02090006OFFICE .. ._ .. .. .. ......... ..
OF
CIBUILDING
DIVISIONN�PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
19625 STEVENS CREEK BLVD
KEITH ROOFING CO INC
02090006
OW ER' N ME:
1�M6� A GEORGE AND MISAKO
920 LINCOLN AVE
APPLICATIONS,URDATp'
09/03/2002
PHONE:
(408)295-8616
SANITARY NO. CONTROL NO.
8 6
ARCHITECDENGINEER: a
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
Job Description
1 bomb Rw that I under f Char 9
lice praviamnaa per(commencing
REROOF
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n 3 oftheeB and
with seeaan Tocol nr nivnron3anne Business and Professions ease. ana my license
inmu rasrte.n Br
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Data 1L Contmc
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' / ARCHITECT'S
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1 unJ<rsmnd my plans shall M used as Public recn -
a, public
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Licensed Professional
Oat NE DECLARATION
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a exempt
I hereby .(Sent ince, 1 am aemnt from the Contractor'sCod License Law for @e
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following rtasoa Business and Professions Cale: Any city countyucture
BUI LDING1 6 8 6 0
S
Permit swmure
construct. , structure
to n vent demmxh, or repair
which req perm r to
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pliclter.
t for such
pose t t ce, also rc9,'rc theapplicant for such perm c so Ek a signed emamem
l ed
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(tel r c, �t'13 ;`iY2Rl {fie a:i_IYy,t!•,P
Valuation
s.tha,
ha a I'cenfed pursuant to the p!ovtsion of the Commerce, License Isw (Chap.,9
(earmarkingwith Secl )LBO) f Division 3 of Ne Bair., Professions Cashel
and
or that he if eiempl therefrom ana the basis for the at leged eiempuon. Any violation
3{jti,
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--a Sect 7031.5 by any applieam for is permit subjecm the vpplicam m a civil penalty
'tofnot marcsnanfive hundred d.11.rsa5oo).
305APNI gE
t '.,ISI`.-. Occupancy Type
01, as owner or he pro,., ormyemployees with wages a,their side compensation,
307 - INSULATION
601 -- ROOF TES Qt��'Ins
"will -do'the 'work. and the structure 'is'not intended or offered for sale (Sec. 70u. -
Business and Professions Code The Contractors License Law docs not apply in an
.erica.
qtp .'
owner of progeny Who builds aimp mvessheremi and was does such worknmxelf
602 - ROOF PLYWOOD NAIL
m through his awn employees. that such improvements ere not intended or
sma
buildin
few ICWwcvcr, the builhinof -- tis sold within one-ar of-
,a
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"__offered
-- - --BATTENS-
603' _- ROOF- BATTENS- •.I"Pv":u .,t
"piklon, the nwne,-Wilder will have the burden of proving that he did not Wild or
604 - ROOF IN-PROGRESS
improverurpurpasseofsalc.).
------
01; as owner a the propene am exclusively convecting with licensed contractors to
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-construct
the project (see. IDaa, Business and Professions Cnae:)The Contractor's
,,. ... ..
liceme Law does not apply to an owner of pri who Wilds or improves thereon.
-
•': ::.._and
who cmurri fu,such pmjeca-with .a corrosions) licensed pursuni to she.
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Contractor's License Low. _
❑lam exempt under Seca' 's's.•,� 1 .B�& P C for this• reason
i"s' (n: Si.:'t it;; r to
Ovom, bate'
" WORKEFUS COMPENSATION DECLARATION
` 1 hereby aR,m under penalty of perjtiry one of the following dalmmions:
01 neve aad will'mainiun'i Ce'nificaie of Crmi;m ,o sel -motme for Wodu's
Compensation, as, provided . for by Section 3700 of the Labor Cade. for the
perf omax a cif the work for which this permit is issued.
rvf'vnd'will maintain Wo kc . Compe . 1 : rand t m,aimd by Section
37M ofrhe IaWr'Cal f Il ,irfromance of the workjor which this ,arose is
sued My Works s C as Oo Id prance tamer and Policy number am:
— .toot...
r37
CimniSrJ� ``��Pol'yIPON
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){, ICE tTIFICATION Ot,E%FMPI ION FROM.WORKERS
t COMPENSATION INSURANCE t�'•
it' no; t ' Qh,i sea on neeJ not W eumplcicd tf the pcmmt is Income hunamd Jallars
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001 or
($1less.) ,L. ,..,, . •
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jlcertify that pef q of the work for which thupctmne
i•ni;,l; i,,-s •s'YI lr. t"-.,
Workers
ny son to tiny mon as m neer)n subject to the Workers
;hell not .uits.
Laws I`r.
Comer. ton Laws of Col'fomt Dine -
.APPI ant _'. - _ .._
NOTICE TO APPLICANT If. alio making the Crnficme of Exemption. you should
.. .. _....._ _. _-._ .. _ .. ..._ - - _. .. _ ._.- - _.- -' _... ..
, .r' ( '• V,
zbecomes
bjn tl¢ Wo' b ,lees Compensation provisions of the LaWr Code, you into,
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fonh th comply'wiflh such provisions or this permit shall be deemed revoked.
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'f•' - "",;'CONSTRUCTION LENDING AGENCY
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- y that there consaactmn lending agency fo th peR ,ince
the b Biim
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a hien@ pc y` __d(S Civ .C)
-Le hers Na,rte
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Lcnd .Add s
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y M1 d this application and state that the above information is
Ie. of, ,hath
W E.,
cbmr , 1 agree to comply,with all city andty, ordnance and .rate laws relating
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eo Wilding construction, and hereby auNonu rcpremmacivexofthk city cornier upon
>„'W
the ubgve.mentioned propcnY formspeammpoyams, -..
t-,.
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rp
IWe)ag etu.cave, indemnify and keep harmless the Chyof Cuinopen'ugMm1
in
L,&UDate
�
liabilities,judgmrerDls and expenses which may any way accrue against said
Cty neon. y ih g tog of th Amit
Lrull
aPeLlr ,TU' pItSTA�DS AN WILT COMP IT k -NO POINT
/
Issued
SOI `ERF ZONS. --
Mum ra a Date .'
Re-roofs
AZARD $.g RIALS DISCLOSURE
W I dIC aPPUcaal or future W lmng ossupant some or handle Was dove mostsolial
-
m def a bY,hn25532( Cupen M n c paj Cod Chapter 9 12. and the Health and Safety
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Cod Smao
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_All roofs. shall be.mspected prior to.any.roofing material being installed...- .._-..
will the applicant f r Wilding ac ,nota ac pmt classics, nch
If a roof i insialled "without first obtamtng an fnspecnon; I agree'to remove
ny
rmt hard om is fined the Bay AreaArO ltyMnag Management,
District?
all serials for inspection Applicant understands and"will with
oY
_comply
nooboint source regulations.,,, j,,,, t.. '
'
1 have rtaavhe nazvaaus marcribla rtquircmenrx'under CWgcr 6.95or the
California Hculth Safety Cuda S<coons 25505, 25537 and 255349 understand the
if the Wildi of currently has arenunt. rsmy rtsponzibili,ym pacify a
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occupy th quire s which m M prior to i ounce of Ceniflcat of
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a[UIB ICanI DBIC
<sf
All roof coverings to be Class "B" or
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woe, oro Dae
.. ,better
OFFICE .. ._ .. .. .. ......... ..
7
LJ
INO
Building Division,
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408)777-3228
Fax: (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 Y" 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:
Address:
Reroofing
Applicant
Joe Antonucci
_
(Chief Building Official)
6125/01