02110137 ` CITY OF CUPF,R'17NO m -- , -
BUILDING DIVISION PERMIT ,CONTRACTOR INFORMATION
Bun1l(Y4k?13LSSCENIC CT T D ROOFING PERMITNc02110137
1
owN90El oSANDRA Q AND KENNETH C 3540 MARGATE AVE . APPLICATElb! tr 2'�2002
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PONE: (408) 892-8872 SANITARY NO. CONTROL NO.
ARCHITECIYENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
ami O D O O
LICENSED CONTRACTOR'S DECLARNFION
wF I hcrehy affirm Na(1 am licensed under provisions of Chapter 9(commencing Job Description
<iU with Scaion 7NXd ofDivisio((((n���s3 of the Business and Professions Code,and my license is REROOF
roan, inlullforccandcffaets on as of — I�'�Illl //1s {���.®
O,N Live',Class(fI Lic.N d7 Ir NIA fa
(n Dam�L� Commctnr
ARCIIITECI'S DECLA A X—
I understand my plans shall he used as public records V DEC 0 4 2002
:oats
33 u.G Licenced Professional
:LLms OWNER-BUILDER DECLARATION II{��/'�
tyi<Y 1 hereby affirm Nal 1 am emcmp(from the Corrosion'.,License law for he BUILDING $10000
❑O following reason,(Section 71031.5.Business and Prifessimm Coda Any city or county
%$� which requires a permit to coommcL alter,improve,demolish.or repair any sirmfur,
poor its issuance.also requires the applicant for such Permit to file a Signed smmmenl
5�a that he is licensed pursmu
nn the plavisioos Of ft Comraco...License U.(6mider 9 _-A._ ID.TCb1)6Ar0t0 Valuation
9 a (commencing with Section 7(XX))of Division 3 of the Business and Professions Gsde)or
y 3$ that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant a civil Penally of N-N Occupancy Type
not mom than Eva hundred dollars(syn>. 307 - INSULATION
01.as owner of the profterty,or my employees with wages m their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sac.7044,Business — �pyy(
and Prufassioru code:The Contractor's License law does not apply to an owner of 602 - ROOF P T W V nsnPC,tiQLns
property who builds or improves thereon,and who doessuch work himulf or through his 1V Hl I
own employees,provided that such improvements arc not intended oroRered for sale.If. 603 — ROOF BATTENS
however.the building or improvement is sold within one year of completion,the owner- 604 - ROOF IN-PROGRESS
builder will have the burden of proving that he aid not Wild or improve for puryom or
sale I.
1,as owner of the property,am exclusively contracting with licensed contractors In
convect the Project(Sec.7144,Business and Professions Glide:)The Contractor's I.I.
cense law does not apply m an owner of property who Wilda or improves daemon and.
who contracts far such projects with a contramor(a)licensed pursuant o the Conmclofs
License Law,
❑1 am exempt under Sec. .B&P C for this remain
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penahy of perjury one of the following declarations:
1 have and will maintain a Certificate ofComen(to self-imum for Workers Crooke-
satin
on,
ompcmcation,as provided for by Section 3701 of the Later Calc,for the performance of the
work for which Nis permit is issued.
1 have and will maintain Wmlar's Compensation Insurance,as"aired by Section
370X1 of the Labor Cole,forthe Performance mum work for which this Permit is issued.
My W..kcr's Com nation lnm�carrier and Policy number am: p
eerier S evtc --YLw.C(Policy No.: 14'1'71 �xp
CERTIFICATES EXEmvi ON FROM WORKERS'
COMPENSATION INSURANCE
(Thissec(irm need oo(becomplamd it the Permit is for one hundred dollars of Xd
or lass)
I comfy that in the performance of the work for which this permit is limed,1 shall not
employ any person in any manner m m In become subject o the WorkersGsmpensu(ion
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:It,after making this Cenificale of Exemption,you should
bearmc subject In the Worker's Compensation Provisions of the Libor Code,you mus(
C)Z forthwith comply with such provisions rat this Permit shall he deemed revoked.
zO CONSTRUCTION LENDING AGENCY
[--i I hereby affirm Nul mem isa,omlmefna leadingagemy lis the pcdurmanee of
a 7 the work far which this Permit is issued(Sec.3N 7.Co,C.)
W Q Lenders Name
z Lenders Addicts
U C 1 eenify that l have read this application and mart,that the above information is
F
Correct.I agree to comply with all city and county ordinances and suite laws relating to
OU building construction,and hereby malborim morescabloves of this city to enter upon the
k1 abnvcmcn(inned property for inspection purposes.
(We)agree In save,indemnity and keep harmless the City of Cup,rlmo against
F'y liabilities.judgments,costs and expenses which may in any way accme against said City
U z in consequence of the granting of this permit.
r. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULA)IONS.
Re-roofs
HAZARDOUS
Signature of APPlicaDam
IIA%ARDOUS MATERIALS ingocc pantDISCLOSURE Type of Roof
Will Ne aapplicant nr future building e.Chaps store nr handle Heallom dSafety Maternal
as defined by Nc Cupcnino Municipal Calc.Chapter 4.12,and the Health and Safety
,allcode.season 25532(a)'!
TfNn All roofs shall be inspected prior to any roofing material being installed.
❑Ye
Will lheapple..,it,future hiddingoccepaduse equipment ordevices Which If a roof is installed without first obtaining an inspection, I agree to remove
mit hamrdnus air emourinanV defined by the Bay Arca Air Quality Management all new materials for inspection.
Dimicn
El Yes Nu
I have mad the miaNnus materials reymarinu ksua&,Chapter6.95oftheCalifnr-
biulical &Sulcty Crede,Sccoons25515.25533 and 2551..1 understand that if the building q//�tlLf�-7 ,f/y/ ff at 1- O
Jrcs not c illJy have u tenant.Nat it kit my res(mnsibilay m rtu ty the t upam(ol Ne /s `X/ wt yl,V
mquiren hfchad"a Ipriamitsuane,nraccniEcme'Xcup cr Signature of Applicant Date
•( aiy 6 j..,
Owmeroraolorirelaocn, kj Dale All roof coverings to be Class "B"or better
Building Division
10300 Tone Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
OCIOF
CUPE�TINO Pax: (408)777-3333
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 1/4"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 of inspection.
We understand the above policy on reroofing and will comply with this policy:
Homeowners Name: EC.eNVx e,tt J a e.
Address: l o y 3 S ceu<Z
Reroofing Company Name: _ T D
Applicants Signature: Date: I O Z
Joe Antonucci
(Chief Building Official)
6/25/01