03030049 (2) Crr 0OF CUPERTINO ,: " �' rM4ex
I[�U�iTG ®R1U�tMta[�1�0^1�1
BUILDING DIVISION PERMIT s
�} PERMIT NO. ,
BUILDING ADDRESS: WINTER ROOFING INC
/ PERMrr LssuE DOI 0 3 0 0 4 9
OWNERS NAME: 151 WYANDOTTE DR
BRENDA SANITARY ND. 03 12 t008NO
P 4083638052
BUILDING PERMIT INFO
ARCHITECT/ENOINBER: - BLDO ELECT PLO 0
LICENSE5CONnlAC70R's DECLARATION Job Description
I bomby affirm that 1 em licoased under Prowls°".,of Cluplcr 9(commencing
with Sa0a70(D)ofDlvlson3ofds Busnev WPmfuslmu Cedo.WmYlicaucia
In fullfarce ends O REROOF
Uoenm Gla^ Lie.
p Dem REMOVE WOOD SHAKES INSTALL .1/2 OSB & 30 YR. CO
j s doll b use DECLARATION (I
1 understood my P�shall w used u Public march
Uncured Professional -
OWNam ER-BUILDER DECLARATIONeConorur MAY 0 6 2003
I hereby,(S o that 11.,Busho from the C schres Code:License law for the
i o following Tanen.(Sadat 7(01.5•Bua art adrom,de oli h.oA.y.IlYan m aunty
$ which rqulrta a permit m emarocl,alte0 wpmw,demolish,m repair any amcwm Valuation
prior m is Issuance, sequlma the aPpliant fonahpermiuo file ulgncd mtemal Sq.Ft.Floor Area BUILD
NG
C9 Ihathe isllaused purmant to the pmvWoe of the Cauacmrs Uanre I--(Chapter 9 g./ L tV�A
-$ (commencing with Section 7000)of Division 3 of the Business and Pmhettinna Code)or
Ir_ Smoot,703°15 by wry app lam ten a pemlthe basis il s the
allehe applicant to, ai I.Mily ai APN Number OCQUiType
not mom thu sew hundred dollars(5300}
will doln,a;kfodom`°pa mma,isyamN dedneoffeeddfr«weismiw eP9shat�' Required Inspections
and Professions Code:The Communes Liam Law does mt apply in an owner of 305 - — FRAME
proNnywhobuild.,arlmpmW Ihertnn,and who d0at workblmselfor through his
own employee.Provided oulsuch lmprowmenu an,unintended cautioned forele,if. 307 — INSULATION
howem.the building or Improvement Is°old within ane)evaf completion-the owner.
builder will haw the burden of proving that he did not build al ImProw for Purpose of 601 - ROOF TEAR OFF
.10.). 602 - ROOF PLYWOOD NAIL
Coammwct the pmtjectt(Se�"04d gW uIeue ser sion$codEmend
)The con`uacmutau 603 — ROOF BATTENS
come law data at apply m as mann ofPropeny who wild+a hopronsft..W, 604 — ROOF IN—PROGRESS
who Monaco,for such pmjm,witha conomatel(s)llcon.,ed pursuant m tis Contranota _
License Law. ,Bd:PCtm dd.,mato"
0 I amenempt mdv Sa.
Data
WORKER'SCOMPENSATION DECLARATION
I hereby air=under penalty of perjury,arc of the following dalvWou:
wend will nen mal.,CatiOmm of Comm,to alGlnmm for Workers Comp--- -
etlon,u provida fm by Sadoe 370D at the labor Code,fm the peffmnanrn of tis
work Mch this permit la Ivued.
1 hew W will malmaln Workers Compensation Iuurame,u required by Section
3700 of the laborCed1.Inn We raAwmaoec of am wnh for which this Permit Is Issued.
MYWorkers CompauWml sea and Polity number Sm:
Col. Policy NosD G KElls" _
G OF PITON FROM WORKER
COMPENSATION INSURANCE '
(This anlmmadentbo MmPhused if to permit Isfalooehundrd dollar(SIM)
or les)
I artily that in the p aimom nee of the walk for which this Permit is issued.I Shall not
employ any person in any manner m as to became object 10 the Workcrs•CompemWan
Laws of California.Dam
Applicant
NOTICE TO APPUCANr IL.,fur making thin Cenincas of EacmPdon,you should ,
wcame aubjat m Iso Worker&Compensation provisionsof the lahm endo.Yau mall -
.7Z forthwith comply withsuch provisions or this Permits hall be deemed ranked.
CONSTRUCTION LENDING AGENCY
(=r I hamhyaflirm that dem in col"uuvion Sending agomy fm tie Performance of ,
the work for which this stook IS Wad(See.3097.Civ,C)
U7 Q Lender's Nana
Lender's Addru
Z
U Cz I cenlfy that I haw read this application and sum that the Sbow mfomWon m
k.. cone".l &=10 comply with all city and county ondhrmr.,and mm laws mulmg 100 buildiRommngMured propend herby authalb<rP0SSL Wvu of ibis city rocmm�o agathe
°now-mentioned topeny Tal Imnify an Purposes
st
haretrom City.f Cupertino dCity
�y Ilabllidu,judgneno,.eowadupenw which may in any boy vas galnn WdCity
C) In cmuqu ofthe granting.!thhpe t.
APPLIC UNDERSTAND AND LL COMPLY WITH ALL NON-POINT Issued by: ate
SOUR UL ONS _ -
fl Re-roofs
Sit c App)an nu o Das 'Type of Roof
HAZARDOUS MATERIALS DISCLOSURE
Wllltheapplicam or future wlldi g oavpmt sour or handle haeNous mv^.<al
Rand by the Cupertino M.ohip ado.Chapter 9.12.and the Health and Safety
Satien25531(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yea u
Will the applicant or forum buillong occupant use equipment m deviw which
If a roof is installed without first obtaining an inspection,I agree to remove
It herardnus air c.numineno,v nc0 by the Bay Area Air Quality Managcount all new m serials for inspection
huic0
❑Yes
I have red the maAmmsmamrhhmquirmeno,under Chiper6.95 arse coif."
nit Hellb@ ssetyCma.Sect 25505.25533W 25334.1 mderund thsttftie wilding S J
dao, monody haw•len 4 serf it h MY mapomibllhy m notify tw acoupml of the Date
requ eau which et Issuance of a Ccnificam ofOeMpency. SI atl eo Ap Ic8 t
All roof coverings to be Class"B"or better
or h 'v enl Dem
Community Development Department
Building Division
_ . d City of Cupertino
10300 Torre Avenue
CITY OFI Telephone: (408)777-3228
C U QE�T1N0 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 Y4"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: fPLL== =' �{- i:�TA-
Job Site Address:
Roofing Company Name: H [u=y G
A plicant's Signatu Date:
Greg eel
Building Official
Revised 1/30/03
Printed on Recycled Paper