02080050..
OFFICE...... ...--...... .. _... _. _. .._._
CITY OF:CUPERTINO
CONTRACTOR INFORMATION:
BUILDIrG DIVISION- PERMIT
BUILDING ADDRESS:
PERMIT NO.
11881.PLACER SPRING CT
OLD COUNTRY ROOFING
02080050
OWNER'S NAME:
MUI.MANCHUN AND LUK LOUISA
125-3 GROBRIC CT
APPLICATION SUB DATE
08/09/2002
PHONE:
-
(707)864-5557
SANITARY NO. CONTROL NO.
Z
ARCHITECTIENGINEER:!- ..,'. `
BUILDING PERMIT INFO
O
.. .
.. ..' .:. ...
.., .. L .. _
BLDG ELECT PLUMB MECH
I"I
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hertby afBnn Iha 1 am licensed under pmvitiods of Chapter 9 (commencg
REROOF
with Section 7")of Division J of the Business and Professions Code. and my liceinnse
ZZ -Z 7
Leo
U
O
Lieen�s
s�J�. Lic. p
In
Dam Comrecmr
-
g
ARCHITECT"5 DECLARATI
• 1 ondersland my plans ,hall be used as public recorJa
IC � tl� 6 ams fl t!• ® '
tt— B7�bx'�LkeCm
O Licensed Proms,knod"
so
so
f OWNER -BUILDER DECLARATION
1 hereby afrm Ihol'I am exempt form the Ciamem.r's License law for the
-
OCT 2 1 2002
r
following reason: (Semina ]0315, Bad and Pmfe..im" Core: Any city or county
$12700
v
which requirez a pemii) to <onswn, aired improve. demolish, or repair any strvnum
_ -
..prwr
-
w ire isivanca'alio ee5u'vuthe aPPlicanlfor such pcmduo Ble a ziened mammcm
dicta Ee is lie<tisedpursudnuo meyiovisionx of the Conuaclor's License Law (CM1upmr9'
ff �'Ilf�r a
ValUffiIOn
'`t
(commencing with SKl1on 700u3 of Division Jof the Buxinecs yN Professions Cddcl
t. f,�:\i g 1-rJ,t!?`Y: •;vv_i,i�'+C!�
-
r!
or Thal M1dih exempt here an the basis (m the alleged ixem'Uoll.'Any violation
-df Section 70315 by any applicant fore permit subjects the apPlicam to a civil penally'
r�i Occupancy Type
Iof: not mom than five hundred doll. ($5oo).
305APNV
, _
nw
01'ai rof'se porpenY or my cmploYccs with wage as their sole <ompensalion.
-
- ---------- _. _....__...- -- „
601 - ROOF TEAREfOOF Inspections't ' "• 1'r.
will do the work: and the structure is not intended or offered for sale (Sec. 7641.
Business and Professions Calc: The Contractor's License Law duet not apply to an
nwncrofpropenyWhnbuimsorimpost thereon, and whodocssuch wnrkhimelf.
602 - ROOF PLYWOOD NAIL
-.
oe Ih gh his nvor a ply s. orcoidod that such Improve nt. on, n t intended or
_._.. _..._
Wilding or mprnl,emenl Id m� year or
m1cond for'sade71f.W c -the boldo -
603- ROOF BATTEN.S_ "" "!"-'•
complei n Ihe owner -Wilder owner—Wilderwill have the hunted of proving that he did not Wild or
Imptwe 0d pnrpnseof sata ),
604 - ROOF IN -PROGRESS
_. ._. ----- -- _.-..
fdl; es owner oElhc pmpmy. am exclusively contracting with license) convenors w',
- '� .I... t•_b `.L1:
-
construct the project (Sec. 7044, Business clad Professions CiNea To, Cammnor's
- -' t „ •-r w '.� i'.. ''.. "" •
License Lawd., not apply to an ownar of poi who Wilds m improves thereon.-
';
_and:who. cbntraet,m, such Prolecit with, u. emnmetor(xllicensed pursuant tn. Ne]
- -
Con=toes License law.
❑ l am exempt under See. ".'i, .s :B& P C for Nis reason
I,J;i L..,: "11'Dta'•
•Date ... .•,
- .
- WORKER'S COMPENSATION DECLARATION
'•t`
I hereby affirm under.penalty of perjury orle of the following dmlamtions:
O I'have •add w01 maimain'a Cenificam'of' Conaem to self -insure for Worker's
Compenxation,'as. provided for by Section 37W -of the Labor Code, for the
f
•peeormanieoflhcworkforwhichthis,pennitisissued..
��,7.r/a•Rave and will maimai6 Worker's Colnpensaiion Insoro ce. as•mquired by Section
g700.7me Le_Wi Code, for she Peifurmance of the work for which This pbmiil is
trued MyW kcftC pcnsafon lnsun mer chit Polcy numberbm
- •,,,,,,,,,,,�,,,,Y„••�
C �. �i��l�/�'Pol'cy No. IGTS/�$^G �L�
..
SI y(ah \', t,� ',� w. �i i1•'.'
7":.0.:,i 'lj f. '; e. Y, i'.•'•�
,Ilse y„CERTIFlCATIONOF EXEMPTION FROM WOI`KERg
). t�..-.7
_.. ..,... .
, "(To, section nccJ no, W nimplemJ If the permn is for one hundred dollars
•'I t l
(fl 000 or less.), ,_-_-
f -1 a mpI that n @e nn i a m nP r s wank become ub perm ii taller l
aihall nm employ any in any manner so as to become xublenllo clic Workers
T I;; • . t t Ii(.`! j ., s
^'
Com f Ca i
a t 1 s fC if Dte
... ..__.
• .NOTICE rO APPLICAM` If. after making this Cinfificam or E peon, you should
become subjecun the Workers Com,varsitioin prov n om of the Labor Code, you most
foMw th comply with such provisions or Nis Permit shall be deemed mvoked
11' CONSTRUCTION LENDING AGENCY
I
m. l f•”or Ne perfomt,m, we1
' rI_r1-
theak for which thh,is¢s(S.. Ji 097.CvC.)
mmtt_i.o 'c.o:a.rd. '. - ''._
.- .. _. _..._-
... _-:.... .. .... ...
.pN...e-•
"•Under',N'me '_
-._ _....-. _
. I ccnify Ihar I have read this application and slam dim the above information is
1 to comply all city and <oumv ordinances odd state laws miming
F.'
V
��ciscct. ogrte with
to building construction. and hereby authorize representatives of this city m enter upon
[�
M.
JIe alia,ve-mentioned pnspeny for inspection purposes. .. - _
(W) g e'io a ndemnifyand keep hatnl.s h City ofC penin against
4ate�
I ab Ihes j dg cm c t d ex,. h R y in a y y acao ago sl xa d
2'
Cry neon. q a fth gra nB oflh perml -1. SOPURCE
'_ 4111 COMP WITH ALIO;Issued
by:
REGULATIONS
Re -roofs /
Slgnammbf ApplicandCommctor Uut ;', I, ',•
HAZARDOUS MATERIALS DISCLOSURE -'
f Will m,',6,dw.nI r out. Wilding occ p m store nor handle h Mout mmen I
Type Of Roof - ..: .. .-. ._..�.._........ ...... ...—,......,._. ......._
'
as def cd by the Cupordan, M ipal Code 'Chapter 9,12 and the Health and Safety
sCode
1 a
Section
• Y s 25532ta1
�
. All roofs, be,mspected prior-io any_roofing material,bemg ]ngtalled,_,,.
s i ,.,- ,
: Will the.ppl oto ret bold' gocc Dat m eel t devicst Kish
shall
If a roof is installed without first obtaining an inspection; Pagree to:remove
'not hazardous co6tanfinants as defined by the Bay Area Air Quality Management
'District?
all new materials for inspection. Applicant understands and will com_ ply with
❑rex 6
..
all non -point source regulations: , , ,.
Y.1 have ad me hazardous •maled.11 ormilemcnii under Chapter 6.95 of the
'Califomia Heallti&Safely Code. Sections 25505. 25533 and 25534, understand that
_ .. _
Wildingdx nal ptrcmlyb have tenant.'ns my spa blit, to sol fY clic'
Z�
Iflh
o p 1 flh 1. 'h <hm IW Ipbno m c ofa nfi ¢of
pml�y
Ddt_e _-. ... ..
9atOZ-
-Signatureo_fApplicant - _. _- - _ __- _
All roof coverings to be Class B ' or better
O ir anmpi,=e i g 11 -,'
..
OFFICE...... ...--...... .. _... _. _. .._._
r
' I
CITY OF
UPEI�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.
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 Y4" 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: 2?/, -
Address:
?/ ,•,
Address: 4
Ct
Reroofing C• • . / •fes.. ..
Applicants Signature: :E)ate:
Joe Antonucci
(Chief Building Official)
6/25/01