02120004CITY OF COPERTINO
BUILDING DIVISION PERMIT'CONTRACTOR
a INFORMATION: '
BCI _A1A1)opl:sLINDA VISTA DR
KNIGHT ROOFING CO
PERMITN(02120004
OWhROWBEL BRUCE K TRUSTEE
42035 OSGOOD RD
APPLICATITIOYBnsmY2002
iii
IONS
5104389077
SANITARY NO. CONTROL NO,
ARCHITECTIHNGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECII
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
I hereby Bind I licensed chapter 9(commencing
Job Description
That am under proo.21.1 of
REROOF
with Seninn ]IMMgo Division Jnf the Busi�nd Professions Cmee, and my licensei s
in full Tome an
C3'( 7S »99
,
Liccne clays Lic.Y
Date -y Cts
—f
ARCIIITIiLTS p7iC�AGAT1—(3N ��
r -I N ►LE®
r 9tll
]understood my plans shall be used as public rttvrds
,ord,
'
DEC 0 5 2002
Licensed Professional
DECLARATION
Oat
1 hereby affirm that 1 I AM exempt b Law for lbe
exempt from Ibe fessions Any
$8475
following reason. 1. Code: c
d :
]cont, Businessandmpr Professions Co de: Any city
which u pent;,, m nm.Urue neer, improve, demolish, repair structure
(aniSecton
it, sires
file col
ed statement prior to its seism, assn nt to the the applicant for soh permit In liens signed (Chapter
(list he is licensed provisionsol thea LiecneLaw lC
3Yg663.AiD(0)ZAI@81
Valuation
witpunamnntbc
Business
(commencing with Section TIYdd of Division of the Business and Code)
vi latdc) or
u exempt on, Any
r exemption Any violation of
that themfmm and Ne far Be
PN -N
Occupancy Type
Schone b Any Per Subjects the
io far a Permit Ina applicant toacivil penally of
than five reddApplicant
not more than five nundmd ennam (ssm).
307 — INSULATION
El I, as owner of the pmpemy, Mary employees with wages as their sOIC compensation,
nWAc ifnS
will do the work, and the structure is not intended or offered for sale (Sec. 7044, Businessvp
and Professions Code: The Cont m n r' License Law dues not apply to an owner of
602 — ROOF P
property who builds or improves thereon, and whodoessuch work himselfor through his
awn employees, provided that such improvements a2 not intended or offered for aale.It,
603 - ROOF BATTENS
however, the building or improvement is sold within one year of completion, the moner-
604 - ROOF IN -PROGRESS
builder will have the burden of provi ng that he did not wild or improve for purpose of
sale.).
1, as at, of the prepaid, am exclusively combining with licensed nmtmcrors m
construct the project (Sec. ]OCC, Business and Professions Code:) The Contractor's Li.
cense Taw does not apply to an owner of property who builds or improves themon. and
who contracts for such projects with a cmnmcmr(s) licensed pursuant to the Contractor's
License Law.
❑ I am exempt under Sec. ,B& P C fof this reason
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penally of perjury one of the following declarations:
1 have and will maintain a Cet ificam of Consent to self -insure for Workers Compere
salion, as provided for by Section 7700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ I have and will maintain Worker's Compensation Insurance, as required by Section
3700.f the law, Code, for the penionnance of the work for which this permit is issued.
My Wnrkei a Compensation Insurance Gamier and Policy months, am:
Coni 5.4X (P�Si Policy :OY&-9r/007_
CERTIPICATEUFEXEM l MWORK[RS'
COMPENSATION IN URANCE
(This section need not M completed if tbe!canis is for one hundred dollars of 00)
or Me.)
1 certify than in the perfmrmMA min, work for which this permit is issued, 1 shall nut
employ any Moum in any manner So as to become subject to the Workers' Compensation
Laws of Cali fore ia, Dam
Applicant
NOTICE TO APPLICANT: It, after making this Cer ilicam of Exemption, you should.
become subject to the Worker's Compensation previsions of the Labor Cast, you must
fuMwith comply with such provisions or Nis Need shall he deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby a07ren that the. is a conshaction lending agency for the perlirmance of
the work for which this Permit Is issued (See. 3097. Civ. C.)
Isnder's Name
Lrece,'s Address
1 ter ify that 1 have read this application and sure that the above information is
COMCCL. l agree m Comply with all city and county ordinances and sum laws relating to
'
building umstmetion, and hereby authorize representatives of this city tit enter upon the
shove -mentioned property for inspection purposes.
'
(We) agree to save, indemnify and keep harmless the City of Cupertino against
liabilities, judgmenu, roses and expenses which may in any way accrue against said City
in of the of
/
This
APPLICANimming
AND UNDEamcc
RSTANDSWILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOURCEREGU ATIONS.
Re -roofs
Type of Roof
Signa Cof Applic Contotot Dm
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building Occupant store Or handle ha a dote material
as defined by the Cupenino Municipal Code, Chapter 9.12, and the Health and Safety
carie, 0YeS 25532(a)?
❑Yen INo
All roofs shall be inspected prior to an roofing material being installed.
P P Y g S
I
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit havardous air contaminants as derined by the Bay Area Air Quality Management
all new materials for inspection.
Disttia? ����'((((
E] Y. /Rhos
/
I have mail he hamNo,,us`materialsrcyuiremenls under Chapter fi 95of the Califon
/�
nia Health& Sitety Code, Satinet 255115,25577 and 25534, 1 undersand Wahl the building
2
dons not currently how a meant, tom it is my rox,madolly m no 'the rccupwt of the
requiremcnu hi wit ..in gma br "` Ccnifcatcuf y.
ignature of App ate
CLQ L ti
All roof coverings to be Cla 'B" or better
dagen
ncr or autha arc
CL
•
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Pax: (408) 777-3333
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
Wand 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 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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
t ocfe 11
Address: I M % LJrI)oL . 665
Reroofing Company Name: K�)9' 4
Applicants Signature:
• Joe Antonucci~'_
(Chief Building Official)
625/01
6,