04070155 CITY OF CUPERTINO
BUILDING DIVISION PERMITCCy�Y'TRAC'TO'fi lN'k"Urx °,
,':�",� ., •ani?' �¢au£, c'i
BUILDING ADDRESS: J TOLENTINO ROOFING CO PERMITNO04070155
*7635 RAINBOW DR
OWNER'S NAME: PERMIT ISSUE DATE
LEE JOUNG P
ONE: SANITARY NO. CONTROL NO,
(408) 578-4141
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
_Op LICENSED CONTRACTOWS DECLARATION D crlptlon
U I hereby affUm that l am Itceneed under provisions of Chapter 9(commencing
'¢ wib S.uan7(KsBm d FI n3ofdscBLidgese Prom sic andraylicenmin REROOF
o in full force sad �/
Z License Cl Lk.p
0
al-
ill
l- Datc Convenor AUG 2004
q❑l ARCHITECTS DECLARATI 1
?a /1 undcrsund my plans shall he uscdA.public records
G In Liccnsetl Pm(csmanal \� BUILDING
OWNER-BUILDER DEC n Conte ON
E:i I hereby.(firm I I.S.exempt from Ne Contras Cc License Law for the
p 0 whfollich
reason.Permit
(Section 75DLBusiness and ss.Professions li h,or raAnyh y ser moury
K$ which mirequires a permit re enrthe alter,impmvu,demolish,of.pair any nmemm
thither its i cared pursuant
requires to he thovisio applicant for such permmeet's o if Lica se LowJ stammcrd
F�P�<
that heirlicenced pursuant to the of Division
of the Commhe ent's Licenselsw(Chapter Code)
Sq.Ft. Floor Area Valuation
k�D (cat he Is
(commencing Section 70n d the
but,f r n allopo Business and Ponfacm.Any
Cade)or
�
that he k exempt tmnfrom end Ne buil for Ne alleged cumpuon.Any violation of
Section 7031.5 by any applicant for a permit Subjects Ne applicant to a civil penalty of 3 @XN+0 ff6er0 0 Occupancy Type
not more than five hundred dollars($510)..
❑I.a owner of3W property,or my employees,with usages an their sole compensation,
will do the work and the strvature is not ncnded or offend for sale(Sm.7044.Business Required Inspections
and Professions Code:The Contractor's License Law dors not apply to an owner of q p
property who builds or im proves thereon,and who does such work himself or through his
own employees,provided dust such improvements ere not uncurled dreamed for ale.If,
however.the building or improvement is said within one you of completion,the owner,
Wilder will hove IW burden of proving that W did cat build or improsn for purpose of
ale.).
❑1.as owner of the properly,am exclusively contracting with licensed contractors to
conswct the project(Sec.7044,Business and Professions Code:)The Contractors Li-
cense Law dots not apply to an owner of property who Wilda or improves flumar.and.
who comment for such projects with acon Tea mr(s)licensed pursuant in the Convaetor9
License Law.
❑I am exempt under Sec. .B&P C far Nit mason
Owna Data
WORKER'S COMPENSATION DECLARATION
I hereby a03tm under Penalty of perjury toe of the following declaatlom:
I have and will maintain aCeniftcacof Consent m self-insure fm WdrkersCompm-
.a..,a provided for by Section 3700.f one Isbor Code,far Ne parliament.of the
work(or which Its pernit is ha.d.
have antl will maintain Worker's Compensation Insurance.a required by Section
3�73700 of Ne labor Code,for the performance of con work for which this permit is issued.
y Worker's@C�topeyr�y-eti�on bwtnn..rricr and Policy number am
> 1ICl , Policy No.: 2
CERTIFICATE44-
OF EXEMPTION MOMW ERS'
COMPENSATION INSURA
This action aced not Incantational if the Permit Is fortune hundred dollen(SIM)
or lea.) -
1 certify that In Ne pafotma..of the..,it far which this Permit is ia.d,l shall net
employ anyperaon in any manner so a to become subject o Ne Workers'Compenallon
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this Camle m of Exemption.you should
become subject to the Worker's Compensation prevision of the Labor Cade,you must
0 O faMwith comply with such provisions or this print,shall bra deemed revoked.
z CONSTRUCTION LENDING AGENCY
'roe I hereby affirm that Nee is a contraction lending agency for the Performance of
CL r7 the work for which this permit Is issued(Sec.3097,Civ.C.)
PWi A Lender's Name
z Lenders Adders
U0 I certify Nve c
Net I haad Nmute
u application and Nat IN aWve fascination.is
F correct I agree to comply with all city and county ordinances and soon laws misting m
0building construction,and hereby authorim repnsentadves of this city to encs upon fee
0. ahove-mcmtdnctl propertycosts
for impaction ees purposes.
(~ (We)agree to ase,indemnify and keep homeless the City of Cupertino against -
h liabilities,jutlgments,costs antleapcnaa which may in anyway ecerve ageinnaid City
V'Z in conscqucncc of Nc ranting of this Pcnnil.
r"s APPLI UN T 5 AN WILL COMPLY WITH ALL NON���PPsOINT Issued by:
G A
L UJ Re-roofs
alum of can onvacror - Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will applicant or future building occupant atom or handle Innuendoes mahout
a defined by Ne Construct Municipal Cade.Chapter 9.12.and Ne Health and Safety
Adlig.do,Section 35532(a)?
Yam
All roofs shall be inspected prior to any roofing material being installed.
❑
Will the applicant or future building occupant use equipment at devices which If a roof is installed without first obtaining an inspection,I agree to remove j
mit hazardous air contaminants se defend by the Bay Area Air Quality Management all new mate as inspection.
District?
I have marl the Wzadous materials mquimmarm under Chapter 6.95 of the Califar. �� `
m.Hm1dhJe Safety Cede,S,x, 5505, 533ud25534.1..&.tandthmifthe Wilding /V V
d rw umendy tum a cnan4 I it' you hi"m notify IN..pent of toe
yuinm swh h ustb p'a uanc a aCcrdldsto Q cy �/ Sign of Applicant Date
o e a thorizcdagcnt Data All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
7CMITYF
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
�CUPE(�TINO .
Buil din De tment
JOB AD SS r l7 w P IT J
0
OWNER'S NAME $'vow bJu I PHONF�49 L
GENERAL CONTRACTOR: .I(g u FAX
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following ' onnation:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
2-
r/Contractor
r/Contractor Signature at
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
U����I�O 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 1/4 " 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 Names �0 S, OL- 4 L 0 k6��l
Job Site Address:112 6
Roofing Company Namew
Applicant's SignaDate:
Greg teel
Building Official
Revised 1/30/03 .
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF U"� 0 7
CUPER INO PERMIT APPLICATION FORM
APN# 3 /� C� -�/ Date: Z O
Buildin Address-
-7
ddress:
Os Name: Phone#t
05 l -0W IJ i N r A-N i t��'T - g7�7
RV
C ntrr Phon #: License#:
l6l n�a IQo INa F SZB� j S Z
Co act Phone#: Cupertino Business License#:
a �i' o sz 8 4C ll
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles 'Asphalt Shingles
V:'Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read, Understand and Will Comply With Cupertino Tear O f Policy: ❑
JobDescripti E �' -e S / ' S rU �r 16 5 li CDk X66 0fLQY(�
S S(�tQ iaSf7le ° �e(lft
t<�o' r wader a to 3e `:�.
Residential ommercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if
there are anrestrictions: LJ
Cost oject nC72 Type of Cons o Occupancy group:
Qt . t
A lic b Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
3�3
zee' 76