The URL can be used to link to this page

03090094;oC �w er�z �r9 GO f GOO -�a L'L C u�4 Z Z 0 ti N Y � �z �o jUU �z CIY OF CUPERTINO 'iRCHIM'ICT/ENGENEER UILDING DIVISION PERMIT CONt1'RACTORINFORMATION 3.P"saixa'S ex .ss'ksa,.i _ . u mx.cuS..8 dL��`i' NG ADDRESS: JNSJ ROOFING INC PERMIT NIb3090094 ' NAME: (-)PPP A17P.NIT9. PRnPP.RTTT7..q 299 D BASSETT ST PERMRLSSUEDATE 091111 003 ' 4082796171 SANITARY NO. CONTROL NO. : BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION 1 her off rte Net 1 am limn d u der previsions of Chapter 9 (eumm mem, with Serio ]fl(My n(Divitlon 3 of me as and Pmfg sinmCo c. endmyliccnais mfullfone d6ff `� �V License Class M Dao: s,� Can \ n RC TEC1 d xRATION s�dndcrua y sal J lob Description p REROOF Lwcnsed P.Wolior OWNER -BUILDER DECLARATIKW I bunchy affirm than I em exempt from the Contractor's License Law for the j fallowing mason. (Section 7031.5, Business and Pr dreaions Code: Any city or county which requires a permit to construct, alter, improve, demnlim, or repair any structure / prior In its issuance. also requires the applicant for such Permiuo file a signed imminent that he is licensed pursuant it) the provisima of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area .ti -Ya ation (commencing with Section 7") or Division 3 of the Businea and Professions Coda) ur that he is exempt therefrom and the basis for Ne alleged exemption. Any violation of 36902031.00 Section 7031.5 by any applicant for a Permit ubjects Ne applicant to a civil penalty of - APN Number Occupancy Type not more than five hundred dollars ($301). _. I, as owner of the property, at my creplorces with wages as their arm compensation. will do she work, and the structure is not intended or offered foraale (Sec. 7044, Business and Professions Code: The Contractor's L14tsse law duck not apply or an owner of RR red Inspections �I property who builds or improves Hereon. and who dcas uch work himselfor through his 307 - INSULAT own employes, provided that such improvements are not intended orolfered for side. It. 6O1 — ROOF TEAR OFF however, the building or improvement Is sold within on yeti of completion, the owner, builder will have the burden of proving that he did not build or improve for purpose of 602 - ROOF PLYWOOD NAIL ale.). 603 - ROOF BATTENS [] I, as owner of the prepeny, am caclusively contracting with licensed convectors to construct the pmjeH(Sec.7(344, Business and Professions Code:)Mc Conlracmr's Li. 604 — ROOF IN -PROGRESS ceae law does not apply to an owner of property who builds or improve Neuron, and who cataracts for such projects with a mourecmr(s) limned pursuant to the Contractor's License Law. ❑ I am exempt under Sec. B k P C for this recon Owner Dam WORK ER'S COMPENSATION DECLARATION I hereby affirm under Penalty of perjury one of the following 4clarnions: 1 have and will maintain •Cenificme of Coma, to alf-insum for Workers Compsm on, a provided for by Section 3700 of she Labor Code, for the performance of the wwk for which so, permit is issued. ❑ 1 have and will maintain Workers Compensatlon Insurance, a required by Section 3700 of NC labor Cade,for Ne perfarmancc of die woh fo�r Nyis is issued. My W�wIh�qicfh �permit orker'raur KaY�l / I ✓Oli CERTIFICATE OF EXEMITI FROM WORKERS' COMPENSATION INSURANCE . md&suction reed not he complete] little permit b foranc hundred dollin ($10to or less.) 1 cattily that in the perfmmancc of Ne work for which this Permit is issued. I shall not employ any person in any manner an as in become subject o the Workers Compeaation Laws of California. Data Applicant NOTICE TO APPLICANT: If. after making this Cenificam of Exemption, you should became object to the Worker's Compensation provisions of the Labor Chose, you must forthwith comply with such provisions or this Permit shell be rimmed revoked. CONSTRUCTION LENDING AGENCY I hereby Afrm Net there its soatmction lending agency for the performance of the dmrk fur which this permit is issued (Sec. 3097, Civ. C.) Lenders Name Lender's Address I certify Nat 1 have read Nis application and state that the above information is cancer. 1 agree to comply with all city and county ordinances and sum laws relating to building construction, and bomb, amhorim representatives of this city to emcr upon the .hove -mentioned property for ioaPection purposes. (We) agree to ave, indemnify and keep harmless the City of Cupertino agaiat liabilities, judgments, costs and eaten., which may in any way seem. against said City in consequerKe of Ne granting of this Permit. APPLICANT DERSTAND ND WILL COM Y WITH I�NQN Pcitttttf��JJ11f'' SOURCE IONS /D/// / Issued by: Date Re -roofs Type of Roof 7ta roto of pelican✓Contractor Data 14pZARD0U5 MAT 1 LS DISCLOSURE Will NeepCuper or (own bullingor anodic materitl e. Chaptstore a defiSke by the Cupertino Municipal COJe, Chapter 9.12, and the Hcahh end Safety Health u❑cties 25532(.)7 Tea All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or Powre building occupant use equipment ardcvicas which s hazardous air contaminants se de0ncd by the Bay Area Air Quality Minagcmnn all new materials for inspection. dict] ❑Yes u I he. mad the huaaN usmaterolsrequimmcnu under Chap¢r 6.95 ofthe Califon nia Her "Safer Code. S.U. 2205.25533 it 25534.1 if building 0 an That the does nor currently have a lemon, Nat it is my mspunsielity w roti c mese, t of Nc requirements whi ugkbc met dor u/ s�fa CcniB �%�f (I/ y Applicant Date Za J L ature of All roof coverings to be Class "B" or better 0 oras or'cd.,nt Date CITY OF UPEI,TINO Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 Fax: (408) 777-3333 Building Department Subject: Re -roofing policy for the City of Cupertino 1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards and manufacturers specifications on re -roofing. 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 re -roofing 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) Pre -inspection 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 a 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 on inspection. I understand and will comply with the above stated policy on re -roofing. t � WtAf AKop��P� Ji Homeowner's Name: �J Job Site Address: Roofing Company Name: A pl ica,' Signature: Greg teal Building Official Zn Date:/ - Q Revised 1/30/03 Printed on Recycled Paper 01 Iwo CUPERTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM o3.70,D i �4 APN #(3r6, U" Z 03 Date: f (/ ^ 3 BENERGY Energy BUILDING BuildingA�lress:Z� Seismic Fee Res Owner's Name: owe `#: #: Contractor: S 5 Phone License #: �� q oO U n a n`� —w y7 r BUSLIC Contact: Dral�>1 � hone #: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: 7 EmL,6, o 1 r- GA Residential ❑ Commercial �S Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are an restrictions: LJ P jec Type of Cons t Occupancy group: Q r Q Qty. if ADDRC_abk Fee ID Fee Description Fee GrouD BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING 77 Z3/-�/ _Z�__-3 8 7, v�