01050145 (2) CITY OF CUPERTINO CONTRACTOR INFORMATION:
r. son.mrvc orvtstorv,., '+ PERMIT" '
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BUILDING ADDRJ�V024 -BRET AVE,— ,, CASTO ROOFING , PhNMITNoi 01050145.
OWNER'sNAM MOB TF-IOD1F'SON i ' ...� , J.9.3B .iOLD M.I.DDLEF,IEI.B)jPi.cMIptyusl�i✓e�16/2001.
PHONE: - .. SANITARY NO. - CONTROL NO.
(650)'96,1,;8922'-j
O O ARCHITECT/F.NGINF.F:IC - " BUILDING PERMIT INFO -
w❑ DC ELECT PLUMB MECH
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FF y'9 LICENSED CONTRACTOR'S DECLARATION Job Descrt n -
pz�'p Ih by fi 'n tIla,l I meritedrude,p or chapter 9(, g > 1 p - •, -
.pM_w with s t 7000b."Dt 301theB u .andP ,m a,Cede,andI rinse REROO.F WITH� TA -B--GRAVEL'.
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ce ARCH I'I HC FS UECLA
1 de r J y d sued be used as pt bl'c rd
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Devoted
- OWNER-BUILDER DECLARATION
I hereby affirm that l pt l d Contractors 1' 1 tonic r _
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following colon,(Section 703 l 5 Busiato,lind Pr f,: .Code:A Y cit,-or county • - -
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whicdmqirmi pi I vidirrionmi.cler,orprove,dem^¢h di optionally structure '.
m pr u,"ill y 're.tl ap, at
a hpd a fl g a.t to nam - '
y ' . dp 1tt a dp nl Contractor ' L (Chapter
acom8 Set ,) r 3 fBiomassdprofession,Coe)
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- -Sq. Ft. Floi -
Valu tion
othat h r, 11 foroI,he h f Ih.alleged p. .A Y violation
of Section by yappin applicant „s,bJemv,he applicant
of t rethad
file bawredgu,r. s5oto
APN, gpbber , OccupancyType
❑l.ar nwnclanhe t,aan, hi c]:n with wa ,bmrama r„�n dr 111041. 00 ..
- willdo'
1 th k pd it Ycrucial,' iintended g fl J 1 of (S 7044,
Ju d P few n Cold,The Crusurnect,License I does of apply to an 1 ' - v � ylCed Inspections
min f propertyWb ld. rtlwait
who
does
h work
de� F
a through pY , d d ibh u l t h: l ida
offered bsale,Jr.h the building or iiimmoureat . , IJ sthill one year of z 307 — INSULATION . .
the,wbtlde dill haveteburden of prov'ng!hm he(lid not bt'Id or
completion, ne
nnpr..c mr pam,mrersmdl. 60t .—',ROOF: TEAR OFF
L1 1,asoverm a the pd,cuy,1".mormicely contracting with imed,led',aindravor,ol 602 — ROOF PLYWOOD NAIL_
Lo .t uct to r i h(S 7044 R d r r s C d )TI c t emir '
a does not triplyt na twoololp eery he n I1:or na,mimerenn 603 ROOF BATTENS -
anJ who contract,far .,It ,,,,jet,,with i.coiannelmod lecnsed pursuau m the
Cmnraemr's laconic Law. , F4014 — ROOF IN—PROGRESS
❑I nm excion under Sec. ' ,B&P C is,,this rc;,cen
Owner - Date
WORKER'S COMPENSATION DECLARATION'
I herebyrfrour rudepandlyoffa,,lu,preofthfollowing dla t n.
❑ I hoi cold will about. a Cornficate of Consent to sell-insurer W k .s i - x
"
Cma,mactior, a, provided for by Section, 37011 or the Labor Coda dr, ,the ,, s
pe f Arra hie walk for which dii,cn d,isss ued.
❑I have land will maintain Worker's Compensation Insurance,as required by Section' - -
3700 or the Labor Coda for lie performance of the work for which,his permit is
"ued.My or Con,creation Insurance'carrier and Policy nun,her are: - •'
room R AdicY No.: ����D� ."
CF. TIFIC TION OF GXEMPTION FROM WORKERS* -
COMPENSATION INSURANCE' o _ .
(Till smtmn need not be gooffered if the permit is forte hitndred dollars -
($10 0)in lees.) -
rtifY Had ill thepoffinandive of thd work ror rich thi,pcould is issued,l -
shall not cook,any person ie a.,an or so as to bcaanm.orhowd sat the Workers' - -
Crmpensaaon Laws of Calibration.Date t •.
Applicant ' r
or NOTICE TOAPPLICANT.If,after drudar,tl'.Corri a,eofEtwor and you should
bee abject m the Wk Cordons[Cordonamian rad,kinalsof the harbor Code, .0 must
froth lh robot, ,In such provisions in this pbunit:hull he rebound revoked. -
aP^ ti CONSTRUC'I]ON LENDING AGENCY
1 Nicht'aB,or that thrid is a m,tsburned lrnJing agency for the performance - - -
W of the work for which this permit is issued(Svd 3097,Civ.C) -
a Q Lender's Nanw'
,z Lender's Address
V 1 certify dm l have mail this application andstate that he chose inputeon is
correct I agoes,to coolly dh ill city and counly rardingaves and:f te laws abating
to building constraction,andh by
orize re,marionatives orli editorial
the h t IP stt f pe(N ) g In rationality purpose.handless betty acoperd gain"
Vliabilities,J db ,. , J e P es which aY ^Y • i .
..
way accrue against said -
(..1 � Cry
'I ten of th •mnYnge hsper,it /� lk��
A RCAN'C DERS SAN ILLCgMPLYWI'[HAL ' NPOI T J
GO,
s b ,7 - Issued by: Date
• .'ga fare of.pplman"Convmnr ,, Uat R'e-roofs ,
HAZARDOUS At DISCLOSURE• '
Will dic ap liamt ar norm buildire,ae^pnm store or handle h l'ach v mated.( Type of Roo as defined by the Cupertino Mame(Pel Code,Chapter 9.12,and the Health and Safety -
Cud,,Section 25532(n)"
1:1 Yes - .re - All roofs shall be inspected prior to any roofing material being installed.
wui nm applicant oefn,nro hniming eontpant red alnipmmn ar devices which If a roof is installed without first obtainingan inspection, I agree to remove
•,oft lmzrNenv air confvtninams fie defined by the Bay Area Air Quality Managerent _ p g
,ad
. , all new materials for inspection. Applicant understands and will comply with
El Yes ` ;El No all non-point source regulations. '
l h read th h tl t I. ,ire f Charter 695 f the
C.1thadill Health&Sal ty Code,Scroval 25505,25533rad 25534,1 understand that
I the holding d .fit clarminlyla court,Unit ti )responsibilityt , [lythe
cep t f op" n Iii us,h nor piorass enf.'Certifcateof
xe ", Signatu�e of Applicant Date
�f 'J
a for ,hariaep agent Dare All roof coverings to be'Class "B" or better .
• ' OFFICE
i
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
kku
IS
t�u� Telephone: (408)777-3228
S Fax: (408)777-3333
I Y OF
CUPERTINO
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.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
Address: -1t_k
Reroofing Company Name: C'Q J
Applicants Signature: ,
Joe Antonucci .
(Chief Building Official)
6/13/00