02020027 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BU1.D1.5G ADDRESS: PERMIT NO.
878 BRENT AV 02020027
OWNER'S NAME: APPLICATION 07/2002
DON MACKENZIE
PHONE SANITARY NO. CONTROL NO.
w O p ARCHITECr/ENGINEER: BUILDING PERMIT INFO
li BLDG ELECT PLUMB MECH
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oZ °z LICENSED CONTRACTOR'S DECLARATION
vim,=o Iherebyafrrrm that l am licensed under provisions of Chapter 9(commencing Job Description
„1_w wonScotbn7lx )or Division 1pfth Busines n Pmesxmnx and myBttme REROOF.
inrmlr an❑- 5O T/O COMP. & RESHEET 1/2 ' CDX PLYWOOD.
a,e a Li<cnse Lic a
mossuOr
w u ARCHITECr'S DEC ARATION
F- 1 u rsm y plvns sM1vll he useJ as puhli<records
y�Y
E a O O Licensed Protessmnal
Em I hereby n?rm OWNER-BUILDER
I am mptEDECLARATION
farmhe Contmena",License Law for the
FaQ following reason.(Section 7031.5.Businessand Prafessime,Cate:Any may or county
se C O which requires a permit to mrsauct,alter,improve,demolish,or repair any stiucmm
u3m Pdorm seance also nequirn the applicantfos such proal ofdea sigrrW autemem. -
hahLlsrliartxtlpursuens+othepmvimomofheContsactohLittnalaw(Chagcr9 S FL.Floor-Area .. Valuation
(commencing whh Satidn,7000).of divixionJof he Busivss and Prpitn"mrs COdcl r";(;[l�'r Pti.kt9'e ty'.r'. ��i!4:9'LC?3`t'
or In..be" sampi her"no and the basis for the alleged exemption,Pny violaion 1692 O'�n
-of Section 703L5 by any"Phovm fora permit subjeces he applicant to v civil peran
:o,manae"..Itehundre❑aonars(SRyo. r APN Number Ir„;,: "a• Occupancy Type
01 sowner of the p pry,nmy employers with wages as their sole compn tion, -
,ai a me Proal, st ter t'nt 's Li offered f le(see 7o a
B3 0 7 - INSULATII�uired Inspections
B o d P ff".s Cone Th Contractor's
tt L er does applyt.
owner ofp pent Who builds p thereon, d who does such workhimself
r through h' n ply s provided th t h' peoverne is t intended 601 - ROOF TEAR OFF
,.,oe elm 1"un the building o p e [ins sold -h- eyoar of 602----- ROOF-"PLYWOOD NAIli x - -
c prove th ow b Id 'llh have bsJcn ofp gh the did not Wild or
improve farv rpefsal ). 603 - ROOF BATTENS
[31 - n r of the i Peoy am lac dye t t g w h l sed -traiors m 6 0-4-------ROOF- - - -
" IN""-PROGRESS
_ co w<i file projm(Sec.704a Bu,iness and Professions Cod l The Contractor's
License Law does not apply to on owner of property who builds or improves thereon, 1 ••t - t n t „d)•b r 1'
-= :. ..and who contracts for.such projects.wih.a contracmr(s)licensed.Pirutra lo.the.
4
CmtombLicense Law,exem
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P n-'. B&PCfonhsrc.sort
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Data :.r•
WORKER'S COMPENSATION DECLARATION
I hereby affiren underjRnalty..fpelury one,ofthe,following declarations
0 1 have and will mai I maia'aC rifest f Consent to odfinsom for Worker's
Compel.fion, asprovidedfor by-Section 3700 of-the labor Cade for the
_ _ - 'perfonnantt of he woR for whish this permi�ix issued.
01 ha ❑ H i1numn.Worker',Co penur o I vena ss Try 'rctl by S t
J700 of th tabor'Cod (o tM1 perform (IA -'ark f h ch th pe Yis
I^xs/ed ',�crl e'sC e t 1p,.arsnae anie�hd P umbo e:'
`:➢[` r
4P.154o ��`'ra� f
l r..r ;l nn� le L�f: N Sl Y J, ry ,.-'"i•.1 u'...1,f, :- �_
(I'jC2Rlr CAT NOFEXEMPIONFROMwoRKERS la1�r96, t 'ir ,Z.. s J �.t rC,),t... i,4.
t b id
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INSURANCE J
1
COMPENSATION INSUR ...:, .... .,..:... -� _'-_....._.- -...:...r...._._�. _.._ _
..._ _._._.. .._.. .... rn;. .. .. .......,
Onb 5. t ori need not be'completeJ ifrhe permit is for one hundred dollars -` •"- �" ,. I ) '.) -[i' I
(gllp)of less( , •
... :,v.. r •.,, ..
r,
1' n fI t m the performance of the k f which ht perm t rxsued,l ---
stiII of m6 ws person in anY man r.so t bedom .ubjat to the Workers' yL.'i _--
Comps lwn ISws of Calilomia.Dare( '
.:Applicant ...... ... .. ..... ;., .. ., ...• '
_ -_-- _. .
NOTICE TO APPLICANT I aft r mak g this C n f le of Ea prion yo ho Id -
bc me."hl not it Work Comps t this
hall
labo Ctidcul, mus
Z Q /onhwnh'complywith. n provisions
oi.Tore or Ih s permit shall be❑anted revoked. ^
'rw. t7tSIcm Csa
-
ION LENDING AGENCY',
> 1 h by fi that in a 'nelending" o agency for Ih-p•rPormnnce
y�0 -of the Led bN no which this p n1 ssi,,d(Soo J(%J7 Cv:C) '
�.� L'enl Adel PF . . . _ -. ._... ..__. . .. ._
.C) 1 cenify that�1 have read ib.a heat on and smte that the above information is
rorrem:1 agree to comply with all city and county ordinances and state Laws relating
mbuilding conarhnion:and hereby omhorim mpreuneitivex ofhii city to enter upon
} [zj fluabntio
ove-mened Property'for inspection purposes.
[.44 juk)ag¢clo'sac:indemni/y acid Axep harmlcs:he CiiY of Cupenindiffmalt
h liab I t pen eh Y n any y c against said
U Z City .e g ant`,f the a d u o-
- APPLIO V yc
STA.
TA \$Df 1 MPLYI\TIL ALL. IVT 1 Q�
$r URGE RE L. s' r. Issued by: at
.1goommotApplicanut, more r. ale Re-roofs /
( HAZARDOUS MATIA{:4 CLOSURE
,.
Will h appl" t ,tire
f building'
a up t in or M1arMl h d u Leri Type of.Roof-,
x❑e dbYth Cpn Motors!" Cd Chapter912 and the Halda dSafety
, yP oo — __. _-.
Cole 5 ton 2sSJ (al ti t y, M lY !v K r s e e - - -"-"-
❑Ya ! GNor ' v 'l 'If to fr ' 135r' k .I1�,.9 -RiTI(V, . �7
( ip, '' a All roofs shall-be inspected pnor to any roofing materia]being Installed. _
. .Will to irmonaminot future huJhng occupant c.Air t e a;n n. If a roof Is installed'without first obtainin an'ms ectlori I- . to remove
em t h iard s a mmr n[x a.J Bnetl by the B y Arta A Q I ty Manage em g p
°ix' " all new materials for inspection.:Applicant understands and will comply with
all
non-polli['source regulations
Trc d the har do (chats qu rc "n¢under Chapter 695 of.the
flfT[m but
-a &Safety Code.Sedans 550525533 and 255W l understand that
ifrhe builtlin9 snot curtcnilyhl'aa,erm:r ams myre,eareetelityberamifythC __.._. .._
Occup'., Inc m cn,,nuSt arm issuance'ofa Cenifcnte uf;
'circ en tic Fi
s
Oos p tic .. .. '
Signature of Applicant"_.-- _ Date
nner a author",e All roof coverings to be Class 'B"or b6tter "-
. ._ -OFFICE--
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTiNO
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.
lip 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 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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
v °
Address:
Reroofing Company /
Applicants Signature: \ Date:CLQ
Joe Antonucci
(Chief Building Official)
6/25/01
Building Division
10300 Torre Avenue
SON)
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
Building Department
REROOF TEAR OFF POLICY
revised 6/25/01
1. You must schedule an inspection for the tear off the day before the date you
wish the inspection to be made. The procedure is to call the Building Division
(777-3228)between the hours of 8:00am and 4:00 p.m. for next day inspection.
2. When the roof is torn off,the nails removed or driven in, and all of the dry-
rotted wood has been replaced, then you must call the City Building Division.
An inspector will be there within one hour.There are special hours for this
service:between 8:00 a.m. and 11:00 a.m. and between 1:00 and 3:00 p.m.
3. If you call for the tear-off inspection and the job is not ready there will be a
re-inspection fee of$100.00 charged,which must be paid before another
inspection is made.
Joe Antonucci
(Chief Building Official)