00070139 NO
CITV
DIGDVSIOIISIN PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: ` PERMIT NO.
OWNER'S NAM': - APPLICATION:UB FAIL
1501 S FOOTHILL BLVD MORAZAN ROOFING INC 0X070139
MOND SANITARY NO. CONTROL NO.
GREENWOOD, KEN 740 SHAWNEE LN, 07/24/2000
O O ARCHITECUENGINEER: - BUILDING PERMIT INFO
(408) 224-57H5 uL.uc eld:cr PLUMB snots
u o u u
�aN
Z S N z LICENSED CONTRACTOR'S DECLARATION Job Description
O Z_ 1 hereby.R.m that I am licensed nndct provisions of Chapter 9(commencing 1)
F t�C with Section 7noin of Par
3arthe llusinese'and Pndessin is Code,mulivy loam,.. _
s y is in full force and affect.
s s a License Class Lis.P '
O O Dwv Cnnmmmr
vj 3 u ARCHI,FLT'S DECLARATION -
t" °" aemtana my plan, M n m as panne co as RE ROOF
ip O Licensed fessinnal - '
o ON'N'GN-BUILDER DECLARATI
1 acres,.(Se"thin 11.exempt&sin the Donnas Cis License Lnw co the /
t? followingreason.peraut I construct,
Businessamt improve,
demolish,
Any city o.ruture
�F C which requires a pemtif io cun.amet,alter,improve,danolish.or repair any,waver.. ,
hotbe ,licensed ptu:noratto hxthcrytpllcmn find Commoner License
Law,(swrter9 -
- mwheisnrenwonSetion7dacproDsinsi of of the femmes andPrlassor,Cte.9 Sq. Ft. Floor Area aluation
Icnmm lie is exempt
Section incision'"I'of Division 3 of the Business and ion.Any vi lrti ) O -
of that ho is exempt anyap and the aper,fir the cls the
excitation.Any l Penalty
of Section a than v any hundred
doll fir o permit subjects the applicant m v civil ` APN Number Oc pant Tyype
°Lsowmeronhepcopcry.o.myemplmov.with wage.vamommecompensation, 512 00
will do the work,and the m acwm is not intended or olremd for sale ISce.76A.
It.mass and Profession.Code:The C.mtrawor.License Law does fen apply m on R quired Inspections
owner of proper,Who build,or improves mereon,and who does such work himself' 34246003. 0
of mrough his own employees.provided that such nnpowements are not intended or
offered for sale If,however.tho wading or bnptov„nent is sold within one year oI
completion,the owner"holder will have the humen of proving that he did not build or 305 — FRAME
improve fir r of pugxwe sole.).
El 1,as ow net of the Property,amexclusoelycontracting with licensed conhactumm 307 — INSULATION
onnmmcf the projem(Sec.711,14,Business•and Profession,Code I The Contract,.,',
License Low does not apply man Dodo of property no build,or mtptnvcs thereon, 601 — ROOF TEAR OFF
Oo who,u contracts erLaW.cn nemesis with a contractors)Ii«ism pursuant to me 602 — ROOF PLYWOOD NAIL
I I me.cmpt under sea. ,B et P C nor this reasoo '603 — ROOF BATTENS - -
OWpe
WORKER'S COMITNSA'1'ION DECLARA'I'[ON 604 — ROOF IN—PROGRESS -
I hereby affirm under penalty of perjury cone of the following declarations:
01have and will maintain a Certificate of Consent to self insure for Worker's
opwwoann, rte provided For by SectlnI 371X1 or the Labor Code, for the -
performawe of the work for which this permit is issued.
C 1 have and will maintain Worker's Cnmpnmwion Insurance,vs....word by Section - -
37110 of the laver Cmc,for the perfnmmncc of the work for which this Permit is
ued.hyS N'or p/e�nvti"n lneumncpgtner and Polis W-7
tZ�
CERTIPICA ]ON OF COMPENSATION
ION FROMINSURANCE WORKERS' -
COMPIiNSATION INSUIIANCIi
(This section need not w completed if the Pont is for one hundred dollars
S l fMl)or less)
I certify that in the performance or the work for which this permit is issued,I -
shell not employ any Pawn In any inn nne t.so us I,,
beams..subject in the Www,,' '
Compensation Laws of California.Date
Applicant
NOTICE to APPLICANT:If,after staking this Certificate ill Exemption,you should
Z beewrombject In the Wmkcr',Compensation....Won,of the Luba Code....dun
ZC Ilnthwith comply with .an provisions who,permit shall be deemed revoked. .
F W) CONSTRUCTION LENDING AGENCY
L hereby nffime that there k a co.incom ion lending agency far the performance
W the work fns which mos permit is ia,ued(Sec.307,Civ.C.) '
C ❑ Lender's Name -
.7 Z Lender's Address
1 certify that 1 have read this application and state that the awse information is
Fy "weer.I.,me to comply wish ill city una county ordinances and state laws relating
Q C.7 fir building construction,and hereby calamine representatives of this city to enter upon '
y ty the wwwomcnfion ill property for inspection purposes.
[r d
(We)now"to love,mctnni fy and keep hunnlcas he City of Cup,,inn ngunw,
Z City in co judgments,case and expenses which may in any way accrue again,.saidcc
C„) Z City in consequence,cost granting and
expenses
this Permit. / !/��
APPLICANT UN STANDSANOWI COMPLYWITHALLNON-POINT Issued by: Date
SOURCE RPA(1 I��s � G �
Signnmra of Applin mcommnor Dmm Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
wnmceppucantorrmumwilding wetipant store or handle harodws material Type of Roof
is defined by tho Cupertino Municipal coda Chapler9,lZ una the Health and S.Iely .
Code,Section 25532(.)!
❑Yes °"" All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building rccupont use Nuipment or devices which If a roof is installed without first obtainingan ins ection, I agree to remove
emit haaardous air contaminants as defined by the Bay Area Air Quality Management p agree
Dismicl7 all new mater' Is for inspection. Applicant understands and will comply with
°Ye °Nn all non- ' Is rce re ulations.
1 have read the huzardw,nmteditis m,mccuttuo under Cl 1 695 of the
C mo buia health&Safety Code.Sections 25505.4533 and 25531 L understand that
tftheanildin doesmmotrb whihnoronbe mat it is 1. m.,aiof iry Certificate
,..Pa
u t Rquiroments which nmst he mat Pri�or m issuun<c of o CcnlGetne of
— Signa ur of Applicant Date
Owner autnorinedi, Date All roof coverings to be Class "B" or better
OFFICE