02050065 CI BUILDING DIIVIISSIIONNO
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT N0.
21695 NOONAN CT FIVE STAR ROOFING 02050065
DWYM MILSTAIN 387-A UMBARGER RD AppU`NAj1TbS/IY6T62
t PHONE: (408) 972-7855 SANITARY NO.
CONTROL NO.
n O O ARCIII'rEC IENGINHER: BUILDING PERMIT INFO
F- BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
' 1 hereb Tran that I am hemnxm ander Tena ter 9leommameln Job Description
r a previxierx e P g REROOF
y F-m whItSeetio7000)of D"ision3ofthell- endl? c,o.r,Cde.jmylleenxe
;YES ixmrmlenm . t. 77/ / WATKINS PREM. TLVY B
ee a Li«nse Lic ro
%O a Lr Contrac r
%W m0 ret % ARCHITECT'S DE RAIN,
A ON
1 1 understand my plans shall berated.,public records
Licensed professional
Oat I am exempt fo DECLARATION
= I thereby.Se, that 1 am exempt from the C scion, is License law fm the
"
F z nfollowing reason.(Serslon 703 L5.Business and o;c.de Profession,Code:Any city stcounty
which requires a pcnnir to consmn,vlmr,improve,demolish,or repair any structure
w€�
prior oi.ehoance.alsore the n licantfor sarn no file a signed statement
_ 143.00..._.-
Wmmen nwith fam�omepm.:wn: nn Contractor sL Laons ode) ., f� Sq: Floor Area-)I a ,� � , Valuation
(commencing with ctmnacnoad Dfvrxi o fm Business dire, ) [II
or mm iIrmo S exempt any applicant
p li anJ he haslx toothealleged eaemprod Any l Plmion 3 571 9'67t`6'0.
-of Section]031.5 by any hundred
do ll fora permit subjects the applicant w•anvil Penalty
,of not more than five nanarea ammra(ssW). APN Number Occupancy Type
111.as owner ofthe pro,im,or my employees with wages as their.sole compensation, 305 — FRAME
-will do the work,.Add the xwcwre isnot intended m offeredfor sale lSec.Tota, 07
%Buslms and'Profeaions Code:The Contractor's License law docs not apply to an '3 — ired Inspections' '• •'L•,'
owner progeny Who builds or improves roamer.and who docs such work himself 601 - ROOF TEAR OFF
or through his own employees.ccs. oviaca that such Ire
-. g_._ P_Y Pr. _ _ pane cnsar _ - __ ._-.._...— ..... ._. ..... ... .....
la r a not intended o
.oga2dfo,xme:wn,havd:the will havetheimpnifjontls nxtha within nn6yevr of — 602- ROOF'"PLYWOOD NAIL, ,I„ .. —.. .,�
reprove for me nweer.bailder will have me narae,r of prevmg that the did rat nous or 603 — ROOF BATTENS
Improve for puryrs erecta.).
-604 '- -ROOF..-IN-'PROGRESS--- -- -- ... -
01,as ownerofsne property,nm exclusively comment,with licensed conmdorx o, .. . .. ,
construct the project(Sec.70WL Business and Professions Code:)The Contractor's .,
License Law does not apply roan ownef of pmpeny who builds or improves thereon, -
'".;' -rnt la,contracrs.fm such projeo,with n.con.ao(1).E1cnsa pursuom ms he -. .__ _ ._.... - .--.._..._.,..... .._..__-. .............
_................._ -.. . ...._... - ...
Contractor's License munLa l I . -
01rexemptderSee: B&PC forthisre ALE10
Owner.,,. Date PIN
WORKER'S COMPENSATION DECLARATION- ,t Q
I thereby af.aade,gcnmty of pc,j.,one of the following declarations. ug
O a} LOO
0 1 have and 'will maintain a Cenificme of Consent to self-insure for Worker's jug
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Compensation, as provided for by Section 37W of the Labor Code, fsr the BUILDING
- 'perfommnce of me work for which this permit is issued. L
BUII
01 have and will maintain Worker's Compensation Insurance,as required by Section
37W of the Labor Code:for the pmporearce of the work for'suwhich this Permit is
ed MyW Worker's Co ,a t n Insure c tamer end Pot y be
.MPTIO
s,¢'m''r1,. FICATION.OF F, NIR WORKERS
CFRTI
COMI'LNSAI ION INSURANCE `'oV
' fTh x semmn need not be completed if the permit is for one hundred dollars
ISI W)nr le'.)
_..• Icodify rhino lCpcf at rrh kf M1' hm, pcnrit ssucd,l
,shall not employ'any Person in any manner s subject to the Worker
0 as to become s'
Applicnxniinn laws. Colifomia.cam ' ' "
ant ,
NOTICE TO APo the Worker's
If.after making this Cerin s cilia,
lia LaNmio dc,you
-
becomm hwith mplywie such provisions
r Colons or
p '. hall be deeeedC yoked. must
z .zit h.such vu rens nr th Permit hall be deemed revoked
Q Q forthwith 'pIY
a~ h ,' `--" aI I'-CONSTRUCTION LENDING AGENCY - 1
"> y Nat then is a construction lending agency for the Performance -
W z of she ink fo h h m pc t d ISa 3097 C v C) _ — — /1
P" O Lenders Addrc. 1
I<neem tlh dth'sity and
and
ming
O.0 compact.I gree m comply with all city and county re o.ardives rid nate lows minting
upon
Q.V to buildingeneoned11anahertbyaumoon uposcnmtiss of this city men¢rupon
0. the ebov e)agree to save, cy for inspersion purpose., _
y IWjI grce to save, ode mi fy and keep h may
an C ty of Cupertino against
Q z limb t s dgfnegts,co is d prises which nay in any y against said
V z City n co eq ante of N t g his perm t
APPI IC U E IA WILL:COMPLY WITH ALL NONPOhYT
Issued by: r Date r
�� rgar ramucomemr . Date; Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
.. n„ Will m a applicant f s rc bu Id' g occupant store er,nanale haznmoux maren.l .Type of Roof. _ _ .. _. .. ... :_ _..... ... ...- ..
u den ed 'y me Capon M c I Cod Ch pm 9 12,and the He Ire end s f ty - t t i l
Code:Section 255321.)
. _,All,roofs shall be inspected prior%any,roofing material being installed.
w it;h',,Iiturt Wfuture failding p qu 1 -tor device,which If a roof is insialled',without first obtaining an inspection; I agree to'remove
emit haArdmu,amhazardcorticarmaid de ned by theBay Area A Quality Management
D n " - all new materials for inspection Applicant understands and will comply wuh
I eve .I No , - - all non-pore -Lir regulations, -
I fir iid the hazed s itinerants q is and Chapter 6.95 f the t/.�p �/Q
Cahill Herilth&Safety Corle;Seldiall 25505 35531 and 25534-I andemomd rent
-ifthebuildingdoespotearready have c t that 1 Is my respon.h I ty to notify me - /,
need at of "cquir Men w ss be I poor to issuance of a Cemfcate of
w oaay� i ), - - O: Signature_ of Applicant _ Date
All roof coverings to be Class"B" or baiter
tdKo imd'dge f -Done
OFFICE
► ' w, Building Division
f 10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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 VV 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: I Q U ^G `y 1 ( I 1, �.S 1 X11
Address: 16 (1 r/ V O r1 dq CA ✓1 O V Y- 1
1 "
Reroofing Company Name: -1 ' ye s -'G V- (1 0 0
Applicants Signature: ZZ22U,//'-- Date:
•
Joe Antonucci '
(Chief Building Official)
6/25/01