02030005 �I so�°F c�PvEiRON� CONTRACTOR INTORMATION:
, PERMIT
BUILDING A�DRE55: ' PERMIT NO.
20954 PEPPER TREE LA CAL-PAC ROOFING 02030005
OWNCN'S NAME: qPPLICATION SUB DATE
SANDRA MURATA 36 RAILWAY AVE 03/Ol/2002
PHONF.: SANITARY N0. CONTROL N0.
� (408) 874-0784
� ARCHITECTIERGINLER: BUILDIYG NLRMIT MFO
��� BLDG ELECT PLUMB MECH
� I� "L'J C-J LJ
�na�
'�`_'� 1 hcabp nR n m�i�m i«ned und<r S DfCLANACM1ONcr 9lvommcncin Job Description
�N y o �,o.;,m�.o v s
;_t J x�i�h5caion]WO�ofDivision3of�hcRusincs�ar,�i������c�a�.a�a���yra�K REROOF .
�����o,� �d�R�3 /3 -a
's��% uauci�� u�.x da S T/O ADDITION IN THE BACK OF THE HOUSE
S3�'N o� c��m��c a
.LLo nacNrrecrsuec� nii 6g REROOF WITH DECRA SHAKE .
;� � 1 unOmmnJ my planx ihall Ac uud a.pubiic rtcards
i
��O O Licrn¢A Pmfneiuwl
pN'NFiN�BUILDCN UECLAItAT10N
�� 1 hcrcby nlfnn�hat 1 nm exnn0��W���il¢Conu'nc�nr's Liccmc Low for tM1e
C�a following rcamn(Saiinn](UI s,pusiness anJ Pmfcssinnv Cudc:Any ciiy or counry
Y F c x�hich mquircs a pe�nn�o eon.arvci,almr,impm.�e,aemolixn,or mpair any swcwrt
6 3 m_pmrio i. . nc al rt9 �M' ppl amlorsuchpermiu fl grcd mm i - - -' ' " _ _
�hmh s�fcrnyJpurtam�o�M1pp . sofiM1cConwnorxl 1� (C�api 9 S . F[ FloorAea V IIIIOII
���� s ,�as i �ux�� ro� ��i�nnen�����,SowP ra�� .ca� � fl';'��v.i�,:'r.r9 . ,_Ii;. :t:wr.�tii:;VY;,S'lir_}.�`u: $56��
nr�hui hv s cnemp�ihcmf i W iM1c M1uz s ior ihe allegcJ exempuon My violauon
nf Scnion]0313 by nny applioam for a pmnii rubjcas�he applicanno a nvil penaliy
�r�o�moa m.�r��n��erca mn��ssro�. 3 5�IjV�u�nb�'0 . � Occupancy Type
o�.u�nwnerormepm�erzy.o myamv�^y«ewlinwas<susmd.rto�ecnin�cmauon.
w�n m�mrw�,�c:,�,a��nr..�„�����,���.nm in¢ndcd'or offerc8lor mlc is��.�oaa. 3 05 - FRAME Required Inspections' �
Uusiness and Fro(essions Cude:iLe Commemr's Licrnse Inw dms noi upply m un '� � �'
��«�r����y wne wne.o,��np���.ro�.���.a�a.-no a�,.��n wo��n�muir 3 0 7 - I NSULAT I ON
or ihrough hi.own amployeex.pmnded�ba such impm�_emems am noi imended or '
":oRttcEforsal<�1(M1mvevcr.ihcMiildin6orimprovcm<mnsald�wi�hin�oneycsrof. . .... ..... . ." - " --._.....'`_ . "'" ___.__ .._ . . . _ _ . . .. .
���„�i�r��,m�,�H-���-c��iar�w�uno��m�m�,a��orn,����smmn�a�a�,��n��mo, 601 - ROOF TEAR OFF � ' . ' . .
�mn��=����r�m�«�r.m�.�. 602 - ROOF PLYWOOD NAIL
�,:ow��.orin�. . .. .. . . . . .. . . . ..._ . .__ ... ..._ ... _.. . _.. ..- ' ---- ._ _ . .
❑�. v�oanr.nm�F<�mi�ciyconvae�gwnnG«oYaconvaionio' � 6O3 - ROOF BATTENS ' ' . `�� . . '
io�.v�n m�p�ojMi fs��.�ou,n�.m�::��e aror�::io�:cm�:)�rn�comacwrs � , � , . . .
.�a�«�aw�a«.�����orvir�����w�or��r�,���ny»�n�n�ua..���m�ry...me.�a�, 604 – ROOF IN–PROGRESS ' �
. .. . nnd who.conlmcL PocsucRpmja�s wiih u mnvacmr(s)Iicnrsc0 Pumm�i.m ihc . . ._.... _ . � .. ..
Comncwrs Licrnm law.. . , . ._. .......__.. ... ._ .... ... . . .. ... . ....._ � . .._.._. _.__..
❑Iemeacmp�undcr5a. ' � ,B&PCfonhisaason . ' .. .�. .
. . ; Owncr , ' � �am •' , . �A����►��.
' WOkKER'SCOMPENSATIONDECI.ANATION [�Cn p
� ' 1 M1<rtby nifinn unE<r penuliy af perjury onc of ihc following dcelam�ions: O L r V � qoo�
O 1 havc and will inainiain�a Ceni&ae of Conuni m sdLinrvm for worker's L
Compcnsa�ion. us pmvidc� Inr by Scnion J900 of �M1e I�bor CMe, for the ��'
pcAnnnance of�hc work fm wLich ihis pcnnii i�issucd. 1 pING .
, ❑1 hvvc and will m�inuin Work2r's Compcnmiion Insumncq es mquirtd by Smion `
J]IXI of�hc Labor Code,for��e performuncc of�he � r which�his pc 1� .
"' ism J MyWnrkersCompensmionlnsuronttcom ra APoI umA c '
f`�t'-2.9`� . . . � ., .. ., - ...
.. . , .
. . ._ _. _ . ., ....., . .
mrtr.��Y��ol<Y No Y . . . .. . .. .
. C2RT1 CATIONOFE ENI'f NFR WORKERS. �r.��w � �� it, j���� � `�� ,S .1'�:-N�k':' •
.. - .,.: COMYFNSATIONINSURAf.CC�a -.•n, ' '. _"._...___..."__"....._.._"'"'_
" ;_' _ . , _ . ._ .�. ,__ _ ___""' _"._._....._....__ _'_ "_'"' _'" ' _ ' '
'(fhis sc<�iun nce0 no�M1e mmpicic�l if ihe permi�ix for anc hunJrcd dollars ` ' ' " ' ' ' � "' � � �
ISI W)or Ica.)
x�all na�emploYhanyperson n�nYmanncrhmosko(bec membJcc�o�ihe W rAcrs'' �. �_� .� :..: . :- . _ .: � . ._. -. ..: ..::.:..:. :r... _ . . . _ . .._...
Cumpvnwiion I,ows ofCalifnmie.Do¢
- A�Plic�nt ' ' ,.. .. .. .. . . . _. ._ . . .. . . .
. .. ........ . . . . .. . . . _ .... _ . .. .. ... ._ ....
NOTICLTOAPPI.ICA�T:If.oflc�makingJM1isCenifcamolE.�emp�ion,ynusM1uWE ' - � �� . �
berome subjca�o��e WorAcr'�Compcnsaion probi.vions of iM1e I�bor GiJe,you musi
0 O fonhwiN�omply wii�such pmrisions or��ix permi�xhall be AccmW mvo4eA. '
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._.. . . .. .. . . ..
z V] .ar' ' '.' , CONSTRUCTIONI.F.NDINGAGF.NCY . � "' ."��� � �. ' ' ...
a.> . '. 'NircbY ufGmi ihni ihcrc is u connmainn ImJinH u6�nry for�hc pcAiirmnncc � , � ' ' �
W �..� ihe work fae whie�ihis permi�is issueJ(Sec.J09].Civ.CJ ' ' . _ .. . . .. ...... . .. . ' _. . _ . . ._ '
Q � Lcnder'sName.. ........ : . ..... . .� � , __"" -" '. .� .... . ._"'. ._ . _ . .
. a.z Isnder's AJdras . . _ � ' . , .
U � , I crnify ihoi 1 hwc rcuJ ihi�upplicmioii oW s�mc ihm ihc�ebovc infurmn�ion i.s �
' W'F tbrmn.I,ag¢c io comply wiih all city anJ coun�y ordinmms nnJ sum laws rcla�ing
� V ioWildingconsuunion.andM1crtbyemhonrortpmsrnm�ivuolNisoiiy�oemcrupon
. �. r� �ihenGave-mcn�ionedpmpenyforinspcnionpu�x ,
� p,i+ jNqugreemsave;inaemnifyandkevpharmlessiheCi�yofCupeninoegninsi
Vi liubiliiics,judgm<nic cosis aml expmses which mzy in any woy,azcrvc o6nin.u�said
V.z Ch'in conseyuu�a�if Ne gnming of ihis pemti�. ' ' � ' ' '
_� 'A PL1CANfU 4NpS \DWI CO� ALLN n- vr` Issuedb � D3I
; URCE UCATIO -� �y Q/d Y�
� SipnnwrcotApp ��vca�����a,� �' . . . . .. ���� . . Re-roofs
" HAZARDOUS MATRRIALS DI SUR2 '
..�. w n m owu��� r� w�ia�a ��v i v�m n�m-n�.ao me���� . Type of Roof . .. . . .. :. .. . .. . . .. ..
u def cd by�he Cupen no Nun c pal COEe Ch pmr 9 1].and�h Hnl�h and Sefcty , ,
Codc Sm[o 355J21a1 ' ' . � . t. (:�. � 6� � � +'� �11 : . ,t � ' ;'_ � �.: �• ' �
°i"� � �� ��" � 3 �� .,, •, All roofs shall be mspected prior(o any.roofng maternl be.ing installed,
' � w u m p�r�,�"m� n iq��e" P m use vqu p �� p �«.wn��n Jf a roof is installed without first obtaining an inspection;I 9gree to remove
cmii herardous nr mmaminams as�YneE by�he Bey Aru qir Qual ly Mowgemm�
u�.�;�n � � all cew materials for inspection. Applicant understands and will comply with
❑r°' �'"° all non- oinf-soui regulations:
r
�� '� 9 M1 � ' e d ihe he<Nous m m'als cqu rcm me u Je Ch pi r'695 Bf'the� � � �// ��
Cil f ' H IiM1&S f ry CWe S i 35505 355JJ d 85J6 I nd i J�hm
dJrtWld' gJ � cilyh � iN� � y ponbliyin�(yNe ,
rccu0am of qu�u w�hmh musi mn pnor�o issmnce o(e Cemf ine of '
Oc<up ry. , , '
�- - Signamr of Applicant Date
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ow�vo� n��,�aa8��� „� All roof coverings to be Class "B" or better
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c- .::. �.,..,.. ,.,, ,. . . . . . ._ • ,,,. , . .. _ . . .OFFICE . . . _ .. . . . . _ . . . . ..
�, .. i��. .. . . .... . . . � . .� , , .
� � q Building Division
10340 Torre Avenue
� (� Cupertino,CA 950143255
Telephone: (408)777-3228
CITY�F Fax: (408)777-3333
CUPEI�TINO
Building Departrne�.�
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 aze required.
1) Preinspection and/or tear off approval.
2) In progress inspection approval.
3) Final inspection approval.
• a) Spark anester 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�/a' 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; ��-�� �Y'z ��� rz �Z
Address: 6 J� S y G�- ��'�� v`� '
Reroofing Company Name. 0 � ���� z c � /'vv`�y
U
Applicants Signature: •� �� Date: `3 �� �
�
Joe Antonucci
(Chief Building Official) •
6nsioi