02100027CIT OFCUPFWl'INO
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ONNTR CTOR INFO' RRMMATION:w:,
BUILDING DIVISION PERMIT
Bu1Gv Esq L TT PL
CAL -PAC ROOFING.
PERMITMO2100027
Dw@;R[sNAmKUO-CHIN AND SHIEW-FEN
36 RAILWAY AVE
APPLICATITI�fyB'tbAiF/2002
77 ��-�/
ZONE:
408 874-0784
SANITARY NO. CONTROL NO.
ARCI II'ILCT/ENGINEER:
BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR derp DECLARATION
1 hereby ultirm tont I am licensed under provisions of Chapter Y (commencing
of hap
with section 70(g) of Sof the Business and n dessionsCodc,an my license is
J $ rip[ion
REROOF PINgLED
in full force and . tD�ivision
6 Z
LiccnscS)a ✓ I.ic. N
0 Contractor
AalTLCTS DECLARATION
MAR 2 5 2003
1 understand my planss shall be used as public mentis
Licensed Professional
OatN[m DECLARATION
BUILDING
1 hereby effrm that 1 exempt fr License Law for the
exempt from be Cessions
$21857
following mason. 703 L. and professions Co Any city os county
e,
which rtyuim a pmmil ac nmss alter, demolish, or
consumer, improve, or maser any
Paned t aper, tmpnwu,
statement poor at he isscensedpuralso
the hPerm
nt(Ithe theisionoapplicant the sucContrcrmdmfle enseUe(slmemem
is licenseepSrsion70th)ofDivisiooftheCommcrodendPro
1514.60 A. T00
.VWfU6AIWaV
Valuation
(commencing Division 3 of the and mionChade)sit
exe with Section ]Iknd) Cade) or
exe
that he is on. Any vi
the? he is exempt thcrtfrom and the basis for The alleged exemption. Any violation of
the alleged
Sacting 7031.5 by any applicant for a permit subjects the applicant to a civil Finally of
PN-N9;%Occu ane T e
p y Yp
no, mom than Eve hundred do][.. (SSW),
307 - INSULAT.ION
0 1, as owner of the property, or my employees with wages as their able comFensation,
will Jo the work, and the swemm is not intended or offered for sale (Sec.'I044, Business
and Professions Code: The Contractor's Licence Law does not apply to an owner or
Roo�5[��y� n �c inns
pmperty who builds or improver thereon, and who does such work himself or through his
own employees, provided that such improvements are not molecule, offered for sale. If,
602 - ROOF P iIYV
603 — ROOF BATTENS
however, the building or improvement is sold within one year of completion. the mi nor.
604 — ROOF IN -PROGRESS
builder will have the burden of proving that he did not build or improve for purpose of
sale).
0 1, as owner of the property, am exclusively contracting with licensed convenors to
construct the project (Sec. 7144, Business and Professions Code:) The Contractor's Li.
cense Law docs not apply to an owner of property who builds or improves them0n, and ,
who contracts for such projects with a comractbr(s) licensed pursuant to the Contractor's
License Law,
0 1 am exempt under Sec. . B N: P C for his reason
Owner Data
WORKER'S COMPENSATION DECLARATION
1 herehy M. under penalty of I. duty one of the following declarations:
1 have and will maintain a Certificate of Conmm tosell-insure for Worker's Compete
cation, as provided for by Section 37W 0f the Labor Code, for the performance of the
work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance. as repaired by Section
I of the Labor Code, for the performance of the work for which this permit is issued.
My Worker's Cu pensaii0n asurance, carrier and Policy usher am:
LI
�
Carrier. -�� Policy Nn.: %C SOI'V oO7756
CERTIFICATE O � EEMPNON FROM WORKERS'
COMPENSATION INSURANCE
QTis rection nccd not he cnmpicteJ if the fetmit is fnrnne hundred dollars (5IW)
or 1css.)
I certify that in the perlormanee of the work far which this permit is issued. 1 shall not
empllly any person in any manner so sts in become subject to the Workeri Comptumbion
Liewsof Celifomia. Date
Applicant
NOTICE TO APPLICANT: II: of ler making this Ceni licam of Esemptibn, you should
become subject to the Worker's Compensation provisions of the Labor Calc, you must
forthwith comply with such provisions or this permit shall he deemed revoked.
CONSTRUCTION LENDING AGENCY
I thereby affirm Nat there is a construction lending agency leu the performance of
the work for which this permit is issued (Sec. 3097, Civ. C.)
Lender's Name
Lender x Address
I havread This application and Stem that the shoo information is
1 )agree that 1 this
stand aordinaries astate bovelaws infrelation
/ l
cortect.lagree loaf withea city county ane to
ply
building construction. and hereby authorise rcpoescmmuca of this city to enter upon the
/l/I/`�✓ J_-^+— 5
above-mentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of Cupertino against
judgmentse costs and which may in any way eccmc against seed Ciy
in conics,
of this Pe
UNDERSTANDS AND WILL COMPLY WITH AL1. NON offf���TTT
APPLICANT) nNDERSTgranting S AND WILL
Issued by: Date / �J
SOURCE
SOURCE REGULATIONS. /
/
Re -roofs
Signature ofApplicartiContractor Dam
IIAZARAZARDOUS MATERIALS DISCLOSURE
Type of Roof
building handle
Will the applicant or futureMunicipal
ptstareor
Health armaterial
e.occupied
as defined by the Cupertino Municipal Cale, Chapter 9. 12. and the Health and Safety
Clove, Section 25532(ar'
All roofs shall be inspected to any roofing being installed.
0 Ycs &Ices"
prior material
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or emus) building oecupans use equipment or devices which
'mit le rardous air contaminants as defined by the Bay Area Air Quality Management
all new materials for inspection.
Diviner/
0 Ycs LFRo
I have mad the havardet, ma wales requirements maker Chapter 6,95 ftlam Ctdfor-
nia health K Safety Code, Sections 25%5,25533 and 255341 undcrswnd that if Net building
Jens not currently have a tenant, that i7 is my responei hit by to It tilt' thea perm of the
regmm s matMmmpdt tismonc)nrac)rtm)amor0.emp r'
SignalureofA icons ''° Date
/ 3 L
All roof coverings to be Class "B" or better
Owerrnnuthuri'
dag)m Dam
•
V;I
r .r
TINO
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.
I. 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 mspe will
require the removal of all new material down to the she so that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of '"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 complywith this polity.
A
Homeowners Name:
Address: _�0�3 / A -Z
Reroofing Company N
Applicants Signature:
Joe Antonucci
(Chief Building Official)
6/25/01 `