The URL can be used to link to this page

R-5346• • OFFICE COP s R R-' 5346 SPE APPLICATION FOR CITY OF CUPERTINO INSPECTION DIVISION PERMIT EXPIRATION REROOF PERMIT (408) 777-3228 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION, BUILDING ADDRESS URESIDENTIAL COMMERCIAL OTHER OWNER'S HAZARDOUS FIRE AREA � ^ ^ f 1 . 1 I � YES If yes — I understand that a Class A NAME �L ' ' `' vv e �I �� JOC'J roof assembly Is required. NO Initial I.C.B.O. # /) / �� 1 - EXISTING ROOF COVERING ADDRESS fC �i�) NUMBER OF EXISTING COVERINGS PHONE CONT TO BE REMOVED TO BE RETAINED NAME / ADDRESS' I h .Z- .I/_ �%J TYPE OF ROOF COVERING CITY & ZIP_ U [[��--22_- JL_ _ EXISTING PHONE BUILT-UP ROOF ❑ LICENSE NUMBER S ASPHALT SH ❑ LICENSED CONTRACTORS DECLARATION hereby provisions o Chapter (commencing with Section that em underprovisionsr 9 WOOD SHAKES ssunder inion Business Code, and ]000) of Division 3 of the Business end y license s in full lone and effect. �� WOOD SHINGLES El License lass, Uc. Num or OTHER (SPECIFY) or Date contred� OWNER-BUILDER DECLARATION PROPOSED I hereby affirm that I am exempt from the Contractor's License Law for the fallowing reason. (Sec. 7031.5, Business and Professions Code: Any city or County which requires a permit to construct, alter, Improve,demolish, or repair any structure, prior to its Issuance, also requires the BUILT-UP ROOF applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions J of the Contractors License Law (Chapter 9 (command ng with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged ASPHALT SHINGLES ❑ i p exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500).): WOOD SHAKES ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do ❑ the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Profes. sions Code: The Contractors License Law does not apply to an owner of property who builds or WOOD SHINGLES El thereon, and who does such work himself or through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the bulltling or Improvement Is sold within one year of completion, the owner -builder will have the bu rden of proving that he did GIQ� 1 rie OTHER (SPECIFY) ❑ not build or Improve for purpose of sale.). ❑ I, as minor of the property, am exclusively contracting with licensed contractors to construct the project (Sac. 7044, Business and Professions Code: The Contractors License Law does not PROVIDE I.C.B.O. REPORT NO. apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contmctor(s) licensed pursuant to the Contractor's License Law. PROVIDE MFG R. INSTALLATION SPECS. [JI em exempt under Sac. a & P. C. for this reason Owner Date WORKER'S COMPENSATION DECLARATION APPLICATION DATE VALUATION PERMIT FEE t: I hereby affirm under penalty of perjury one of the following declaration: have and will maintain a Certificate of Convent t0 self -insure for Worker's Compensation, as provided for by Section 3700 o1 the Labor Code, for the performance of the work for which this p UI ng permit Is issued. V� an Worker's Compensation the wokfor Insurance, as required by Section 370001 ❑ I have end will the performance the Labor tiotle, for the padormence of the work for which this permit Is issued. My Worker's lay]G{� Compensation /Insurance carrier end Policy number are: Carrier _-J-"�"it fi n k7 Policy No. .- I��ss..+A�e Total PERMIT- �..JIiHORIZATION DATE, CERTIFICATE OF EXEMPTION FROM WORKERS' V ,• COMPENSATION INSURANCE N.C.Q (This section need not be completed If the permit Is for one hundred dollars ($1 DO) or less.) I certify that In the performance of the work for which this permit Is issued, shell net employ any person in any manner so as to become subject to the Workers' Compensation Law. of can- All roofs shall be inspected prior fing material being tornia. installed. If a roof is installed without first obtaining an Date Applicant inspection, I agree to remove all new materials for inspection. of me 1d me11 TO orkers'CompensatPLICANT: It, ion you must App, understands and will comply with all non point provislonls of theflcate subject to the WOTICE Labor Code, fa comply with such provisions or this permit shall be deemed revoked. source reg tions. - I cenity that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state Tawe relating to building construction, and II roof coverin s to be c ss "C" or better. hereby authorize representatives of this city to enter upon the above-mentioned property for In- spection purposes. (We) agree to .ave, Indemnity and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may In any way accrue against said City In consequence IGNATU OF APPLICANT DATE of.the granting of this permit. PRE -INSPECTION: PLYWOOD: IN -PROGRESS: ' INSP. DATE INSP. E INSP. DATE TEAR OFF INSPECTION: BATTENS: FINAL: INSP. DATE INSP. DATE INSP. DATE NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION OFFICE COP • SUBJECT: REROOFuIG POLICY FOR THE CITY OF CUPE`TIiNO BUILDLtiG DEPAR MENt1 PRIOR TO ISSUANCE OF PERNITT ANID NSPEC TION . D-'a_E. 1. Pilar [o pe mi[ issuance, veu mus, ag ee to comply with U.S.C. standards and ma ufac rea sec's on reroofing. 2. Nety roof coverings shall not be applied withour first obtaining all ince^ion and wrinen aceroval from the building in fir_tar. A final inspr_':ion and approval shall be obtained from she building inspecror when the re:ooring is ccmpletcd. 3. All types of roof shall be inspe_'.d prior to any roof being installed- 4. nstalled.4. In order to receive a final, you muSE complete stets 1, 2, and 3. 1,) Prcinspecdon or tear off aperovrl. 2.) In progress inspie:.ion approval. 3.) FinalinsoerSoa approval. a.) Operable smoke de,.,:or verification b.) Spark arrestor installation 5. If plywood is installed, a piywced nail inspection is required. d without firs: obtaining an mspe=.ion, you will be required to remove all ne v 6. If any roof is applie material down to the sheathing and a building in_cector will inspect all sheathing at that time. WE UNDERSTAND THE ABOVE POLICY ON REROOFING POLICY VO*NfEOWNE.R<S NAME: t ADDRESS; REROOFu`1G COIvfPANYNANIE: APPLICANT'S SIGNATURE: CITY OF CUPERTNO BUILDING DE?ARTMENT RercofAvimvdrd PND WILL COMPLY =H 'rH (.Ill' ul Cupertino March 20, 1998 Homeowner 10297 Vista Knoll Cupertino, CA 95014 SUBJECT: REROOF PERMIT Dear Homeowner: 10300 Torre Avenue Cupertino. CA 95014 (408)777-3228 (408) 777-3333 (fax) We have been going through our tiles in the Building Department, and contacting those people with re -roof permits remaining "open'. Our records show that either you or your roofing company have not (1) called to schedule a final inspection, or (2) missed getting • the sign -off after calling us for a final. Sometimes an inspector will return to a job and sign off the permit in the field, but neglect to inform staff for input into the computer. If this is the situation and your permit card shows the final sign -off, would you please contact us so we may complete our computer records? If the permit is not signed off, please call to schedule an inspection for final closure of the permit. Because of the large volume of paperwork within the building department, we cannot separately monitor the progress of each permit. We ask that you give this notification vour immediate attention. If we do not hear from you within fifteen (15) working days, we will expire the permit and remove the records from our computer. Thank you for your assistance. Sincerely, CITY OF CUPERTINO Christy Akatiff, Administrative Clerk r1 U 171cvc;ed Pine,