02090019 SITY.OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDtESS: PERMITNO:'
2`2890/22900 RIDGEWAY DR 02090019
O APPLICATION UB DA
S9�bMRIDGE OF CUPERTINO HOA 09/04/2002
PHONE:,'- t SANITARY NO. CONTROL N0.
Ole ARCHITECDENGINEER:. BUILDING PERMIT INFO
i
ZC BLDG ELECT PLUMB MECH
Z LICENSED CONTRACTOR'S DECLARATION J� f}E�'
pz:n 1'd':Ihereby alarmthat lamlicensed under previsions ofChapter 9(commencing REROOF JAb�e On
Fmt. with Section]000)orDivision3oftheBusinaaandPrfessionsCode,and mylicense L�
Is in lull force an /
oa`e '6 License Class' Lic.p (� '
oaG Date. : Gontm<m
DECLA JUN 1 '7 2003
C LL in0 „J _ ARCHITECYS
i 3 t;• Iunderstend my plans shall be uud m public rcco s
ILDING
a S Al.fi Licensed Professinal
.OWNER-BUILDER m the RATION
tt ='nd Thereby gal&m that) 1. exempt from the Cocoons Cry License Law for the
t?'Q whicIfiriquiresa Permit
]OJLS,Business ter.im improve,
Co de:Any city sameture 35898
�CZC which'rcjuircs'a permit so construct:alter.improve,demolish.or repair any swnum •
prorm Alas rce,atsorcq see provisions
o for wchpermufleneLaw(Cht t - - - -- - -- - ---- ----- -
o.3m thvthf if hccaied purstWnitpdie provisions of the Contractor'sLicensePrlawmrs B. Coda)
.,.v '34Cs.v;&tri13gpr00a u.•v Valuation
(eomr he ikeaim Secuor)h'and the basinort alleged
ssraplon.An vi Cadel /v, y t i Y-el-. y,3s n's•Kl (.,a o
or
barhe7031 b tanyerrotn'and the hoer for the ctsthe applicant to Any l violation-of Section]031.5 by any applicant for n Permit subjects the applicant v civil pcnalry-
bf not more than Bve hundred Bogan lESW). 305 APNbm Occupancy Type
oinitially, 307 - INSULATION LP
-willw
do he the stru<ture-il not intendedoroffcrcd-tor sele'ISec:]6w,' 601 - ROOF TEAj Ij(NPYAI Inspections
Bu dnesi ions am)ProfessCale:The Contractors License Law does not uppI'y to an
owner of progeny Who Wild,or imp n:vermerem.and who does such work himself 602 - ROOF PLYWOOD NAIL
or through his own employees,provided that such improvements or not intended or __ _ _ - -
..___ ....._ ..._7- ._....
"offered fors leaf owner
tb building rtmpsovementhsold he
one year of - 6'O3- - -ROOF BATTENS r•_ shy ( r
'improve for the owner bu e.).well have the buNcn of proving that he did no,build or -
imProverodparyoeeorwk.). 604 - ROOF IN-PROGRESS
r OO
I,ox nc,.f,ha pmpe.7,am Business
vela comrocung with licensed contract..tractto
License
construct the does
n Iappl to a,Bra nese and Professions Cale)The ses Contractor's rt+ •,
'License I:nw Joes not apply m an owner h progeny who budJs u improves thereon, t '
cmanictues License Law ch Projects.with n commcmgsl.licensW.Pursuamao.the.. ...... ....... ..._-..._....____..__.__....- .- .. ._ ..._...-.-.__�. __.
-:•.,,-- Contrvmors License law.,, -.. -.-.._...._ _.
Tx
,.. ❑I am aernpl under Scc.' B&P C fonhis
Owner •A lllo•l. Dale
WORKI 0.S COMPENSATION DECLARATION
slb - -. ..
Ih by Remade der penalty ofRjury of tham
e following declions.
❑ 1 have and w ill no t Cenin6te of Conti r to self insure for Workers
'Crucapersionan,- provided for by Section 37ql of the Labor C tile, for the
PQfoml of Inw rk f r wh h th's re t is issueq...t
hate and willmamam Workers Co peaiat Insmma dby Section
ql of the labor Codefor the performance of the work,for,which this permit is
ussuad MyW sC pc ns nee tamer and Yol y bar/ere:' ^
n le I t Icy Noy ZS 02v f.l. { t -
� � (( 55 J ii t ..
IGEItTIFIGA9IG OP,E.GMPTION PROM.W RKE S." f.• A -�'.L. E 4h L1�1ll.l Ja a�'t,�s.j.,'l 9hjf;
n u
COMPENSATION INSURANCE 4 1 f•
''P tl'Cl:e'Benton need not be'compinW if the permit is for one hunJrtd dollar 1' t i t, '_ i! 'i 1 �s `
les.)
PyY tiP performance
as(he whch tl)pc.' . -." .,.. ..., .. .._. , ... .:
I tf nh tin 11 of fine work for rets ed;I I
'hell n t em In on a nn con h t to the Workers t ,
'Co.per men laws of C.Ufamin.Daie`
�Alipl I,
NOTICCTOAPo the Workers
ompumatton ro rfcme-fes pdon, you
must .,t•
O Q ,tie<omehemop y the Work r Conipem t rip ora of to Lobo Cale,d. must .1
, fonh uh c illy:with h provisions nr the.perm t'hall b tl m d r keJ.
:'CONSTRUCTION LENDING AGENCY t
.a 'a -• .,it for 3ih that N d i,'tori d(See lending ap n Y f the pesfosmaae res
oeia k f which th s perm t ssuetl(Sec J09],Gv.C.) "
:D4Z Lenders Addes.,ial _ ....
„a:} I certify that 1 have d this application and state that theb romu
infuon is s
Qrw 4. cored 1 agracm comply with all city and county candinabletv and state laws relating
to bolding consolation:and hereby authorize rtpraiematives of this city to enter upon
above-mentioned fruit for inspection purposes.,
'p,. ^=• (Wa)agrec lomve,indemnify and keep hart the City 6f Cupertino agamont
rn `liabllnms,judgments.m.is and expenses h ch may in any y e rt .gains[said
(.) 'Cityy c cq nc of the gmmmg rth t _ -
APPLICANTU'D RSTAsry�y/y61 L MPLY MITI LL Ef N NT Issued b Date �7
SOURCE REGULATION a
Signature of ApplicadulCmuractor_'•,i • t . .. . 'Dart Re-roofs
;1 t HAZARDOUS M RIALS DISCLOSURE
Wll the 3plic w or future milding occ pa tst ie or haul'hazalloas mate al _ Type,Of ROOf�
as defined by theCupectin Municipal Code Chapter9.12, d theHealth and Safety
Oade,Sttuo 25532(a) 111 ' ',a, l. '.al >:
❑Yes , ' 'i Allroofs shall be inspected prior-to-any.roofing material being installed..
_ If anewfmate materials for inspection.
she ction first ant u es to comply.with_
-,Will theapplicantorn buildingay pant aseequipment d tees whichobtain) 1 p ctioml '1 agree to'remove
earn h t d it omandran a as defined by the Bay Area Air Quality Management'
of t t .' �- 11 r r pe Applicant rid rs ods and will comp] with
ria °Y all non-point source regulations. P };
� t read ; .
1 h' dud th Safety
Co i mammals q meet undo C4.1 u 695 of m
p S f ty Cade Sections 25505 2553)esM 23514 I understand the, _
.Owner auNo ern currently - - tenant thorn ryr apo iblty nam fY the O Z
ah ora Health& 9 a��
tithe Wilding tlas -
cu ani f t eel h h tint he m t p 't'rs nc of a . rti l of
°ro 9 y pL ' Signature of Apj}hcant, -.- _ Date
d agent Dam, All roof coverings to be Class B" or.better
[ . >, a ".i - .., •,_. ..OFFICE _ _.._ .,._. ._. ._. ..... . . . ..... ........ .. _ .. . ..
Building Division
10300 Torre Avenue
4 Cupertino,CA 95014-3255
Telephone: (408)777-3228
OCIO Fax: (408)777-3333
CUPEkTINO
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 VV 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: ey-
Address: 22�9d ZZ pU '
Reroofing Company Name: __ �-
Applicants Signature: Date: q a Z-
Joe Antonucci
(Chief Building Official)
6125101