00120085CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
.
BUILDING ADYK 88-90 MAXINE AV
L ANGELES ROOFING
I'ERMITNO. 001.200135
OWNI?R'S NAM1i:
WANG STANLEY TRUSTEE & E
r AL 15310 CALLE ENRIQUE
APPLICATION SUB DATE?
12/J4/2000
MONK
SANITARY NO. CONTROL NO.
40$7794688
ARCHI'I'I.C'I diNGINFIiR:
BUILDING P17RMEIINFO
BLDG F,LECT PLUMB MITCH
I_I LJ I_I I_I
1.ICIiNSI'.p CONTRACI'OR'NDIiC1,Al1AI'ION
- Job Description
1 berehy mfrs thin I um li en,el under pmvislons oI Chapter 9 tconllnencinp
withseetit„Jap)ufIns om3ofhelosire.. undrld!..ior,rnde.nndn,yfanse
TEAR OFF SHINGLES/ 1/2” PLY AND PUT AS
in hB fora and effect.
nil[".w spun Con
�T
30 YEAR SHINGLES
actor
ARCHITECT'S DECLARATION
I understand np, plan. shall be used m public mord,
I,feemed professional
OWNER-BUILDER DECIARA'I'[ON
1 hereby affirm that I am exempt from the Contractor's License Law for the
ollowiny mason. (Section 7031.5. Business and Prore„iom Co& Any city or county
which requires perolit, n t ,. alter improve, demolish. (it repair say,, Imre
Emi to it,I:n rester-he ppl ant lot Suchpc it III life a signedstatement
hat he N licensedp :.; I the P o f he C , e ', License Law, (Chapter9
Sq. Ft. Floor Area
Valuation
(eotmnvoicing w rm Secret, lap) or Divi,00 9oche Bursitis-andProt iot,Code)
or tem Ile i, cse,npl thec rant and me nazis roc be mllcgcd exemption. Any violation
111 Section Tans by roy om'Im To nl I pemtit nubjcax Ilse :q,plicunl Io n eiv't1 "a ty
APN Number
1"
- Occupancy pe
olnotnlor, to five to,dreddopm.ta5om.
01,aeownerol',hc propmy,ormy eo,pwyeea w its wage-, Iheirn,le.... inion.
quired Inspections
wd1 do its, work, and the ]moms i, ma imend l or Mfured for sale (Sec. 7144.
'rhe
Bu.mc., and Ptnressim,.s Code: Commalor4 License Law does not apply to an
owner of pmpcny Who build, or improves hereon, ami who does such wort, himself
or though his own c doyee,. Pm,idcd It., such improvements me or intended or
offered ,de. lf,how ever, one year of
is sold he
or odes
305 — FRAME /
/
milefor
will Ifn,ros did
improve forEben,cofs.adm,dl nave he btrrden urproeing rose, he did int build o,
707 — INSULATION
impose for pu,po,.e of sale].
5
01.a% owner al the progeny, am exclusively contracting with licensed contractors to
601 — ROOF TEAR OFF O
/
unane, the pmjwt (Sec. 7144. Business and Prnrrsstnns Cmic:)'Ihe Contractor',
License
n r /
602 — ROOF F I_ YI400D
Law does not apply to as owner of propen, to, hold, or imp rnhereon. ern.
and well contracts Tor Inch projects won a em,Imetod.) Teemed pursuant h m`
603 — ROOF BATTENS
Cm,..actor's License Law.
El l,ttn esemp, under Sec, B,v P C hr this reaxnn
F04 - ROOF IINI—PROGRESS
Dwne, Dom
.UB"""COMPENSATDON DECI.ARA'I ION
,-
Ihereby of1h order[woolly of perjury nor of the yellowing declantionn:
] 1 have cold will flaimtell a Certiliva¢ of Cmnenl to sell-insure for Worker',
Compensation, as provided for by Section 3700 of the Labor Code. for the
redonnance ill he work for which his penin, is issued.
01 have and will maintain Worker', Con,remation Insurance, as required by Section
Pal of the Labor Code, for be performance of the work rill which this permit is
,wed. Aly Workers Compensation Insurance carrier and Policy number arc:
.
Camcr:.s%%/1�Policy Nn.: D� p0 V-OOD
y
CHRrIFICAf1ON(IF EYEMPTI INMOM WcRkpRS
CUMPENSAI'[ON INSURANCp
Mis welon need not he completed it the permit is tin one hundred Jolla,
.
is I Ial)of It,,.)
I eerily thaf In ,he lerfomuraa of the work lot whirl, lin, permh i, issued. I
,Lull uuI empby xny porxmI in city Iran Ill so us w become subject to ,Ila Workers
Comprm,uliun Law, of Cul ltornia. Uare
Aprim t
NO[ CI?'1'fIAI'IIUCAN'I:If, mffurmaking this Ccnilicle of i?xcngmim,, on I old
becnnm,uhicct to the Worker'., Compensation ...... siun, or me Labor ales you must
hoth will, comply with such provisions or this pemtit shall he teemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that here i, a construction landing agency for the pe forma r
of the work Rn which his permit is issued (See. JUG. Civ. C.)
Lender, Name
lender', Address
I ceni ry that I have read this appl isatin sort state that the ab,c infom,ation is
,ionco. I .gree ,, comply with all ci,v and county ordinances and stare laws relating
m building onvort nI and heresy amhoriie representativclot his city to enter upon
the ubrvemanioneJ Progeny na msrec,ion purposes.
(We) ni,me it, me.indemnity and keep ferrules, lee Co, or Cepenino against
hithilows, judgments, cues mod expr se, which may in troy wry accuse ugaim„ said
City In .......hien', at Esu, cuing of this perm".
NON-POINT
/ '
-%•_\C l'—
API'LICA N" NDI?RS'I'ANDS AND WILL COMPLY WUH ALL
Issued by: Date '12—
S, URCtI' .ULATI,QN� li
�JJ GD,rm
Re-roofs
sign: pplicun Comuseoror[
HAZARDOUS MATERIALS DISCLOSURE
Will ,heapplicant nr fume building occupant ,acre ar handle hirattlnu. meormil
Type of Roof
az defined by the Cupcnino Municipal Code, Chapter 9. 12. and the Ilealm and Safety
Code. Section 85321x1:'
O Ye. KNo
All roofs shall be inspected prior to any roofing material being installed.
Will hearplieadorFuture brilding',ectpamuseequipment nrdriceswhich
If a roof is installed without first obtaining an inspection. I agree to remove
emir hvardou, air contaminanec:u defined by he Buy Area Air Quality Management
)alMcft
all new materials for inspection. Applicant understands and will comply with
ores _KNn
all non-point source regulations.
I have and ,he ,gni under r fi,95 ill the
ration,
Coon.
14. 1 understand
Cuile Isliaile,ee Pa Soley Citic.Sectio,,ral, thn" is anal 255,.4. it,tomd that
Safety 2 5. 25.533 a
thebdl the
i,y,ow,ate
iEn toy reyusle
w.cnot enrre,which
q ♦ 9_ /-C.',� DO
first helmet of of
cnrmn of ihu rttµtirumm�m which moa bt nm, prior to is.nancr of a Cenifaum of
If the
V' _�—�/
(iaEtl+an'
Signature of Applicant Date
All roof coverings to be Class "B" or better
Owner or aud...7, dxgca, True
OFFICE