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CI OF SIION
BUILDING DIIVIS
PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO,
10980 MIRAMONTE RD
02060015
OWNER'S NAME:
APPLICATION SUB DATE
_JLAHOS JOHN B AND CYNTHIA
06/04/2002
HONE:
SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: - -
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
1.=7 LJ L..J I__I
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hereby alTinn that 1 am licensed un er provisions of Chapter 9 (commenting
efof Div Bt ¢ss end Prokssiom code. ane my Ecense
with Seci area
ism I oma end off
Licen ou LCi�cryNppp
RE-R�o q
AR ITECT a 08CLARA
.ON
I undcntand my plops shall be used as punlic records
M
'
Licensed Professional
ION
OWNER -BUILDER DEthe
Com
I hereby effmn Net 11. exempt from the Commoner's License law for the
Jj
'—
following rcmon. (Section 7031.5. L4 Bueinms and Pro. Co
Professions Code: Any city or county'
6 O ) 0
which requires permit de any
construct, alter, improve, demolish, ores
. re sig statement
such Permit torileLaw
to sljts issuance.nylodolsosequires theapplicantof
-
thal heor
the haisee9
thmhkiscmjwdpuhbant. l0. ofDivisiin3ofth Bucm(sLndPrWwonsC r9
(commuicingwithStttion.70(10)of DivisionJor the Bu sinew end Pro@ssio.Cole)
a-, ,+ca sp.,[MG OCcA�y`�� a !14,1;Valuation
f)'r1r35Stq.0F10F�°1','rVVJ;f,.'
at Nat So ii eiinipt theiefmin'trad the basis for the ellegeilexemption. Any violation
'
-of Secdun7031.5bymry...lican fare permit subjects the applicant to a civil penalty
ofnotmmethere&,landieddol (S500h
305APN>�j •e:•: I,.• Occupancy Type
❑es sof the property, ur my employees with wogs as their sole compenw[ion.
3 G7
-' .. U n m terms; 'and is Codc; Th is norintended ronse offered Law for snot apply to o:'
Business rid Professions Cade The Contractor's License Law does not apply to elf
—
' - -' _- - 6 01 - ROOF TEPIJF Njgo Inspections
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owner of property Who lades or Improves thereon, and who does such work himself
merec!thraugh own employees. Provided t uenotintended or
602._-__ROOF_.PLYWOOD_NAI L..._.
.d6ekdfor silo. oranphimprovemenu
for ono yart of
bildin cir
the building bg or urden
is dau
'co'mpletion.
, ..,
603 - ROOF BATTENS
omerwuildI of Prov he
to owner -Wilder will hove the burden of proving that rte did not build or
improve for purpose of sale.),
604 - ROOF. IN -PROGRESS
,__... ..__, ._.__.._._,.._..
'(7l m owner of the property am exclusrvdycommming with licensed contractors to
-construct
_..
the project (Sec. 76 . Bus end Professions Code:) The Contractor's
Liccmc law doe noupuc to en awns of property who builds or impmvex thereon,
_ en w o-canuacu, or. sue ms.wM a communists) he
projects rO-B nsed.PursuaaLto the.......
._ _. _..._.._.. .. .....__._ _. .__._..._.._... _.___. ___. ____.__.�............... ..... .. ..
Conuarofs License Ww.
❑ l em exempt under is & P C for this reason
; .a; ec'
..
Ovine ^ `Date..
'r WORKER'S COMPENSATION DECLARATION
•�'
-I hereby eRrm under pepelty of Q"juiy one of the following dectamdom:
,
❑ 1 hove end' wilt 6mmmfn i Cenificme of conscorm sclLinsum firs Worker's
Campolsn[ion, as, provided -for by Section 3700 of the Labor Code, for the
perfe romwe of Ne work far which this permit is issued.,
° 1 have nM will mimidin Warier's Compensaiion*insurance, as rcyuired by S«tion
37M of the Lobos Code: for Ne, perfomunce of the work for which this permlt is
' Issued. y Ys mpen non Insu c c mer and
11 t F Policy number
,y I
>_'M
'CERTIFICATION PEXEM IN FROM WORKERS'"'
ry
t ry,it-..i�i
I' " "COMPENSATION INSURANCE ' - _v t s ' -'
_..._....__ ___,.,._..,..,_,_.
ienioti need ndt Po etmpleiW if the permit is ror one hundrW dollars
•',o
..
' " -
tc
151aD) or less.l
'
..(`-tr-h 1 ce that n c f the brk f' h h int t s¢
ersimiforma
. o u c
employ any p n any ma n r x m became ub,cct to the Workers'
,1
Compensation laws fC 'iu.'Da¢
alms
:
Applicant .' '.
NOTICE TOAPo after making this Certificate oiLabortioade:you oulst
i
thewaricer
becomeh tdthe Labor Coaevoked. mutt
Compensation permit
tthe
n r
m y with such ro s o o th t sh II bed ed ke
mEp such provisionsShia[]
P P a
t d N CbNSTRUC'1'ION LENDING AGENCY
i
'f
1
flim thattmm a int ace
aBencYf the Hu -
oed
o 'or
the work f r wh ch this mmi,
i,sa
Pe' (Sec.3097,Civ'I ILL,.
-Lenders - _
Ad re•'
Leec Aime1
1 n fy that I have read this applmm on and state that the above information is
'cmrc
[ 1 time comply up
and do ; ty d; ad,lateenter
io an wmmnand hereby n
hereby p e t tiv sof thiscity t enter upon
above-
the eb a mem ncd S pony f pet p po ;
i spec
(We) gree sav d dy and keephammy the Cuybrc penins against
t in
liabilities, tyil dgmcnu se and cxpenu which may n any y true gainn said
Cry ca scq ftp gmt gar this permit
;1PPL'ICA YDj ND WILL COTIPLY U"RHtd1.L NONhOMT
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r
IlT��3Et�,L`f
OURCAt Ul'A r
E -o. -o
Issued by: Date ov
S4
sgnmureof APPlicamoCamriew, ' y <''"'- ',;'Date'
j
Re -roofs
HAZARDOUS MATERIALS DISCLOSURE - -
W11theupdicantorrt buildingbccupanutoremh ndleha datermmcnal
Type of.Roof ._ ... .. ..,.. _ .....-, ... - ..T. _W.. _.. -
m def dby,theC penmo Municipal Cala Chapter 911 and Ne He IN and Safety
Cod Serino255L'la) " -
r. x1 CI �,..,t b Y,• `.'�,
I I pa ..
q E i „ it
All shall be inspected to any roofing being installed,_-,
W;O the uppfc t fuim:butldmg a cep muse eq p nt or device wm�cn
roof's prior material _•
If a roof is installed' without first obtaining an inspectidn; I'agfee-to'remove
inn harmtknis air contaminants 6 defined by the Bay Area Air Quality Management
Ulama .. ...: „
all new materials for inspection. understands. and will comply with - -
°YeS ' ' �"° "' .. ' ;
,Applicant
'all non -point source regulations.
t }
I havEtread vne haz rd . maienala equ rements'under Chapter 6.95 of.the
C Idomm Health & 5 fety Code S coons 25505 25533 and 25534ndcut rid that
if dr. building does car rrcndy hme'a tenam that It is. my responsibility m notify the
'cm3
�/, G� ""' --' - /'76_0.3 _pZ
of the requirements whichmust be met prior to issuance of Cartifcele of
.
yp'm,
Signature of Applicant ✓✓"11 Date .
..
All roof coverings to be Class "B" or better ,'•
pesos au@origed ag ��' 'D to
t
t;..; ...��.:,.' _:.. .. ... .OFFICE -..
0
11
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
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. 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 YV 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: S 0 (^ 'k . I Cl k o S
Address: 109 fb a Or -
Reroofing
r
Reroofing Company Name: I h R G ��R oh�o �� in Q
Applicants Signature: L%✓1 Date: U 3 —0 2
Joe Antonucci
(Chief Building Official)
6125/01