02020008CITY OF G
CONTRACTOR INFORMATION:
DIVISION
I PERMIT
'h U1LDING ADDRESS:
PERMIT NO.
10254 MINER PL
WOODS ROOFING
02020008
OWNER'S NAME:
APPLIC TION UB DATE
MANCUSO MARJORIE F
1020 HICKORY CT
02fC 2002
PHONE:
(831)637-5576
SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'5 DECLARATION
Job Description
I hereby affirm that I am I¢emed under provisions of Chapter 9 (commncing
REROOF
with Section 1000) of Division J of me Business and Professions Code. and my license
is «;°cj;:°"deH t' q / 3
.
T O SHAKES, RESHEET 7 16"OSB & 30# FELT,
tie..
Dat=� cnntraemr
ADD 40 YR. CELOTEX PRES. COMP. SHINGLE.
ARCHITECT'S DEC LARA ION
1 understand my plans shall be used as public opectinfif
Licensed Professional
OWNER -BUILDER DECLARATION
1 hcteby affirm that 1 am exempt from the Contractor's License Law for the
following mason. (Section 7071.5, Business and Professions Code: Any city or county
which requires a Permit to construct, alter, improve, demolish, or xpair any structure
prior m i¢ isavenae, also icqulres the applicant for such permit to file a signal smmmm.
that h,s-fence pursuant td lhpp provisions fthe Cmumeam.L se Law (Chapmr9
(commencingwith Seti 70pfl) (Divi.' Jof the Bupin. d Pmmsson.a Code)
5• Ft./Floor Area rk-ai s.'+
f..t�l)41i iY s`.s
$121y4uation
or that he is exempt therefrom and the basis for the allege) exemption. Any violation
f l9 a,,'16 't. k}.{. t C'•J.'''
of Section ]031.5 by any applicant for n permit subjects the applicant his civil peachy
of act mm than rive hundred dollars (5500).
3164Mt99ITItUT
i1'," •• Occupancy Type
° 1, as owner ofihe property, or my employees with wages as their sole compensation.
305 - FRAME Required Inspections '•� "'
will'do -the work. -and d'stsucrdm is not intended or offered for 'sale '(Sec 7016. -
Business and Pmdf�sskrrs Code The Contractor License La does to an
not apply
os'liWild, inipposeathe...strl does
owner OfProperly or who such askhimself
307 - INSULATION
or through his ow ply provided that such improvementstintended o
off a f . 1 If- m b- la g p t la m y nr
_
"' 601 --= ROOF TEAR`_ OFF - ---
1 - "
completion.N 6 Id itIh theburden fp proving did not build
impn
fv rw f ).
602 - ROOF PLYWOOD NAIL
-
oInn p peer I ' 1yc tract g mi sea t- tanto
-" 603 -----ROOF- BATTENS
construct p (5 ria cna rime Contractor
604 ROOF IN -PROGRESS r
ah
L Jc. it p reproves thereon
License s o of builds
O
4 com awho
_ anwoo contmts.for .such Projects w th a commtor(s) licensed Pursuant Jo me
uch projects s
._. .._ ._ ... ,.. ... ._ _ ... .. _.-_ ... _... _ _
Contractor's License Law. -
01 .xcmwrkerSec."' � � r r,B&PCfor this rtason
° 1p
a.
.,-..::ai",
Owner °' �f' Dam
WORKER ;S COMPENSATION DECLARATION
" I hereby aRrm under penalty o(perjury one or thefollowingdeclamtions:-
° 1 hav< and will mairoma'a Ccrsifcate'of Consent to self -insure for Worker's
Compensation, as, provided lis by Section 3700 of the Labor Code, for the
ornmofthe work for whI ich this pcn1.mi is issued.,
penfma
.ynvhave and will'ri,aiamin Worker's Compensation Insurance, as rcquind by Section
T100 of the Labor Code: for the performance of me work for which this permit is
iso ed My Works' C pe to Inaarne tamer and Policy be arc:
Cent .!�'. path, No.: 285-
s !' )`.t 1 r1 "1• ..., '
1 t: 1. T 7.Y"1 y1 1.j
CrUIFICATIONOFEKEMPf1ONFROM NORKP S
' COMPENSATION INSURANCE ix ts+1 1-"i•
.a>.. .Ifo a..
(Tm,' tenon tired no he c"mplcicd if the permit is for one hundred doll—
performance of the'woricfor-4 h his.it ii iaaued'I
-' _ _ _ _ __ __ _ . __ - . I .. L . -- ♦ ....._ __ .�_. _ . _. ._ .. _
shall not employ; any Person in any manner so as io become subject to the Workers
Cn,npnnaan"n Law, of California. Date
Applicant'
... _._ .. .
NOTICETO APPLICANT: ff r a should
became to the Wolroffer
ro eeddmust
,
foahwithtomI thsucheons orths�mm hall dmerevoke.
... .;..., ._-
CONSTRUCTIONLENDING AGENCY'a
I
" "1 hereby lending agrncy forme perfomianec
that Vert is a issued
wIT
himn
(See
of the work for which this Permit is issued (Sec. 7097, Civ. C.)'_.
Centlers Names ._-.. �. ._.. �.� .. _..._ - :.. .. ..,
_ ......... ... .... ...... _.._.__.. _. _. —_ _._ _.�_.._ ._-...__ _
Lende'r's Address
I artily that I have read this application and state that the above Information Is
ries I agree to comply with all city and county, ordinances and state laws relating
to building construction. and nimbi omnorim represimatives of thji cisy m enter upon
the above-nmmimeed property for inspection fmpoxi.-„
Wnj Sgrceln save, indemnify and keep hcrmless the cny of Cupertino igainst
liabilities, judgments, C and expenses which may Ia any %ay ricrac against suid
City in tnnscqucna of the gromin ii permit.
APPLICA4T,ac C!RSTAND .Drs ICLCObi' "\VITH ALL NUNpOLy��
r' v
Issued by: ate
SOURCE REGULATwNs + .. a;,.. i/, f /
Signature of Appl,cantlContrucmr T' "':. 'a " ). ,Dwc
Re -COOP$
HAZARDOU MATERIALS DISCLOSURE";t
Will m applicant fur bolds gmc pant Stott or handl hv-mdous material
Type.of Roof_
u ❑fed by the 32(.)' Municipal Cade Chapter 9 12, and m Health and Safety
Cbd Se<i n 35,SR(al
i s . , 1-
- • - H, °
t, 9 ti
°Ys - (
+ �!� •�' 's''
V ,, ,a
roofs shall be inspected prior,to.any.roofing,material .being installed,___,_,
_ ... _ •,
Will theapplicant future building c pant use equipment ent de vice4 which
_Al.l
If a roof is installed without first obtaining an inspection;-I'agree to remove
craii balrarchous air commannams as defincvj by the Bay Area Air Quality Management
District? .-
. all new materials for inspection., Applicant understands and will comply with -
all non- 6ini'sodree- regulatlons:,.f,, it
t I have read the hazarsou. ate' I. req is d Chapter 695, of the
California Health &Safety Code. Sections 25505. 5537 and 255311 timerstimulthat
„
_. .. -, .-1.
if thWilding does not currently have atenant that lsmyrcponsiblity to notify the
'-'-' --'(`" ___.
L� a%�Y
4
ins
acupent of the reqs r rah mut et pnono i ante til a Ce ifc . of
occupant, .. ,.
Signature of A lican[ Date
41
All roof coverings to be Class "B" or better -
owneror ea ria:edagent _ .. oat
i.,..,.,:. ..........,_ .. .. .'. :.) _,._,.,.t.aa. 1.-_. OFFICE--- ---._.._. _.... ... .... .. __ .. .. ..
t
I�
CITY OF
&UPEkTINO
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Fax: (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
IMPORTANT:
1. Flat roofs must have a minimum of 1/" 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:
Address:�-
Reroofing Company Name: s
Applicants Signature: q Date: `7�° z
A4115
Joe Antonucci
(Chief Building Official)
6/25/01
and manufactures specifications on reroofing.
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 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.
6.
If plywood is installed, a plywood nail inspection is required.
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/" 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:
Address:�-
Reroofing Company Name: s
Applicants Signature: q Date: `7�° z
A4115
Joe Antonucci
(Chief Building Official)
6/25/01