01100082 CITY OF CUPERTINO -
a BUILDING DIVISION PERMIT CONTRACTOR DWORMATION[
BUILDINGADDRESS: PERMIT NO.
-18770 LOREE AVE . ROOFCO OF SILICON VALLEY 01100082
OWNER'SNAME:
APPLICATION SUB DATE
BRIAN BONNIE FIELD 844B EARLE AVE 10/11/2001
PHONE: - SANITARY NO. CONTROL NO.
- (408) 795-3335
O O ARCHITECDENGINEER: BUILDING PERMIT INFO
Id BLDG ELECT PLUMB MECH
�s.?
O H_2 LICENSED CONTRACTOR'S DECLARATION Job Description
I Z I hereby affirm that 1 am licensed under provisiom of Chapter 9(commencing p
,_i. withSmion700(1)ofDivision3uftheBusinessandProfessionsCode,andmylicense REROOF. (HOT MOP)
i u is in full fore and that.
-C �6 DtaLicense ss Lic,
'❑n.U Data Contractor C
u3-.¢O Ci ARCHITECTS as in RA to
1 understand my plans shall be used as public rt Na
I p O
Licensed!Professional
k a OWNER-BUILDER DECLARATION
uuuu1111-,n 1 hereby affirm that 11. exempt from the Con orst CA ,My c ty O county the
t? fallowinguire,.(Section 7 construct..1"".
,.mora Co de My city or country
❑ which.quiry rr permit n c som the ahce improve,hparaish,or Pat,any stmau. $4100
-O
t6y3$ -pnortons Issuance,also.quirtatheaplrlicmtforeonh tiisUmn Uw(Chument. .__..__ .. .- _______ _ __area. ____ __. _ _ ______.�__________—
(commencing
Section 709ppro4btomof the Cont.ctoh Licenu law lChepttt9 / 4 -fc{+,f yps'Ys ppb [e P,.+p y.i,.♦♦ ^ Valuation
(commencing with Section 709p)of Division 3o(the BppJnes}}anQ Profutsssions Code) _R) 'i`y�3_' '1'O VF•�,j stl a {_-<i.l ` ,
ar thm fie is exempt therefrom and the basis fm the alldged elenptban.My violation
of eo�thnnnedm �swbjuu Ne applicants toecvl pcvlry� iaa drdllar (ss0o) - 305 APN N,,�,I,e,• ! Occupancy Type
- FRAME {
❑I;d oche w.rheproperty,or m em ar mended o a rs their axle compensation
1
Y employees 8 penmtion.
- will do the work,end the aroma.is nos intended or oRtad-far role"(See.]044, _ ,
Business and Professions Cade:The Contractor's License Law does not apply to an 6 01 - ROOF TEA�@gCjjpo Insp°dtions t (
-
owner of Property Who builds or improve thereon,and who does such wort Affinity
m through his own employees.provided that such improvements arc not intended or _.-,,,_, 602 _e .ROOF PLYWOOD-NAIL
.
offered for sole.If,however,the building or improvement is sold within one year of -
ivtheowner-Wader
will have thWitten of proving that he ria nd hilt a 603 ROOF BATTENS
improve for earae J. '
_604__ ROOF IN-PROGRESS
construct the project
(Smly%,_ saes._. .. _.. ._ _
memo.of the propatY,vmexcluuvclY rowxNhg with It'mxd<oouacwmw area . .__. {_ _ . ��i
r he ro no S ]OM Business and Professions Code.)The improves
the Dr's � i f ,, y'1 tint'
i and who
Lu owner fpr pony who builds or improves thereon, '
ond.wh contracts for wch rn.sviN-a contractor(s)licanswul purwent.ho the. _ _ __ _. .-
Coatructor.Lima.Low.
❑lam c map.undirlc 7 ' '� OAPCfor this reason �ti0 !`tpllt
c . _ .� �� j
WORKER S COMPENSATION DECLARATION
]h' Ihe.b affirm under " 0
y pevlty of pmjiiry one of the following dulaaonsr V /
❑ I have'and'wih maintain i Cenificam of Counter,td uhf-insure for Worker's
Campenmtion, as provided fa by Section 3700 of the Lmor Coce;'for the
- _ performance of iba work for which this Permit is iaued. t ,
❑1 on and wili mviniairi Workene Compenmhion Insumna,as required by Section
3]00 of the Labor Code f r the perfaniuic f the wort for which reds parrot
rss ed My e s C pensat 1 w n e aerie Dort Pol umber art:h "
Comet 'e,' CERTIFlCATION DF,EKEMPTIQN FROM'�W RKER OOH 2 O �� `%.}' I �.? tti• t! r1I.�v7�(?D�..a+.:
r"t•(Thii ecciion 6eee nm be cuidpiened if the permit is for one hundred dollsrs ri r'?, it'I L�:P {a (f,'C❑y)I'-'l, lei diC
' (11001 or leu)
Ca pe mtwnylawty p rs n in man i
i
C.
of to woh for which thispemut'ie issued,I I
shall a mploy ny pt n m any ones es to become iubl p to the Workers
Own
-Apple r
.._area area.
after
Q Qrr INOTICE
4TO .. ANT If.
nhis Certificate 01
1area hn
becames b)e,1.the Workers Compensation nsofthemp1cy.ausum must
fonhwuth oro IY nthhproouw r th permht Nall be deemed ked,
f
CONSTRUCTION LENDING AGENCY o i
Iht by am enthatth sa<ohsWmionl ding agent yfo theperfomna c ' I e.
ofthe 1wkfrwhich this Permit ec
t is issued lS3W7-Civ C)
r L" area Lenders Name...:. ...... :area
a;Z Isoder'siAJdicasy'•'.�.. o s. s a re a li,! I%C.w'I'1 f'ti�,l'
nim . nom ,
1 cagey that 1 have reed this city
and on end stem thea the above inaw,,cion is
-O'U tobuilding
agree to comply with all tlry aril t1fir ordinancesf thi sine laws relating
'�'.W the idnive-nomredpropertyor m,,xviceertp.iemetiveiohhiscitymenthe upon
_96 the ebo(We)st tin property And
mows.,-_,C
f�...rl 0. 1 Wel agree ro save:indemnify an8 keep harmless the City of Cupeno against
F'V] liabilities,judgments,costs and expenses which may in any way tame egurr, sold
City in consequence of the growing o/Ni permit _ -
ICANT L' ER AND D WILL COMPLY ^U NON-POIM'i`
ceRE oNs " Issued by: Date
Signedure fApphcam/C mmctor - - t Data Re-roofs
V s HAZARDOUS MATERIALS DISCLOSURE 1. .
�t Will the nt PPlicaoft building occupantrldle par store mhahvvdous matwhi Type of Roof-
as defined by the C-Pamim,MunicipalCod Chapter 9.M and th Haads and Safetya
cdde seen x;s3xy r lc ri 3 C:i : a t t ;,! { i
)r;.
.r" f " ..-All roofs shall.be inspected prior_to.any roofing.material.being installed.
APol the applicantar future Wilding..,a.macaluipmcnt or devices which If aroof is i5isialled without first obtaining an inspection,h'agiefi tai'einove
emit haimicas our contaminants.defined by the Bay Ara Air Quality Management
t
ct - all new materials forInspection. Applicant understands_and will com I with
iOYs
C)No P.Y._.,
all non-point source regulations.
a read'ibe h=rdous maenads remrnamot ntltt Chapter 6.95'of them aHealth&SafetyCade ave a hes15503 t itis apt25134 IundemendNu (buldutgdoxesnot currtn0yhaveatetmnt that tismy dip nibitymnotifythe '�/G// "ant of the regoiners wh ch must be mm prior to hammee of Cth ficate oh gnatyreofApplicant- Datenear non=m a e t . Date All roof coverings to be Class"B"or better
8 'fir r .,S 3 :•.,,
L.
OFFICE