01120013 CITY OF CUPERTINO
- -, -BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10225 IMPERIAL AVE ALLIANCE ROOFING 01120013
0 g
APPLICATION SVS DATE
*MW`TiARTLEY (HARTCO) 1250 CAMPBELL AVE 12/04/2001
.PHONE: (408) 261-2595 SANITARY NO. CONTROL NO.
O O ARC HITELT/ENGINEER: BUILDING PERMIT INFO
. BLDG ELECT PLUMB MF.CH
'60 I-1 U t—'t LJ
LICENSED CONTRACTOR'S DECLARATION
e 5�= Job Description
z»0 rood 7 smile mat 1 am Eeenaea ander pro„signs ar chapter 9 aan,mmeing REROOF .
torso with Section II)t10)af Division3of Ne Business and Prot mCadc. d license
ryy5 is in fall force RZ BUILT UP ROOF.
s a License Class `- •� Lic,p
a O N Dae S DEC ler
ARCHITECT'S DECLARA
� I understand my plans shall be used us public records
SE>
ii p p Licensed Professional
o� OWNER-exempt R m the CoATION
=' I herchy.(Sero thin I arm exempt from the Cdoores o License Law for the
I Z a following reason.(Section 7(131.5.Business and Professions Cade:Any city or county
Z F G wNah ouquires,n pemut t t t aper,beforeapplicant
for such
dental h r e a sig any swment
-poor tot issuance, rcqu rt thevi'mrs o for Con racto n fl a signed statement- - - -- - - - - - - --- - -
ththe .l'ttnseJjmnunnbNepavisionsofineCommmm x LicamalawlChepter9. ,,, '. 'u 5'q,FI.'FIOOrArea: l s ) Valuation
Prmamm&vvuhSeuo 810(1of Div..1..3 of the Businessand Profession,Code) `td,s =z 'k. Ti's e
or Ila,he is ckimpi tBcmfrom and the basis for she alleged exemption.Any violation,
-of Section 7031.5 by any applicant for a pximm,subjects the applies..ta e civil prna s
or not mart than five handmd dollars 15500) APN Number Occupancy Type
❑I,as owner of the property,ar my employees with wages ns their sole compensation. 305 FRAME
wlll'do the work.-and-the structure is nor intended or afiered for sale(Sao:]tug. 307 — INSULAE Idd�Illred IDSpCC[IODSI '`"t
Batumi,and Professions Code:The Conm
mraor's License Law does not.,ply an
er
awn of pmpeny Who hiltls mimprovn thereon.and who docs such work himself 601 - _ROOF TEAR OFF
or Ihrongh his awn employees.ptnvitled tom such improvements ere nm intender or
compllemer,sthe.le howuvcr,the l hasboldingemeow is what within one r ...._..... ' ...-602 '.-- ROOF -PLYWOOD'NAIL- ....-
or improv year o
eomplee(anfmaaweerf.k.er will have me harden of proving that rte did oat agate ar 603 — ROOF BATTENS
improve puryoua
..._.._._._.. . __...
con as weer of the prorcny,, xclusively conducting with licensed,au Cmactun to - - .... .. .. t
License
n the does
n(Sec.]tui,Business and Professions Code)The improves
tmcmr's ,
-' License Liv don not apply to an owner With
property who builds ex 1.pmvcs t.to the ”
%: .end who contracts(orsuch projass with a consmnor(s)licensed.puauam.to the .......... ... ..........._-
C ec License Low. .
❑I am aro exempt under Sec &PCfor this reason ' i >�.•:' i'I"''�"•1
Owne, Date FI Nq L E L1
WORKER'S COMPENSATION DECLARATION
' I herchy nffem under penahy of perjury one of he following dedamtions:
❑ 1 have and will maintain a Certificate of Consent to ulf.insum for Worker's JAN 0 7 2002
Compensation, as provided for by Section 37M of the Labor Code, for the
raformation.fthe work for which this permit is issued., .
❑I have and will maintain Worker's Compensation Imumnce,ai required by Section BUILDING
3](111 of in rdYouf theradar .of the xmk( h'ch this Pamir a
- d.My cr . ton Inwrance camcr end P I' n mbar arc:
.. t.• .`/
Corner :PohcY No � .l %•2 'Lo - _. :,..., - ....` -.._ ,_ _,-......... .
a..�s Y sl fir
t ER CATION OF EXEMPTION FRDM WORKERS?, t s It?-r N�•,,,I I. 5I ! iSs`�
COMPENSATION INSURANCE',,,,
' (Th s seciion-iced not be complied i(the Permit is for one hunercd dollars
(Simh orkIx.)
_ _.t in e performance in an meaner a or m become sub t to the Workers -., .• . — -- ._ ,....- ._ _.... __.
1 certify shat in the nI.ayre of the work for which subject
to t e iauee;l
',hill am employ any rc Y jec
Compcnsedon Laws of Cnlifnmie.Dam-
NOTICETOAPotheWorleers If,Comper ensating on
prow
of Labor Exemption,you you muld
st
z fecome whammy the Waders Common t p ¢ions of the Labor Codeyou must
z O
forthwith riamply with su h....isionx h or Is Permit shall 4 dee neat rtvoke,
.F > ' CONSTRUCTION LEND
ING AGENCY
I hereby M.That N ie on euctton IoMg rig icy(or the perforritence
W z of she ark fo'which th s perm t s lsued IS' .3119]Civ.C) L,.r.....
'.y.Q L2 ders Ndmc ..___ -.. .._ _ ._._.-.... ...... ...._...
� ZLeaecr's Address,•. _ - .
C.1 0 I a oify that I have read this apphicetion and state that the arouse information is -
'tz'. cbr'rcc�.1 agree to comply with all city and county ordinances and stale laws rebating
,.0 m building constriction.and hereby ambtirim mptesentmives of this city to enter upon
"r'W the above-mentioned property for inspection puWous.
��.a.tL IWe)agrcatn save.itrde eiperne.1whihemyin me City ofropeninoeg said
L.r fn liabilities,judgments,Goss and e,ird'u,whic-may in any way eccros egains said
It in conte uenci th mg of thin permit.', ','
APP T NT -L AND AND WILL COMPLYWITHALL NON'PO`INT Issued by: Date
'OIR t h NS ,
Sigit rep Apphcanticont cto - - Data _ Re-roofs
HAZARDOUS MATERIALS DISCLOSURE 7 �/-
Will me insomniac o f m W ld'ng ex ip t tom forhandle haierdWs mammal Type.of Roof .. -/r` '- / - O-
•az tl food by the C.,din.Municipal Code Clexpoar 9.1Z and she Health end Safety !v I
de.
CoSeadrift 255321.) ❑No.' r fits. u rS -4Ii , . .t\ ./a. .t". ... t
� All roofs shall be inspected prior to-any roofing.material;being.installed------
Wdl the applicant orf Lurebuibingoccupa s use aq p t o da'vioe,'which If a roof is installed without first obtaining an inspectional-agree t6-remove
emu harartl x air co t ena as defined by do,Bay Arra All Quality Management
D , at all new materials for inspection. Applicant understands and will comply.with
117Yes t.. 13 No
1 .. .-.. .. _
all non-point son e raga bons.
r
e reed Ne hesnrdous xxrbsmis requ re 533.m1255 4.1 to 6.95 d the
ocI 1 of uses
Safety eami bases
to 25505 25533 and"rima 1 undersmM Nat _
Calf aH
fifth bu hof don ctentl haveamnemth pri or my.rtspo 'be iymnotifyifirm the ""-
u ey re , r u r roan be met prior to s suance of a Ccnineme of 0
ir a _ Signature of Applicant Date—
—Dwour nerflamradgain t . Darte
All roof coverings to be Class "B"or better
' "OFFICE-
Building Division
.10300 Torre Avenue
L' Cupertino,CA 95014-3255
�- Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEI�TINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance,you must agree to comply with 1997 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.
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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: (R�
Address: ( f�9 o�L f3 jrvi0s2J 4(- Q v-2
Reroofing Company Name: AAA re+Ue� iZac)zz �.
Applicants Signature: l C �h j2c,—' Date: l Y '0
Joe Antonucci
(Chief Building Official)
6/25/01