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03060066CITY OF CUPERTINO C " 'W BUILDING DIVISION PERMIT CONTRACTOR N F01IM110M B BUILDING ADDRESS: U, ROOFMASTER OF SANTA CLARA PERMIT NO' O 03060066 OWNER'S NAME: 1 13BRAMANTAM PO BOX 2711 Py"T"sUgA/709/2003 YNE: (408)741-4900 SANITARY NO. CONTROL NO. ARCHMECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION chapter Job Description I hereby Affirm that I Ann licensed under provisions of 9 (commencing with Section,70M) of Division 3 or the Buzincespyt(ftliessMans Code. Arad my license 1. in -j / - Dewz Contractor REROOF un rnanJ my pans shall ho used u hl nrds 'N3 Licensed Professional OWNER-BUILDER DECLARATION 1 broctry afarom that 11. exempt from the Contractor's License Law for the followingmaws section 7031.5, Business and Pronfewfloos Code: Any city or county which requires a Permit to construct, bor. improve. Mumoinh. are my structure Prof to its issuance, I. requires Me applicant for such permit to file a tigned statement Met Wincing lcensed p ... Am to Me proof thea License La. (Chapter 9 Sq. Ft. Floor Area $ 6§;"ion (commenwith Section 70M) or Division 3 of Me Business and Professions Code) or that he Is exempt therefrom and chat basis for the alleged exentrotion. Any violation of 3 OAFN MMer0 0 Occupancy Typenet Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of An. Man five hundred drdlars; (M). 0 1, As owner of the property, or my employees with wages As their sole compensation. .3 U b - ections d Ins p (Sec. 7, Business will do the wort and Me structure is not intended or.ff..d W And Pfsi.. Code: The Contractors's License Law does ml apply in an owner or property who bullidsor harprowsibamen. and who does such work himself or through his 307 - INSS UULA nR own employees, provided that such improvements Are, an, intended tooffeuredl fortals. If, 601 - ROOF TEAR OFF however, the building., Improvement I. sold within one year ofcmmpletion, the a.,• builder will M. the Inurciam of turning that its did not Wild or improve for purpose of 602 ROOF PLYWOOD NAIL "le.). 603 ROOF BATTENS C3 1, as owner of the property, am exclusively moustasing with licensed contractors M 604 ROOF IN-PROGRESS construct the project (Sec. 70414. Business and Profession& Cade:) TIZ Contractors U- mosse Law does not apply to an owner of property who builds or improves thereem, and who contracts for such pmjecis with a contractor(s) licensed pursuant An the Contractors License Lan- 0 I ..xcmpnurdar5 .B&PCfmu1Msmaven Owner Data - — WORKER'S COMPENSATION DECLARATION I hereby affirm under panal of Perjury on, of Man following declarations: I I I h.w..d will maintain A Ctudlicate fC...t 0 self-irm. for Worker'. Compm. I have san .. As on, As provided for by Station 37M of Ant, Latherr Code. for the of Me wet it for which this permit is Wool. it for hausand will maintain Worker's Compensation Insurance, As ranIukand by Smdon of to Labor Code. far the performance of the work for which this permit is issued. .W. VF3..N$4tIon =1i: and PFRI A We C CA P a.: �P� N FROM WORKERS' CERTIPR I Mr COMPWSATION INSURANCE Cu om �•s(C/Gtu vel an need �Iplttcd Ifffic Permit!, ronces, hundred di (SIM) or to..) I certify Met in to performance of the work for which Its permit is Issued, I shall not employ any person in any marmur an As in become subject In the Workers'Compensadon Lam, or California. Dam Applicant NOTICE TO APPLICANT. If, after making this Cenificato of Exemption. you should become subject un to Workers Compensation provisions of the LAW Code, you an= forthwith comply with such provisions or this permit shall Ac Ammer! revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that More is a construction lending agency for the Performance of the work for which this lamenit is issued (Sec. 307, Ch, C.) Lenders Name Lowder. Address I certify Max I have road Mi. application and sow that the show information I. context. I alince to comply with all city And county ordinances and state laws onlifing; to building construction, And hereby aunhorine representatives of this city to enter upon the above-mentioned property for inspection purposes. n (We) agree to save. indemnify And keep harmless the City of Copenim. Against !I AbilidesJudgm c o is cosT-diwhich may I. any way c Against said City in I on L pe 4'" ": a %"'9 APPLICANT ERSTA W; WILL COMPLY WITH ALL NON-POI Issued by: Date M WE W — — Ke-roofs Type of Roof In .0 0 lean ontra.ek ate AZARDOUS MATERIALS DISCLOSURE 0 CZ11 ilift. i.nt.rf.[=bildingmcupmtsmmorhandichaardommawdaI A CurammeM Pat Code, Chapter 9.12, And the Health and Safety n"building ree Sees. 255324)? All roofs shall be inspected prior to any roofing material being installed. 0y. 0 Rf, If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant occupant on equipment or devices which it havardoos air contarri nn4m,,cflncd by the Bay Area Air Quality Management all new materials r inspection. L until 0 yes 0 or t I have Mad the hoo Inu,ate ni.H.Ith&S.f�,,C�.S�cvm255O5.25533�25534.1..dc�ifft building Jaen III h Icnam. Most It is my resionsibifity to ry Me occuparn f the re ci Signat e Ap ant Date All roof coverings to be Class "B" or better was law • Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 Fax: (408) 777-3333 Building Department. Subject: Re -roofing policy for the City, of Cupertino 1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards and manufacturers specifications on re -roofing. 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 re -roofing . . 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) Pre -inspection 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 a 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 on inspection. I understand and will comply with the above stated policy on re -roofing Homeowner's M Job Site Address: Roofing Compan 1;i Greg eel Building Official Revised 1/30/03 Prinbd nn Garvrlar' Pere. GQ CITY OF CUPERTINO v3 � �-o o L"6 REROOF tMkTINO PERMIT APPLICATION FORM APN # Bld Permit Fees Date: r (q \ l 3 Building Address:�t ,PC'0?_ S N S c ( Owner's Nam . g �A " Seismic Fee Res Phone #: Contr tor: Phone #:t�9a� - License #: �b4 2.6 'L6 Contact:Y� Phone #: -1 L Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles O' Asphalt Shingles J9 Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Other (Specify) ❑ Wood Shingles ❑ Other (Specify) Number of existing coverings I `& To be Removed ❑ Provide I.C.B.O. Report # ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description:J �N S� LLJO 6 S Residentia Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planp�ttng-De I. if there are any res fictions: Cost of Project- Type of Cnstructi Occupancy gro p: Q�1� A olidahl. FPA m BPERMFEE Bld Permit Fees BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING #Z2d�/ e(�/-7 P