03030054 (2) r CITY OF CUPERTINO gxaacu«,a `TI I `a"'
BUILDING DIVISION PERMIT rCC1NT12A�CTUR INFO ' ATONc.
BUILDING ADDRESS: PERMIT NO.
WINTER ROOFING INC
OW NE0.'S NAME: PERMIT LSU
151 WYANDOTTE DR
BRENDA CT SANITARY NO. 3/12
LNG.
Er . 4083638052
ARCHIlBLT2NGiNEER: BUILDING PERMIT INFO
I O PLUM O O
0o LICENSED CONTRACTORS DECLARATION )Ob Description
I hemby.m.that 1 Am licensed under provision,of Chapter 9(commencing
M,
Section 7OO)or Divislon 3 mW Busincumd profesainu Code.and my liecnre is
in f ill forte and IT REROOF
Llecnm Clw Lk.1
oate TIISCr REMOVE WO DEf�� foTALL 1/2 OSB & 30 YR. CO
Aacxl7Rcr'Uxx u o
I understand my plana shall be used As public mxords APR 2 9 2003
c Licensed Professional
OWNER.BUILDER DECLARATION
i f 1 hereby Affirm that 1 am Attempt from me Contractor'.License Law for the
:O o following reunn,(scedan 71131.5,Bustew and Proclaim Code:Any city m county
$ which requires A permit to eenureet,alcor.Impmn,demolish,or repair any atruetum P1 It,
ire Pnwm)u Issuance.also requires me appaesmforsuch permit to file a signed suument Valuation
I < thathet,llccnwdpmsuantiothepmvisiomo ftContrecmr'sLkenseLaw(Chapter 9 Sq.Ft.Floor re
&--
$ (commencing with Section 7000)of Division 3 of to Business and Pmfwions Code)or
YY
that he is attempt therefrom and the but,for the alleged exemption.Any Walston,of
Section 7D31.5 by arty Applicant ru a permit wbjwu the Applicant to a civil Penalty of APN Number Occupancy Type
notmore than fin hundred dAlun(1500).
❑1,u Manor or"property,or my employees with wages u their tole compensation, 36943007 . 00
will do the wank and me awmum Is not intended proffered forsale(Sm.7014,11usitreaa Required Inspections
and Prorwmru Code:lire Com ncMrt Limm law does not apply 10 an owner of fl P
propenywhobulldsmimprovea thereon,and wWdoestuchwodrhimsalforduOughbt, 305 — FRAME
own employees.provided mmsuch implvemenes are not Intended Or offered for We.If. 307 — INSULATION
however,the building or improvement la told within Arc year of complelmn.the owner.
builder will hen the burden of proving that Im did not bund Or improve for purpose or 601 — ROOF TEAR OFF -
esk')' ' 602 - ROOF PLYWOOD NAIL
❑1,as owner of the property am exeluAwly contracting with licensed conuacura M
construct the pmJen(Sec.7M,Business and Profeasms CMm:)The Communes u- 603. —' ROOF BATTENS
cow Law does not apply an an AMOU of property who builds or improves thereon.and. 604 - - ROOF IN-PROGRESS
who contracts for such pm.Rcu with a eontnnor(G licensed pursuant M the Coummmi
Lkew law.
❑1 Am exempt under Sec. .B k P C for this moon
Owner DAM
WORKER'S COMPENSATION DECLARATION
I hereby of an under Maly of Pa Jury ore of the following anchorman;
inn and will maintain A Certificates of Covent to salFinrere for Werteri Compen-
radon,As provided for by Section 3700 of dm labor Code,for the Performaw of the
work for which this permit 1s loved.
kve tad will maintain Workers Compensation In,urence,As required by Section
BO of that labor CmAt for dm performsrme of me work for which this jaunit is blued.
My WorkdaC rope taomy tunmectrncrand Policy numberam:
Caner, Policy No.:4g o''gog�sC
CER IFI T OOF fEMP13UNPROMWORKERr
COMPENSATION INSURANCE
(Nu ocdwo raced not he c ompleold Else Pamir is for one hum bead dnllm(5100)
or less.)
1 mify met in the performance of the work for which this Permit is issued.I shall not '
employ any person in any meaner an u M become mbJestto that Workers'COmpeuadon
dews of California,Dam
Applicant
NOTICE TO APPLICANC IL after making this CenlnesM of Exemption,you should
become subject a de Workers Compewdon IMMinom of the Labor Code,you most
.,O forowith comply with such provt,inns w this permit.hall be deemed ranked. -
'�0 CONSTRUCTION LENDING AGENCY
F' (hereby a(Brm that mem is A construction lending agency for the pwformgnm of
CG > the work for which this permit Is issued(Sm:.3097,Civ.C.)
W Q Isedcri Name
]z Lenderi Addma.
O 0 1 cedify that 1 hon read this Application and man,that the above information it
W comet.)Roe to comply wed all city and county ordinances and cubo laws milting 10
p building c e)itgn ti to n ,Inde authonre re P It les ft Cita cGy to enter upon the
W shove.memioted pmperty for Inspection purposes.
gy (We)Rua to on,Indemnify and keep h Iso the City of CuPUIMO Maty
W IIab111des,Judgmenu.cosu and expenses which yin oyway ocroc sgtenchAlnatsaid City
U4In con seq roof the is mtag of this mah, Da
F7 APPLIC UNDERSTAN W COMPLY WITH ALL NON-POINT Issued by: —0
SOU ONS.
Re-roofs
Set ora IIUn nit or
HAZARDOUS MATERIALS DISCLOSURE Type Of Roof
Will dm applicant or furore building Occupant at=orhamk hazardous MAWIW
ec0wd by the CupeNno Munici I Code.Chapter 9.12.and the Hulse and Safety
me,section 25532007 All roofs shall be inspected prior to any roofing material being installed.
QYes u
Will the applicant or future Wilding mcupent tax equipment Or devices which If a roof i installed-without first braining an inspection,I agree to remove
t haadous Alt contamioou o d d by the Bay Area Air Ow11ty Management all new terials for inspectio
luricl7
❑Yes u
Ihave thehoadnw mamrI.am menuunderCMpmrA95ofthcGlifor- �3
nb Hoalth etycede.5eemw25505, 35m25 Aurdenundthatirue Wilding
docs no ndy ban a ten t, It y mspwulblllty to-dry the omupot of the Y��
req. an mu O as.orA Cerulea=of Occupaec;� 'gra are fApplican Date
mer r awhonA .gem Dam All roof coverings to be Class"B"or better
a(B",
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OfTelephone: (408)777-3228
C U PE k 1 No Fax: (408)777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
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 re-roofing
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) Pre-inspection 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 a proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of r/4" 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 on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name:
Job Site Address:
Roofing Company Name: W l►t�✓ FTM5, l y G
A plicanrrs Signature: Date:
Greg eel
Building Official
Revised 1/30/03
Pdnred on Recycled Paper