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05040170CITYOFCUPERTINO '" "Y"'r"''-"�, TN'F'URlv1ATT1�"-- BUILDING DIVISION PERMIT CO1VaTRAGTUR BUILDING ADDRESS: ALLIANCE ROOFING PERMIT NO. 05040170 OWNER'S NAME: PERMIT ISSUE DATE, ftONE: SANITARY 0. OL NO. CHI7ECT SNGINEER: BUILDING PERMIT INFO BLDO ELECT PLUMB MITCH .p LICENSED CONTRACTOR'S DECLARATION Job Description ��b 1 bewby affirm mat 1 am Hawed under pmvi+iom of Chapter 9 (rommencin6 e withSection IWO) Divl,IN3of a Busineuand Professions Coda.md.,licensB in ren face andel _ �� Cie. 4s}Oen. Licenw I REROOF W/DENSDECK & FIBERTITLE OVER (E) i Dem Contractor 4 rArA ARCHITECTS DECDECLARATION w � 1 underuand my plena shall be used as public records [� i Licensed Pwfesommal DECLARATION OW NEon t F 1 hereby exempt License for RIC that 11. exempt Item the Cnsitocs COAL•: p 0 city O m6bR feecmM 71DL5, and detiew o Any ally nr county (SOc Impansu demnlhh, or mush v S .�' whichfollowing t.LLlot, ve. which requires s permit re rnnatmeL alar, lensed c. tes;he do applicant for such permit toiecomle 4 ed statement ConitwmsandPraUonsCodo9 Sq. Ft. Floor Area Va uadon < aw(Chmmenl thiormiu pursuant to of thalheencingwdputwantutheprovivision3of $ nal Code) of Section 7000) ofth pth IneisofrI allegac ed exemption. Nat k ts exempt Unrefrom and the buss for Ole altered eaempdan. AnY Nolallan O( that he exempt 31AM1409100 Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to arnil Penalty of not mom than five hundred dollars ($500). ❑ I, as Owner of the property, or my employes with wegal u thok sale cempensadm. aired Inspections will do the work and me+wcumtsml intended or offered formle(Sec. Triad. BusinessRe and Professional Code: The Cesuaoo or+ License law clue, napply m an owner er 9 P property who bui Ida or im prom+ thereon, and who does each work himself or through his own employes, provided that such i m prowmanu tee not Intended or a@red for ante. IL however, the building or improvement is mid within one year of completion. the awner- bullder. will have W burden of proving that be did am Wild or Improve for purpose of sale.). 0 I. as Owner of the property, am exeluively connecting with licensed conuwmrs In comlruct the project (Sec. 7014, Business and Professions Code:) The Conmcmh U. cense law does not apply to an owner of properly who Wilds Or Improves themes, and, who contracts for such projects with a comrwtar(s) licensed pursumt to the Conumtors License law. ❑ I an, exempt under Sm .B k PC for this resen Owner Dam WORKER'S COMPENSATION DECLARATION 1 bemby a Tm under penalty of Petiury One of the following declarations: I hems and will maintain a CeNOmte of Consent or self-insum for WorkeesCompen- mdon, as provided fm by Section 3700 of the labor Code, for the performance of the work for which this Permit is laved. ❑ 1 have and will maintain Workers Compensation Laurance. as numbed by Section 37W of me labor Code, for the perfomamxof six work for which this permit is Issued. pnPolicy No.:&Z— OIL 3s)O_)2r 6 CMayrtWieer kek4 p�e1�snm carrier and Policy number an: - D CERTIFICATE OF EXEMPTION FROM WORKERS' ' COMPENSATION INSURANCE (lhlssectim need mnNeumpleted Ifthe Permit Is Intone hundred dollars (SIM) nr less) 1 certify that in the performance of the, work for which this permit is issued, l mall not employ any person In my manner w as u become subject to the Worked Compensation Laws of California Date Applicant NOTICE TO APPLICANT: If, after making this cer incate Of Exemption, you mould become subject m the Workers Compensation provisions of Om labor Cade, you muss ' z forthwith comply with such provisions or this Permll shall be deemed revoked. C CONSTRUCTION LENDING AGENCY14 , 1 hereby a0'um that dart B a construction lending agency for the performance of > the wish fur which this permit is issued (Sec. 3097. Civ. C.) Gj Lenders Name Lender's Address z 0 1 certify that 1 ban mad %is application and sum that the soon information Is corm I epee to comply with all city and county ordinances and sole laws relating to building construction, and hereby authorize reprcwaumes of this city to enter upon the W show -mentioned property for inspection purposes WIiebiliti less the City of against (We) agree m save, indemnify and keep harmCupertino fn againsl send City ser and I xpcmes which may my way aarne i nsequence0 the ofthis Permit. LICANT U DE A S AND WILL COMPLY WITH ALL ON -P INT Issued by: Date SO EG 4 as a Re -roofs Slgnose ofAPp,..,Co..0 Date at HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding mupani pow Or handle huardons material defined by the COP'MineMunicipal Cade, Chapter 9.IZ and do Health and Safety alk, Sed25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes PNo If a roof is installed without firs[ obtaining an inspection, I agree to remove WIII the applicant or future building Occupant use equipment o devices which emit ha'rudnu air contaminants u defined by the Bay Amo Air Quality Management all new materials for inspection. District? ❑Yes t$NO I hive mW the hazardous materials requirements under Chapter 6.95 of the Califor. nu 'au 25505.2SS33md25534.I undereunA thatifdm Wilding not cum ly ha a 4 that it my responsibility m ratify tbe up of the Immentsw' metpal aroissuanceofaCcrtiBcateofOcc they. Signature of Applicant Date '7,D a "B" All roof coverings to be Class or better Owner or autharixe0 agent Dale C, Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date 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 Owner/ Contractor Signature Date OCITY OF UPEkTINO, E 0 Community Development Department Building Division City of Cupertino 10300 Torre Avenue Building Department Subject: Re -roofing policy for the City of Cupertino Telephone: (408) 777-3228 Fax: (408) 777-3333 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. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re -inspection fee of $176.18. The re -inspection fee must be paid before another inspection can be scheduled. 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: Job Site Address:-sa"?, D4 F V i7W ' 61,'t r - Roofing Company N i Arl Applicant's Signature: Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper Date: 4 -_2z� - Q 5 - • • aKt CITY OF CUPERTINO REROOF livol CUPEkTINO PERMIT APPLICATION FORM APN # l U 01� O T? Bldg Permit Fees Date: BENERGY Energy BUILDING Building Address: /0 Seismic Fee Res 55 5 049 V1646o4ce; Owner's Name: // '' � fd#14i-E T ALG ACD Phone #: oi4l-�dr��i Contractor: nn /V LL1ArIGS� �> ir� License #: ))'' TR�0.26L Contact:Cupertino Business License Business License #: ✓� AGI— Type of Roof Covering: Existing: Proposed: 18 Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles O Wood Shakes ❑ Wood Shakes ❑ Wood Shingles 13Other(Specify) ❑ Wood Shingles .0 Other(Specify) t'46 TO f€ 1�4bd f L, 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 Cu ertino's Tear Off Policy: Job Description: =,,Isf�LL 4 c " fBusDaeA, AJ0 r,g,,,er,rd' ctfe(Z Bx 7-, J4 — act+ o Lei T7-�/L Residential E] Commercial Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if there are any restrictions: Cost of Project: Type of Construction: Occupancy group: 4-48 Duo Qty. if Applicable Fee ID Fee Description 2 ITTM, 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