01100081 TINO
CITYUIDING DIVISION CONTRACTOR INFORMATION:
• PERMIT '
BUILDING ADDREti PERMIT NO.
10060 SCENIC BLVD ROOF MAX INC 01100081
OWNER'S NAME: APPLICATION SUB DATE
GILBERT HUANG 656 EAST TAYLOR #1 10/11/2001
• PHONE: .. . . . . _ _ SANITARY NO. .. ..CONTROL NO. __......._..
(408) 738-4035
O O O ARCHITECT/ENGINEER: _ __ BUILDING PERMIT INFO
w F FILED ELECT PLUMB MECH
Nub I_1 CI 1—"U LJ
-�.H 2 LICi hcrcbY alLICEN EDCO`NTRaCfO CONTRACTOR'S DEC'LARAnx CION 9 aormn«=m Job Description
mf.pJ with Scnion7(1f10).fDi,ixma3xfthcBusinessandP f=esianacae�.anIf license RE-ROOF
to in ran rmae and n«r
1 ce mrdr,�
LicenseO.S. ic a
i 3 t 6 Dam 's ..- caaoa'to
o RCHIT 'S DEC 10
i="O g .1 urdersivid my plani sfiall he used as public records
i c OO Li<tnud Prufcssional-.W
= OWNER-BUILDER DECLARATION
1 hereby a11iw that 1 vat exempt from the Cocions Co Liccnx law forth=
C Z a following reason.ISenion 7031.5.Business and Professions Code:Any city or caonry
Y F O which requires a permit to construct alma,improve,demolish,or repair any structure - •� 12 7 O O -
i3m -pct itai.mmew.1."rires theepplicam for such sarmiun file.signd supmeno-
0 0
tKatheines,wispues."'71 hepr Di.i.mof the Commctors License Lew(Chapter9 , F F1 r a- •y Valuation..
(=anrxrcing with Seciion]00and t e biri birds
th a BusinesF yd Profµsions Code/ .
or that be i3 exempt theicfmm ad the bazis for the alleged exemAtioe.Any violation
of Section 7031.5 by any applicant for a permit subjects the applicant o a civil Penalty
:of not ream then me hundred do[]..(s5oo). 305APN i '<n Occupancy Type
❑1,as owner of the property.ui my employees with wages as their sole compensation. I
will do the work,and the Cuda:
B not intendedLi or offered Law far an4(3e1 7oaa,' 601 - ROOF TEP�FglAip*Inspections
'Business and property
Who
Code:TM Comm�arLicense law does not apply m an
owner of progeny Who builds or imides t thereon.uchimprovements
who encs such work of
ore through his own employees,a Willie that such impravrm ai a i nm intended or- .-. . .__ 6 02 -...ROOF..PLYWOOD NAI L
'comae for We.If;hbwcildethe Willing«imen of Prot n sold within nor Wild
of
:completion,the awnrr-builder will have the burden of proving that he did nor Wildm 603 - ROOF BATTENS
reprove rarpumeae mfxal=.). 604 ROOF IN-PROGRESS
co L'uu the prodar,ject
p(Sm,y,a.-Buss aiss and PtofeisB wi Ceiceased coaommuctsto . . . .
_- - License
the does
(Sec.Ito a:Business and Profusions Calor im t< vas tmreon,
Lic L J f apply I whet of progeny who Wilds ice p thereon,
and h i ix far Such p I, -with n conw=mr(x)licensed pu am.w die_ _ _ ._ _
Commencer LfmXld
0 pt neer S«f' t � B&PCf this rtvmn
-_ Owner - Dam
WORKER'$COMPENSATION DECLARATION '•
1 hereby eRrm under penalty o(petjury one of the following d«lantiov:
'O'l.have-and'wilCmvinwm.a'Certificate'of,Corriere to self-insure for Worker's
Comp rvaishn, is provided fon by:Section.3700 of-ihe.Labor Code, for the
performance of the'vi for which this gamut is issud.
❑I have and will mormin,Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the poformvva of the work for which this permit is - - - -
fnsurence<erti<r end Pol c n bar pe
issued My Werkef Come.at on I,• .,
s - /y yyQt .. .-
can v ts•gepol cy No S `i ! �A / ( ,,+ �a t '•7 ft I s rbl
RTIPICATION OF.EXEMPTION FROM WORKERS'i
I- f F �tsf YE J;-s �L 7 ..• _� -
COMPENSATIONINSURANCE'
'(Thii xciion treed na tie'<ompleied if the permit is for one hundred dolim \' �' \'� it. -_" - �i x it,�t�. t%T,
.
[g100)arlcs.
I'canify that in•the perforrrwce of the work f«which ens permit is issued,) - kill,,, •- - -- -_
shall not employ any person to any manner so as to become subject to the Workers'
Compensation laws of Cal ifornia:Dem"
.Applicant -
NOTICE TO APPLICANT:If,after making this C<nificam of Exemption,you should
0 become subject to the txorkcex Compensation provisions of the Labor CWe,you must
forthwith comply with such provisions or this Permit shall be darned sevokd. _ - -
CONSTRUCTION LF-NDING'AGENCY
_ ,
a'> - dbri•w xrk for which this drtie is a coned(See lending agency for the Performance - I:
W ti r which this permit is issued(See 109].Civ.C.)
of the work(o
Lender's Name"
7 Z LeM=r's Ad
drfsa
1
C.1 .,I certify that I have read this application and state that the above information is '
W 1._ coirks..I agree to comply with all city erid county ordinances and smm laws relating
(� m Wilding conswction.and hereby authorix rcprcunotiv<s of this city to enter upon
the above-mcmioned property for inspMion Purposes. _
t~ L (We)egree io save,idemnify and keep harmlesxthc City of Cupertino against
h liabilities,1 dgmems)count and xprngs hch.may in any ay w againstssaid
C.7 Z Cityconsequenceof the (dri RB��6i,t: - .
SPP A N�UERS S- NDWCOMPLYWITH ALL NON-POINT Issued by: Date
sigraffire ofApple HAAZARDOU ATERIAIS DISCLO Die. Re-roofs // _
.i i $URE , '. 1,_ L .. �..I...
WII theeCupertn future Coe..Chant ape2,Mel health an Safety
�I Of Roof ..-' - - - -
vedefndbyNeCupen oMn¢tpalCWe.Chapter 9.12,and theH Health reed Seery - •J1, ,
cod s«f n2ss3zt 1 - . . f: -
-❑Yci, ,:L ut. ❑No•. 1iIr�aY..ir r J. l .
. ..,;r,Jr•'�• � roofs shall;be.inspected prior to.any_roofing.material.being installed,.-
Will
nstalled.._W II the applicant or future buildingo,cupant use equipment or devices which If a roof is installed'without first obtaining an inspection;I'agree.to remove
emit Issurandours air cormannintions as d find by live BayAma Air Quality Management
D.tint - all new materials fofinspection. pplicant understands and will comply with
QY ON all n-point source reg tions. t; t
1 h e' ed'dr h eardoC er 1 gwremrnu ode Chapter6.95 of 0m q /
Cahfomu Health It Saf=sy Cade,Secuans 25505.35533 and 853x.I undenund that
if the building Jas not currently havZmarret
,that it is my responsibility to nmify the t"-1(! �d��/-��,. .
o«u tt_0 the mquirtments wq ch priano issuance'of a Certificate of - "' -
"± .C. ignature of Applicant Date
/1`d /D-ii-or
Y r bwn ror numan,d aganr . Data
, All roof coverings to be Class"13"or Better
_t _ OFFICE
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
ICUPEkTINO
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 1/" 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: �ILAL-d wl-(airy
Address: /00 &0 SGL?n; C- ��✓d
Reroofing Company Name: /tG
Applicants Signature:
Joe Antonucci
(Chief Building Official)
6/25/01