03010152 CI'T'Y OF CUPEWI'INO .z•,, ' .
BUILDING PERMIT CONTRACTOR_INFORMATIONt
But
U B.DING ADDRESS: CAL WEST ROOFING COMPANY PERMIT NO.
7704 OROGRANDE PL 03010152
NI7R'S NAME: 3508 CUESTA COURT APPLICATION SUB DATE
SANTA CLARA CO. TRAFFIC AUTHOR 01/27/2003
ZONE: 408 531-1961 SANITARY NO, CONTROL NO,
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MF.CH
o o
000 LICENSED CONTRACTOR'S DECLARATION
0u P I hereby affirm that I am licensed d provisions or chapter 9(commencing Job Description
�w inithS 1 7000)of Division 3 of NC Busoir...and Rofcssions CtAc.andmylicenmis
z0a� htmn amlcflect. Oq •� qq REMOVE EXISTING ROOF
Licca. 'lass ( —J J Lic.LR 1 3SL] b
0z�o e,e✓w.r! .r INSTALL 12 OSB PLYWOOD & ASPHALT SHINGLES
`�" ARCIIITECTS ARATION
Wul dcrs}anJmyEpla�fSshaMt us deq spuhlic records
Wu Lai t` rt
usi 3 u
Licensed Proyssishmai
y
OWNER-BUILDER exemptr.the
FEB '0 4. 2003
I herch affirm that I am exempt Intro the Cuntrecmr's License Law for the
i S O O following reason.(Section 7031.5,Buxinnu and Prnfessines Cole:Any city rr county
a�$ which requires a permit to construct.alter,improve,demolish,or repair any structure
Y�C per he is licensed
issuance art. prima mind for Cmajacmil lnfile
earseI . statement ILDING
Pont
tois licenuJ puart."o"ones'he
the such1.1's Licenselaw(statemrY Sq. Ft. Floor Area Valuation
ex $ (commencing with Section vBfk)of Division 3 of the Business and Professions Code)or $6500
�— that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy T
not more that five hundred do[].. 362 18 0 3 6 . 0 0 P y ype
I,uowrmer of the pmpeny,n my employtts wish waguutheir sole compensation.
will Jo the work,and the structure is not intended.,offered for sale(Sec.7W.Business
and Professions Code:The Convector's License Law does not apply to an owner of 305 - FRAME Required Inspections
progeny who Mtildsnr improves Hereon,and who does such work himarror through his
ownemployces.provided Hatiuchimprovementsare nor intended orolfered forsale.If. 307 — INSULATION
however,the huilJing or improvement is sold within one year of completion,the owner
builder will have the burden of proving that he did not build or impmvo for purpose of 601 — ROOF TEAR OFF
sale') 602 - ROOF PLYWOOD NAIL
❑I.as owner of the property,am exclusively contracting with licensed contractors no 603 - ROOF BATTENS
construct the pmjcci(Sec.IINa,Buiness and Professions Code:)The Contrutori Li.
arise law does not apply to an owner of property who builds or improves themon.and 604 - ROOF IN-PROGRESS
whir contracts for such projects with a contractors)licensed pursuant to the Contractor's
License Law.
❑ I am exempt under Sec. ,B&P C for this recon
nor Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penally of perjury one of the following declarations:
I have and will maintain a Cenificele of Consent to self-insum for Worker'sCnmpen-
salum.as provided for by Section 3700 nl'the Labor Code,for the performance of the
work for which Nis permf is issued.
❑1 have and will maintain Worker's Compensation Insurance,az required by Semon
370()of the labor Code,for the performance of the work for which this permit is issued.
My W..kcr!a Cnmpmodurn Insurance currier and P.ut�oyy)gum itr arc:
Cam r: TCWT���n� Par icyVM.- iS 90
CERTIFICATE OF EXEMPTION MOM WORKERS'
COMPENSATION INSURANCE
(This section need not Ito completed if rbc permit is form c hundred dollars(511)(1)
lose.)
1 cenify Nal in the performance of the work for which this permit is issued,l shall not
employ any person in any manner an a m become subject o the Workeri Cumpcnsation
Lows of California.Dale
Applicant
NOTICE TO APPLICANT If.after making this Cenifcale of Exemption,you should
become subject to the Worker's Compensation provisions of the labor Code,you must
OO forthwith comply with such provisions or this permit shall ere deemed revoked.
z y CONSTRUCTION LENDING AGENCY
[r I hereby affirm Hal there is a conjunction lending agency for He performance of
Rpt the work fpr which this permit is issued(Sec.3097,Civ.C.)
QLcnJcr's Namc
z Lender's Address
U 0 1 certify that 1 have read this application and sate that Be shove information is
u. P coned.I agree to comply with all city and county ordinances and state laws relating to
C U huilJing conslmclion.and hereby join yc representatives of Nis city m enter upon the
{gt above-mentioned property Int inspeclion purposes.
P. (We)agree to save,indemnify and keep harmless the City of Cupertino against
to hahililies,judgments,costs and expenses which may in any way accrue,against said Cily
U in consequence of the 6 mmi ng of this pe,mi t.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULAT
Re-roofs
ignaturre1yrApplicanchContruclor Difir,
HAZARDOUS MATERIALS DISCLOSUR Type of Roof
Will the applicant r,future building occupant sure he handle huntedous material
as defined by the Cupeninn Muni 'pal Cotte.Chapter 9.12.and the Ilealth and Safety
de,Soctien zss3xan All roofs shall be inspected prior to any roofing material being installed.
❑Ye, No
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
emit harardnus ei,contaminants deRncd Ity the Bay Area Air Quality Management all new materials for inspection.
Dixuict?
❑Ycs Nn
1 have mail the mospe nus materials requirements hm&,Chxptorfi 95 crime Califor,
maHcalN&SafetyCotfe.Sections 255115.25533 and 2553a.lunderstanJ WliftM huilJing / ! 2 D
Hes nowdo1w ly bare Nat it is my respoaihiliry to notify the compatriot Ne YSI I ` e
,cop •mcntswhie m he mm 'seri°'sm:mccolacenifica r I.parcy, gnatureofApplicant Date
"V %net'o�/e �r All roof coverings to be Class "B" or better
OwnershuthoriaJ exam � ( Date g
Building Division '
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
oclo 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 1/4"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 �!A4t " ._✓� p/_
Reroofing Company Name: ? e '
Applicants Signature Date: I b
Joe Antonucci
(Chief Building Official)
6/25/01