The URL can be used to link to this page

04070043 r F"ILDINGADDRESS: ITY OF CUPERTINO `t' BUILDING DIVISION PERMITQNsrI2nCmOR I1�F' I.tIIII�'I 'TTOv:' T D ROOFING PERMrrN04070043 57-A WOODRID= QT-OW NER'S NAME: PERMIT ISSUE DATE ONE:- SANITARY C OLNO. CHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH X00 LICENSED CONTRACTOR'S DECLARATION Job Description u 1 hereby shorn Net 1 am limned under provisions of chapter 9(commencing with Sweden 7000 of Division 3 ofthe Beat.and Professions Code,and my license is rt� in m0mmea.derce 3q 2 2 REROOF W/DURALITE SHAKE INALE 5 2 .f It f Class Lie. nH Deo: Course. QQ ARCH ITEC17S OECLARAT 'T .g t tZZ l understand my plans shall W red as public records AUG ly 2004 ��u 30 Licensed Profnsi...I 3 OWNER-BUILDER DECLARATION 1 hereby affirm Net 1 em exempt Wm the Canraclor'a License Lew for 1W U[LDING O D following reason.(Section 7031.5,Business and Professions Code:Any city or county k a f which requires a Permit to construct,altar,impmw,demolish,or repair any ausetum or prior m its issuance, requires the applicant forsuch Permit w file a signed statement L'x�e that he is licensed pursuant to the provisions of thc Comment's License Law(Chapter 9 Sq.Ft. Floor Area Valua ion W51 (commencing with Section 7")of Division 3 of the Business and Pm(essons Code)or that be is exempt tearefrom and the basis for Ne alleged exemption.Any violulon of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 4V3141411 &0 0 Occupancy Type nos mare Nan five hundred dollars(5500). ❑Lasowoerof the pro formic(See, 044,rumens will Pr thcwons,and the he Con is is Limmer ffenedate do(s not apply t Oan owner of Required Inspections and property Codc:The Cenuectors and Law does not apply to an owner of q P pwn easy who buildscrimpuraves ed Bud such improvements and who doesouch won himse]f or through his however. the ca,provided Net improvement a.not intended ofd orofferopted ed forThe ow.r- however.the building ru improvement ie hath within one year or completion,The owner- ral..)rwill bare de burden of proving that W did not Wild or improv fm Purpose of saleJ. ❑1,as awner of the property,am exclusively contracting with licensed contracts.to construct the project(See.7044,Business and Professions Cade:)The Concractorh Li- cense law does not apply to an owner of property who Wilda or improves thereon,and who contracts for such projects with a commater(U licensed pursuant m the Guarantees License Lew. _ ❑1 sm exempt under Sec. B R P C for this reason Owner Data WORKER'S COMPENSAMON DECLARATION I hereby affirm under Penalty of perjury one of the following declnatimu: I have and will maintain a Certificate of Consent o half-insure for Workers Compen- r oma as provided for by Senior 3]00 of the labor Code,for the performance of the work for which this permit is issued. ve sad will maintain Worker's Compensation luau.....required by Section 3700 of the Labor Code,for the performance of Ne work for which this permit is issued. , My Workers Comap�ena ion Ins e n 'cr enup Ii number em: - Cartier: 1 Q Polity No.: )�I Z"1 CERTIFlCATE FFXEMPnON FROM WORKERS' COMPENSATION INSURANCE (This section need nm W completed ifthe permit s return hundreddolla.($100) .r loss.) 1 madly Nat in the performance of the work for which this permit is issued,I sh ll not employ any person in any mannerw as to become subject to dN Workers Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should become subject to the Workers Compensation provisions of the labor Cnde.you must ,JO forthwith comply with such prnvissm,"is rermft ana[]W deemed revoked. zCONSTRUCTION LENDING AGENCY rA[r I hereby all that there is a contraction lending agency for the perforrearm of CG 7 tint work for which this permit is issued(Sec.3097,Civ.C.) aQ Lender's Name z Lcodees Address U Q I mnlfy that I he.mad this application and rate Be,the sec.let rml.due ie U. correct.1 agree o comply with all city and county ordinances and oke laws relating to CU building construction,and hereby authorize representatives of Niseil,to enter upon Ne W .hove-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against y liabilities,judgments.costs and expenses which may in anyway a<eme agains,seid City V z in consequence of tie{r7 ting of this permit. ti APPLICANT ll R6 ANDS AND WILL COMPLY WITH LL N N-POINT Issued by: Date SOURCE REGU IS. T 7�q / `�`t Re-roofs Signature of p icam/Conma or Data ! HAZARDOUS MA ALS DISCLOSURE Type of Roof Will the applicant or future building occupant sore or handle haeardous maen.] defined by the Cupertino un u ape]Code,chafer 9.13,and de Health and safety []Yes N ale.Stetson 35533(a)? All roofs shall be inspected prior to any roofing material being installed. Will. de applicant or future building amupam use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove mit hovard.u.air ccntarrinanta u defined by the Bay Arca Air Quality Management all new materials for Inspection. 7naaH.Iffi&SdfI is.icl7 ❑Yes No (have mad the hmamoes materials requirements under Chapter 6.95 of the Califa- adrSations23505,35533md25534.lundc.tandthatifthc building an nos currc ly aa¢rnt Wtit is my msponsihility o nntir them uproot ofdte "` IIXCCquiremcnts 'A t oroissuanceoraCcnificae Occup cy. Signature of Applicant Date �� '7 N1 o( All roof coverings to be Class"B"or better Owner art mthoriacd.gem Dao Community Development 10300 Torre Avenue aclor Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 UPERTINO Building Department JOB ADDRESS: l.' PERMIT# as.s 3 VV oo d U- � e c t" O v 3 OWNER'S NAME: ;Str : coo PHONE # yo$ yy 6 o R R A GENERAL CONTRACTOR: FAX # I am not using any subcontractors: M32M& $ O Signatur Date Please check applicable subcontractors and complete the following information: 60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile 8 O Owner/Contractor S• tore Date Building Division 10300 Torre Avenue Cupertino,CA 950143255 Telephone: (408)777-3228 oclo 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�/"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: Address: 3 S 3 4N o o c� tr A G e Ct Reroofing Company Name: I D 'Annoo'� Applicants Signature: --� �Date: 3 o y Joe Antonucci (Chief Building Official) 6/25/01 CITY OF CUPERTINO Gly ' REROOF CUPERTINO PERMIT APPLICATION FORM APN# Date I 3V Z - lS -- b65 0 Building Address: AAS 3 W ooc` T-i A c, Q'T Owner's l same: Pho e#: S ee Leh l �c�o �408� 44r. oq8 � Contractor: Phone#: License#: T D Quo'&) -249 to 4,0. 6 ro (oaa Conta t: Phone#: Cupertino Business License#: Noo�tn Cyo$) S°1.. 88Tl.- a 3 t SS Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ . Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles L3 Other(Specify) X Other(Specify) eon CV f.L, Number of existing coverings ❑ Provide I.C.B.O.Report# To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: heJ-noJQ- vWooc,. S�ic,-La a-t'? wQL w (:-�L C. a?Q-9- Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dent. if there are any restrictions: }�1 Cost of Project: Type of Construction: Occupancy group: 1 4 Soo — noo Qty ifA ble Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING Z6z3 �/L i v