03010137 CITY OF CWPERTINO
E(JILDING DIVISION PERMIT -CONTRACTOR,INFORMATION:
BUILDING ADDRESS: ROWE CONSTRUCTION CO INC PERMITNO.
19985 PRICE AV 0
rWNER'S NAME: 980 SMITH RD APPLICATION SUB DATE
'GEORGE MONK 01/23/2003
HONE: (831) 722-1204 SANITARY NO. CONTROL NO.
ARCHITECOENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
�00 LICENSED COMRACDJR'S DECLARATION Jb Description
U I hereby affirm shut 1 am licensed under previsions of Chapter 9(comop
mencing
z with Section 7000)nr Division 3 of Ne Business and Professions Code,and my)icenw is
,�
:n!,11 fame and effect, ( (, REROOF
Fye Oatcnsc Class canuaao_)♦+02 oY REMOVE & INSTALL ASPHALT SHINGLES
ARCHITRCrS DECLARATION
I undcrsmnd my plans shall be used i s public records 2
3 uc
Licensed Pndcssional
00
OWNER-BUILDERexemptDE Ce Contractors
DN
we <f I Worry reaso affirm thea 1 ore exempt from the eonlranoosLicense: c law for the
i 6 0 O following rcuua(Section 7031.3.Business and Professions Code:Any city or county
a0$ which requires a Permit m construct.alter,imprsve,demolish,or repair any structure
prior In its issuance,also requires the applicant for such Permit to file a signed mucincnt
'hat he is Licensed pursuant lothe provisions ofthe Contractor's License Law(Chapmr9 Sq. FL Floor Area PI a ion
g a'� (commencing with Section WMa)nt Division 3 of the Business and Professions Code)or 0
Out he is exempt therefrom and the hasis for be alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of APN Number Occupancy Type
nut mom tram eve hundred dollars(SsaB).
36905041 . 00
❑I,ssowrmro(0m property,or my employees with wegesss their axle compensation,
will do the work.and the stumu,isnot intended or offered for We(Sec.7044.Business 1'
and Professions Code:The Conluotor's Lim.law,does not apply in an owner of 305 — FRAME Required Inspections 1
property who builds or imp roves thereon,and who docssuch work himself ordtrough his YY
own employees,provided that such improvements arenol intended aroRered pursue.If. 307 — INSULATION
however.Be building or improvement is sold within one year of completion,be owner-
builder will have the burden of proving that he did not Wild or improve for purpose of 601 - ROOF TEAR OFF
sale.). 602 - ROOF PLYWOOD NAIL
01.as owner of the property.am exclusively contracting with licensed contractors to 603 - ROOF BATTENS
construct to project(See.70,14.Busincas and Professions Code:)The Contractor's Li-
ccnaeLaw dims,not apply to an owner of progeny who Wilds or improves thereon,and 604 - ROOF IN-PROGRESS
who canaries;for such projects with a con rwou(s)licensed pursuant to be Contractors
Limuse Law.
❑I un exempt under Seo. ,B h P C for Nis reason
13010K)
wner Data
WORKER'S COMPENSATION DECLARATION
1 hereby all under penalty of Perjury one of the following declarations:I have and will maintain a Ccul ficam of Consent to self-insure for Worker'sCompon-
ion,as provided for by Section 3]ou of the labor Cook,far the performance of the
rk far which this Permit is issued.
1 have and will maintain Worker's Compensation Insum fie,as required by Section
of Ne Labor Code,for the perfomanm of the work for which this Permit is issued.
y Wofkcfs CompeytsatipR Insud Policy number am:
m. vkev(Ww. PolicyN.&gc 00011 410
CERTIFICATE F EMPTION FROM WORKERS'
COMPENSATION INSURANCE
Coussectim need out Mcompleted if the permit is forums hundred dollars(SI)(d)
,It tread
I eerily that in the performance of the work for which this permit is issued,1 shall not
employ any Person in any manner so as to become subject in the Wnrkeri Compensation
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Lava Calc,you must
OO forthwith comply with such provisions or Nis permit shall M deemed revoked.
'x N CONSTRUCTION LENDING AGENCY
[-+ I hereby affirm Nat there is a construction lending agency tar the Performance of
Cvi ti the work for which this Permit is issued(Sec.3(5],Civ.C.)
Q Lender's Name
7r Lender's Address
U O I certify that 1 have reed this application and state that the above information is
� ^^ cartcct.l agree to comply with all city end county uNinances inisue laws relatingm
.OU building construction.and herebyauthorise representatives of Nis city to enter upon the
} W ahsvomentioned property for inspection purposes.
6r (We)agree to save,indemnify and amp haradcss Ne City of Cupcnino against
„Hs fq liabilities,judgments,costa and expenses which may in any way accrue against acid City
U Z in consequence of the graining of this permit.
F-t APPLICANT UNDERSTAND ND WILL COMPLY WITH ALL NON POINT Issued by: Dat,6 ;)3// S
SOURCLE RY.GULAT ONS.
/� J/2 3/03C7 I
xisuTffApphc5t� oar I—' mT a Re-roofs
HAZA DOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant m future building occupant atom orhandle bamrda n metenal
sa defined by the Caperton Municipal Code,Chapter 9.12,and the Health and Safety
crave,senior 25532(&)9
All roofs shall be inspected prior to any roofing material being installed.
❑tion Nu
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
.if h onNous air contaminants a defined by the Bay Area Ain Quality Management all new materials for inspection.
D'nria7 /
Cl Yea; /qN
I have read the humorous materials requirements under Chapter 6,95 of the Califor-
niuHcahhdtSxLtyCodc.Sccaare25B5,25533and25534.1um mndounifthc building
docs nal cuucaily have a mnamL I it;s a o t ty to nntily the Occupant nl Nc
hmaatbe tl - racenineamar xapan Signature of Applicant Date
30
owner ar aathanvcd age Dale All roof coverings to be Class "B"or better
t _
Building Diviaioa
10300 Torre Avenue
C%Xrtino,CA 95014-3255
Telephone: (408)777-3228
1 Pea: (408)777-3333
CUPEDTINO
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 U"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: Ae xW'J W
Address: 44 %S- Div e -
Reroofing Company Name: poft r-n SS
Applicants Signature Da}e;�2 d
.
0009
�
oe Antonucci
(Chief Building Official)
60/01
George Monk
` 19985 Prke Avenue,Cupertino,CA 95M 4.4OB 4461025•georgemmonk@yahoo.com
RECEIVED
June 5, 2003 JUN 0 b 2003
City of Cupertino
10300 Torre Avenue
Cupertino Ca 95014
Attn: City of Cupertino Building Official
Dear Sir:
Re: Permit#03010137, re-roof permit
Replying to your June 3 letter, I would like to request an extension of time to complete the
referenced permit.
The permit was part of a larger project that has been delayed due to:
1. Additional effort for code compliance required by the City of Cupertino
2. The bankruptcy of the General Contractor working on the project.
I would appreciate it if you could allow a one-time 6-month extension to complete the re-roof.
This length of time is being requested because I am told that additional engineering work will
be required before the actual re-roofing can be started.
Regards w
GeoFge Monk
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PERMIT NO 03010137 STATUS O OPEN APPLY DATE 01/23/2003 OPERconniew N.,...d
MASTER NO NOTES 0 PERMIT ISSUED 01/23/2003 OPER conniew
Bolds
PROJECT CERT ISSUED OPERi' Oanoet
PROD DES- CERT NUMBER TYPE
"r1eM roa.o
APN U36905041.00 so
- O UPDATE ADDRESS O I user 9onens
PARC ADDR 119985 PRICE AV C/S/2 ICUPERTINO SCAJ 195014 sort Ae Col
OWNERI GEORGE MONK JOWNER2 I9nn lie rnie
O ADDR C/S/2' j 19503.4 Yler Obieol
_ Ow-Lint
PERMIT TYPE SFDWL-ROOF US.0-404 TYPE 434 ENRGY COD ',
Nutr
USAGE CLASS N A PERMIT FORM APPLICATIO TANK SEWE
APPLIED VALUATION fi000 APPRVO eY:
CALC VALUATION _ -=F ol ol 4084461025
OWNERSHIP 1 PRIVATE NOTES (Y/N/0) CONTR PIio' 4083757676
't. SPECIAL CONDITIONS/NOTES ESCROW
'REROOF - - - - -- -- - -i'i VERIFIED
REMOVE & INSTALL ASPHALT SHINGLES FILE LOCI
7
PERMIT STATUS - <0>pen. GC>105ed. <V>pid, <H>old. <R?kiect, <Enolred ._
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