01050127 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
1131 KENTWOOD AV ARTISAN BUILDER 6)1090 127
IWNER'S NAME: APPLICATION SUIT DATE
WEN CHEN—TUNG AND HSLJEN OH 17005 SORREI WAY — L711
PHONE (408)
SANITARY NO. CONTROL NO.
O-O Z ARCHITEC IEN'GINEERo BUILDING PERMIT INFO
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w❑ PLUG ELECT PLUMB MECH
W - rJ' IJ CI L'I
Z yi IACCNSEDCON3'RACTOR'S DECLARATIO Job Description
O Z_ 1 mi iffem thus 1 ran licensed order lowidnns of , art 91c n j.
G sic
In t w is in hadSection
rce rad ol'Dav ❑nl the BllFlncvv Lind Pn,fps, 'nJf.a A
'n lull force Ind of
��ca �Uctoo,Class�— Li'. REROOF.
w 3�,U Dmf commetnr Y
t, ARCu1T.Crs DE . A N SHAKE TO COMP.
Ca O g 1 unJersmnd my plans.hall he used Public cords /
.Y_
R,i o�O Licenarl Professional
5 usin a_LL OWNER-BUILDER :CIARATION
I hereby,(lien the 1 arm t cf the Canmr's acaLicense law far the
F Z>' allowing rcmon.(Section]Osl S,Hliusincs and Pwfcsinnv Coda:Any 6yo,county
I S
acpro to its4 thc;IPPILCcntt I permit rile itsigiud.etcmcnt
a. th;L1 he is serwilryr, :, , dap I nc h antro1 1 (Chapter Sq. Ft. Floor Area Valuation
aror,ma
enng with Scow.,7000)of uivl,lnn 3.1 ie Basin...o nd I'm@„InsCode)
et than he i,evmnp,thcrcfrorand,he ba,ls Bn the alleged vW p,ion,Any violal'mn
of Section 7031$by any,pplici n,tar a we,mu ollpea,hC apVlicnmtall civil penalty
(if nor more than five hundred dollars MOO). APN Number Occupaniy446b
01,a,owner of,M pmpcny,or my en,pb,recs with wage,as their wle cmnPee,a ter.
will do the work,and,he swcturn is not intended or offered tar sale(Sec.]DLI.
Pusine..v.aid Pmm,,inn,Code:The Contractor,License law due,nm appy a an 3593] 0] 1 R$*�ired Inspections
owner of pmpeny Who builds,ar improves the..,and who does such walk himself
or through his own employers.provided that such improv ri cros an not intended or
offered Por sale,IL however,the building or improvement is sold within one year of
mnpmdr-b
on.the will have the burden of proving that herd no,build or 305 —' FRAME
hnprmr ter porpowof,alc) 307 — INSULATION -
0 L ov owner of,he Propeny,um exelmively caaaeling with licensed contractor,m
o,he pmja't(See.]1114,Bev and Professions Cairn)The Contractor, 601. — ROOF TEAR OFF
Liman c law dors not apply m an owner of pairs,who build,or improve,
and who contrasts,for such projects with a caatmctmt,)licensed pumamp to the 602 — ROOF PLYWOOD NAIL
01 a exempi underSw` 603 — ROOF BATTENS
O I tr exempt under Sec .B K'.Y C for this Mason
Gxnrr nate 604 — ROOF TN—PROGRESS
WORKER'S COMPENSATION DECLARATION
I hemby nttinn under penalty of perjury Inc of,he,following dedatatiane.
Cl I have and will m:dnrain it Ccniticam of Conseil to vch-linsure fur worker's
Con,pen,nown. ;is pra liDd Iia by Section 3700 of the [.nhor Code, for ,he
partunmmke of the work inn which da,permin is i„ural.
01 have and will maimaia Wmkcr',Colattep tion Iisnance,m required by Section
J]W of,he,labor Code.Iia the peHbrmanee of,Ile work fygxJ,�a i.c PCrmikys D
issued Com tion l Irene tamer vly Ynlia(�Jt c� BUJ
Carrl�fJ Policy'Nn:_/S
CFRTIP1CAIfON OI'IiKEMPTION FROM WORKERS'
COMPENSATION INSURANCE
I I Ill,well n"I no,he compleicd If the permin is for one It food]dollar
151 Nth or Icss.)
1 verify that in flue letlim.same if'he link far'hich,hi.v Penni,i,issued.1
shall no,employ any Pca,n in any Inunner so as,to heroine subject,o,he Workers
C..a,nc,tion Laws of C,lifomia.Date
Applicant
NOTICE TO APPLICANT:IL then taking this Cer ificaa of Exemption,you should
become come subjectn the%iCon,pensmion provisions of the I,alna Coale,you most
Q 0 f nthwi,h comply with such provisions or this Permit hall M deemed revoked.
Izy ti CONS'I'RUCI'[ON LENDING AGENCY
a .} Iblreby nflilm that(here is uamnntmcllon Irish ng ugiucy for the performance
oI rhe work Ior,hid,It,.,pwnnit is Issued(Seo 3097•civ.C.)
ALender',Name
Z) 1 Lender's Addrt,v
U Q 1 cenifythat 1 have read this application and state that the above information is
❑.,E. correct.I agree to comply with all city and count,ordinances and stale laws relating
Q (� ,o building construction.and hereby umhoaim rtprevematis” cimmerhrupon
} fa] the abn'e-mentioned to for in,pec,ion parry,
f" y (WD agree to e,tactually and ke esuhe City of CuNdual against � ^
Vy City inca x <,cost and cspf may in any way ammo against said '! j
U City In cons DERShe grami , ' rout CO � � �/• — v
'--I AI'1'LIC UNDEftS'D\N .LCOMI'LYWn'IiALLfynNl•ONT Issued by: Datn..>
S LAI 10" l �•
—,armo APPItc,we...... elYf Date Re-roofs
HAL\RDO AlER1AI-S DISCLOSURE
Will,he,app I'an ' lu ilJing occupam,n,re nit handle humanities maetial Type of Roof
as defined by the Cupcnino limina,Code.Chap¢r 9.12,Ind the Health and Safety
Code.See ion 255320)!
o Yc, 0 N All roofs shall be inspected prior to any roofing material being installed.
Will meapplicmnnfuati•building occupam use equipnmmor devices which if a roof is installed without first obtaining an inspection, I agree to remove
cmn hazardous air enmandnanu us,defined by the Bay Area Ab Gua1'lt management
011ttict'r all new materials for inspection. Applicant understands and will comply with
El Yes 0N„ all non-point source regulations.
I havr reed t lawaahn,man, re, ,s under Chapter 6.95 of the
C.hforniu H ahh :nfcny Cock 1 s,25 533, d25534.1 understand that -
itthcbuilAln not carrel u, ,at it is any ne, mibilly 1.notify,he
r....a, mm prior ro isstmn¢nt a CettiL.'a a nit
'k e ' u mm /_ Signature of Applicant Date
ywierrr'ummri,ager, D',e All roof coverings to be Class `B•'or better
OFFICE
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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'.
We understand the above policy on reroofing and will complb with this policy.
Homeowners Name: I �
Address:
Reroofing Company Name:
i
Applicants Signature:
� Joe Antonucci
(Chief Building Official)
6/13/00