02070080 CITY-OF CUPERTINO PERMIT "
BUILDING DIVISION `CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
19814 LA MAR DR DAVE SMITH ROOFING 02070080
OWNER'S NAME: APPLICATION SUB DATE
ED BREWER 1052 KELLY DR 07/15/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 973-9427
P,+0 0 ARCHITEC'UENGINEER: BUILDING PERMIT INFO-
EkC BLDG ELECT PLUMB MECH
f"-1
LICENSED CONTRACTOR'S DECLARATION
$,In I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description
F nF. with Section 7")of Division 3 of the Bus es rid Professions Code.and my license REROOF
m is in full o on effect.
6 Q 6 V License Lic.M
3 am
u. Dote ARCHITE 'g D"acto"An
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de, and my p
u°i¢ lans bused as rc rccoNs
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pO rofemon
a e. OWNER-BUILDER DECLARATION
R 1 hereby affirm that 1 1. exempt from the Cantrurofa License Law for the
F z< (allowing tures.(Seats.]o L5,Buainess end oe,de ons Code:Any city or county $4000
F C which requires v permit re cores me alter,improve,demolish,or repair my swencit
3$ _that Ird its issuance,also requires Ne riamapplicant for such permit a file s signal Chapteen[,
that ik Wdputstaimh Sc,do ,p&XI)of Diiision the hejo la License Law tChaptnr9' �y D �A+����y� p� Valuation
(e 1pencin8 with Sxction17 fDvisionJof thegusne;saad Pmfessons Code? L;fjN`S` 'er9� : �;r,Y'IIl{lO
or Nat he s exempt Nemfrom and the buts for the a] 9 it ma.111A.Any violation r
-of Section 7031.5 by my-applicant for a permit son*,,the io piicatn to it civil penalty
lof not no.to.five hundred dollars(SSW). 305 APN i r 'B•nT st; Occupancy Type
El 1,as owner of the property.or my employees with wages as their sale compensation.
-will do the work;andthe structure'is'no,intended or offered for sole(Sec'9044;' ----'-
I Bustneka and ProfeKo Codi The Commnor's License Low does not apply 1.as 601 - ROOF TEAWgORg Inspections r' - -^ +'
owner of prolixity Who builds or Improves Hereon,and who does such work himself
or through his own employees,provided Nmre
at such improvxxnis anot intended or 602 - ROOF PLYWOOD NAIL
-,cones for stile If.however,the building or improvement wed within one year of 6 0 3 - ROOF BATTENS `'`�'^ ''^ "' r''
'completion.Ne owner-Wilder will have Ne huNen of proving that he did nm buil)or
improverd"orposeofeale.). 604 - ROOF IN-PROGRESS
(] m has owner.of the pmpeny.aexclusively comracling with licensed canvacarsm 31_:--..:J Fi:>IIT:A°l•
= - _ consnuat the projat(Sec.76W,Business and Profusions Cade:)The Contractor's -
:e License Law does not apply to an owner of property who builds or improves thereon, -
NAb
`0 _send,who.conwense Law.
contractor(sl.liccnuJ-Punuunt.m.Ne
Co 1 1 ( License La 1 R'L l\ l l c. \ I '.,. �I� Q
❑1 le P!order S - B�PCf for remmun ff_: i 200[
^Date
WORKER'S COMPENSATION DECLARATION
''•t' Ihmery firm drpenally,ofperjury, neofthffollowngderlaratims -- BUILDING
❑ I hove'and wili'maim].da a Cenificatew Conant"10 self-insure for Worker's
Compensation; as-provided for by Section-37M of-the Labor Code.-for the
performance'of Ne'work for which this Permit,is isls�Iml.
❑1 h d'will ina man Wo kei'a Compensmion In¢urmswe oa'rtquited by S&tion
3700 b tie'Labor Code,for the performance of the work,foi addich'lhis remah is
s"s d My Workefa Compeeal Insanieamrad d Polynmberam:CamlrI�(Po1ryN
It' 'I ERTI COf��'2'E�F�SATIIOJNIION CEWOR_KEI�S�
nC lLp Ondi sent on nbed ndl 6ecomplewVdd if Ne permit is for one hundred dollars w'', ',-"'^' - _'V (t C�+:it�V"--t1-C' t1. 1 1, 1,1'1•
a
.'' Ic nfyNrl Ne perfytmencc ofN" rk( wh It print"
drs 1.,.41. ..,,� .1.
shallot nemploy any lien..m aslar any mann rs' hen wm h)eu the Workers' , 'l
{ '
Cr rope t dh LoweCol lompa:Date
. APpLan
et - :• : ...._._.. ..... _ ..- _.._ ......... ........ . .1_ %_ . ------------
' INO'ICE 70APPLICANT;If.'after making lh Certificate
fExemption.you should
Qbecam bjea the Workers Coralkniiiiiian provisions of he Lador Code,you must
'fonhw 1h comply-with such proves ons sr Nis perms shell he deemed revoked.
CONSTRUCTION LENDMG AGENCY ` •,�,..i a,••f XN
IYi 7 t' 1 hereby flim Ili t Nete's con 1 t b I Mingg rg y f N performance n.. .,
�.Qof 1h ork for hick W permit 1s ssucd(S ]097 C' C j, .
-Le de Nemo•-."e �..�,.___st :...,.,.v--.-_, :_: _�. .- -.____. .._ ....._ .,- ._ ..__-.- -..__.___ .- .-_. _ ____.--_ _ - ._.____ .. .
y V.O t::i,yp�'::. w... .,,.,rc..,-.-...p;;+...._.-..::;:...,i,. ., ..::cr• iG llrix..:�:;l.a;
r y Lai I have reed Nis appljcation and slam that the above information is
feu F. ;cor`rectl ogrm 10 roinply with rli city and courtly wdinanccs,vnd 51me laws relating'
':.��V no builJing co.nruaion:unJ herebYeuthoriu ieprtuntalives of]lis city menlerupon
�,�ss_(t], Ittie ub e n enY Bed p pony f-'ospceyon purpo. s
E..;gG (Wdj g tic w m e indemnify and k<p,harmlcn Elle Ctiy 1 f Cupentnn ago net I
V z, f iabtuu Judg tens, t rid expenses wh chy In uny y c e ago n 1 said'
quencc l f he grant ng til perms f�
" LI I'UN�E 1ND6AN�,WILL CONPLY'WI7 f1 ALL NON:PdINT''�
Issued by: Date
m r' fAPPIkanVC nt t ,, 1 '.. .;j,. Umu "'We-roofs
HAZARDOUS MATERIALS an5e
DISCI OSUR
W 111h .p'l'ead,or tum building acciprm tae or handle haiallous ra teal _Type of ROOF_
as J f nal by IIs C pen rd,M c pal Cale.Chapter 9 12- d Elie Health and Safety' ---'" -"' """'^-"""""
CalSect2 J ll i f a I T "t f C - C
e 1 "•!P:1 a:n
tQY- ar fI I.( rtlr t i� I ? 11 y 1 1 Ilk I' l`fF'af. l!X a 9v x
All roofs shall 6e_mspected prior to any roofing material being installed:
W 111h aPpl ca to t rcb Idingac p t u qtr p 1 o a ex 'n h If a roof is installed without first obtainingan s ectton tI agree to remove
emit h b a m
conlama nasdfned by[he Bay AreaA ( almy Management mP - g
DlaEdxt - all new materials for inspection. Applicant understands and will comply with
-ova . a - t. , Z-, - - all-tion oifiCsource reguI tions.,,,
J 4M 1 E e M1aaardo mal pals rcy ementi'unde Chapter 695
'of the
be u , f t eh, Set ty Code S Bions 25505 255]3 and)SSW I under and that
Cul font Heah11
ti theWld gd ne nese which
aaic Nplus DIYrepo bddyE noufyN "'"'_
p requi em 1 h h must be e1 poor to tw sec f o Cenifcete of -
gnature of Applicant i
r out odaeJ g a.;, S 1 Date
en Y �•,
mi
^� All roof coverings to be Class"B"or better
r. ..... . - -- --OFFICE--
-pr r •.�,',,. s A- AL. t
--'a.
Building Division
10300 Torn Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CI Pax: (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 V"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: Pc L, t C-
Adg ss: 19
Reroofing Company Name: ))-a, .
Applicants Signature: E
Joe Antonucci �
(Chief Building Official)
6125101