00070189 CITY OF CUP6RTIN0
uuu,nmc ntvtstOy PERMIT CONTRACTOR INFORMATION:
IlUI1.UING AUURF.54, I'IiRN�N1ad '8
(,WNIIR'S NAIJII'186 RUPPEI_L PLACE_ LOS GATOS ROOFING AppuoerlD�i'*¢���
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,iRYR BODAPATI 1771 SMITH AVE SANITARY No
Coo ARCIII'I'FC/IiN'CINIiIiR: (4lDB) 359-1233 BUILDING PERM F INFO
FLOGELECT I'LU IB MECII
¢�LLCi, Gl CI Cj I_I
Ga
N L.. list ID,licenRACIOR'S Dikiorl t Chapter
0Oo ddhon 7000)of tlmtlam oftheeBmxacrpnd profssins Code.
mmeneise Job CSCrlpll011
p_ w with section 71gM11 nrr3i.i.inn3onne Busfnesx and rmre..mnscode.ane ter license
n bill fume.sod eft"O 1S
2 it°i en.e _ c 39_ Lie.h }►�
ed G n tJ Dalc ep_ Conlmcan ^
ed ARCIIITECI"SIIFCLARAmON fOtJlT/ TEAR OFF L LAYER OF S HKE, INSTALL 30c.E
,der.ent nnyhlans shift neua,d:opnnrhef' �'��Q AND MONIF_R VILLA TILE_
s _
w oo Lmcn.edl+r:ocmud o,
OWNER-BUILDER DECLARA ION
d 1 michy altirm that I am cecnnpl Inns the Comtruc,ra Llcen.0 Law for the
(,donning mason.(Section 703 .5.Buainas and Pmfe,mor,CcAc:Any city or county
2 M which requires it permit it) .t t alter, p c demolish. R y structure
el
3pi a-I I ,alk: b :B pylic t '1 p noun fileg .datemem
e. 'bar he is licensed pursut to the provisions of t Confusion's Le Charm,9 Sy. Ft. Floor Area Valuation
(commencing with Section 7000)of Division 3 of Jim Fuxin...and ISces,ions Cole)
now he is exempt thercfmm and the hasis fur the alleged c,saboion.Any violation '
of Secdon 7411.5 by:ury applicant hn a pcnnit nt,hjcas the uppllcarl loo O"l penalty
of nal roorethm it Hundred dollar,15503. APN Number. 'Occupancy Type
❑I t he pri,Nny,or,Y employees withwages J I pe ton. SFR.
will do the work.and'lr t an incaded or allcucdr '. I (Sol.71)44,
Brame and 11 motion,Code:The Contractor',laccii,o 1 d t pplyman Required Inspections
ow f p @ow cu l Wiimprovesd ,theirJ n J such nt himself
ro for sale. 11 e n ' 1 1 did 1 t t r intended or 362230047. 00 (V^/
Come lei If (hebuilding y p I' IJ Iti ycar of
wmplmmn,the owner x JI hoe the burden of proving that he did not bade or
nnpmwe for peso...clove.). 305 — FRAME
c0 1.oo n of the p(See 7 I .iv lycontrollingroin licensedcontractorsla 307 — INSULATION
Lest ct thep ) t IS 7"'l business J professions bCurl1h Contractor's `
u i J t:such r n11 pa tri who Halle. 1 thereon
and n a Iso tnr s projects win t t to licensed pur,mid to the 6a 1 — ROOF TEAR OFF
cont t r:Licca,c law.
D l am exempt under See. .B&PC firnlns mason 602 — ROOF PLYWOOD NAIL
Owner Dale 603 — ROOF BATTENS Q
WORKER'S COMPENSATION DECLARATION 604 — ROOF IN—PROGRESS
a—A Mrchy amour under penally of Penury enc of the ollowing declamtimu:
❑ 1 have and will n tinmin a Certificate of Consent,self-insum for Worker'.
CaTopcosatia, its pmvidcd fur In, Swoon 3780 of the Lana Cuda for.the
performance nr the work tor'which this audit is i...ed.
hove and will main aid Worker's Comiscmat Ireumnae,as rcyofred by Section
0)Cf the Whur Cale,fin Jim pert'mmance of the work for which this permit is
issued.N rk99�QQc}}rsCunpcm' iC I1 nON 1'nlicy number art: '
Cartier_ CNIII"A'1lON O�f11'119iWO 6"IiIt.S � l
COAII'ENsxrboN INSURANCE
1'nucetinn need no be mmpicmvl if Ilm perinit Is bur one humdrW dollars
1Y 1010 nt les.)
I sally that In the perhunwnen ul the work for which this permit is i..ed,l '
shall not enydnY any person in eny manner so as,barons,subject to the WorkmM
Compensation Inxv CI Califnmia.Dam
Applicant
NCI'ICH 10 APPLICANT':If,ufmr mtAimy this Cortificam of Excnmlion,you should
b,con. object to Ne Worker'.Cumpnum:on pnwision.of We Labra Cade,you mus
0 forthwith comply with such provisions or this permil.hall he deemed revnkcd. '
F ^ CONST RCC[ION LENDING AGENCY _
a ' I Comfy aBinn than them is a ronswninn lending agency for the performame
of the work for whicM1 this pcnnit ie issued(Sec.1097.Clv.CJ
O Lender',Name
� Z Ixods,s.Address
U
CI
certify that I have read this application and stale thin the atone information is
W c rrect.I ngme so comply wins all city:and county it J,cs and.lam law,mmlh,
Q (� to building construction.and hereby atuhmim mpreunmtives of this city,enter upon
the atmvcmemimod property for Inspection purpose..
96 (We)agree nam indnnnify and A sop fertile,,t he City nl'Cupertino agulnYl
Z) liabiles,judgments,coax and cape
who,n y way accrue against roue
C.7 Z City in co uence of the gra 1,up/.I'h' ^
SID'PLI UUsi — T ALL NON-POI Issued by: Date
S' re
ontmno—r " - `1:ntcr)X•— Re-roofs
IIA%ARUUIIS MATERIALS IIISCLrISURE
sun Bm appBernt m m,re Iwildg tacunanrt.tofu„n handle hm,Neaa n,aledal Type of Roof
m dinned by the Cupcnino Municipal C, , Chapter 9.12,and the IIcahb and Safey
Calc,Serono 25532fa1'1
o Ye. X'lo All roofs shall be inspected prior to any fooling material being installed.
Will the applicant or future building occupant use eyuipmem or devices which If a roof is installed without-first obtaining an inspection, 1 agree to remove
'mit ha/ardCo4 air mnum/mums as Ja lined by the[lay Arm Air Quality Management
,Tied? all new materials for inspection. Applicant understands and will comply with
Oyes VA, all non- out source re ul 'oj s
I hoc read Inc ha'earcbns mamtiub reyadrmncm,order Chapter b95 of Jim
Calla mia ucdlh&Salcty Cole.Swoons25505,25533 and 25534.1 undeomnd liar �` �,0k
able bui 'ng does not currently h:�:e a l a in l is my ropm.ibi lily m notify the .3 �/V
ncmtpa a the reyuircmc ce__nl a Cc dip to o
0
3/ natureol'Applicant Date
— arra arnhod,cd neem -- - — Dam All roof coverings to be Class"B" or better