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CI OF
BUILDING DIIVIISIONNOPERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
10404 MELISSA CT
WAGNER ROOFING CONTRACTORS
INCO2090028
DP iL�K GEORGE E ET AL
12242 SARATOGA-SUNNYVAL R
APPLICATIQ $rjN�A{>i 002
11 /lCONTROL
PHONE:
(408)777-8331
SANITARY NO, NO.
ARCHTIEC IENGLNEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing
REROOF
ROOF
with Section 7000)of Division 3or the Bminessend Professiazsqq C"de,and my license
is in full force and eHe /' 9�
License Class C Licit Z 2
Ips+ I
��
"'
Date Contractor'
tCHITECT'S DECLARATION
1 understand my plans shall be used E public recorrecordscds
SEP 1 3 2002
Licensed Professional
OWNER -BUILDER DECLARATION
1 hertby muni that 1 am exempt from the Contractor's License Law for the
BUILDING
following reason. (Section 7031.5, Business and Professions Code: Any city m eoumy
$9300
wh ch eq es a Permit to con. wctalter, improve, demolish. or repair any structurt
. applicant Permito eels
poor to itsc also requiresprovisions
- - -
„ 34 14�}O�QPEOfpa• n a
j1. ?�• £,
Valuation .
Law Chappr9statement
Bust! UccnulawonsCod)
thathe I -sed vorSeuamtotncpmDl of Division
(cot njwthScci-]U00)"fDivsi 3 of the Bones}and Prufesvom Code)
or that he is exempt thdifm;M and the basis for the allijid exception. Any violation
l.�{ll``s
" > i� as a , gwyuwa' t.r.fl;ir 1:) i .r 4
- of Section 7031:5 by any applicarn for a Permit subjects the applicant to o civil Penalty-
tof not mon than 0.e hundred dolan(s5oo).
AP_N
3 O S CsR¢tY'4E`
r,:c>;r.:r Occupancy Type
❑Loa owner rinne Prottny.�rmy=mPlnr==•wim wag<a as th=p aol<=ompenation,
307 - INSULATION
6 O 1 - ROOF TEPA � �' Inspections "'• +L B 1.', "'-
-wilt do the work.-and'the stmemrc is not intended oroffend 'for sale 'sm. 7(14,1;
'Buiineto is'anit Professions Code: The Contractor's License law does not apply on
owner of property Who Wilds or improves thereon. and who does such work himself
602 - ROOF PLYWOOD NAIL
or through his own employms. provided that such improvements arc not intended or
..offered for-sida.lf-howevir. the building of inniinivernenti., sold ithoineeiwof
- ---_--603_.__.__ROOF-:.-. ._ BATTENS .... --_
minpi i the ner-builder Id II have theburden f proving that h did not build or
604 - ROOF IN -PROGRESS
imp r prpo.cur.l 1
-- --- - —.. -. ... __.._.... --
a has ane property, am exclusively contracting with licensed comm<mrs to
mistrust the pmjmt (Sm. 701,, Business and Professions Court) The Contractor's
Jl .O,L('. ..;, s!e' 11
License Law does not apply to an owner or property who builds or improve thereon,
-and who cum emit.for such.projects.with.acontusion) limnsed.pursoant to the,
..-------- .-------- _,_.___-____-_.-.-_.__._....._.
ian
❑lamase ms BP,Cfor Nx rtso
P underSe�„ &
i;l'„ii;•�,'r;l�t)a�
OwnerData
”'
WORKER'S COMPENSATION DECLARATION
' J 4 I herby mfimr order penalty crime, one oLBh= following declamtiom: -'
❑ I have aod'will maintain •a'Cenificate of Coossnt to self -insure for Worker's
Compensuion."aa provided for by Section 3700 of the Labor Code, for the
perfontun a of the work for which this permit is Issued. O
❑ 1 h ❑will maintain Worker's Compensation`Insurance, as required by Section
37Oq of the labdr Cndc, for Ne perfn'rrnancc of ilio workfor'whi<h this pcmut'is
Issued My Work r Co do Insu�enc c a d Policy robe c'
s I3I6 �O •�
it i i',
Canter i/'°f("��T`+Nt`i Poli y No.
P �T L..,` t't 4, t r,n"+, k�.
f-{%:} 1[\'+'S. '.1 rn, G"'.5 -" 'j1'-1•
n I;, CERTIFICATION OF EKEMPr10N FROM W'ORKERS'i'. •
� •'
"'l"'t °' COMPENSATION INSURANCE "' "'sa'
-o"i J. -. _.- � e,. .. ... __fin.._
._.._.. _ _ . . ._ _ —._ � .�_.....—___._ �. ___ ._ __.._-__— _—• __ .-_•
f -f '(TMsun ori ncid he not compbstd if the permit is for one hundred dollars
.U.
A,-...,.
-. to
sAall dt employ onypc . n n any manner so > m become zublen to thb'workers
dicngtnt�tn t'i 6orso is 9. tawmra.n r,m
,.
.tit on Lawi of Calf ' .Data
.?APPl cant - - - .__-. _.-�.-.>
Applicant
_ -- .-_..______... ......-_.._ _.. _. .__ __. ...... _
fNOTICETDAPPLICANTIfaR=rmakingth-CeniOcatebf Exe pton,yo.phould
become subyH to the Worker's Compen.auon prm0 tis of the Lonur Gde, you mu.a
ronhwith comply with {och'pmvisiom "r this permit shall h JttmeJ revoked.
IiLN •.}�.,^cnnI'It'�'CON$TRUCTION LENDING'AGENCY '' .:"""
•.,' ... 'f1,0•
11"'1'M1ertEydRnn'thattheicisaconsimctionlendin8agencyforih<perfomrdnce'
north
S•' ' -- •-••'r
` k f "hich th pe i - cd 15 ". 3097 C '. C )
-
s
Cern Name -
.........
Lendr Addrc:,-.
I nfy th tlha =read Nrcappl cut nand ... eflaufficabsocinfinerinimi,
co}mm I agree to o ply nh all,ciry and county ordinances and state laws relating
co son andh mbya thorfre repssrmin es of this city to enter upon
:.Wildingwcu
he abu(W-) jmfrified p mpenyLud Por, f1 mod k p harmless to, City f C
IW) g 'ion t demm,a and keep ha
try
Iran l tie 3 gg ma. a d p< hi nen y in nr 'r era g inat said
!,xgdrxt said
Ci in seq nttof tribe t g f hi Lamb.
VVDER$TANDS DWILL GOMPLY WITH ALL NO.' OIYf �'
� y
Ca —v
sSPPLICA\i
SOUR F LATI NS - ) ` i
Issued b ; Date `
Y
9 __
sj r, ofAppl antrc t eto_ "' - War, t -
Re roofs
,.- HAZARDOUS MATERIALS DISCLOSURE
'- Will the applint or future bu Id ng occupant store orhandle hurardo material
Ty e Of ROOTn �. - - -•_ -- - - - . -. -
a"d f ed by the CupertinoMunicipal Code Chapter 912.and th Health and Safety
-1 1`_.10
sL.z.6 )`s
Cod Seeun25532Wt a
°Y f.
t')1 :. :a:'J'
All roofs shall.be inspected—prior—to—any—roofing—material—being
..Will the applicant or future budding recupant use equipmentordeaa+,wm=n'
Ifaroof is in5[511ed witflout first obtaining ati itispection;'I'agiee to`remove
<m, hrsmd s - ri t dined thymic ByAt.A Quality M u'ream
District?
all new materials, for inspection. Applicant understands and will comply with•-,
❑r ;:, oN
all non -point source regulations,..,.
I n' n m mmerima rc ntrcments. under Chaps r 695 of the
Cal f m i H Rh & Safes Code Sections 25505 25533 and 25534 I d rstaralthat
- "
btWn dnegnmcned havcost Lth^t repo ourythe
6 Y Y
m
- ^ s •,- q- y O"`�.
orac
occupant of the re uircments which must be met m notion, of CeniEcate of
G<
Sign Nt e of Applicant_ _ Dae
— -
- — Z
--
All roof co gs to be Class "B" of better +
ow auNora=a,;gent,; v!%%
OFFICE -
_. - ...
9
C
Building Division
10300 Torre Avenue
Cupertino, CA 950143255
Telephone: (408)777-3228
Fax: (408)777-3333
Building Depa ent
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.
0
Homeowners Name_
Address: / d L/O y
Reroofing Company Name:
-All
Applicants
Applicants Signature: Date 6 "
Joe Antonucci
(Chief Building Official)
6/25/01