02060093 CITY OF CUPERTINO " - '"''
BUILDING DIVISION PERMIT CONTRACTOR:INFO TION:
BUILDWGADDRESS: PERMIT NO,
10408 STERLING BLVD SUPERIOR ROOFING CO. 02060093
.a0WNER'S NAME: APPLICATION SUB DATE
MARY THOMPSON 421 BURGOYNE ST 06/17/2002
PHONE: SANITARY NO. CONTROL NO.
(650) 969-3103
z ARCHITECTIENGINEER: BUILDING PERMIT INFO
C BLDG ELECT PLUMB MECH
`y<i —1 I_I Li
z8 N= LICENSED CONTRACTOR'S DECLARATION Job Description
O z_O I hereby ofiun that 1 am licensed under provisions of Chapter 9(commencing
FOC J
with Section7")ofDivision Jof the business and ProfcssionsCode.and mylicense REROOF
a Limit.°Cnys am errttt.�_� L+= g -77Z�o0 T/O LAYER BUILT UP ROOFING,
DoleF/7-D� CmIm.,m V a /-
u�a. ti ARCHITECT'S DECLARATION INSTALL APP 4 . 5 TORCH DOWN INTEC/PERMAGLA
(_=0 O; 1 understand my plans Shill he used as public records
Y
w p O Licensed Porkssional
z OWNER-BUILDER DECLARATION
u- I hereby aRrm that I am exempt from the Comtmcmr'o License law for the
C?a fallowing reason.(Section 7031.5.Business and Professions Code:Any city or county
I cc O which requires a parrot to construct,alter,improve,demolish,or repair any swcture,
3m _priortoitsissuance.also mVuirts
provisions
roc Commit
aw(Chmmcm.
mpf hgiNice,ped pu¢uTnt,gm proyisum of the Conwctoh License law...Code)
f v S . &G Bl ,/ Tea S + aluation
Or I hnciogg iNvftiarxn]B'oanof Division 3 of the Bpainrs)ds iprh Any vi Cade) y,�(,):si�G.�:klq I E)1t'.Od!�s,j V-,F r';Ys'.;�Ell
L 1: 7 9�v
or that io 7031.tib tang aplm'anJ the basis for the stx th0'eKmdne o a SY violation {
-of Section than five
anyapplicantfar rsnWI,,it subjectthe epplicmu=vcivil Penalty
of not more thamfive hundred dollars 1$588), 375 � .m , .... , Occupancy Type
❑1,as owner of the Masi or my employees with wages as their sole comprnm,ion.
will ne the work'and the ode The C tat attended en a Law foes no (See 7044;' -- --- ---_
'Bus eros ane Pn,W o rs ild,c The Contractors License Law docs not apply to an 305 - FRAME Required Inspections
or throe h his`ow mplo res.provides!ethe such,im a wnm improvements are not i��himself
307 - INSULATION
e1@reA f n.the.lChope employees.
the lbabuilding - p s stha with n one of - - --6 0 —
nmpro natant r==r 601 - ROOF TEAR OFF •
iumplction,the ownerbuilJer will have the burden of proving that he did not build or I
mproseforpotpewoftelc.). 602 3-
PLYWOOD NAIL _ _ _
_. — - --- ._ .. ..._. _ - -- .. -- - —
,r ❑i:os mwnerafthe rmpeny am emwdvely conpacting with lm<mud comtractortm' 603 - ROGF� BATTENS � � �� �. '� .i'�� i�
.l contrast the project(Sec.7064.Business and Professions Cade:)no Contractor's `-II'..
LicenseLa does not apply to n owner of property who bu lds improves thereon, 604 - ROOF IN-PROGRESS
"and h momclato uch projects wth n contractur(s)Iceo.ed P ant to N<. .. . . _ ___..... .......
Com « License
0 pt dSer tt '+ .I1l&'PCormieaom. )
Is Date
WORKER S COMPENSATION DECLARATION /a?.
herchy aRnn ndcr,pcnaly mf pcpury one of the folio mg deelareuons: - oC O��C
I have said'will"atomism a Cenifcate of Contain to xlGinsum for Worker's
Compensation:asprovidedfor by Section 3700 of the Labor Code. for the
Performance of the work for which this permit is issued.
❑1 have 6nd'will acimi'O.Workeas Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit it
sued.My Workers Compensation Insuromm coiner and Policy number ore:
Cerrtcrs F Palc No.: ZZ9' Z' �ZZiZZ iiYY 1 - yy
l CERTIFICATION OF EXEMPTION FROM,WORKER$" - crl :rry,ty/..�� f.f3, IyVTS1YL N: ilk. R.
'I - ' COMPENSATION INSURANCE I
..-...._.ts rea,on need not.. «_..._ ..-: .'._ ... ..: ._.__..-........................._.._-.__ ....._..._.___._ _�.....__ - - ..._ .._..... ...,,.._.
+ ('IL" be completed if the pnmit is for one hundred dollars
IS IW)or lm.) . , . -
,+J c n II,atm the performance of the k f which this at Permit IS issued.l
Shall not employ any person in any Data er so a ,o Ixn:me suhlea m Me Wnrkcn
Comn Luws nl California.Date
..
NOTICE
Applicant
NOTICE TO APPLICANTrker's Compener sation
this C6nins of the
Labor Code,you
Z Q fonhwisubjeci to the Worker's Compensation pormiohadf the LoMd Code,you must
b«oma
' M comply with such provisions or this permit shall be deemed ranked.
71 r;rn :i"'.I" F':Co' CONSTRUCTION LENDING AGENCY '� I'
'r Ihreby fftin the,'here a msmaemi lending agocY forthe arroifnance
> of the work which his permit issued 3097.Ov C)
Wr -Lcndame-S-.- _ .,..: ,.. ... .. .. _. ..-.__ .._. _.___ _. - . -.. . _. _ ._ _.
. . ,_, ...__. .....
4'Z IanJcro Ncr'x Addre."
f..) 1cenify,hat1 have read this application and state that above information is
mares'!
rrt t 1-m t mill,with all,sp and county ordinances d state ml nn8
�.0 sob Id' B t do dh byes tho ze p s t t es of this ctle toe Tar pen
�,,, rW the bn e t ed P Pent f .pact p+W _
(W,agree t,. d 't Jamp h .the City fC p against
of%aid
W City in< judgment,. t tl expenses which Y any Y 8 est.aid
C.7 z,' City nes eq RST Seaming Of this permit.
Alp RCA NT UNDERSTANDS AND WILL COMPLY WITH ALL NOfJ-POINT ' ISSDedby:
Date
_ SOURCC REGULATIONS. _
signatmegr ApplicanUCnmmrmr .."Date.•. Re-roofs /
HAZARDOUS MATERIALS DISCLOSURE' ,
W llth _ppbcp for foram buildmgaxup b,omoormadle stiondbuxnummil Type Of Roof_. .... ._.. ...,.._..-_... -.......... .. ._,._._.._. _...
as A=f ed by the Cupertino Municipal Cod Chapter 9.12,and theHealth and Safety
I s
Code Sct'0Yet 25532(a)I I f .j - .+. �I �, r S w4.l.t a; I
- "+ _ All,roofs shall_be-inspected prior-to.any roofing material being.installed._ _
Will line applicant orfuture buildng occupant use equipment or devices which If a roof is installed Without first obtaining an inspectidn,I agree to remove
m,tr afdtux v ay rconi contaminants as defined by the BArc,Air Quality Management
Districts Illall new materials for inspection. Applicant understands.and will.comply with,_
0Y`t " - -- all non-point source regulations. ., ) "
1 h et
read he imr.,do.,marcrul, requ rem ms under Cluslam 695 d the
California
ali(rniaHeltm&Salary Code.Sections 25505 25533 and 251 understand that
tflbuildingt have a tenant,that it is my
sponsibditymth<
/7
O�
ocespdnr of the requirements which must h met prior to e _.
of a Cenifiet f
«
Y. 1
;`(/(1— b �7/0Sig attire of Applicant Date
Ate' All roof coverings to be Class "B" or better
0 thonzcdagr _ Date . _ ) -
:. :.:'. :. . ' _ . . .. _ . . OFFICE. .... ... . . _.. _. . _ - . . _ ..
Building Division
1 10300 Torre 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 YV 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: /�'��i t1GvI,aS0N
Address: /6 x/08S%7-72L //V6-/� pLVO .
Reroofing Company Name: wnky(o/c 12oo,1�iiv6-- �p .
Applicants Signature: Date:
AS 52 -.9 AZ=i,
Joe Antonucci
(Chief Building Official)
6/25101