03010025 1 CITY OF CUPERTINO ,OP
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION
BUILDING ADDRESS: PERMIT NO.
20276 VISTA CT
OWNER'S NAME: APPLICATION SUB DATE
ah PETER WOODMANSEE 01/07/2003
ItPONE: SANITARY NO. CONTROL NO,
ARCHITELT!ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0
P400 LICENSED CONnsed..or, ro-;indsof oar
w I hereby affirm that 1 am licensed under,provisions of Chapter 9(rommcnse is Job Description
DON
�<� with seri Taff)Of Division Sof the Business aryl ProfessionsCode.and mylicenu is
'ova in mu a_,ree�toderf}'�J.a s//� REROOF
ZOg, Liecnu Cyst_(..5�._Lic.N�
=Ltc Dam_'1 ('}T/�/)� Cnn�(H�t REPLACE 40 COMP. SHINGLE W/1/211 CDX PLYWOOD &
F'A�� ARCII17��CI'S DEGI.ARATION
iLoEU �I s�hl used as public records LAYER #30 ASPLATT
6 3 ca Lic sed Pial ��U
t..u.0 OWNER-BUILDER DECLARATION
p'r�a a 1 hereby affirm that I am exempt from the Contractor's License Law for the
ue i 0 O following mason.(Section 7031.5,Business and Professions Code:Any city or county
aeS which requires a permit to conuruct,alter,improve,demolish.Or repair any structure
NZi prion its issuance.also requires the applicant for such Permit o file a signed statement
xx that he is licensed pursuant to the powisionsofthe Command's License Law(Chapter 9 Sq. Ft. Floor Area Valuation
yF$ (commencing with Section 70(10)of Division 3 of the Business and Professions Code)Or
3— that he is exempt therefrom and the basis for the,alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty mf APN NumberC Type
not marc than fire hundred dollars(5500), y yp
❑ 1,as owner of the property,or my employees with wages as their sole compensation,
will dothe work.end the structure is not intended or offered far sale(See.7044,Business
and Professions Code:The Character's License Law does not apply to an her of Required Inspections
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.if, 305 — FRAME
however,the building or improvement is sold within one year of completion,the owner-
' builder will have the burden of proving Nat he did not wild or improve for purpose of 3 07 - INSULATION
.It.). 601 - ROOF TEAR OFF
❑ 1,as owner of the properly,am exclusively contracting with licensed contractors to 6 02 - ROOF PLYWOOD NAIL
consumer Ne project(Sec.7(W4.Business and Professions Code:)The Contractor's Li.
cense law does not apply to an owner of property who Whoa or improves thereon,and, 603 — ROOF BATTENS
who contacts for such projects with a martactor(s)licensed pursuant to the Contractor's
License Law. 604 - ROOF IN-PROGRESS
❑ l em exempt under Sec. ,B&P C for this reason
Owner °am 1=11V ALED
WORKER'S COMPENSATION DECLARATION
I hereby alarm under penalty of perjury,one of thc following declarations:
I have and will maintain a Certificate of Consent to self-insum for Worker's Compete JAN AI 17
9003
cation,as provided for by Section 37N)of the"We Code,for the performance of the i . L
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as required by Section
3BUILDING
71p of the labor Code,for the perfurmmm wor
of the k for which this permit is issued.
My Workers Compensation Insumncc carrier and Policy number are:
Came': CD2Q Paliry tJ [�}Sf '
CERTIFICATE OF EXEMPTION OMWORKERS'
�C COMPENSATION INSURANCE
(This section need not be completed Iflbe panoth is farm e hundred dollars(gltll)
or ICs,.)
1 cenify that in the accommodate of the work for which this permit is issued,1 shall nm
employ any peruan many mannerxn as m hecomc subject to the Workers''Compensmion
Laws of California.Dec
Applicant
NOTICE TO APPLICANT:IL alter making Nis Cer ibcmc of Exemption,you should
become subject to the Worker's Compensation provisions of she laMu Code.you must
z forthwith comply with such provisions or this permit shall M deemed manned,
rZ. O CONSTRUCTION LENDING AGENCY
F I hereby alarm Nat there is a construction lending agency lou the performance of
the work lir which this Termor is issucd(Sec.NAD,Civ.C.)
fat A Lender's Namc
] z Land cr's Address
U O 1 cenify that I have read this application and state that the above information is
f' Corea.1 agree to comply with all city and county eminences and stem laws relating to
0 building construction,and hereby authorise mpreunmtives of this city to enter upon the
} 12a above-mentioned property for inspection purposes.
G (Wa)agree to save,indemnify and keep harmless the City of Cupertino against / 7
.Fs V2 liabilities,judgments,cosu and expenses which may in any way accmc against said Ci ty
U 7 in consequence of the granting of this permit.
C+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NQN-POINT Issued by: Date
rU
GULA 1 J.[/f�
Re-roofs
fA con o actoraI an'Nfu OUS MATERIALS DISCLOSURE Type of Roof
the applicant or fume briding oecupant stnu or handle hanvdous mamnel
y the Cupertino Municipal Code.Chapter 4.12.and the Health and Safety
on 25532(x)'! All roofs shall be inspected prior to any roofing material being installed.
cs Nol plc applicant nr f tore building occupant ase cyuipmcm or devices which If a roof is installed without first obtaining an inspection,I agree to remove
ous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
❑Yes {b No
(have real Nchvallous atcnalsmquimmenmundcr .Chapmrfi95orthe Calif(ic
niallcalN&SafclyCW,Sabi)m25N15,25533andB5.W,Iundcrmnd Nvifft building '
does not currently hastatenant thus itismyresponsibility to notifytWacupam. the
mean men icham npnonoissuanccofaCcndicak l ccupyry Signaturro—TA44icant Date
r k/�LA/
t ahem a t ate All roof coverings to beYilass "B" or better
CIO Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CUPERTINO F= (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
Wand 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) Pinal 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 VV 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 po]iry on reroofing and will complp with this policy.-
Homeowners Name.
Address:
Reroofing Company Name: 1')peJ% R2.Nn
Applicants Signa _Date: ' e13
Joe Antonucci
(Chief Building Official)
6/25/01