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03060170CITY OF CUPERTINO'" `'"`mlaam Ofonhwithcomply 0 z Q F V W *+€. _� '` " •= BUILDING DIVISION PERMIT ,CONTRACTOR INFORMATI,0N BUILDING ADDRESS: PERMIT NO03060170 30601%0 1-1 W NER'SNAME: PERMIT ISSUE DATE ONE: SANITARY NO. CONTROL NO, ARCHITECT'/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION I hereby that 1 of Chapter 9 (commencing Job Description �''�^ p affirm am fth. r under provisions w with Section )IXXq of Division NC Busincxs and P fcssionxCMc. and mylicense i "` %� �t� Z—� J License Clash' ST Lie N REROOF JUL O ZOOS p Dare canDECL CONTRACTOR: GUANANTEED ROOFING ARCHITECTS DECLARATION /' U Aa 6 andcrundmyplanaMalllxa,cd.,paM1hcrecnrda V nST BUILDING a u Lmanmd Pmfcssinnal 117, 3 OWNER -BUILDER DECLARATION Y 1 hereby affirm Nal 1 am exempt from the Contractors License Law for the O following ninon. (Section 7031.5, Business and Pmfeasions Code: Any city or county ' which minutes a report at construct, alcor. improve, demolish, or repair any suu[mm i prior its issuance. also requires the applicant forsuch Permit to file a signcdsummenl cmatbeislicensed pursuant tothe prevtamnsoftheContractors License law(Chapter 9 Sq. Ft. Floor Area Valuat"000 $ (commencing with Section 700o) of Division 3 of the Business and Professions Code)or — Nat he is a.cmpt thcmfmm and the basis for me alleged cremnin m. Any vitiation of Section 7031.5 by any applicant for a permit subjects the appl¢anuo a civil penalty of 3B�BI3xD39i1leS00 Occupancy Type not ream than five hundred dollars ($500). I, ot owner of the ny, ar employees with verges Heir Solt due a is r 044, Business will d" the work and the swcmm is not. Livens Lir offered Tonle (Sea. 7Dd4, Business and Professions Code: The Contractor; License Law docs not apply to an owner Required Inspections and who dos Such work his is who builds or ed 305 - FRAME that suThereon, ... any awnedthough M1imprmemenuartnet intendedearolfcmoRercd for safe.Ir. .,offered 307 — INSULATION ver. doces,ping or i prove however, Nc building or improvement is sold within one year of eompleuon. the owneo- wilder will have the bares. of proving that he did not wild or improve far purpose of 601 — ROOF TEAR OFF sale.). 602 - ROOF PLYWOOD NAIL ❑I, as owner of the property, am exclusively contracting with licensed contractors to comtma the pmjem(Sea.704d, Business and Professions Code:) The Conuamer's Li. 603 — ROOF BATTENS [arae Law dares not apply to an owner of property who wilds or improves thereon. and, who contracts for such projects with a cone acmr(a) licensed pursuant the Contractor 604 - ROOF IN -PROGRESS Li ss taw. 1 ar/lyxcmpt under Sec. a h P C far this lassoo r WORKER'S COMPENSATION DECL�gbo`ION 1 hereby Nine under Penally of pc jury one of the following declarations: I have and will maintain a CeniBcam of Concert m salt -insure for Worker'sCumpem- soup, ss provided far by Section 3700 of the lawn Code, far the Performance of the work for which this permit is issued. ❑ 1 have and will maintain Worker's Compensation Insurance, u required by Section 3)00 of the labor Code, for d¢ Pefformvtce of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number am: Cam p CERTIFIC FROM WORKERS' OMPE S COMPENSATION INSURANCE (Phis seadontread not w completed iftbe permit is for one hundred dollars (SIM) Or less) 1 certify than in die pelforroame of the work for which this permit is issued. I shall not n employ any perae i manner m u or become subject the Wmlmrr,Compensation Laws of California. A Pica" N ETD APPLICANT:If,afmr making this Ccnif[eteof Encroquomyn shnul e subject to the Worker's Compensation provisions of tbe labor CsWc, you must with such povisiner or this Pcrmit shall be claimed mvnked. CONSTRUCTION LENDING AGENCY I hereby affirm that them is a construction lending agency for the Performance of the work for which this permit is issued (Sec. 3097, Co. C.) Lender's Name buildings Address /v _ I certify that I haw read this application and sum that Nc .hove information is correct. l agree to comply with all city and county ardinarees and stare laws relating to construction.andhereby of this city to enter upon Nc Chow-mandarnalding forimpctiorimrposescmatives for i purwhich (We) agree to save, indemnify and keep harmless the City of Cupertino against Nadlitmcnuunedpmpcnt expenses may men0. costs and expcmu which may in any way accrue against said City in consequent of the Prolong Sthis Permit, A APPLICANT APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL N POI SOW{CEREGU_I�t IOIN /)In-',. Issued by: Date �C � / let Re -roofs cofofAppluaint/CcouurricaurAw^,(a I Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Willthcapplicanturfuturewildingn upantstoreorhandle ha i u defined by the Cupertino Munn�al Coda, Chapter 9.12, and the Hcalth and Safety Cade. Section 25532(a)? ❑Yea [UN. Will the applicant of future building acceptor use equipment or devices which it hmardnus air contaminancfncU by the Bay Area Air Quality Management nrin7 C] Yes N 1 have read the hmarNms materials requirement, under Chapter 6.95 of the Califon nice Hculth k Safety Coda, Sectimt, 25515,25533 and 25534.1 understand that if tM building does nal currently have a ¢.ant that it is my mspmuihiliry m notify the ogcupanoi of Utc requy.Tanti which musl 4pgcMmlof or issuance of a ocioreate of Gear, nnev. AH roofs snail be Inspected prior to any rooting material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. n_!� A Signature of Applliiean Date All roof coverings to be Class "B" or better �CITY OF UPEkTINO Community Development Department Building Division City of Cupertino 10300 Torre Avenue Building Department Subject: Re -roofing policy for the City of Cupertino Telephone: (408) 777-3228 Fax: (408)777-3333 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: Job Site Address: Roofing Company Name: A phcant'rs Sig^nature: . Greg teal Building Official Revised 1/30/03 Printed on Recycled Paper —,27 t CIT 0O CUPEkTINO s CITY OF CUPERTINO REROOF o3 0 l 7 0 PERMIT APPLICATION FORM APN # -> 2 �— 1Yu VIvu BUILDING Date: Ener BUILDING BSEISMICRE Seismic Fee Res Building Address: 0 h Seismic Commercial BUILDING BPLANCHK ner's Name- BUILDING Phone #: 7 ,/ ontrac h #:�-63 �� License #o? Lj-3 4z Contact: �n #: on CupertinoBusiness License #: Type of Roof Covering: Existing: Proposed: p Built -Up Roof❑ uilt-Up roof ❑ sphalt Shingles B Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) Number of existing coverings ❑ Other (Specify) ❑ Provide I.C.B.O. Report # AY'_ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: P"p m 0 1,- 46 Residential P,1� Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with P ning gpt. if there are an re fictions: W Cost of P sect: T e of Con c n: Occupancy gro p- 0 Qty. if ApplirabI Fee m �� T _ I BPERMFEE Bld Permit Fees 1Yu VIvu BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING -2-2,7.7"