02080010 CI Bu7L0 pPERTONNO CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRESS: PERMIT N0.
10355 MORETTI DR. 02080010
WNER'S NAME: APPLICATION SUB DATE
IGI VALENCIA 08/05/2002
1 PHONE: SANITARY NO. CONTROL NO.
MOO ARCHITECTMNGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
�NH
z
LICENSED CONTRACTOR'S DECLARATION JobDescriPMNALED
Z_G 1 hereby affirm that I am licensed undo provisions of Chapter 9(commencing
p_FW wiNSection](100)ofDivisionJofNcBusincxsendProlcssionsCode.undmylicrnu NEW ROOF OVER EXISTING
iz ca
is
cense force and eRat. DEC �.,� 2002
s m a License Clens Lim.x
O a O Dene contractor
u" G ARCHITECT'S DECLARATION
C-O S I understand my plans shall be used as public mcoNs pp��
w c,p p Licensed Professional BUILDING
an OWNER-BUILDER DECLARATION
C?<a 1 hereby affirm that 1 am exempt from the Contractor's License law for the
following mason(Section]W 1.5.Business and Professions Cale:Any city or county $8000
E=n which requires a permit to construct,alter,improve,demolish,or rtpar any structure
aim "'Pdomn its issuance,also.,It.dwitpplimam for such permit a Rleaxigwd stamtrcm -- ---- --- - ------ - ------
thasht'ixdicrnsedpitsuMittolh 'p.Adons of the ComrocmtsLicense Lew(Chapter 9 F p Or ea Valuation
(cammeocing.wiq Seetisn 5z)i(Division 3 of the Business and Professions Code) ('{?Ni'.�3;Y7�� '4 bil`�'•.0`l vI2'S'1 rt 3.I 5.' I
or that he hi exrmpt'Oimfrb'ti and the bods for the alleged'ciemptipn.Any violation
of Section 7031.5 by any applicant for a Perot iubjens the applicant to a civil Penalty
-
ano,wase than five hundred doll.(S500L 305APN�{ trpB\Lrw: OccupaneyType
❑['.a owner of the property,or my rmPluyeen with wages ax Nen sole Inin,madim,
-
-will-dothe-work:and the'suucturc'Is not intended"or'offered for'.sale(Sec-70441
'Budoess and Professions Code:The Contranor's Liana Law does not apply to w 601 - ROOF TEARegDM Inspections-%t�•' Sl,l u,::f.
r of propcny Who builds as inn mocx dro on,and who does such work Idntalf
nor°` improvements tintended or 602 - ROOF PLYWOOD NAIL
or Through his own employees.provided that such imp "amen s arc no
-oTrtd'for ule7Ehow6cr.tM1c Wildin-of ins mvetnem is mid within one'e_.of ._._._ _._.. _..._.._. __.__- _____.____.__ �___.._._....._.-____...-.__.-____-___.._._.__
'completion the owner-Wilder will have the Wrden of proving thin he did nest Wild or ROOF BATTENS 5'''L' " '� a" :^t•'.:'u.
improve for putposcofsale). 604 - ROOF IN-PROGRESS
OJ.0 owner ofthe gvpenr..mesdoxiveir contracting wit licensed contractors to 0:'ILDo,''.PP.<ga c''n
_ conswet the prgect(Sec.](JJ,Business and Profusions Cade:)The Contractor's rx;f, f;.:'T t.. „ \'Ia rl
Licnnsc Lew dos not apply to an owner of property who Wilds or improves thereon.
._and whp.ca. _for-auch,projects.wid,a,coaoactods).licenecd Pursuant...the. ._..__-___......____._______-_.___.._-_____�_..-..—..___-....__.._-.._..__.-....._____..�
Comacmr'e License Law.,,.,,)�,�„3 r..I-Trr;c t,;u.'k ”` h
_::. ❑lam exam tootle,. ,... :.p. , reason !l!, lie;fd'1':�iililR
p rSec: B&PCfonhis
Data
.=. ,•a•nf p. ,„ I. .res .... .:..•
"'WORKER'S COMPENSATION DECLARATION
w
in crtby.Rml urdcgpcnalry of perjury me of Ne following dalaratim e:-
❑ 1 have'and'wlll''maivialn•o'Cebifibeic'bf Conserv(in self-insure for Worker's
Compensation, es;pmvidad-for by Section 3700 of the Labor Code, for the
Peiformadce of the work for which this\Permit is bored;TLA
❑I have and will maims o Worke s Cor K'"Wint I' prance a�required by Section
3]tXl f the labor Cod f thePerformance of the work h h this permit,is
hired My Workers Compensation 1 . emir,and Policy be
C<u"t!er ItYA ( ri N°'•7. •IIPbI¢YN - " 'x .........' ys •,•Uar,• , •vi l+!Ii�J!°01'
p, t IY CERTIRCATION OF EXEMPTION FROM,WOyKERS ` c,,' ` �+��+ 1 4+.�.1. Y 4 p xS d• i i i .•Yt t i 1: •.Y i+1.'
COMPENSATION INSURANCE' ......_..-..
q"u't'(Thii seciioh need not be completed if tM1c permit is for one hundred dollars •. ,i IICC!1(3,1;1CC Type
18100) les..)
1 cert fY'thatn Ne performance fdre work f which his pt to th is;WEr Worker -
Ccuru nm cmrn Lawsf lit n any manna'sons to become mblect to the Worker
Cbmpc et Laws Cal to .D¢
_Apel cwrt •'• - - •' .._- __.. __ ... - ___.__._.. ._ _.._ __ ._.-.._ ._ _ _..._ _ _. ...__ ._.
NOTICE TOAPPhhCANT I`Cormakingth vis..xofE a pbon you should `••'Td^' t,, ' t'r" '
Q Obac bl it'NeWk I Co peeiws npro 6fih LaW Cod you st
forth N p ply th h p w N s perm t sh II be da d ked
:CONSTRUCTION LENDING AGENCY ' t • sr`
1% "" I hereby"Wenn Nat Neter binsirpn i Ina ng agency for Ne performance ❑'s 'L:' •t 'h
r�-t of h k!qwhichdipc t 'ssed(Sic Drk{eTx�1.N_i3r_5., 3_p.R]
G�V C
{rodefsName'":_
Londe sA= Z
U Q t
W on
I fth t l h d this application O state .tt.hI...above
w eseinformation
f .u.l
.. is
that
[r ut I gr to comply with II city and my rdce d at 1 I ng
Vo,aId goo wet d heirdBy nuffinanne orpmsentatives ofthii cityt tr upon
-0
' Ne We em n d Finite,rry f pea p / 'S0ii dgecepnB keep=xCnaof Cupertino6
` liabilities,judgments. osts anileens which
mayin way accrue against said
City neo q eof h gm tg fNis . .' -1.
oMPLY W7H AaNON'POINT"'ASOUCE REG'MuTIIssued by: DalePLICATNr
.-.�_�..
_
-
Spat a fAPPliwnr/QetllfpC oR:i.;. - am,"f-n. Re-roofs /.
HAZARDOUS TERIALS DISCLOSURE tlgl' `
y' WIIN pplicant W future building orroprammm Dr handl haraidou tow al Type Of Roof_
a5 defned by Ne Gupcmno M P�Cad Ch Pt 9 12 and th H IN d Safety 1.(., \'C't I:, )❑
cone s�<i, �'S7itP) n trr <,' I „ ,- 7" ,ur'iP t'4` {,a•"3 i.:1 1'.'�"'.
-_All roofs shall be.inspected prior to-any-roofing.material being.installed.--..--,_-„
' W 11 sh ppli,o t `Ins h Id ng op up m use equ P t ae�jcex which If a roof is installed:tviftut first obtaining an inspection',-1 agree to'remove
em t M1azallous a rcona n t ii defined by the Bay Airs A Q lhy Management
Dixtnct , ; all new materials for inspection .Applicant understands and will comply with
5the
all sourceregulation{ x I
nil
undersmtthe
1 V 1 have rcadhhc h redo matcnal. req trcments and Ch Dter 6.9nhe '
Cal Tom a Ne51th'&Safety Code Sedtionx 25505.355JJ and 355JJ 1 that
if the Wilding dwpnot curtemlY haveamnan61ha1 it is my mponsibiliryao notify the . ..__-.-
W r 'q.• 'st be- iP'oto its arca ofoC nifiam of
p cy r
r o n t r rt u!rcm<nt4 w mm� Signature of Applicant Date
Or n
oamra m {gage t r _f , , „ Dat All roof coverings to be Class "B" or better
i
-OFFICE_. _. . _. _ ._ _ _ _ ..._.._ ..__.
Building Division'
`1 10300 Torre Avenue
r' Cupertino,CA 95014-3255
Telephone: (408)777-3228
OCIOF Fax: (408)777-3333
CUPEI�TINO
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 V"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 o�/nn/reroofing and will comply with this policy.
Homeowners Name: s ' l/a l e n c i w
Address: /03SS G�Jo� �/� :,,r l��. �„� �yg 9S0/5t
. Reroofing Company Name:
Applicants Signature: Date: ?/S-/O _
Joe Antonuc
(Chief Building Official)
&25/01