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03040069 CITY OF CUPERTINO t°�� BUILDING DIVISION PERMIT CO..,NTRACTOIi INFO XtMATION `- xzaM } von s?x �:.-4u'wn'iaa^zA�. v�h - Bt2L213(5�6DRpeMESTEAD RD JNSJ ROOFING INC PERMIT No.03040069 OYUu,9HTEN LU/ADVANCED PROPERTI 299 D BASSETT ST PERM rn D5R.A.3`1l 1/2003 NE: 4082796171 SANITARY NO. CONTROL NO. ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH i00 LICENSED CONTRACTOR'S DECLARATION Job Description Mdiu 1 hereby affirm tlot 1 am Ikeuad on r romoso ma of Clap c,9(Comm..1.g with Section.?^0I��1Q11�y�of Div o afd,e Bu' ea ,Ip.P�O f£xdmyliccnxis BNJ �,e in ren ffpaY REROOF j�Z Lkcntt Cluj/" Lk.s 3 DW \ ' I ARCH CSD on sur RATION APR 1 7 2003 1 undS91A�rpy DWPs 11 calif Pamk rtnrds p� �`o ucascd Pm onaT BUIL®TNG OWNER-BUILDERDE ARATION OWNER-BUIUDEBD If I Comby affirm that 1 am clomp,from the Contractor.License Law for do ❑O following meson.(Section 1031.5,Business and Professions Code:Any city or county 5$ which,equines a permit to emumml Chat.W prow,d...IM.or repair any structure _Z1.^ prior In his issuance,also requires the applicant for such permit ro rile a signed sutemenl < that w is licensed pursuant to the provisions of the Contractor's L eerie Law(Chapta 9 Sq.Ft.Floor Area $,Voy�ion $ (commencing with Section 7")of Division 3 of the Business and Professions Cods)or �YJ that he is enempt therefrom and the buts for the alleged exemptiam My violation of yam, Section 7031.5 by any applicant for,permit subjects the applicant m•civil Penalty of 3 A09 A 0M18'r O O Occupancy e net mere dun five hundred dollars(S500). p y -+p l,uawnw of the properly,or my emPloyw with w,gautheir sok compemudon, willdothcwork,endNeawetertlsnaHnkndodoroRertdfw..].(Sce.?ON,Business 305 _ FRAMERequired and Pmfccdom Code:The Conuu,oM1 Umme Law dao not apply m an owner of 3 0 7 - I NS ULAT I OviInspections proany,who builds or improves themen,end who dons such work himself or through his own employees,provided that such Improvements are notinurWrd aortered faa,k.If. 601 — ROOF TEAR OFF however,the Wilding or Improvement Is sold within one year ofcmp]etion,the owner- Wilde, will hew the burden of proving wt w did not wild or improve for purpose of 602 - ROOF PLYWOOD NAIL 01. 603 - ROOF BATTENS ❑1,ru owner of the Property,am Business si and confessions with licensed macurom to Commm LAW does not Apply yoga, any osssudrty whomCade I The Cs fiercest, toU.nd 604 - ROOF IN-PROGRESS Law dos not apply rotor owner of property who wd p or improves theseom era whocontractsLow, for such projector with s canlradoHa)licattd pursuant u the,Contractor's License law. 1 em mcmpt under Sc. .B&P C for thla,euon Ov Dak WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of me following dakradons: I love end will mainuin toCW fiakaf Conscnttoself-imu¢for Workerto Compere utio.,"Provided for by Section 37M of the Labor Code,for m m the perfor .of the wok for which this coni,is Issued. ❑I have and will animal.Wokces Compenudon Insurance u requimd by Section 3100 or the labor Cade,for me Performanceof the work for which this Permit is issued. My Worker and Polign /r zoo' � Cam . � � /' Policy li. ( �1� l e/" CERfIFlGTE OF EXEMPr10N FROM R S' COMPENSATION INSURAN (Thhsctlonnond notwcomplekdifllo Pe� a proton.hundmddallus($]W) or ten) I certify met in the performance or the work for which this Permit is issued,I"I not employ any aeon in any mnener an as to become subject in the Worke,%Compensation Laws of Cdifomia.DOW Applicant NOrICE TO APPLICANT:If,after making this Cenificak of Exemption,you should become subject to the Worker's Compenution provisions of me Latter Coda,you must .JO forthwith comply with such prons visiow this Permit shallw decmW revoked. 'Z•" CONSTRUCTION LENDING AGENCY Pr thereby affirm that then iso construction kndingegcncy to,the perform,..of C Y the work for which this permit Is issued(Sec.309],Civ,C.) Q Lander's Name =z Lenders Address U Q 1 certify mat 1 have rad this app]icadon and sok dot Ne above information u C)t" comm.I agree et comply with y city and county oNinsnas and cute hors r upon m C)V bullaingconseuctiao And hereby sureorirertpreunutivcs of this city tornkr upon the �[�]t\�Q//��// W awve-mentioned property for inspection purposed I (We)egme to save,indemnify and kap harmless the City of Cupenum against \\ rZ incoiuuut,nee rthecosts and expenses which mryin any w.y acme egsinsl uitl City / V z In eomeganee of the granting o is armil rm.f UNDERSTA AND WILL CO Y WITH ALL NO - O Issued by: DaleU SRe-roofs f AppIian on,rumrHAZARDOUS MA LA DISCLOSURE Type of Roof lltheapplic,morfummWlldi a.up,mamrcwhand]chsr us materiel by the Cupertino MupalCode.Chapter9.13,and ate Halm end Safety on 35532(x)? All roofs shall be inspected prior to any roofing material being installed. es oll the applicant rtoneWildingocuo"daseequipment at dcvkcs which If a roof is installed without first obtaining an inspection,I agree to mo e hm"air Conumin u dcrned by the Bey Arta Air Quality Management all new materials for ins ection. ❑Yee No / Ihavx read thelourdorssmakriahrequiremcnu :,,ch pkr .9of the ifar. Wa rah Halth✓E Safety ro,SaUuu 25505 33uu12553x.1 rsurddad the ikidons not cuoeml tenant. i ruIII rainy nndry dor ac tnfrtquiremcnu Ccf SlgnatureofA locant Da All roof coverings to be Class"B" Community Development Department �I Building Division 4 a City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 CITY�F Fax: (408)777-3333 LUPE TIN© 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 l/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 t)hee above stated policy on re-roofing. I Q Homeowner's Name: l� 1�);{� �'Lj lgD04 AC&Z Peur�S Job Site Address: Roofing Company Name: SQQ �I 1h C A plicant's Signature: Owl Date: \il/�WpC.X1 Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO 19 Xi ; , l „tel REROOF fllY tri CUPEI(TINO PERMIT APPLICATION FORM APN # 32 6— o l — 6 I Q Date: C� y —Io— o3 BuildinAd ess: ZZ� 19Y e Sacl ?c( , Owner's Name: Phone #: yv— Slliet^ LtC /idv�w) Qro eS CA 2 `17 - SSI I Contractor: J N S J Roo r e License 739980 Contact: Cupertino Business License #: J1n S-►� ►mss Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up root ❑ Asphalt Shingles R�AsphaltShingles — 40year ! 1z* C3(ft-A R'_Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(SpecitN) ❑ Other(Specify) Number ofe.xisting 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:- 0, Job Description: PZ,h , (e) Srdo fr i1VIS� S01%'&Q t zS lnre ( � Ibfhbl CQn('. Residential ❑ Commercial [ ZO s ,- Fire ne. Yes ❑ Noy❑ Confirmed tannin —e,Pt. if there arsran restrictions: u ost of Project: Type of C st ction: OccupIgo— cy oup eo QtY• .f A tic ble Fee 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 Z/ � 0-1 ?- 7. 70