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01100023I L a A CITY OF CUPERTINO .; nlm,DIN G DMSION PERMIT CONTRACTOR INFORMATION: BUILD WG ADDRESS: PERMIT NO. .20172 RODRIGUES AV MARTINEZ ROOFING INC 01100023 OWNER'S NAME: APPLICATION SUB DATE JOHN LIEU 4640 TAMPICO WAY 10/03/2001 PHOIt Sf','.: SANITARY NOCONTROL NO. ,,.: (408)269-8901 z ARCHITECTIENGINEER: O BUILDING PERMIT INFO .B ELECT PLUMB MECH Z LICENSED CONI RACfORS DECLARATION Job DescriIOn 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing 'with RERCOP. Section 7000) of Division 3 ofthe Business and Professions e, endmyJjcense. "'i" ° "?� < Li Lic. N _ REMOVE SHAKE, INSTALL 50 YR. COMP. O IT csc Comm ARCHIT[cr S 0 ,A ION 1 understand my plans shall he used as public menrds olensed Professional w 'OWNER -BUILDER DECLARATION 'I -I Wheby effort hot I um exempt from the Contractor's License Law for the. a following reason. (Section 7031.5, Business and Professions Code: Any city or county o which costumes a perhat to construct. alter, improve, demolish, m repair any structure - - - - - • prim to its itsuarce. also proposes the applicant far Mali permit to like a signed statement :_; C�••(i }} -,Sq FtaFloor Area, l m-a.„r ai, )4,;'_'e 1, alUdC10R - thatheislicertsedpuisuannathcpmismnsofthe Con=ctoesLicenssUw(Captu9' '(commerieing Section 70M) Division 3 the Business Professions Code)- with of of end *rot that he ii exempt therefrom and the basis for the alleged calmption. Any violation ,5 y„u ";7.,i , ' of Section 7031.5 by any applicant for a pcmtit subjects the applicant to a civil penalty ofnnt some than rive haired dollars (s50(1). APN Number - Occupancy Type '❑ 1, as owner of Ne property, or my employees with wages as their sole compensation, 30E; - FRAME 307 - INSULAT M#uired Inspections will do the work. and the structure is not intended or offered for sale (Sec. 7044. Business and Proresslons Code: The Contractor', License Law does not apply to an owner of propcny Who wilds or improves Whom. and who does such work himself — ROOF TEAR OFF i *othrogn his own employees. provided that such improvements are not intendeA or fRadwfor,iade.'lc however, the wilding or improvement is sold within arm of _601 year 602 — ROOF PLYWOOD' NAIL ycompletion, the,owner-wilder will, have the burden of proving that he did not wild or ,, . . immprnva fo:m ppnse ofsale.). 603 — ROOF BATTENS con "B with - rein th licensed ❑ 1, u owner of the ism. 604 — ROOF IN—PROGRESS ` - Busidexclusivelyarocdn 7 Contin's consumer the 7644, Bu aro Profession Cade:) The - nesMiss'Isco. ve, W tins, our o who builds or improves thereon, License law does not to on owner of r such and who.contmets for loch molecb with a contractorts) licensed pursuant to the a contractors) Contractor's License Law. . ❑ I am exempt under Sec. , B ffi P C for this mason ' Date FINALE® Owed t r WORKER'S COMPENSATION DECLARATION ,•- Ihereby nlfindunder penalty ofperjuryone ofthe following declamlians: OCT 2 4 2001 0 1 have end will maintain a Ceni(cata of Consent to self -insure for Warkeh Compensation, as provided for by Section 37W of the Labor Code. for the - performance of the work for which this permit is issued.. 'and BUILDING ❑ I will maintain Worker'i Compensation baiia es. as required by Section 37 d the labor Code, far the perfonnme of the work for which this permit is s V m ma' nlnsumncec and Pobe nombe�r- '. PolicyN ���'�L O ?l A _ af�i �'I'l:fi' a.rric t iR IFICATION OP EXEMPTION FROM WORKERS'] .'..i. COMPENSATION INSURANCE' .. .._-__._.. ._------ .._. .. - mas section need Out be completed if the pcmdt is for one hundred dollars t i •:' m ' (SIM) m less,) , 1 cmify that in the mance'of the work for which this pconso is issued, I perfor chalk., employ nby person in any ..no, so as to become subject u, the Workers I Compensation Laws of California. Date - Applicant. '.: NOTICE O TAPPLICANT If, after making this Certificate of Exemption, you should - �t 'j,buome subject to the Worker's Compensation provisions of the Labor Cade, you must • I ' flmdwv rb'comply with such provisions or this permit shall he deemed mvokcd. CONSTRUCTION LENDING AGENCY 1 hereby'oRnn that there is a construction lending agency for the performance ' - of the work for which this permit is issued (Sec. 3M7, Civ. C.) Lender's Name LeMer's Address 7 I sandy that I have read this application and state that the above information is correct 1 agree to comply with all city and county ordinances and state laws relating m wilding conevuctiou. and hereby omhbds a praaimuth yes of this city m enter upon the above-mentioned profit for inspection puryoses. 'of y' (WH agree to save, indemnify and kap humless the City Cu,si against n liabities, judgments, costs and expenses whichmay-in any way acerae against said in Ci I consequence of the grant ti N AND WILL COMPLY WITH N NIPOI (/ ANTTUST - Issued by: Date 5 )URC awrc pl' anvCanwnor Date Re -roofs ` RIALS DISCLOSURE ` E the applicant or future buJding occupant stow or handle heva'rdous material Type of Roof •. .._.. ..... .. as defined by the Cupenmo Municipal Cede, Chapter 9. L2. and the Health and Safety u ' -s �'' 3 •.` tl .f ' `. i �`';:; :5. � +: : • Code, section 255321a1? ' `'•',t �•i' -. _ .(':, m \ ❑res - ,;'❑ rvp;. . . All roofs shall be.inspected prior to any roofing material being installed. :Win me applicant or future Wilding Occupant ussequipmem ordeviceswbich If a roof is installed without first obtaining an inspection, Pagree to remove emit Wrombous air contaminants as defined by the Bay Are” Air Quality Management District? ll new materials for inspection. Applicant understands and will comply with oyes ON. non -point source regulations. 1x - I Woe mad the harsiduss mamriels acquirements under Chapleth.95 of die Ca domia Health & SafetyCode, Sections 25505, 2553] and 255]4..1 understand that (all l 'if a building docs not have a tectum. that it is my responsibility t°notify the t c v V int aParn of the requimmems which must Is, met prior to issuance of a Cuiihca¢ of a"ry ature of A licant Date poo coverings to be Class "B" or better ow aF ant =ed agent - � late� OFFICE Building Division ' 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: (408)777-3228 CITY OF 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 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: Address: L Reroofing Company Name:— Applicants Signature: te: Joe Antonucci (Chief Building Official) 6/25/01