02060097 OF
• CITY n
BUILDING DIVISION
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10324 VISTA DR WESTSHORE ROOFING CO 02060097
OWNER'S NAME: APPLICATION SUB DATE
HERR HEDY 5869 WINFIELD BLV 06/17/2002
8 PHONE: SANITARY NO. CONTROL NO.
(408) 629-2100
00 ARCHIT=iENGWEER: BUILDING PERMIT INFO
w- BLDG ELECT PLUMB MECH
baa
i 8y? LICENSED CONTRACTOR'S DECLARATION
Job Description
O z_ I hereby rations that 1 em licensee under visions of ChapterWe9(commencing
Si3 wimseationlogB)oforvi7yyp3onhe13axmCy�md rpt. ode.arpm ken.e RE-ROOF
xy full�orrr�Il_d rid,
//'' Ts � t y
a.p6V Lia SI l Li,Dlidd .n fr OT� FI��d.E®
���ARCH'TECf'S DEC �y
Tu O S 1 understand my plans shop be used as public records 5 2002
oodooe oo Licensed Professional JUN 2
OWNER-BUILDER DECLAKATION
I hereby affirm that 1 am exempt from the Contractor's License Low for the
?< following reason.(Section 7031.5.Business and Professions Code:Any city or county gUi LDING S 1 s s a o
I"❑ which requites a permit m construct, he,improve,demolish,or copal m
y msacre,
i 3 m ,-poor m sts Issuance,elsorequ'ucs N<applicmu for such perms so fk a sigrcd suremcnt
Wtllklslicerurd puryu�nt tq M<pmvisions of the Conwttore Licenm low(Chamer9 or Valuation
(commencing with Scruon 7000)ofdivision 3 of Ne Busincsyyand P,rofS,ions Cade)
or Nm h6 li e'xcmpi therefrom End the basis for Ne ull<gcd edann'rylorl.Any violation
of Section 9031.5 by any applieont for a permit subjects the epplicam m e civil penalty
-
ofnot marcthan five hundred dollars(S5W). 305AQND'IR ,fE r Occupancy Type
°1,as owner of the property,or my employees wuh wages as their We compensation. - TNSTIT ink TT ON
-will do and Nk:end Ne'sw:The C not intendedcaroffered Law doe said(Sa:to an
Basik'ss and Priifessions Calc:lTc Comracmr's License taw does not apply to on 601 - ROOF TEPHPgO&U'Inspections'• ••
owner ofproperty Who builds,,,improves thereom:md who does such work himself __602 - ROOF PLYWOOD NAIL
or N gh H sever,t invited that such improvem nl.-<ran tended or
-'co @d Por-isle If however,the building or urde. finent I ut th -one Year or '_. - _._- ._ -_ _. _ __
completion,Ne owner vender vent M1ave me nadenorprovmgmat he and na build or 603 - ROOF BATTENS ,_ r .
improve forPurporeofsale.). 604 - ROOF IN-PROGRESS
- - -_ -- " _ i'.o. _ ---- --- ------._ - - - -- -
conris6wner of Ne pmpeny,am exrwsivdycontrorescimas littnudo Cam dm I'�V'.Lr� ?
Licari she project(Soc. loan
Business and Professions ills or Thewes hereon, L.:•1 -L•.t f !'o ",. ..
Lid_w1 Lawtl«a not apply m an owner with,
p contr who builds or improves hereon,
the
andwho.r.LicenseLaw.such,projects.with.a conlrucror(s).licensed.pursuanuo.she- _ ._--..... ...._.-_.-.._...__.. -..- _.__....._-.._ .. _----.___-.--..._-.._-_.__._._.-..__..._.-.-._.___... ........ ...._._.
-------------
Contractor.License Lew..
�,. °Iame'empruroderSxc. r n " i .1 B@PCfor this reason I(i? 1)C•..'I'i Iii l(rIi
owner .,::. :,nim . ..
-- r WORKER'S COMPENSATION DECLARATION
I hereby affirm under pctaahy of perjury one oWe following eeclamtions:---
=c ° 1 have and will ponman a Cmiheme of Consent to self-insure for Worker's
Compensation, as provided for by Section 3700 of she tabor Code, for the
_ - performance of she work for which this permit is issued.
_ $1 have and will mainuio Workers Compensation insurance,as required by Section
3IN of the labor Code,for the peffotoancebf the-work for which this pi is
Issdd My Wo kerb Compenm on I Burn -- c e Pol cy number art _
S.�n � 'tlrolryrv, ' ZAS"g�' '1690 N .tlFL .t't,`'fi1S. EiW.'`T31'if�4��1`gg1(,ti;_......___..,,,_.._--:-I'-'. �.�-�-------_..
�,'I CIiNTIFICATIO OF P.XEMPIlO SROM WORKERS'!
___ ,;' ' COMPENSATION URANCE �•'"I.:'
r1'%'in(T,is icctmnnced not be cmnplemd if the permit is for one hundred dollars
IS I I%1)or less.) _
. . .
1 st fy Ih t o the perform e f N k for h ch rhl. penli t i I. ucJ I „
sbvll l ply Y Pe. n y aur becom ub)en m the Workers ' '
Compensation lows M Cal forma
APplic m -_ ' . ._. ._- . v . . . __ ._ .—.__. ... _._..
NOTICE TO APPLICANT If after making thCcnl5cme of Exemption.you should t 'r
Q �r�ra��asubject m'Ihe Workers Compensation pmvisicns of the Labor Cale,you must
Tv ith comply with such provisions or this permit shall be deemed revoked.
,�, - -_._.._.-.._ _ .._. _ -_ .. - _ .____- _ . .
fq ,a'h' ` "�I'"u'CONSTRUCTION LENDING AGENCY '_91.
a°5� '"' I hereby hlBem Nm there is a con.amction kndidg agency fonhe performance' r.' .•t
,.
of Ne o k ft owhich his Permit a d(Sec.3097 C'v.C)Lende,'s Name
r^7 iZ lender's Address ..--
'U'Q , r I ri fy Ihm 1 Isad this gtphc t nd state that theabove information is
correct d agree m comply with all city and county ordinances and state laws relating
to Wildingconstroction,and hemby amborirz¢presenmtivesof Nis city memerupon 1
,y trW the marve-mentitandp-pony f specs P rpt: .. .
a. (W) g .ioa de 'fy andk ph nl. the Cly fCp i ougamo
W liab 1 e judgments, d pe se h ch:m y rs any y g inst mid yw
U z" City cons c tt of c g t t. TN pc t c V
A J AYT F)s T1YD MPLY, LAOWPM9a11 sued b ( Date
50 IR r cf ULr' IONS !iI "�A LI Y /
nature ofw_pplicaolComracmrUa¢"" Re-COOTS
HAZARDOUS MATERIALS DISCLOSURE
u wit Napplicant future building«ding n t t n handle hazardous m t m Type of Roof_ .. .....-.. ...._ _ _.._.,_ .._.... .. .___ ._..._.. ..
JI edbyN «
Cn Municipal Cd Chapter912.and the Health and Safety I t.. �,.
Cod S t 25!3_1 ) is i 1\. "' Y� IA ' 7,Zli 7;gam,Tt T. ,.
°Yea 'S\'' All roofs,shall be inspected'priorto any.roofing material being,installed.
Will the applicant or future buildingoccupantuseegapmentordevceswhich If a roof is installed without first obtaining an inspection; I'agree:to remove
emit hs,mcbms air contaminants as defined by the Bay Areas\r Quality Management
Di t o - .- all new materials for inspection. Applicant understands and will comply with
. . _ ,..
rc
°i .117)4- all non.-pom[-soue regulations. , :no e"reacl the heiaidoui materials requirements under Chapter 6.95 of the
I
Califo i dalN&Safcry Cale,Sdtiom 25505:25531 and 255.W.1 understand that -
IfNe in] ng do snot c rte,, have a tenant. sp
that it my reon.tilty to notify the
occ p i 9 the q n ich,unin b t prior to ixs < f u Cemf of
r acus nes - g of ApplicantAll to
:• 3i nature _ -
:., '..
«n „rlvadpgeni roof coverings to be Class "B" or better
OFFICE
Building Division
10300 Torre Avenue
✓'. Cupertino.CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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 abovepolicyon reroofing and will comply with this policy.
Homeowners Na..I, I 2
Actress D 7
Rero ofingCompanvNam&
Applicants Signa e:
` Joe Antonucci
(Chief Building Official)
6/25/01