02050147OF
CITY ILD( G DIVISION CONTRACTOR INFORMATION:
If PERMIT
'TM"!!ff'TsILSON AVE ABOVE ALL ROOFING PERMIT NO. 02050147
Ofq!i 's ItRTELL 700 NORTHRUP ST AU7 f L )D7 ?fU2
PHONE: (408)292-4188 SANITARY NO CONTROL NO.
O es Z ARCHITECT(ENGINEER! BUILDING PERMIT INFO
Poo W5 BLDG ELECT PLUMB MECH
g <i L — 1,=.J C"=_I I__I
.8i = LICENSED CONTRACTOR'S DECLARATION lob Description
g _ C 1 hereby affirm that l um licensed under provisions of Chapter 9lcommancing REROOF p
»;insertion7(wolurDmiamn3armeBusm.a aP,aresai ,. nue.m9m dgaa T/0 WOOD SHAKE, INSTALL
in tint aria eH«,
+ m z 6 Isiccm Sic
:oa ,rte ✓°'"" enmm r 7/16" OSB 40 YR COMP
LL O ARCH( ECr'S
DEC
TION
1 understand my plans shall ba used a .bit cords
Y
I0
Licensed Professional
o
ti OWNER -BUILDER DECLARATION
=' 1 hereby affirm that 1 um exempt from the Contractor's License Law for the
t ? following reason. (Section 7031.5. Business and Professions Cade: Any city or county
which rcquirm a,rumu m mmauct, alter, improve, demolish, m repair any stmetorc
i3m prior to its issuance. also acquireonmi
e applicant for such pert to rile a signed statement -- - --- - - -
thgtloL�rcensedpummoutnmeprovisimmofineeomractc. License Law(Chapterci ,.r ,Sq.,Ft-Floor Area, ...... ation
(commencing with Section 7000)of Division3 of the Business and Profusions Cade) ? f ;'C's. ,IpiLs, 1 r,c, k: is \ t •n
,,,,bar he is exempl therefrom oil the basis for the alleged ezemptiod Any violation
of Section 7031,5 try any applicant fora permit omor, the applicam m a civil penalty
ninon more than five hundred dollars ($500). Occupancy Type
° I, as owner of the property, or my employs wild wages as their sole mmpcmation.
ME Jo the work, and the slmcoro, is out intruded or off -,d For s,ilc'sr, 7044.
Business and Prdassinnx Code: The Contractor', License Law does not apply to an fired Inspections
rthrough
owner of pm,e yWho builds or im.... q, thereon, and who does... b work him.<lf 307 — INSULATION
oreredfrhi:ownloweveemployees .,moldin mai sun,vement mems arena) intendednyen, or "601 —'--ROOF TEAR -OFF ---
completion,
for sale. If. Fuwcver, me building or improvement is sol] within one year of �
me owner -builder will have the burden of proving that be did not build or 602 - ROOF PLYWOOD NAIL
improve for pugmse of sola.).
-'-ROOF- BATTENS .. _ ..._ .. _._..
° 1, as owner of the pmpcny, am exclusively contracting with licensed contractors to .. .. .
onstruct the pocject (Sec. 7044, Business and Prufesuons Codo.) The Contractor a 604 - ROOF IN -PROGRESS r ,
License Law des not apply man owner or pro,eny who builds or improves demon, and who contracts for.such projects.wiin a contractons) licensed pursuant to the.
Contractor's License law.
° Imo excm,o under Sec.' .B& P C for this ..,an
Owner' '° "Dace
WORKER'S COMPENSATION DECLARATION aa■■tt .+_r�,■�
I hereby affirm under penalty of perjury one of the following declarations:
FINAL -ED
y���J ° 1 have and will 'maimaio a'Cemmam
ficc of Connt self-iouire for Worker's
Z
Compensation, os provided for by Section 3700 of he Labor Code, for the M J 1 " q poo9
pcdunnmw
,<of the ark for which this p<tmV J L
i l is issued JuN L
° 1 have and will maintain Wnrkcr's Compen4ation Insurance, as req red by Section BUILD
/'�
I IID
3700 f theWtro Code, for the perform of thework f h this permit is B INV1
rs. d`.j�'1WOTkc'sCom tan lnsur dPol y be arc _�
COMPENSATION INSURANCE
n.
(This section need not be completed if the permit is for one hundred dollars +' '
(SIM) or less.)
I certify that in the n i(nany manner
the wart for which this permit a oded,or, 1
shall not employ any person in any manner zo as to becom<.abject to the Workers' -
Compenmtion Laws of California. Dam -
NOTICE TOAPn the Worker's
If. ager making this Ccrtin of or Uslior io de, you must
Z bechwithcme subjectinWorker's Compermamin provisionseranab demand rx,.I d. must
Q O forthwith comply with such provisions or this permit shall be deemed revoked. '1
VI - '`((CONSTRUCTIONLENDING AGENCY
1 hereby 115m, that thro, I, a corsrmctmmlending agency for the liedor nmea ' t
Ls7A of @e o k f h' h th perm t H (S' 309] C C) Le J Name
U/3yf�_
7 Z Ii.J Address
U 0 I<nfy that Ihave read this ppl'cr J state that the bove inkinnation is
las F. correct. 1 agree to ply with all city and county ordinances and state laws ralroung
U to building construction.and hereby aumonttrepreienmuves ofthi.s city to enter upon
the abovenentioned property for inspection purposes. - !!!
F y 1 agree¢,save. indemnify and keep harmless ine`City of Cupertino against 7,
V] liabili" dgmenrs, casts and expenses which may in my way accrue against said 1\\l
CiZ City' m,c,rcnce of,ha ehiring of thispentor. yt+r
AP'
ICA TUNDERSTANDS 'AND WILLCOMPLY WITH ALL NDN PO
`LT3I�sr,3 r0 Issued by: r Date V v
St RC 'L 1 N. ��,- .. _
5 awre of ApplicanUCommmor � �-- LD/ac, Re -roofs
HAZARDOUS MATERIALS DISCLOSURE `.
Will,
the applicant or future building occupant store or handle hasardomtnamial 'type of Roof--
. 5 d f ed by the Cup n rtMu , -,ol C de Chapter 9.12 and the H Ith and Safety ,
Cade Section 25532(al t t • [' r 1 s +, +
°Y' " 't - _ All roofs shall be. inspected prior_to-any.roo5ng,material.being installed..
Will �he,applic t fnbuildingxcupamusecq equipment If a roof is installed'without first obtaining an Inspection, I agree to remove
emit hazardous air cnmamlmd,s as defined by the Bay Area Air Quality Management
Distr o? all new materials for inspection. Applicant understands and will comply with
°Y h " rn r all non- of source regulations.
1 base sad I hazard masers I rcy n t o d Ch pt -6.95 of the n
Cal fold 'g'
& 5 f ry Code Sections 25505 255]3 and 25514 I and mond that
'11heb dyesnotcartetlyh etc tthYl ryr.po .binytonotifythe
oe< t f too
rcgmrt is ac
must be t poo to is a c t C ni ¢arc of
one
l�G Z9 "Signa[u e of Applicant JJJ Date
J _ ..
�wrur or suinodzedagent „ . Dale All roof coverings to be Class"B" or better
OFFICE
Gg
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408) 777-3333
CUPEQTINO
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 V" 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: e -
Address:
Reroofing Company N
Applicants Signature:
a4z'._
Joe Antonucci
(Chief Building Official)
6/25/01