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04090013 CITY OF CUPERTINOy h' i�� PERMIT Alto, BUILDINc DIVISION . . _ ��QR'INI+'U�2� BUILDING ADDRESS: ROOFCO OF SILICON VALLEY PERMITNO04090013 7733 RAINBOW DR OWNER'S NAME: - PERMITLSUEDATE IghJAMES JEIL ` ONE: - SANITARY NO. CONTROL NO. 40 79 - ARCHiTECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH u o o LICENSED CONTRACTOR'S DECLARATIONO '�(Y 1 W.by affirm thm 1 arrIicensW under proviai ns of Chapwr 9(commencing lob DeSCrip with Smdon]IXg))af Diviaion3ofthe Business an uaiaw Code,andmv ylicecis n nlife"'-- 6 9 REROOF W/ MOIRE BLACH j Z Lieenx CI Lk.p Cantrmtar SEP 14 2004 reqq ARCHITECTS DEC AT ON y a 1 undcamo y plans¢hall W used as publi cords ip BUILDING o� Licensed Professional g OWNER-BUILDER DECLARATION d Q F 1 l..a .(item that 11. exempt from the Contrecmo License Law for the p C whrollich .res a perm(Secit to cont. t,altass end Profession h,or re repair piny m c ante k$� which requires a permit to.I.the elves improve,demolish,terse Sig any statement �iy prior.slimnsnce,auu mquircs theapplicantfur ContratoSuch r'm0lcasLaw(Chapt cm p 0 that heioungwitpursuant70th)ofDiviovofthe eBusinessaLimnuLvw(sCodnr9 Sq.F[. Floor Area Valuation y $ tht(Comm11 ngwith Section70M)and of basis for n(Neeged exempt Pfa(eni0vilatae)or - Sa he is eaempn Nerclrom and Ne bash far be alleged exemption.Any violation of Section the.5 five tory applicant for a permit subjects the applicant to a civil penally of 3 GON4`Ii3�t18er0 0 Occupancy e not mare then Ove hundred dollen(gsao). P YTYP ❑1,as owner of Ne property,m my employees with wages as their sole compensation, will do thawo&-end on,structure is notinended oroffered foraale(Sm.7044,Business - and Profession,Com:The Commiserates Liwe owne aLaw does out apply to an r of Required Inspections propernywho builds orimpraves thereon,and who doessuchwork himself orthrough his own employees.provided than such improvereanu arc amounted oroffered for Wa It. however,the building or improvement is sold within one year o(compledon,the owner. builder will have the burden of proving that he did cot Wild or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with Ilecnsed amntracmn to canswcl the project(Sec.7044.Business and Professions Code:)The Contractor's Li. cave Law docs not apply to an owner of property,who builds or improves thereon,and, who conmets for such projects with a conuacnor(s)licensed pursuant to the Contractors License Law. ❑Iamexempnunder Sea ,B&PCfmthlarcvon Owner Data WORKER'S COMPENSATION DECLARATION 1 hereby affirm under pevlty of perjury one of the following declinations: l have and will maintain a Certificate of Consent to a 1r iesum fm Warkcr'aCompen- auion,as provided for by Section 37M of dm Labor Code,for the performance of thc work for which this permit is issued. 011 have and will maintain Workers Compensnion Insurance,as required by Section 3700 of the Labor Code.for the performance of the work for which this permit is issued. My Workers an ation l rvpec a cr and Policy roarkr..: Certje{:C Poliry ON Re 1760 ✓✓Yy CERTIFlC O•OF COMPENSATION INSQ ORKERS' COMPENSATION INSUR (Thisaceien need not W completed i(%an permit is laronc hundred dollars($1¢00 ,elects.) 1 cantly than in the performance of the work for which this permit is issued,I shall not employ any person in any manner an as to become subject o the Workcri Compcnsalion Law¢of Calif..!..Data Anal usunt NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should become subject an the Worker's Compensation previsions of the Labor Code,you must .JOforthwith comply with such provisions or this permit shall be deemed evoked. z CONSTRUCTION LENDING AGENCY [-r I hereby affirm that died,is a construction lending agency for to performance of qi> the work for which this permit is Wood(Sec.3097.Civ,C.) GLenders Name z Leader's Add. V O 1 certify than 1 have reed this application and soon that the show information is IT Fcored l agreedinm to comply with all city and county orces and sun laws relating(a O building convection,antl hereby authorim nprescma ivv of this city to enter upon the >ia show-mentioned Property forinspection which may (We)agree to save,indemnify and keep harmless the City of Cupertino egeinat iE"y CA liebilitia.juagmenu,costs and expenses which may in anyway accrue agalnstaeid City (�,Z in consequence of the granting of this Permit. ^ APP CANT U STANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU R L IONS. Re-roofs i o(ApplicenUContmctor Dan HAZARDOUS MATERIALS DISCLOSURE Type of Roof 111 the applicant or future Wilding occupant store or handle barardous material aaaj'az do recd by the Cupertino Muniripel Code.Chapter 9.13,and Nc Health and Safely sa,sec den 2ss3z(a)? All roofs shall be inspected prior to an roofing material beim ❑res �r41; p P � Y g g installed. Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants az defined by the Bay Arca Air Quality Management all new materials for inspection. District? l ❑Yes I7tm I have mal the hmaMnus manrialsmyvircmcnts under ChaPnrg.95 of Nc Califoo- q tie HcmlNASafcny Cadaseedov2550S35533and25534.1undcm.dthssirNc Wilding docs no urently haw a w 1,Nat it is mY rcspovihilitY m nodfy the accupent of Ne my ' me sw 1 m etpdorwissuenceotaCcnigcawofOccu m Si tea re ofAppll nt Date y 3 a All roof coverings to be Class"B"or better Own auNorizcJ agent t Data Community Development f 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 77773228 CITY OF Fax(408)777-3333 UPEkTINO Building Department JOB ADDRESS: r PERT # -2 Z 3 CCt Gl Lo �i OWNER'S NAME: J re vtI PHONE # GENERAL CONTRACTOR: d , FAX # I am not using any subcontractors: �— 3 Signature Date Please check applicable subcontracto4 ancomplete the following information: SUBCONTRACTOR USINESS 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 . / or Signature "Iz�� D to Community Development Department Building Division City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 U p C kT I A l0 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 Name: V'�y� C,nr1`�-�j Job Site Address: -7-73 3 /"L�//f C n) 4..�,jJ Roofing Company Name: T�GCJ 1'" ��Cy'g f''`//3,1 Gant 4140�000 A plicant's Signature: ..� G.i' Date: 9131a Greg teel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO IGqC 000F :> -0 REROOF - ZFD CUPEkTINO PERMIT APPLICATION FORM 6 APN# o V O! 7 Date: q-17- Lee Gi Buildin Address:. Owner's Name: Phone #: S �t ] n yt/G — Z/Co0 C tract Phone#: License#: Contact: hone#: Cupertino Business License#: arvtG 2el 5 3 s v> Z23`/S Type of Roof Covering: Existing: Proposed: ❑ ilt-Up Roof ❑ ilt-Up roof NO" Asphalt Shingles S' Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings 2 ❑ Provide I.C.B.O.Report# W"—To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: 7;-5 "// 30Mol'�ei (cam ZZ -/e Residential 0 ' Commercial ❑ Fire Zone: Yes ❑ No Confirmed with PI ng Det. if there are antr1Cti0 , 13 Cost of Pro'ect: Type of Constructi n: Occupancy o GrU�U� Qty. if A tc 1 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 ��� 27