02070050 CITY
DcupvuOND
BUILDING N
PERMIT CONTRACTOR INFORMATION: '
BUILDINGADDRESS: -
10615 LARRY WY LD COUNTRY ROOFING PE (�2070050
OWNER'S NAME:
RINALDI MARIO E AND MARLYS A T 25-B GROBRIC CT APPLIIlJ // U`�Lyff 61g >,T,E002
PHONE: L
(707) 864-5557 SANITARY NO. CONTROL NO.
OO ARCHI I LU UENGINEER: BUILDING PERMIT INFO
a u BLDG ELECT PLUMB MECH
I.__J
al 8 u Z LICENSED CONTRACTOR'S DECLARATION Job Description
O Z-O 1 hereby affirm that l am licensed under provisions of Cherie 9(commencing p
F=FW with Section 7") Division 3 of he Basin",and Professions Code.and my license REROOF
y ism( a de/gn
o 5 u I.i==n �,� C2e # Zai 1 REMOVE 2 LAYERS WOOD SHINGLES & COMP.
'a5a� c°"'m` r INSTALL OSB 304FELT & 50YR COMP.
t 4 O ARCHITECT'S RATION r
S
ran my plans shall M used"s p lie recd I
y�o O L¢ensea Profesvowl
es OWNER-BUILDER DECLARATION
vo 1 hereby a(Brm that I am esempt from,he Conualum's License Law for the
(_?gfollowing reaon,s (Section 7031.5,Business and Pmfenims Code:Any city or county,
which requires a penni,to construct,after,improve,demolish,or repair any stmcmm
i 3 z prior to ds Issuance. 1 requ rt th Wfi ,for such per iu rl< s gal ua«mem
!(to aUin wibenagn m pro,dso rmec t air L¢<selew(Chaptn9 FLF1oorArea ' $800`791uation
(,"but m with Sento ]INN)1 o(D'-isionl fthc Busn.sunJ Profesxmns Code) \ `.t {` "1''
of thatio sex e5 by anyelrona tto peopir subectsthdesecanno Aniviol�tion /' ' � vs'1. p
of Section 703 LS by any applicant f«a permit suhjcc,vhe applicem m a civil wnalty '
pr stat m°rt tnen Rx<stoma«a muars asw° 316 GVM*.n @rOccupancy Type
❑I,as owner of the p,npeny.n my employees with wagrs as,hcir solc comu
pcn ,ion,
will dn1he'work:'and the'vrucm«'is not intended.1 offered for sale(Sce.7O . .30b - FRAME
Busmen and profession,Who
Code:The Cam theros License law does nm apply I.anRequired Inspections' ..
owner ofpropertyhis-I Who loye.lds or improves to such and who does e a work himself 307 - INSULATION
anhrough his awn employees,provided,hat such ire icat is sol u«nn,one yen or
offeredfortale:¢howNec thebuildinghave t serimen of proving
sold he
did no,year or . . .. 601 — ROOF TEAR OFF .. ,_.. ._.. . .-_ _._. ...._ .. . _. .. . _.. _
Completion.the owner Wilder will have the burden of proving that he die not build or •
impro"e mrparpn«°raae.). 602 - ROOF PLYWOOD NAIL
0 L vtq,wncr of the P"I'ny aai c-1-holselY"momiltho. "th filtroado tocros,to - '603 — ROOF "BATTENS
the project T, .fa dProfessionscW Irena'sLicenseLawos no apPYon owner
oproperty whoIds serimproves,hereon,
604 — ROOF IN—PROGRESS
one who contracts for suchprojens wi,M1.0 contractors)
licensed pursuant,o the
CI I..es's Licc"u Law. �. .. .. ... .. .. ..... . . ..... . ...-..__.. . .. ..... .. ... ..
i O l am exempt under Sec. ",B&P C rorthis remon �B I
Ownei Date F=IN
WORKER'S COMPENSATION DECLARATION G
Ihereby affirm under penalty of perjury me.(,he(mining declarnamon: JU)_ Lrsoo�
:_• 0 1 have and will maintain a Comfiwm(if Consent to self-insure for Worker's U
Compensation, as provided for by Section 3700 or the Labor Code, for ,he
_ performance of the workforwhichthis Permit isiseuW, BUILDIN
01 have and will'mmairia Worker's Compensation Insurance,as required by Section
,' J]W f,h Labor Cul fc th perfom 2 of the work f h h,h s pe mit s
" is eQp My W k is C p u n Ins a rt er nJ P hey tuber ae
ISToTtF fist - _ ;
(',ER9'IFICATION OI EXFMPTI OM WORKpRW f � ( ,1 YI �wy'"
COM1IPLNSATION INSUR !CE � � ,
This ieciion read not be<ompletW
f51fp)or len.) if the permit is for one hundred dollars
-'-
I c rt fy,hai' 0 reflurrmace of,h ark(u-hich.his perm,11 ued 1 _ . . -. . • - -. - _ .. .. .
ah II ma employ any Person in any manner so as to become subject,°the Waders .
Compensat on Laws f C(Torn a.Dust �'
Applicant. _
NU110ETOAPPLICAMPIf, her maks gthts Cen,
u n hcmc mf Exemption,You should -
Z bechwithc comply
it suchpo Compensation provisions of the labor Code,you and,
Z forthwith comply with such provisions or,his reor i,shall be deemed revoked.
l her by ffr
CONSTRUCTION
there li ac0moucunnl leadinNG g
for the rfamance -
ya ,mt . . .. ....
of the work for which this permit is issued(Sec.3097,Civ C.) p`
� .
y p Z Lender's Name -- - .Z I- ' r'n AJAreas .. .- _.. .,. .._ .. _ ._._ .. ...
cnJe
V I cerii(y Na,I have rend this applicator,and stare thuuhe ab,we information is
0�,t.. coven.1 agree m comply with all city,and saumy ordinances and stale laws relating
V ,o builtling c°nsvuctairrand hereby omborieereprc stoves of this chy memrr arm,
>; (y the above-n¢n,innctl properly for inspection par s.
L. 4., lW=)ugrtemsove.indcmmfy rend keI Snnlese,he City of Cupenino against
h i liabilities,jud a .,is and tape n ich may in any way accnu=against said
V Z ' City in w nee a the granti
s permit.
SOUR( 'UND- Sl'ANI \N LL COMPLY N'TfH ALL
SOUR '-PONT 1 !
. ,u .TioN'^ 9GZ Issued by: Date
nal nppq=a Dam Re-roofs
AZA DOGS HIATERIALS DISCLOSUR41 / 1.
ai Jef'Will,he plicatorfcorebuilding occupantstore orhandle huartlousmaterial ._Type of Roof. .
nW by the Cupenm M st ip I CW Chapter 9❑ d,h Italia d Sol,,, "` - —'•+"- -- .. ..
Citric:Set n2553211 Mv! 'jDate'{ u1,: id t p, J.4.. a,-- ill be inspected prior to any oofing,material being installed.
11 tierpi'� ' t rehalei n« p n, key tore eevm=ewmmh installed without first obtai n an ins ection,'I a see toremove
em,hazmd tspsdefnd by th Bay AF..i QIuy Managememg p g'Jflt�i/tteria nspecti n. Ap cant understands and will comply with
' - n nice egulatl s. " \:have r<adlhe haeardous mamrials m mems under Chapter 695 of theama y Code.Sections 2 .25537und25534.1umdersmmd,ha,
d,hebuild smm urreNly haveaethat it ix my«sponsibilhmnn,iry,he«cupano mens which be met prior,o issuae of Ce 'hcate oOccuf pliant Date
°"'n=r«a,uh°^ reg Dale 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
CUPS R.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 YV 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: 07 49 (S ! 0 E ),tib I
Address: _J oG / S 1-/9?22 ` tjn- �y
Reroofing Company Name: 043 C.0t4Al-T-0-V O0FING
Applicants Signature-- Date:
Joe Antonucci
(Chief Building Official)
6/25101