02080020 CI BUILDING OFDIVIISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
I 20128 LAS ONDAS CT WILLIAMS ROOFING 02080020
WNFg��4P
MEG APPLICATION SUB DATE
TOKKC; ILBERT A AND LORES J 4921 CABRILLOPOINT 08/06/2002
(isPHONE: (408) 252-5120 SANITARY NO. CONTROL NO.
e Z ARCHITECT/ENGINEER: BUILDING PERMIT INFO
tin o BLDG ELECT PLUMB MECH
G a i L'J CJ L7
Z8 y= LICENSED CONTRACTOR'S DECLARATION Job Description
O Z_C I hereby affirm that I am licensed under provisions of Chapter 9(commencing REROOF
F_tt! with Safi 7 )hf Diviaion3of NcB Professions Code.and my license
is infull fh def ln. Lie. Y�ALED
o Lice u C." ° .Lie.M i 7 ° ��
3 ma Dare com��aa��44LLr
n ARCHITECF'S D'ECL*-
t�-O g I undsa
arnd my plans shall be,used as public records
ao LicensedPhfesslonal AUG 1 9 2002
OWNER-HUILDER DECLARATION
to at1 hereby am Ruthat 1 am exempt from the Coatroom's License Loa,for the
tZtfollowingreason.(Sation7031.5,BusinessandProfessionsCode:Anycityoramna, $14000
BUILDING 14OOOBUILDING
F o which reclaims a paran to canTher,improve,demolish,or repair any swcmm
3 . prior 1.its issuance,also requires the applicant for such permit ro filea signedsmmment.
That he is linenlM pursquit to its,provisions of the Contractors License law(Chapmr9' Val
OallOn
mommehcin .with Scal ionJ000 f Division 3 of the Buismu and Pmfeasions Code), !`s,-'J"36'711 VOST�VVa"" ^ 1: ) .;.
or Thai he is eien t themfiduhand The basis for the allfged exemptlsih.Any violation (�.�Y. v•. r;t. s s+ .
of Section 7031.5 by any applicant for a permit subjects the applicant u a civil penalty
of not mom than fire handled dollars 195001. 305AP`�NR%4 M - "•nr : Occupancy Type
°h11'as owner of Nge
Ne progeny,or my employees with wages ax their sole compensation, In7 INSULATION
`w do The work;and the structure is not intended or offered for sale(Sec.7 H , ""--
'D.mnea.and Professions Code-The Cmaractah License Law doe.not apply to an 601 - ROOF TEAl&gfilRB'Inspections
owner of property Who builds or improves Nermn,and who does such work himself' 602 - ROOF PLYWOOD NAIL_ _ _ _ __
or eyed fo his own ply provided!Nat such improvements menB arc not intended or.
-co rail f r ole w er-milhavem,to bd Idi g m old,. f Falling
s sold within one year of '—'�-' -"'-603 '"'—
completion,the ownenhuTlder will hove the hurdenafpmv ng Nm had Jam buildor' 6O3 -
improve for purpose of eine.). 604 - ROOF IN-PROGRESS
71 ( ,sits owner of Negolc.7 em Business and Prof ProfeS*isssions Colt
liltcen-no Cormacn to - :-.Is' .
License t the project Iappl to a Easiness and Professions Code:)The improves
tmreon, :. - .,..
License .madues not apply man owner of property who builds se improves i.to th,
._.
-and,who.conticense Law.such projects wiN.a.contraztor(sl licensed Pursuam.to Ne. -_.-_.-
ElIarnxe pt undo Le
❑lam exempt unde'Sec &PCforthis reason rr �' Lc i. .
Ow e.
- WORKER'S COMPENSATION DECLARATION
/- Iha<by eRrm under
panally of perjury tine of thefnllowing declarations:.,.
❑ I have and'willimeinlaim a CeniRcam of Consent to self insure for Worker's
Compensation, as provided-for by Section 37W of the Labor Code,-for the
- - perfomunce'of the'work for which this permit is issueJ. ,
" °1 have he LiuB r Code. orWorker's Cdrmanc of s e Insurance,as required by Section
7]00 . the Labor Code.for the perfdmunee of er work iforcy nuwhich rail pennii is
.; 'is a d'My Wo kers Compensation In unnce comer aril Policy number am; 4
C er
TGBRTI CATION OF EPoI ry Na b { v i 7 1^ .
�1,� ' f%EMPTI OM WOR RSLc. t ! s t - - it4 rat I I .,. �"
COMPENSATION IN URANCE ` e •''
. .. _. ....._._..-. _ .-. ...,. . �, .... _....--.
) (The section aced'nhr be completed if the parr t is for one hundred dollars s t ' s "' I'i'
' (SI00)arlem.)
.._t _-:. ...... :-
1 Certify ThatIn the performance of the work for which dais perm t is issued I s.
;hall n t employ any Person in any Thermal s to become subject m the Workers f"' -
Compensation Laws of California,Date "" "I I "" ""
.Applicant .. .... --__ _........
NOTICE TO APP LIC ANT 1(aftermaking thn Certificate of Exemption. should
licEmaric theW k r C provisions the Lebo Code,youmust
Q z forthwith comply with such provisions or this permit shall
s '
No deemed milked,
.,rw rr !'-�tl""t''"`'�""<'CONSTRUCTION LENDING AGENCY -
'i'o'1rk for which
thin Nerals amed(Sion Cin,
C) for the pcdonhance ."9
;ofrwhkfo hich Nis pertiit aissu df5ee'709r,Civ C) - _.__- .-. _. .__-. ... .. ... .. ......._ -- --_
Pr Z Lend s Address - .. (.� •!' '
DV' I ramify that l have read this ppl c t J state that the bo f t o is,
(L [,n �iioimct 1 Time to comply with all city and couriv ordinances and state laws relmmg'
to buildmg construction.ad hereby malone representatives of Nis city theater upon
} fw7 theho e i dceJ property f inspection P To - _..
F. Fn (W 1 g its save, tide fyenJ keep h may
th<Cny (Gruen o gine V
ti rlm s judgments,c t d expenses which may in tiny ay cane Sgain.t saW
U. uy in cons q once f the gramTny of ih15 perm t kA PLICA] UNP RST SYDS AVD WILL COvIPLY'WITH AUL JO.Y PtdIN7 I$$Ued by: Date
� 03
n t e )Applicant/Commcsur,, ""t . ..Data ` RC-roofs
i T HAZARDOUS MATERIALS DISCLOSURE
Tedbydm Cufant fumie bp'jCgocChantr9.1 had the
Health
Safety eOf ROOF, a -y. .. ... .,.............•
a def Sed im Ne Cupenmo M m ipa�Cade Chapter 9 12 and the Health end Safety
Care,
ode S ctTon 25512u0 `;
r /-^' T yet l aT a. fps p s (
All roofs shall',be in!. s . n41: tIo'a1 ny ro
ofng-matenal.¢emg installed.
T' µll th pph<em o forum build ng heap t eq p of ee eta h' h If a roof is installed without first obtammg an inspection I agree to remove
annit haiudins air cotam nu t d find by th Bay Ate Ail Quahty Manag m m
District? I. allw matenals for inspection Applicant understands and will comply with
°Y a' al:,non-point source regulations.,.,,
1 have read Na hazardous halentils refs minar is under Chepi i 6.95 oldie
(;ilifalnoH Ith AT5 fay Code,Sc tions 25505 2.5533 and 25534-I nil t ndthat _
M riling doe.note rtgndy ha item mNauus my rapansibllny to not fy Ne Z�f -' - 8 �/' bZ�
cupaat of the quirtments wh ch mu t be at print to tic f Cen fat of
Pane
ignatureofApplicant _ .- „ ., Date__ _ ... ..._.
V . e.
Owner
r armonree ag qt o e All roof coverings to be Class `B" or tietter '
OFFICE..... ........ . ..
Ir ._.
Building Division
10300 Torre Avenue
*C10
Cupertino,CA 95014-3255
Telephone: (408)777-3228
Fax: (408)777-3333
CUPERTINO
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 VV 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: L-o n i - a Rk E
Address: 7_07-e, Lq.s Ohd,4s CIP.
`.
. Reroofing Company am . 1W i c• s moo ��
Q==
Applicants Signature: )ate: so —
Joe Antonucci
(Chief Building Official)
6!25/01