03070087 CITY OF CUPERTINO ' '°� sr � cca�Q °
BUILDING DIVISION PERMIT �aCy0NTRACTOR INFORMATI=ON ay
e BUILDING ADDRESS: SAN JOSE ROOFING CO oo_ PERMITNO03070087
OWNER'S NAME: 350 SENTER RD PERMIT ISSUE DATE
ONE: (408) 227-4931 SANITARY NO. CONTROL NO.
ARCHITECfIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
so.
O o LICENSED CONTRACTOR'S DECLARATION Job Description
�w 1 hereby affirm that 1 am li crund tt Qq.6�m provisions of Chapter 9(commencing p p
Z with Section 7MBof Division 3 of lie BusiodW an ufessiom Cnd ,and mylicenu is
n< in full
ucensc� '_ Lie.g REROOF
MD,\l` ' ARCHITECTS t RATION
W �7U enderwnd my plans shall he used as public records ,JUL 16 2003
lin.
Licensed Profcasimul
g OW NBR-B W LDER DECLARATION BUILDING U'LD e p gG
2 e f I hereby Qlfirm that 1 am exempt from the Contractor's License Low for the LL77 G gxL
OO following mason.(Section 8131.5,Business and Professions Code:Any city or county
5$9! which requires a permit to consumer,slier,improve,dcmnfish,or repair any nroerum,
-Zi poor to its issuance,also requires Ise applicant for such Permit o file a signed statement
£gmm< that he is licensed pursuant othe Mosimm(if the Commune's LicemcLaw(Chapter 9 Sq. Ft. Floor Area Valuatwn -
y+l-O (commencing with Section 7")of Division 3 ofthc Business and Professions Codc)or
y`<�
that he is exempt fhcrefrom and the basis for on alleged exemption.Any A.Wion of 36226050 . 00
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of APN Number Occupancy Type
not more Non five hundred doll..($M. P y YP
❑1,u owner of the property,or my employees with wages as Noir sole compenutlon,
will do th.work.and thesuucfure,is not intended orofteed I...ie(Sce.7044,Business _ FKAME and Pretensions Cod.:The Curiosities License law dam trot apply 1.an owner of 307 - I NSULAT l ON Required Inspections
pro,my who builds or improves thereon,end who d.cs such work himself or through his
own employees,provided that such improvements are not intended ordlfered for sale.If. 601 - ROOF TEAR OFF
however.the building or improvement la sold within one year of completion,the owner.
builder will ban The burden of proving that he did not build or improve for purpose of 602 - ROOF PLYWOOD NAIL
rel`')' 603 - ROOF BATTENS
- ❑huownerof the property.ons cxd ss and Professions
with Ifttne Contractor's Lt.
construct doesnoGpplytoinonworofprodrtywhotinsorOThoContractorsLi 604 — ROOF IN-PROGRESS
cane law da.not apply m ts owner of property who Wildspor improves thereon,orad,
who contracts for such projects with a ctinu¢mr(q licensed pursuant the Comrecror'a
License Law. -
❑l em exempt under see. ,B&P C for his rcuon
Owner Dote
WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the fallowing declarations:
I haw and will maintain a Certificate of Consent o ael Gnaurc for Workers Compere
safion,as provided for by Section 3711(1 of Ne labor Code,for the performance of the
work for which Of.permit is issued, ,
❑1 how and will maintain Workces Compensation Imunnc,as required by Section
3700 of the labor Code,for the performance of the work for which this permll is issued.
My Wr. Cq sunpa canirf anitl Policy M I— ^ O O
Carrier. 5 �F EX r o.: {�
CERTIFICATE OMPE SATION'lIN 'ARD WORKERS'
COMPENSATION INSURANCE
TITis section need not be cornplcwd if the permit is fnrom hundmd dollm(Slag))
or less)
1 cenify Nal in the performance of the work for which Nis Permit is issued.I shall not
employ any person in any manner an ons thematic subject n the Workcre Compensation
Laws of California.Date
Applicant ,
NOTICE TO APPLICANT:If.after making this Cer ificaw of Exemption,you should
become subject to Inc Workers Cam pensuion provisions of[be labor Code,you must
Qz forthwith comply with such provisions or this permit shall be deemed revoked.
Z O CONSTRUCTION LENDING AG ENCY
Ihcmby affirm that there is construction lending agency for perfurmane of
C'r> the work for which this permit is issued(Sec,309'1.Civ,C.)
W Q Pander's Name
7 z lender's Address
V Q 1 cenify that 1 Mw send this aPPfiea ami and state that the above mftimrnion is
Uy Corea&l agree to comply with all city and county ordinances and slats laws relating to
0 building construction,and hereby authorim representatives of this city to enter upon the
a ahow-mentioned property for inspection purpose&
(We)agree m saw,indemnify and keep lum icss the City Of Cupertino against
rF'-r N liabilities' cru,costs and expenses which may in any way scenic again said Cily /
U 7 into qucne (Ne'n�ting of this permit
r� A ICANP U ERSTANDS ND WILL COMPLY WITH AL NON POINT Issued by: Date (�
EG TIONS.
\' <� Re-roofs .
Signawrc til ApplicaHAZAR OU pest
)IAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupvm imrc err handle herartltius materiel
as dented by the Cunhm Municipal Code,Chapter 9.13,and the Health and Safety
Code
,oro sss321peg7 KNIu All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which If a roof is inst without first obtaining an inspection,I agree to remove
It hmardous air contaminants as defined by the Bay Area Air Quality Management all new Class or inspection.
r-liniad?
Yes —y
1 read Inc hvsNrms materials requirements under Chapter 6.95 of the Califor. D '7
ria t u ollyyhaw.s .m.do loid understand that occuclruilr the ! /f
J not curtently hawemnant Nm it is yrtspomihilityr nndfy the¢cuPant of the
r agog meats wnmh Ibemet primum vanes tit mmtetiroe.npan.r. 'B_A�pplicant Date
79-l0 raraithoricdagcnl ,,. All roof coverings to be as "B" or better
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
Fax: (408)777-3333
UPEkTINO
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
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 re-roofing
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) Pre-inspection 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 a 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 on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: U:60
Job Site Address: —S "�
Roofing Company Na
A plicant's Signatur . Date:
• Greg teel
Building Official
Revised 1/30/03
Printed an Recycled Paper
• CITY OF CUPERTINO -7
REROOF U j0 7 0 /
CUPERTINO PERMIT APPLICATION FORM
`• APN# � � Date: /I
Buildin Address: C/ ( '
' S'
Owner's Name: Phone#:
.J 215'z-78'S
Contractor Phone#: License#:
_ oca C cam., Y z7-5" 2-C.
Contact: Phone#: Cupertino Business License#:
2GLN C o - ?
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
$ Asphalt Shingles ' Asphalt Shingles
13 Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
�N tuber of existing coverings 1) ❑ Provide I.C.B.O.Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comp) With Cu ertino's Tear/Off Policy:
Job Descri�ptiD &P 2
Residential Commercial ❑ .
Fire Zone: es ❑ No ❑�-, Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of roject: Type of Construction: Occupancy group:
�DD 0
Qty
A ca I Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUMDING
IT 0