01090056 CITYDIGnrvEsONc
BUILDING iNPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT N0. '
21103 GARDENA DR. RESPONSIBLE ROOFING INC 01090056
OWNER'S NAMEAPPLICATION SUB DATE
GEPRGE MCGEE 2882 SPRING ST 09/14/2001
i PHONE: SANITARY NO. CONTROL NO.
(650) 969-6151
0 0
ARCHITECT'ENGINEER JILDING PERMIT INFO
u G ELECT PLUMB MECH
h« CJ IJ LJ
LICENSED CONTRACTOR'S DECLARATION
z ul1 herebyaffirm that 1 am licensed under mrisions of Chapter 9(commencing Job Deserip n
!mt-u9 with Seaion70)of Division?of the Business end Profession Code,and my]area. REROOF.
-' is in fol orae and effect
...< Lire Class _ ur.x ? g4g FOAM RF. OVER EXISTING TAR & GRAVEL RF.
Da Q— u m
ARCHITECT'S DECLACOntrJClA O
0 1 undue rand my plans shall he used as public records
T
iar
p Licensed Professional
OWNER-BUILDER DECLARATION
uYl o or m 1 hereby affirm that 1 am exempt from the Contractor'&License Law for the
!' < following mason,(Section 7031.5,Business and Professions Code:Any city orcounty
E p which requires a permit to con truct,alter,improve,demolish,or repair any structure
Ewa` Pr t as chance.also req'eth apPlc tl uch permt m fl gned ata. t "-- -
N t nes t I«baed.pnr f rn Ne pro 'sat rine c ntmrtor L law Ich Pt 9 S ,Ft Floor AT�ea -Valuation
(commencing with Section 700(1 of Division3 of the Buenas dprof s ns Cod). , _.1:5 _{3.x 's{fact+'
of that he rs exempt therefrom and the basis for the vllegefl eabmielon.Any vidauon 1
-of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
nn
Iofnot a;methan r.ehundred dollars($501 AP umber Occupancy Type
❑1,as owner of the property,or my employees with wage,as their sole campenadion, _
will,do the work,and the structure is not intended err offered for sale Sec.7094," --'
Business'and Professions Code:The Contractor's License Law does not apply to an 307 - INSULATIdddlAired Inspections"'• " "^
,
owner of atopen Who builds or improves thereon,and who does such wart himself
or through his own employees,provided that such improvements are not intended or 601 - ROOF TEAR OFF t _
offered terraria.If,how ih Wilding- - improvement sold within one ear of - - ' . ' t "`,
p y 602 - ROOF PLYWOOD NAIL t
completion,the rte builder will have the burden !pro moving of buJd or
improvef purpose of sale) _ __ _ 603 - ROOF BATTENS +
.p L as ounerof the property,am eadui el s.unman n wnh bcensed commctnrs to
g 604 = ROOF IN=PROGRESS
consumer the project(Sm.70W,Business and Professions Co ici The Contractor's
License Law does not apply to an owner of property who builds or improves thereon. "
and who contracts for suchprojects with a contmrmr(s)licensed pursaant.to.the, . .. .__..._..-... 1..._.__.
:
Contrc,tos License Low.
lame.em underSec
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&P O.f.".rthis rcnan
laoe, Data
....... ..... . ....... ............ ...._..
9=09MlslL[SDD
WORKER'S COMPENSATION DECLARATION
Thereby affims under penahy . perjury,one of rhe PoBowing declarations:
/ ❑ 1 have and'will'mulntoin'a Cenircme of Com4m'm self-insure for Workers OCT 1 5
Compensation; os,onsided for by Section 37W of the Labor Code, for the.
perf eofthuwork for ]rich this p cot .s J ,. BUILDING
''11 pp��^^
❑I h e and will m6 n Worker's Canpensai o I a s once,aS required by Section p{J I ®'Itl W
37M of rhe'Labor'Code,for tbe,performane,of the;work:fer which this permit is
ass Y i WCERtI C ATION OF GxEMPI'ION�Rnd Policy number .
y pen ton ln.umnce escort
er�/�
A� RS'
IThn ani6n need nd M e - DM�W RKERsa `
COMPENSATION INSURANCE
I maideted if the permit is forone hundred dollars
15100)a less.) ,
I certyoyanintrson in an=centthe - kfo Ixhchth a tis issued 1,
shall r e gloy_ws person any ma t bccom ublect ta'tha Workers
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C P s u n Lows f C l f .Dam ' ,
mption: .. .. ...._.. _...._... __ . ..._
P NOTICE TO APPLICANT IL after makingthisCnificme fE you;should] is" t •�
becomebt dr retire W rise.Compeneia on p' ions of the Latme Cote,yo st
mu
Q O forth th comply with such Provisions or this parrat shall W domed revoked. -
�. a o t CONSTRUCTION LENDING AGENCY
lih reby'R'im that there 3a nswct nlending gsmac forth peHam aiwa
IW �- of tho workfor which this pdmr I,I..0d(S« 1097 C C)
Lender s l,bare
a'z L der Addess
• I Gen fy.d of I have read this app]cation and state that the above information is
:correct:]agree to comply with all city and county ordinances and state laws relating'
Q.0 Oo building construction:end hereby'amhorize representatives ofthiscity to enterupon
W
LLLUz"' fthe aha yyyyyya������mssssssenti ed progny for inspection Purp .
fy (W)sprat.t ndctn,nify and keephvthe
at
hjdgems costs and swhich
may.i any acme against
cst
h
titregmna,.fths;pmr '
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In NeEkSTANDSANDWILLCOMPLYWITALNON:PINTAPL qUI� ��U CEOULAT NS �n Issued by: Date
S tune fA PIicHAM'rr;U5 hfATERiA i'`{ i� .n... Re-roofs
d -"` LSDISCLOSURE
Will the applicant Or Ondm building ocauparn alone or handle h cars ma¢nal - Type of Roof- -
-
/as defined by the CopicarfirioMuncipa_ICd Chapter 952 and the Health and Safety a
Code Scatted 255321a) s t r yy' is <r_+ 1. r i ) 't .. ,; .t 5r
❑Ye : LAN s' C. 1 :: .�
a All roofs shall be inspected prior-to.any roofing,material,being installed .
crrae;s
the applicart;im future building occupant car equipment or devices which If a roof is installed without first obtaining an inspection;I�agtee'to remove
em t h rd it corm m nt. s defined by the Bay Area An Quvbry Manag corn[,' (
District? -, ,all new materials for inspection. Applicant understands and will comply with _
-s Yes " ❑No, .,h t , •,? all n0 -point S011me regulations.,'.
1 ha reatl.th hazudo s material eq ten nt,u der Ch pmr`6.94 of Ne
California HaI Safety Code.'Sections25505,25533 and 25539..1�undemmrd that'
Fit,It gdes norm tly have atom that its tgyresponsibilityr aonfyine
cup t 8f rhe eq is h¢h mut be m r Print!.a ace of a Cenificate'oC
r
re� /Algnature of Applicant Date ----
q��T aNmmed agent pant, roof coverings to be Class "B"or'better
OFFICE - - .. .._......
nt
Plan Check Division
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax (408) 777-3333
City of
upertino
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance, you must agree to comply with 1994 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.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: Genrge WC-nee
Address: 21 I O3 C-AG f d e nCA nY .
Reroofing Company Name: IZenl;2 nns bI.e KC)C'fn!P 4 IYIC
Applicants Signature:
Joe Antonucci
(Chief Building Official)
LICENSE # 328490 PHONE(650)969.6151
010 fi—llu to ctit
No
The name says it all
2882 SPRING STREET, REDWOOD CITY,CALIFORNIA 94063
Fax:(650)568-5988
September 14, 2001
TO WHOM IT MAY CONCERN:
MARK CHACON IS AUTHORIZE TO ISSUE PERMITS FROM CITY OF CUPERTINO FOR
RESPONSIBLE ROOFING, INC.
SINCERELY,
U/U"7
ALEJANDRA CHAVEZ
RESPONSIBLE ROOFING, INC