03030050 (2) CITY OF CUPERTINO '"' ' " `"' '
BUILDING DIVISION PERMIT " r �Toly "
�
BUILDING AODRFSS: PERMrr NO.
WINTER ROOFING INC
I 997c; BRENDA rT
pWNER'S NAME: Pf:RMRI55
151 WYANDOTTE DR
BRENDA CT HOA
E: 4083638052 SANITARY NO. LNG.
BUILDING PERMIT INFO'
ARCHITECT'/ENGINEER:
' BLDG ELBLT.. PLUMB 0
pp LICENSED CONTRACTORS DECLARATION Job Description'
8 1 hceeby&M Nat I in licensed smile provisions of Chapter 9(commencing
with5oetion 7001)of atlon3 of the Business and proiciMms Code,and my lkemo is _
� rmllmraaneortec D REROOF
b in full Cohn Lk.•
Damr� ARCHnRC.'.0 cr RATIN REMOVE WOOD SHAKES Ig OSB ' & 30' YR. CO
' L
1 understood my plan[{hall ho wed Y Public rtearW .
I
MLicensed Professional al
OWNER-BUILDER DECLARATION MAY O O 2Qo3
f I homily Attire that 1 em exempt from the Contractile,License Law for the
p o following mason.(Section 7031.5.Bwlness end Profusion Cade:Any city or county
t
ME which requires a permit on construct,slur,improve,demolish,in repair any structure p�
1•ZNv, price m its issuance.else rtquirea tic applicant for such permit to hie a signed statement �Itl� Valuation
s—� est he is It=. punuam to the pro,Mom of the Com mine,Liame law(Chapter 9 Sq.Ft.Floor Area -
3 >as (commencing with Se Mine 7000 of DlMuon 3 of the BusMusend Profuinn Code)or
— that be k exempt therefrom ami the basis for the sihcgcd exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not mom than Eve hundred dollen(5500). '
❑I,anwnerofthepmpenywmyempluymuwithwevsu Wekmkcompcmton, 36943003 . 00
will do thework,and the structure Is not intended or offered for sale(Sm.7044,Box., Required Inspections
end Pmfeulom Cade:The Canvacmes License Law does not apply in in owner of q
properly whobunmorlmpmrw merlon.anlwho doessuchwokbinaelf nthmughak - 305 — FRAME
low empryees,pmvided met such improwmnu amnminknded ceoQered fceasle.u, 307 — INSULATION
however,the building or Improvement Is cold within one year ofromplatkn,the own.
builder will Mw the burden of proving that he did rot Wild or Improve far purpose of 601 - ROOF TEAR OFF
Asia')' 602. - ROOF PLYWOOD NAIL
❑1,a owner of the Property am exelu dwly cenksetng with licensed ronmacton in
core m n the pmjeu(Sec.7011,Bwlma and Profesunm Cade:)Ilse CnIVACus a Li- 601 - ROOF BATTENS
erne Law does not apply to m Owner of propeny who Wilds or lmpmvu thereon.Md. - 604 — ROOF IN-PROGRESS ,
who contracts for such pmjecu with a commactor(a)licensed pursuant m the Cantnewes
License law. .
❑I Am exempt under Sec .B k P C for this within
OwnerDau
WORKERS COMPENSATION DECLARATION
1 mby eMmundermrWtyofpcdwyowoflhfollowingdeeWnlom:
sew and will for by
a Cetn37M of Consente rCode.fum roe performance
opere
corn,u hick this pe by Becton 3700 of the labor Cade.for the peRormance of the
woh for which the permit Is issued. '
D 1 have and will maintain Warkees Compensation Insurance,as mquked by Section
370D offt Labw Code,far the performance of the work for which this permit Is Issued r
My Worwesc pe$Ad 1 rice -1'.ad Policy number ere: '
Cartier: Poliry No.: u
CEKfI'n ATEOF .KBMPIIONpROMWOR
COMPENSATION INSURANCE
(This action need notal completed if tic permit k fn one hundred dollar($100)
or kW
I artlfy that in the pufmmance of the work fm which this permit is issued.l Mall ma
employ any perem In any manner ail As th become abject o the Worker,'Compemation
Laws of California.Dam
Applicant -
NOTICETO APPLICANT:If, net making this Ccnifieste of Exemption,yen thmld
become subject m the Workees Compcm adon provision of the IaWr Code,you most -
.,O forthwith complywithsuch provisions or this permit shall be deemed revoked.
'Z 0 CONSTRUCTION LENDING AGENCY '
F. I horeby eRnm the
that a D a co etwe inn lending.geney for the performance Of
of
ai ter work
for which he,permit is issued(Sec.3097,Civ.C.)
W Q Lendce,Namc
=z Lender's Address .
U2 1 certify test 1 Live rood Ws application And was that tem show Informal-k
Li. Collett 1 agree to comply with all lily rid county ordinances and mate law mbdng 10
C building comweein,atehereby authand keep
anmiw of the dry tocols Aglpon re
fl7 above-mentioned property,for inspection purposes.
(We)agree re taw,indemnify and In It herr InAn ere City or Cupen1L gsimt
paq
:n on rid expenw wMchm In nY wYamaspinn aid City
U 7 APPLIC was of UNDERSTANDS
pcmtk.
F7 APPLICA UNDERSTANDS ND IL OMPLY WITH ALL NON-POINT Issued by: D e V
SOU
RC UL ONS.
Re-roofs
S gnat r lis nUCont err D e ,
'HAZA DOUSMATERIALSOISCLOSU0.8 Type of Roof _
III tem appllcantor futum Wilding uccupsm nom or handle haudo s material
As
defined by tee Cupertino Munich I Code,Chapter 9.13,and tiro Health and Safety
Section 25532(.)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes e
Will the applicant o future Wilding occupant sec equipment o devices which If a roof is installed without first obtaining an inspection,I agree to remove
Itharamnusair romuninnu u ncd by Ilm Bay Ana Air Quality Mwgemcnt all new ateriels for inspection _
tar
❑Yea u
I have mad me hoaNaa muerjj'ggg111,mqul=34.de r Cheptee 6.95 of the til if"I
calthd:SafuyCade.gatom255ss533oWss531.h mtMnuM mattha Wildingn tcurremly law a ren 4 it k my responsibility m nodry the cccupnt of the
l hcntawhich t m orakmwhcoofaCertficeteafOccuency. •eofApflicant Dale
o r er.eth �o. a ossa All roof coverings to be Class"B"or better
Community Development Department
Building Division
' City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
C U P E k1 I* O 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 l/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:
!4 v "ol
Roofing Company Na k
)ie--
Applicant's Signatu : Date: .U3
Greg eel
Building Official
Revised 1/30/03
Printed on Recycled Paper