,Coca,Chirpier 9.12, ad he Health dSafry "'"' +• - - --
Code Scat 255J O - _ +r, T', , .. .._. .... .
r O Y - �/ I i t'jlti An { w • }I . I'Cita t T L': (.
All roofs shall be inspected prior tgany roofing_matenal being Installed. _
can me at,amma f t bu long occupant yAea Ai I devices.na'anuwhich If a roof is Installed'�without first obtaining an'inspectiont I'agree:to'remove
corn d .'a
comam t: sdtfned by ha ByA Area Air Qal'iyev m
°tad„ . all new materials for inspection Applicant understands and will comply with _
' OYet f all non-pointsouice regu]ahons
,
/ 1 hive d he.hicsrd s renal qts ntsnder Chapt 695 of Na
California Health&Safety Code'Sections 25505 25533 and 25534 I understand th t
ifthomilding does not currently have a tenant,that itmy,responsibilityt dtifythe
'otcup t f N regm r -h It m i be t p t uuanc f a n'ficate of
Occup°
��.� . Signature of Applicant Date 3
^ OZ
own N9 d,'gp' rgat ,1,n, All roof coverings to be Class "B"'or better
- - i.- OFFICE
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
f Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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) Preinspectioh 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/n"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:
Address:
Reroofing Company Name: 77
Applicants Signature: Date: 3 6 Q Z
Joe Antonucci
(Chief Building Official)
6/25/01