Loading...
03050080 CITY OF CUPERTINO �`�""^ * °""""��''` ' BUILDING DIVISION PERMIT -O RUT RANEPMa�WON: BUILDING AGGRESS: TEO a S ROOFING PERMIT 50.03050080 OWNER'S NAME: 691 W SAN CARLOS -p�"J$19/2003 EN SAKIMA NE: (408) 279-8797 SANITARY NO. CONTROL NO. ARCHITECf/ENGINEER: BUILDINO PERMIT INFO BLDO ELECT L� O PLUMB MECH D 0 o ij LICENSED CONTRACTOR'S DECLARATION ly 1 thereby aRtrm met I am literucd under Provisions of Chapter 9(commencing Job Description with Section )of Division 3 close Bu'n and Profeamona Code,and my license It FIN a LCD mmnmleean e y_ io5 REROOF ,1 G S Inallf rte 3 LtYx ° D Co. `X MAY 2 2 ARCHITECTS )ia. RA °N 2003 I understand mY pans shall he usrd u public meards jo Licensed Profcuional OWNER-BUILDER DECLARATION BUILDING 1 homily.form that 1 em exempt from the Camomile's License law for the 0 o following moon,(Sudan 703 1.5,Business and Prorcuinn Code:Any city at county $ which requires a Permit to construct,aher.Improve,demolish,or repair any stmclum FSS^ pduNita issuena.atsu requirta the appiinnl foranch permit 7o fie a signed ststemenl < that he la licensed pursuant In the provision of the ComracmeWano Law(Chapter 9 Sq.Ft,Floor Area $-y2l"ion $ (commencing with Section 7M)or Division 3 of the Buincsaml Profestlnna Code)or .. Nal he is exempt therefrom and de but,for ds,alleged exemption.Any violation of Section 7031.5 by."applicant fora Permit aubjecu the applicant to a civil penalty of 3A&M Mi0er00 Occupancy Type not more than five handled doll.(5300). ❑I,ssowoerof the property,or my employcta with wguulhir axle cvmpeametion. and Promotion, r thewo*ana thetwduleltnmmteicense aw does Out apply,nono owner --FRAME Re aired Inspections and property who Code:The vesmeConaraton.res and who law don let apply lf rt owner of 307 - INSULATION p property who bu I Ids or int proves Nelem,and who does ouch work hi mself or through his awn employees,provided thauuch Improvements am not intended motioned for sale.If. 601 — ROOF TEAR OFF however.the building or improvement Is=to within am you of compledon,the owner. builder will have the burden of proving that he did met build at improve for purpose of 602 - ROOF PLYWOOD NAIL `°1e')' 603 - ROOF BATTENS 0 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.70ed,Business and Profusion Code:)The OMMICmr's U- 604 — ROOF IN—PROGRESS ane law does not apply in an owner of property who bull&or Imprews mleon,and who contracts for such projects with a conlracmrt0 licensed pursuant to the Contncules Liana law. O l am exempt under Sec ,B&P C for this reason 137100 ner Dam WORKER'S COMPENSATION DECLARATION I hereby aRlrm under penally of Perjury ate of the following deelamtm ov I bow and will maintain.Collimate ofConannt m self-inure for Worksb Comfort- .must, ompete io°,u provided fu by Section 37W of the Labor Code,for me performance of the rk for which this permit Is Issued. I haw and will maintain Worker's Compensation Insurance.u required by Section of the Labor Cade,fm lie performance of the wah for which this permit is Issued, Wallace,Compensation Insurance ypier and Policy number art: ntic`�Tftil�. FwLn.Q, Palrt .:7 - G�i033 CERTIFICATE OF EKEMPn MWORKERS' COMPENSATION INSURANCE (This secllmrcrA not be completed ifflat Permit isforone hummuldollaran](a)) of Ieaa) I certify that In the performance of the wark for which this permit Is issued,I shall not employ any penin In any matter an u to become subject to the WorkeW Cornmas.tlon Laws of C.lif..I..Dam Applicant NOTICE TO APPLICANT:IL after making this Ceeifaeam of U,mption,you should become mhjecl at the Woher's Compensation prevision of the labor Code,you most .JZ foMwith comply with such provisions or this permil&hall be decreed revoked. OCONSTRUCTION LENDING AGENCY L.t IM1emhy allirm that Neo its eaautmctlnn lendingagency,far the Performance of 6i r7 the work for which Nis permit is Issued(Sm.3097,Civ.C.) WMr-�Q Lender's Name ✓ y Lendaea AddressC)FQr . I unify that 1 have mad this application and sum that the above information is IF cortetl.I agree to comply with all city and county on inaruzs and tum laws mining m Q building convection,and hereby authomm mincmnutives of this city to cater upon the ` W about-mentioned Property for InflaIndemnify and keep ha / (r^y IA (We)agree to saw. Ind expen and kith may In m me CITY o C lsoloino againold City IA liabilities.judgments,ethegrowing ro in ofthisseswhtCM1maylnanywayaaNeagalntUOidClly f 3 V 7 A PLIC NT or me grantingof this Permit. F7 APPLIC NT UNDE TANGS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURC EGUL NS. Re-roofs SiIIcu of Appl antremlor Dam RDOUS MATERIALS DISCLOSUR Type of Roof Will the app amt Or future building occupant mom or handle hasudou material as danced by the Cuperlim Municipal Code.Chapter 9,12,and the Heald and Safety IDisnict? ce.Section 2553:(.)7 I, All roofs shall be inspected prior to any roofing material being installed. DYta LyNo Will the applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove It haurdous air commarmanta u krincd by the Bay Area Air Quality Management all new materials for inspection. No 0 Yea % I have mad the hasaknu,7ss mamrialtmquimmenu undcrCM1amr6.95of Ne Ca ifaa Hedm&S IyCo00,5ection 25305,25533 and 25534.1 understand thaH(thc building `ta amt cu sly by tenant,mu Itis my rtsponiMlity m notify t aecupant of me man 0 hich bcmetpdortnPssuanaofsCeNfita of )' % a S lure ofApplican —' Date L -� r unm mf ted*01 Dem All roof coverings to be Class"B"or better n Community Development Department Building Division (f� City of Cupertino �! 10300 Torre Avenue CITY OF Telephone: (408)777-3228 U^���I�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: Lc—�AV" �C', G� Job Site Address: -7 ro b'S h40 I ICA N dy v'r V Roofing Company Name: TD�eti Uro n J!UF)c A plicant's Signature: JCcl "O_k-Ce. Date: Greg eel Building Official Revised 1/30/03 Printed an Recycled Paper t CITY OF CUPERTINO REROOF .S^ o o � CUPEkTINO PERMIT APPLICATION FORM APN# '��/ . O Date: Build i_- Address: r�603 �l Owner's Name: Phone#: /f: S <, M CL Contractor: Phone#: License#: / �C�0S tK. �y08 �V$�OS� 6 8100 Contact: Phone#: Cupertino Business License#: S Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles �n(� L3Other(Specify) C3Other(Specify) I �'St��M?t k/ 714 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: / I've. kc TaIl 3oLt, lreQ -P'esrrbet[?lc{ 17 Residential �_ Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project: ype of Construct Occupancy group: 111,2, JO.ot7c- roo{• / Qty. if AppliFee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING X137• � °