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CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT N0,
7512 WATERFORD DR
JIM KRAUSE ROOFING
01060073
OWNER'S NAME:
APPLICATION SUB DATE
HOUSER CHARLES W AND ANN TRUS
2310 DIANA AVE
06/12/2001
PHONE:
SANITARY NO. CONTROLNO.
(408)779-0704
zp ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BhDG ELECT PLUMB MECH
1" I IJ L_I
i LICENSED CONTRACTOR'S DECLARATION
]Ob DBSCC IOn
I hereby affirm that 1 em licensed umler provisions of Chapter 9 (commencing
0 with Section 7000)nf Division 3 nfthe Bucinccs and Professions Cade. and on, license
milrarteans9�rr�,� �'iL3 5.1
teens C� y,✓-/ Lich
REROOF
ate _G.F Conuxmr
'S DEC
ARCHITECTLARA 1
g 1 undcntenJ my plans shallh used es public records
7�
or Licensed reanal
OWNER -BUILDER DECLARATIONor
/
hy caffirm that 1 am exempt from the Contractor
1 hereby License Law for the
(q
Qfollowingairer;a (Section 9113L0.Business and Co
professions Code: Any city acaunty
which a permit aper, improve. demolish, repair any suumurc
Peale
/
its r,Os
pr t t n. q tl applicant f h permit fl g J statement
e chem a file
requires
„Sq, I h1'1001 •
m,n--
100 wplllan011
- tli tM1V 51 'rip nm 'deps+',t fol C vamt 1' Lav, (CM1y+c'o
or nm exnh5e to ]00.0)dar ba 3 ftp Bged uWmn. 'ions Cody
of Nat he Is therefrom and me basis for the
eplicantii, Any violation
-ie ,. /
T i r :Il i 1ii1: .1 -vi. A' ?
31.5 b subjects
of Sectnotmnvonsvahundreddamfor a rs(550mit.abjat.meappheantmacivilPenaey
the
of not tarme man Eve hundred dollars ISSW).
366i��i� fP (9
Occupancy YP
OCCU ane Type
C h as owner of me property. or my employees with wages as their sale compensation,
'U 1
1
-will do the work; and the stricture is not inteadecror'offered for sale (Sec. 70,14,
Business and Prolessiuns Cade: The Contractors License law does not apply to an
305 - FRAME Required Inspections '
owner of propcny Who builds or improves thereon, and who does such work himself
307 - INSULATION
itu d that such improvements within
nin intended met
or through his own employees. building
-offered outside. IChowmer, the Building or impmo f n sold one met
" - -
Prov
rmpinirn, me owner -builder will have the burden of proving mm he did not buil) or
tha he did
EAR
601 - ROOF TEAR OFF
improve for parp se of.,ale.).
'
602 ..- ROOF.. PLYWOOD NAIL
_ -----_ "- ---...
- C1,asownerofthe nopeny,amexclusively contracting with llcensevicoutrxmrsto
--
603. - ROOF BATTENS
construct the project Sec. 70F4, Business and Professions Cwle:)The Cmatictor;,
.. „
t- License law, does not apply to an owner ofpropeoywho Wilds orimpmvasthe—.,
604 - RO SS
and who contract, for summ
.projes with a.contrxmo
ns) licensed tme
.._ .OF._,I
- _N- _"PROGRE
- _ . _
Contractor's Liecnse Law.
C 1 ant exempt under Scc. . B & P C for his reason
thvner'' - Uite -
' WORKER'S COMPENSATION DECLARATION
Ihereby affirm under penalty of perjury one of the following declarations:
C 1 haveandwill maintain a Ccnincate of Comcnt to sciriname for Workcr's
Compensation, as provided for by Section 37W of Lou Labor Ceske. for the
performance of the work far which this permit is issued
have he will maintain Worker's require
t lnsworkf
37 I,
3]W of the Labii CMC; for the perimman<e of Ne work for which this Iwrmit i.a
.,rom , or r thispermit
-My
' is d War is o t Insu ricr'and P91' y be ort:
X' ' ,CENfII ICAl10N OF EXEMPTION FROM \YORKERS '('
t- � s 's's- S t l 1. ^ ,' i 14 V. L i s 1
,-
(This xninn need not be compo&N if the permit is fm one hundrtd dollars
ISI W 1 or less.l
I ccmpl Chani tMp f • IB "kf}'use th'p l i:: J.1
...,• .• .
,
person n
any ma as to become subject m the Workers'
,shallCom notation
Laws r
Compensation Lulls of Calilomiu. Dine
.Applicant
NOTICE ,C of
this CerinCode.
the of youhmull-
comeso1'OAYo theCompcnortian provisionsof the Lahr Code, you must
� Compensate Labor
becamehcom
such
Forthwith n+n+ply with such provisions or this penmt shall be deems) fnmkeJ.
comply
,
O, ,CONSTRUCTION LENDING AGENCY
I he affirm that them is a construction leading agency far toot perfumume
oft he work I'., which this permit is issued (Sec 3097. Civ. C.)
] Lender's Name + _ _ _
Candor's Address
1 verify That I have nor mi, appucation and slate Inas me above unform.amn is
correct. I agree m comply with all city and emmy ordinances and suite laws relining
to building mnstracnnn.and hereby authorize repr¢cmmives of this city l0 enter ruin
i the above -m rationed propcny for inspection proposes,
L (W.)agree m save: indemnify and keep humlensthc Cary of Cupeninn agaiaa'
y accmc main,, said
liabilities, judgments, cost and expenses which may in any wit, ag
City in ciamel,xnee rf the ,at nS fit this permit.
G
APP CANTUNDERSTANDSA. LLCOMPI'WITH ALL NON -PENT
Date l G
S RCE REGULATIONS:
Issued by
Y
Signature of Applicnm/Conlmcntr/' (Date
Re -roofs
MATERIALS DISCLOSURE
Will ma applicant r future building orcupim store fir handle hamrdous material
Type Of Roof. -
htun
m defined by the Cupertino Municipal Code, Chapter 9.12 and me Health and Safety
:. .. .. .
CJdc.$enion 25533(al?nn
. ' •
_ i. fd' s Y
sh' I be inspects .prior to any_roofing material being
Allshall
„ _, ..
Will the applicant or future building occupant use equipment or devices which
..... .roofs -installed... _. ..
If a roof is installedwithout first obtaining an inspection; I agree to n6move
emit hanNous air umtaminant as defined by the Bay Area Air Quality Manngemem
District! '
all new materials for inspection. understands and will comply with
Dyes ' ..
,Applicant
all non -point source regulations:.
I have read the haeallou, materials requirements under Chapter 6.95 of the
California Health & Code.Salta am13553ilundersuind that
L, - Z lO)
ihhc building Jacs teu.505.35533
Irtlb By huvcaRnantJhat it is\ray rtpomibility nrnotity the
�,//
[��j ,, /
of rhe rc uiremcnt whi h mint be met prior to umance of a Ccrtilicaue of
m"`
'IL]/ -\A.
�Ocycuppantt
Signature of Ap licant Date
—h
All roof coverings to be Class "B" or better
_ l Ownerpramhnaae ti
OFFICE