02040115 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR''INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10919 FESTIVAL DR WAGNER ROOFING CONTRACTORS INC 02040115
OWNER'S NAME: APPLICATION SUB D TE ,
MACK STEVEN R AND JULIA A 12242 SARATOGA-SUNNYVAL RD04/22/2002
PHONE: (408) 777-8331 SANITARY NO. CONTROL NO.
'
C ARCHITECT/ENGINEER:
o o BUBDB:G PERMIT INFO
o:H BLDG ELECr PLUMB MECH
Z LICENSED CONTRACTOR'S DECLARATION lob Description
C
v I hereby uffem that l am licensed under pr visions of ChrPm,9(mmm ming P
y�S withSealon]0w)ofDiom.3ofthe Busibe dProlbuionsCMa.andmpant. REROOF
ma= is in sen me ands .n
o L u«tit uc. 2 T/O SHAKE, INSTALL NEW 50 YR
e _. Come , II u
3�G gRCHITECT'SDECLA ION A PRESIDENTIAL W/OSB NEW METAL FLASHING
O 5 I andemand DIY plans shall be used a,, r.cv,ds
a o O Lit<nsed Professional
o a -BUILDER DECLARATION
off" I hereby al& that I mm that 1. .Busin from the Cosions C s :License Law for he
e,?a following rens a Perot
(Section]031.5.Business and Professions Cade:Any miry or county
za which rtqui,00pe also re uims the aper,improve,h permdemolish. fie.6,anysorucmre '
a 3'4 "P^m,o its issvana.also rcquim the applicant for suchpcnniuofleaaigne0 mrcmeno�
- olurheecttvn1bSaa,mb,oD0),fisionsa3.f,onrmnnrsLiwnsehw(Chapmr9 - ... S Ft:_.FloorArea— 14t4siation
or that a is s wirh Smrian;]Bp0)pf Division 3 of rbc Busioess acrd Professions Cade) f 1' _ 9, i • ' i ' $7 4lfl V
or th.f be is eiemP,rlreiefrdm and the basis for the allejed<zem..n6 Any violation - '` �• '
-of Smian]031:5 by any applisam for a pe,mir subjcns,he aDplicanno a civil penalty-
7.f 6.1
rnalry-mf6.1 mora thin five hundred dollars ts500). 36Occupancy Type
❑I,as owner of rhe pro,ar,.or an,employees with..,.as their sole compensation,
as ill the work:and the structure-is our inrcnded-or bfrcmd ser:al.g1c.-7134.
'Business-and Professions Code:The Contractor's License Law does nor apply or vn 3 05 - FRAME Required Inspections ,°"' 7 ,_c
owner of property who holds m Improves thereon,and who does such work himself 3 0 7 - INSULATION
_
prop o h his pI)ce: pr o dud that h' p, r es rintended
'fond<a l Irmo me building-orimprovement re ora- thin—ohm year of _.._.._ ..._. __.___ __ _
completion.'he esvner Wilder will have the WrEen of Pmt in,char he did not build or 6O1 - ROOF TEAR OFF st\ �,v '- --,�.: ,�.. .p"—
improve forpurpoaoraele.). 602 - ROOF PLYWOOD NAIL
- — .._.... -.._..w. am ex-cl piasownerofthm prepcny,arrr Bm,irivclYdProfesions etchn)dcamraesoraso 603 - ROOF-BATT ENS..—__._.-_. it 11
construct,he mpjen(Sx.]044.Buziness and Professions Caae:)Thc Comreaor's 604 ROOF IN-PROGRESS';'_ -. '_I^ry :;'It
-- License Law does our apply to an owner of property who builds be improves thereon. - - >.
1C ...nd.who.ceenvc.fm_rchpmjce¢.wish...'crammcold.liccnoW'ressm.toabW_
_ rsliccnst lssw. f., _ , -.
G
" ❑Torr xcmPr under Sce."" �-' ,B'8 P C fonhis rcuon "•t-
u; , . . ,.. . .
Owner' 'rDaie s - -
WORKER'S COMPENSATION DECLARATION
I bemby affirm seam pe,ulry of perjury one stops following aedarsriom:'-
f-�0 1 have and^sid11 ami,rtein'a Ciriifcmc of Conserv io aclf-msum for Worker's
Compcnsasion ter-pravided for-by Section-3]O0-of the Labor Cast; far ,he
perfomunce of the work fm which his pmmi,is forma;
h d -11 Toro W rke, Compo re bra s b'S r
W f theLabm'Coam f ,h Performanceof rh) qg ,W�.Muy�Ir �+ Matto
❑ledI.My W kef o pe son I umr:ce c al y nu be .rt
Is
1 „ T EPolicy NO N FROM.WORKFRS2 I. �•s .t....,. ... ,,.O..
AP
. .; :CO MPEIJ,SATI0 INSURANCE`.
(S f (Th sk i'n needn not complmea if permit is Imo hundred dollars - -'III'^r r .µ-
rrSI00,a I ), , , l3UfC®IiVG� r .
•n(r 1 certify Thai,in the perrom a ae of rho o k f which th s pe 'f a rxsued 1 "" - --^^•------------ .„
shall nes employ:any person to any manner ss m to become xub.1 m Ne Workers ,:I:t(' 1-..r?_ -. - o L:e
Coinpesai U f Califoo .Dam - '
.Appl coni. ' s,°. ."
,NOTICE TO APPLICANT If,after making
.
.. ._
this-Ce.m.f--rt E m.pt.on yo
shouldzbbcoard m rbc Worker'sCompensationpe s of the Code youmm
- • -- - \ r`
aWr
forths, Icomplyntisuch p rs mlhipemo hallbd meed revoied.
A ct.t,0 T (PCONSIRURION
- ' -"----
LENDING AGENCY •' :_..,_ ) <�; '' -
a h for Which rhos e rt is
issued
(Sec.
Son le Eng agency fo rhe performp t ., t
fdI l' kfo Which his permit s 'bed lSec'309] I] C) "-'
IY:a tenders Name v__... _
�.Z Ldid [Add _..._.__.... - ._._. _..._.
UQ
I scarify oho I have d this application and state rho the above information is
tr..E,rcor,eco I egrtt m calla
oh 0 c,y arrd my archness,nand o to I ws 1 ting
�,.V wWildingco tined pr nap rtbyamhon ,res sr"es ofN scryr enterupon
y 0. the abs a me r ed property nd r inspection p rposes r ,
0. Wg aro save and mmfy and keep patrol ss Ne C ry of Cullen o'.gmnn
h liabilities,3 dgmc ors e pontes h m y in y way crus gained said
V
V'sem Chi consequence of the Inseam,ermat penny - -
APPLICAN'rUNDERSTAN•DSA\DlA CO\1FLYx(1}f ALL\O\ TTr h
- s uRDE 'L- Ns -- b Issued by: Date
m ppl canVC.ands r _ ReroofsHAZARDOUS MA AIS DISCLOSURE
Will rhe eppikim,m furore g.upSnl stoic m hmrdle haraiaous ar al
as defined by the C penin Mu pal coat Chopin 9 11-and Ne HIre a lately
'Type of Roof
Cade yesion2;,%,. 1 / Nn. l rf 1-) I .'1-.-
w. _All.roofs.shall be inspected poor to.any roofing material being installed._ _
.1„Wdlare ppplicenro c cud budding mcup trim ryuip ,are ,«t which If a roof is iiisialled without first obtaining aurins ection;'I agree,to iemove
e0mir har.fd us ser con,ammanrs as def W b5 the Bay Arta A Quill ry MWnigehe r g p
s6,m inspection.all new materials forms ecuon Applicant understands and will comply with
Ne all non point source regulations.,. ,r,
mad the harardout m oriels req mento unecr Chaper 6 95"of Ne -
Califom H ITh&5 fety Code Secr as 25505 25533 and 25534A understand art,
ifthebuildingdoea of rlyh ve- tenon,that t sin -
y,cspo btl,y rotrosifY,he
a parr of rhe req m nu hich'.ust be at p o re swance f W C nofcW of
Or an - „
... _,'''_' Signa e,of Applicant --
este
a rnaaaed agem t <r, All rot coverings to be Class "B"or better -