02100069 CI'T'Y OF CUPFRTINOi a&"
�
RUD.DING DIVISION PERMIT GONT"GT,OR%INFORMATION
But 1 6U7AT0_R1T=M9ER DR MCCARTHY ROOFING SERVICES PERMITNC2100069
owhIES(R,CE MARGARET A 466 (A) REYNOLDS CR APPLICATT)0`YP 19`J2002
HONE: (408) 436-1560 SANITARY NO. CONTROL NO.
ARC)11 I'ECI'/I',NGINEER: BUILDING PERMIT INFO
BLUG ELECT PLUMB MrCH
t� o
ON
asLICENSED CONTRACrOrproviCons of bar Job Description
as 1ion70affirmNalIamlicensed underpmvisinnsofaCtuh. 9(commencing REROOF p
�zt. with Section and
effect Uivisinn3of No Businees a/N Professions Cnde.and my license is
in full tome anJ cffat. a/ j
zp�4 License Glas.J Lic. C� FINALED
oz—� Dam Jet i d Comch 11),
ARCHITECT'S UEC \TION
ow< lundcamnd my plans shallNuseda records MAR 5 2003
G
LLO Licensed Professional
Ear OWNER-BUILDER DECLARATION
K S sea a I hereby affirm Nat)um exempt Intra the Contraanr's License021999
y����s.
Law for the BUILDING
9 9
i 6OO following reason.(Section 7031.5,Business and Professions Code:Any city or county
m$� which requires a permit m contract.alter,improve,demolish,or repair any structure
fze Pdor In its ismmace,rd",requires the affluent for such lsermine tiles signed smmmem
f�n that he is licensed pursuant n the previsions ofthe Commrsal's License Taw(&pmr 4 28g211.ff0&5Al@1D Valuation
Na (commencingwith Section 7000)of Division 3 ofthe Business and Professions Code)Or
Nal he is exempt therefrom and 0m basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects fee applicant o a civil penalty of PNN Occupancy Type
not more than BK hundred dollars($W)' 307 - INSULATION p y YP
I,is uwnerof the p.NO,,or my employees with wages as their snie compensation,
will do the work.and the structure is not intended or offered for sale(Sec.7030,Business (�,�}r gT�gO3
and Professions Code:The Contractor's License Law does not apply to an owner Of 6 0 2 - ROOF P S P!V n LVH7.Itns
pmpeny who builds or improves daemon,and who does such work himself or through his
own employees,Provided that such improvements arc not intended or offered for sale.If, 603 — ROOF BATTENS
however,Ne building or improvement is sold within one year of completion,the owner- 604 — ROOF IN-PROGRESS
builder will have Ne human of proving coal he did not Wild or improve for purpose of
sale.).
❑1.as owner of the property,am exclusively contracting with licensed convectors m
construct the project(See.7044,Business and Professions Code:)The Contractors Li-
censer law Nos not apply to an owner of property who builds or improves thereon,and
who contracts for such projects with a contraemr(s)licensed pursuant to Ne Container's
License law.
❑ Ism exempt u der Scc. B&P C to,this reason
OwnerI R Date /o d Z
WORKER' MPLiNSA'1'IONDICLARATION
I hereby aRrm under pcnelly of perjury one of the following dcelatniorts:
1 have end will maintain a Cer ificam of Comenuo self-irs ure for Workers Compere
nation,as provided for by Section 37011 of the Later Code,for IN Performance of the
W
ork let which this Permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
3700 of Ne labor Code,for the Performance of the work for which this permit is issued.
My Worker's CnLmpcns tienlnsurancecanicra Policy nuntherme:
Ca +� G liry No.: Z -���
CERTIFICAT f li%EMPTION PRO KERS'
COMPENSATION INSURAN
(This archon need not N completed if be Nornit is fortune hundred dollars(SI10)
or less.)
1 eenify that in the perfam mance of the work for which this permit is issued,[island not
empby any person in any manner sit as to became subject to tire Workers'Compensation
Laws of Caluomia.Date
Applicant
NOTICE TO APPLICANT:II;after making this Cendleate of Exemption,you should
become subject to the Worker'a Compensation provisions of the Inter Code,you must
OO forthwith comply with such provisions or this permit shall N deemed revoked.
z CONSTRUCTION LENDING AGENCY
[-r 4 1 hereby affirm that the re is a construclion lendi ng agency l in the perfurmence Of
p: ► the work for which this Permit is issued(Sec.31147,CO.C.)
aM Lcndcr's Namc
z Lsndcr's Address
U O 1 cenify that I have mad this application and sum that the above information is
EL F career,1 agree to comply with all city and county ordinances and state laws relating to
O U building construction,and hereby authadve mponablatives of this city m enter upon the
} ahove-mentioned property for inspersion purposes.
f~ 11 (We)agree to save,indemnify and keep harmless the City of Cu a Aima against
N beef blies,judgment,costs and expenses which may in any way accrue against said City
U z APPI CANT UNDEof the granting
STANDS this
WI L COYLY WITH ALL NONPOINT Issued by: Date
SOURCERE N
o Re-roofs
1 p oaHcontractor
A RDOUS MATERIALS DISCLOSURE um Type of Roof
Wi I'- or future building accupant store or handle heMous material
as defined by the Cupcnin,M1un'ipal Code.Chapter 9.12.and the Health and Safety
Cable,Section 255RIa)? r\ All roofs shall be inspected prior to any roofing material being installed.
Will the applicant Or future building external use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
'mit harardo.,air commoinan s defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes Nt C_
I have mad the humorous mearnalsrequiremcnts under Chapter 6.95 of the Califory
nix HcalN&Sa@ty Qsk,Sadnrts 25015,255J1and255J0.1 un@rs orifi the Wildingziz
dre,not curen0y ve a tenant,that it is my respnnxihility m nedfy the um of the __.
ucgyfcmc mIt most ho ssuan f Ccnificamof0.cu cy. $jp at o p ican Date 7
��- �`� y All roof coverings to be Class "B" or better
Omer authnrir. agent Dac
Building Division
10300 Toren Avenue
Cuperdao,CA 950143255
Telephone: (408)777-3228
0 Fax: (408)777-3333 .
CUPERTINO
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 on reroofing and will comply with this policy.
Homeowners Name: - A��
'Address: /0
Reroofing Company Name:
Applicants Signature: Date: /21 c)
Joe Antonucci _
(Chief Building Official)
6/25101