The URL can be used to link to this page

03070129 CIT]'OF CUPERTINO ,�'.ti § BUILDING,DIVISION PERMIT CONTRACTOR INkORMATION s BUILDING ADDRESS: PERMIT NO. 03070129 E AM PERMIT ISSUE DATE ONE: SANITARY CONTROL NO. ARCHITECi/FNGINEER: BUILDING PERMIT INFO BLOC ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that 1 am limned under provisions of Chapter 9(commencing Job Description with Section 7MF)of Division 3 of Ne Business and Professions CMB.and my licease is n in full forte and effect, License Class Lie.# REROOF '1n Dam Contractor ARCHITECTS DECLARATION u 1 understand my plans shall be used as public records 30to Licensedprofeatinna, JUL 3 0 2003 I OWNER BUILDER DECLARATION <I 1 hereby afnam that I am exempt from the Contractor's License Law for the BUILDING o following mason.(Section 703 L5,BusinessP and mfeasiom Code:Any city or county K g C� which requires a Permit to construct,alter,impose,demolish,or repair any structure ria poor In its issuance,also rcquios the applicant for such pmmil to file a signed statement no f e that he is licensed Puts uanuotheprovisions ofthe Crot.1W,LicenscLaw(Chapter 9 Sq. Ft.Floor Area Valuation he (commencing with Section 70fq)of Division 3 of the Businmand Profcetions CsNc)sir aaF_ that he is exempt transitions and the basis for the alleged exemption.Any violation of 19.C40009 nn Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of APN Number 0ccu ane—Type not more than five hundred dollars B500). p y yp I,m owner of the property,or my employees with wages as their.sole compensation, will do the work.and the structure is not intended or offcnA fondc(Sm.7044,Business 305 - FRAME and Professions Code:The C,nuactors Limine law dors not apply m an owner of Required Inspections property who builds or improves Hereon,and who doestuch work himself or dtrough his 307 - INSULATION own employees,provided that such improvements arc not intended oroRemd for sale,If, 6O1 — ROOF TEAR OFF however,she menl e building or improseis sold within one year of completion,the owner Wilder will have the burden of proving that he dm not build or improve for purpose or talc.). 6 0 2 — ROOF PLYWOOD NAIL znas owner of the progeny.am exclusively contracting with licensed contractors to 603 — ROOF BATTENS [�i uel the project(Sm 7044,Business and propositions Code:)The Contractor's Li 604 — ROOF IN-PROGRESS cerate law dues not apply to an owner of property who wads or improves thereon.and who contracts for such pmjccu with a contrutogs)licensed pursuant to the Contractor'a License law. ❑``I�cam exenj)Ku dd'er Sec. ,B A,PPCCffor this mason �t 03rd, & til tD L`�� .. Ar7j'-- J. //////��"'''" WORKERS COMPENSATION DECLARIie]ON 1 hereby affirm under penalty of perjury one ofthe following deelarnions: 1 have and will maintain.Cenificam of Conten)to self-insure for Worker'sCompen- sation,as provided for by Seedier 37M of on,labor CMe,for the perfomnanee of the work for which Nis permit is issued. 1 have and will maintain Worker's Compensation Insurance,as required by Section 37M of the labor Code,for the performance,of the work for which this permit is issued. My Worker's Compensation Insurance canner and Policy number am: Cartier: Polity No.: _ CERTIFICATE OF EXEMPTION FROM WORK ERS' COMPENSATION INSURANCE ,it less.)(This section need not M completed if the permit is for one hundred dollars 1$100) 1 sanity that in the performance of the work for which this Permit is issued.I shall not employ any person in any manner sat as It become subject o the WorkersCompensation Laws of California.Date Applicant NOTICE TO APPLICANT:if,after making this Cenificate of Exemption,you should bocome subject m the Worker's Compensation provisions of the Latin,Chair,you must Of9Mwinh comply with such provisions or this Permit&hall M deemed revoked, zh CONSTRUCTION LENDING AGENCY r Thereby affirm than there isacons0oction lending agency for the preformuree of ".� the work for which this permit is issued(Sec.3(07,Civ.C.) 'Stu. Q Lcndu's Name z Lender't Address U Q 1 cenify than T have read this application and shave than that above information is U. t"� correct.I agree to comply with all city and county ordinances and Snare laws relating Ie 0U building construction,and hereby awharim mpomemarive4 or this city to enter upon the abnve'memloned properly for InStimLion purposes. H y (We)egos to Save,indemnify and it. harmless the City of Cupcninp against to Iiabilitiu,judgmenu,cods and expenses which may in any way accoe against said City U z A APPLICANT of UNDERShe TANDS of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NONPDINT Issued by: SOURC EGULATIONS. O ignition,of ApplicaMContractor �te-roofs Dam HAZARDOUS MATERIALS DISCLOSUR Type of Roof Will the applicant or future building becupanl store or handle hvsrdma material as defined by the Cupertino Municipal Code.Chapter 9.11,and the Health and Safety Code,Section 25532b)? ❑ret YIN. All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building emollient use a If a roof is installed without first obtaining an inspection,I agree to remove gequipment or devices which �s p it haundous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. istrict7 ❑secs ll'No I have mad the waallous materials requVremenuunder ChaPme695 of the Califon / /y'��) / n. ria Health k Safety Cods,Sections 25505.25533 and 2!55M,1 understand out if the building V /X / : D�� 1l�' /s I �Do�� Jlca not curtcndy rase a tenant that it ii my ruPomiM1ility m nattily plc meupant of Ne wV//III /�] L.l milems which must W met Prior to issuance of a Certificate of OG, ry �1oac-6�� ' ,J7�� Signature of Applicant Date eroraulhonmd agent - oar 7�V All roof coverings to be Class "B"or better Community Development Department wW Building Division City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 U P^kT I N O Fax: (408) 777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 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 re-roofing 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) Pre-inspection 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 a 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 on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: b u k f Ty C( 0 A-C-A Job Site Address: ('O 6 9 9 k A-C-C 101-8-CC— CUPC271 go C6- !rair, Roofing Company Name: )Z, -jr. lQ_©C>r_(1'!` Cr A plicant'sSignature: Date: O7f('7/2003 \�llo6WpCJq . Greg teel Building Official Revised 1/30/03 Printed on Recycled Paper r CITY OF CUPERTINO b 3z� REROOF CUPEkTiNO PERMIT APPLICATION FORM APN# 2 -��/ ^ O Datoe� Building Addresgo" /0 6 5> ,3 fc i4 L E 0 �-Q ko Ck7i 4-o c di -)J-ID / Owner's Name srC2E �� aGk A,Phone 5)121 J 3/ 2 Contractor: Phone#: License#: PoNALD OtLoc (-70'111.6? -2o S-o 39J4 'JO Contact: Phone#: Cupertino Business License#: Duki c\oAC 409 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles ❑ Wood Shakes Wood Shakes A❑ Wood Shingles ❑ Wood Shingles Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: 4&�N. � A / / Residential "LCommercial d �r �Yv Fire Zone: Yes ❑ No ❑ Confirmed with Planng Dept. if there are -inv restriction - Cost roj ct � Type of Const on Occupancy group: QIY• i A 1' ] Fee ID Fee Description Fee Group BPERMFEE BldgPermit Fees BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING 7BUSLIC Business License BUILDING �fS ZZS • � 17� c 20