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02090147 CITY OF CUPERTINO ' BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: a Ql)a-D)f(('s(s "§'t'VEN SPRINGS DR OLD COUNTRY ROOFING PERMrr02090147 111tJ0.1 tJ DS bb CHAN 125-B GROBRIC CT APPLICnN`Sy Bd)n 002 PHONE: (707) 864-5557 SANITARY NO. CONTROL NO. pI '• O O ARCHITECT/ENGINEER: - BUILDING PERMIT INFO BLDG ELECT PLUMB MECH Zt f=1 f=1 L_I L...3 to Yk.. O1 LICENSED CONTRACTOR'S DECLARATION G i 3 I hertby aRrm thin I am licenud under provisi nor of chapter 9(commencing REROOF Job Description with Section]IXp)of Division3of the Businns and fesi dmyliceme ' _�' 7t ('� r �'yg is in full force an aryc /pm�/7 ) l'! I" \ i�'" ':L..,.. s O K, License Class C el.9 7 Lic.is lX L/ / f e Y LL KO Data Contractor ,^ Y WW {1- ARCHITECT'S DECLARATION f E:0.] ItInderstrnd my plans shall be used as public accords W ;r : ,1 ` o>d-+ Licensed Professional frcOWNER-BUILDER DECLARATION Di I heacby aRrm Nat 1 am exempt from the Contractor's License Law for the C Z following rceron.soctioa]031.3,Business and Profesomas Code:Any city or county $120 O O which req acs a Permit m concoct,alter,improve,demnbsh,or mpair ony suvctum Pnorunivii suan«,e[so«gones Jw app1wand for such promo m file¢ugnedsmmema _-- _ ----- - _ ---- ---- Jlatfarlhapafed-u-a toJspkNslodumrmecanuxtdsl,ccnxLaw(Chapter9 365 -EObCb�ptO?Ue�� .I y' Valuation (commmcing with Secuoa7000)of DivnronJof the Busmemantl Professions Code) {s�(�j t 1'lrkc,. ] A,fl': rf h liI zH f�N� I or met tie it exempt dicta 'sad the basis for the alleged exemptloh.Any violmion t -mf Section]031.3 by any appliaat for.Permit subjects the applicant to a civil penalty of rot than five hundred dogars fssool. 305 APNH4Md? Occupancy Type ❑I,as owner of me propengurm'yemPloyecs with wageses theirsolecompenmtion, 307 - INSULATION r mai ed SrC "-wd meas rid'Po;'and she ode:n C nm ons's Lice a Law foe sale no apply to an - R OF EAAe kL§) Inspections d..e,si proper,Who build, :The Com thercos License Law does not apply to an dwner of pmpeny Who builds or improves mcrcon,and woo a«s a«n work himself 602 - ROOF PLYWOOD NAIL or trough his own employces.provided dust such improvements am maintained or -_.__-_- .1 PtI � Ihr tole:If.'uwee thebuilding ortmprovemem is sold within one year of 603son ----ROOF-'BATTENS' 'dopmmvera thrown bis Ida will have the burden o(pronngtumhedid not bisIdm 604 - ROOF IN-PROGRESS improve for puryose o(mle.). ._ 1 ...,_.,._ ___. the Q ofownerhe dec p(Seenyam exclusivelydPramisi wimocrnsehe Coactors to O..I,' ':❑ "� cads(- nue Project(Sec.]044 Business sod Professone Cadet The improves tmnors License Ladoes not apply t owner of progeny who builds or rmpro.es Merton, _sad who convects.fors such projects with It canuacmda) Catharine.License Law., .. ' ❑1 am exempt under Sec:` I' �' i ;B�dk P C for this reason :ire ,'.; Owners";.•,e,t - ,, .Dine WORKER'S COMPENSATION DECLARATION mfr L hereby am.under penalty of perjury one or the following doclarafirmt: 0 ep yoneofthe.followingdeclambons° I h.a end will mamuin a Cirtificate Certificateof c6ment io self ms me for Worker's Compcmad n as provided f by Section 3]110 of the Labor Cade, for the pe fomtme'f the oro k for h ch this perpin is issued. r °I bio arW If maltimn Worker f Co int ton Insistence as outpaced by Sect \ 7]00 Pme Labm-Code f she perfonc rmae f Joe work for which mis permit.s VO C suad My World C mgp�rsa�t on/Jnsum ce tamer/qnd P I y mbe ,C(amer'r Tj E T TIONI Ek I No + ri' CERTIPICACOMPEN EXEMPTION FROM WORKERS. COMPENSATION INSURANCE v „ry.- ✓ 'Iyp 'iThis'se¢tibn"need not w aimpkieJ if the permit is formic hundred dollars (S I00)m less.( ,,,: .tor, pl - _ I Genlfy that in ihe petfor is cc of which this Permit is nscued,sl 6141 int c nplmy any pJr,W in any raark: s O'bec.me subject 16,the W kc,s Com sation Laws of C hl-'iu:Din ,NOTICETO'APPLICANT If p'r makingm Cnificm bfEc peon,youuld )' o.. Q Qhewme uhj iso due Wo ler C"pe d p vfm Ltio CWe,yd nmmsd fmh the nPly- dh a hp ns th' R l hollb dam drc ked. ^-� -I r ' CONSTRUCf10N LENDING AGENCY _ - 1 hetntiy`e(firm dhbt[hart t a connmuion lending agenpy f Ihi-Performa'e, 1[ c r GLI.Q bf[ne,wbrk for Which dun permrz ended(g ._Lenders Name -. '�- • -_.. . ... ._.___ . . ._. . .__.________ _._...._ ......_ _ _. - ' �'.z Lermers Addrt1i 1, c ,. U-0 I cm fy..that 1 hove reed tun meet cadron end slam dhm.the above infmrmmmn is fis'Fy 'coirdci.I'egrce to,comply,wim oil city.anJ coumy,pNinunces and nate laws relining � [) -m building conntciidn.anJ heresy eumouiei semmives of Nie city memo upon 07 7 Ay the aboveanegree dpropeny for inspection e _ N n pct (W'e)sgrce for .indemnify I. k' oimlein an ways cruc no against 1 y I' bit ben,juJgme o d,expe vh'any in any y true.gains[said .z Cuy m conseque a of gFamr' f t permit APpL(GNf I' tL COMPLY WITH ACL NON:POIM so1mCE RF. N :'' .� &A� Issued by; ADate Signe fApplican ondractor�!., :.. ' r [,Dam : „ _ Re-LOOTS _ ZARDOUS MATERIALS DISCLOSURE r Il thenppI can la f burldng oceapmi store or handle ueiarddss matinal . .Type Of Roof - . . ,. a.. -.. -._,,,.......... ." a defirrcd hYm Cupen Mu IP IC..Chapter 912 dm Best and Safety ` .,j ..� i. qod Sect n.25g3 (1 t j. ❑Yes !-e; I i I --All roofs shall be ins erred. nor.to oofin matenal.bem installed..._ .._ f P. P g g Wllth.appbcont tr but on ldmg«=upmt use q p rd ��a`wnch If a roof is installed withbut first o ing an'inspection;�I'agree:'to`re move veto hamN c m omits Jefned ny the Bay Arc Air Quality Management D tri=+ all new materials inspectio plicant understands and will comply_with °Yee all non- Oin ice a uteri p g I have read the lieSafety Cole,esti nsln 505. emends under 4.1 understand r 6.93 of the Cohrmmmingdo, Snhy Code;Sections25305t itis end265341itytontithat JmebntlJfthe,mdi.menti0hicve.tenant.matiNstomy rcsu responsibilityto the occupant of me rtgmmmeme which muni be mei piior.da'usuetrc of a Cmificade of Occupancy., . Signature-of App (cant w«r,or Ztholed agent Data All roof coverings to be Class"B" or-better ' =r Building Division 10300 Torn Avenue Cupertino,CA 95014-3255 Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 CUPERTINO 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: n V,--1©n1,.' G/4-1 Address: if(() 3d'152e<'//J Reroofing Company Name: CQ!L2 C O U/t)2�� o (n5"/t) G Applicants Signature:. Date: g �d Joe Antonucci (Chief Building Official) 6/25/01