03010074 (2) CITY OF CUPEWrINO -" '• .
BUILDING DIVISION PERMIT CONTRACT0*INFokM �,h6N' .1,'.
BUILDING ADDRESS: EL CAMINO ROOFING CO INC PERMIT NO,
10198 CASS PL 03010074
OWNER'S NAME: 1650 S 7TH ST APPLICATION SUB DATE
HSU THOMAS AND AMY YUN 01/13/2003
ONE: 40B 292-7644 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
an00 LICENSED CONTRACTOR'S DECLARATION
u.0 P I hereby affirm that I am licensed under provisions of Chapter Y(commencing Job Description
with Section 700(f)nf Division Sof the Biline. J Professions Cm1c,and mylicense is
hold
frnccv3/
Loose clal4, ca:i17" u.a C"Z�i REROOF �y��AA I �,,,
a. Dam T/O WOOD SHAKE, 'IIB 1� CDX PLYWOOD W/
ARCHITECTS D�61d-(Rn'fION
go�� d rsuntlmyplans hallh uuJaxpu�licrcwNs PRESIDENTIAL TL JAN 24 2003
_ Licensed Professional
O
j OWNER-BUILDER DECLARATION
E
Y 1 heresy affirm that I am exempt from the Contractor's License Law for the .� ��®���
6
00 following maxon.(Section 7031.5,Business BUILDING
and Professions Code:Any city or county U
x 2� which requires a permit to consumer,slur,improve,demolish,or repair any structure
1°�'^ Four to its issuance,also requires the applicant for each Permit to rile a signed statement
=S< that he is licensed pursuant to the provisions of the Cunlracsnr'sLicense U.Chapter9 Sq. Ft. Floor Area Valuation
as 1- (commencing with Section 70(f7 of Division 3 of the Businesa and Professions Code)or
i $
that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for in permit subjects the applicant to a civil penally of APN Numberc T
not mart than five hundred dollars($50) Y Type
1,as owner of the properly,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7AW,Business
and Professions Cade:The Ciarmuc or't License Law does net apply m an owner of Required Inspections
proPer y who builds or improves thereon,and who doessuch work himulfor Omugh his
own employees,provided that uch improvements ue not intended or offered far.10.If, 305 — FRAME
however,be building or improvement is sold within one year of completion,the owner-
builder will hats the burden of proving that he did not mild or improve for purpose of 307 - INSULATION
note) 601 - ROOF TEAR OFF
❑1,as owner of the property,am emhodwly contracting with licensed contractors m 602 - ROOF PLYWOOD NAIL
construct the project(Sec.704,L Business and Professions Code:)The Contractor's Li-
mare Law does not apply to an Owner of propany who Wilds or Improve,damon,and 603 - ROOF BATTENS
who contracts for such projects with a contrumrp)licensed paranoid to the Contranor's
License Law. 604 - ROOF IN-PROGRESS
❑ I am exempt under Sec. B K P C for this reason
Owner Dale
WORKER'S COMPENSATION DECLARATION
I hereby alrum under penalty of perjury one of the following decimations:
I have and will maintain a Ceniricate of Content to self imum for Worker's Compere
notion,u provided for by Section 3701 of the Ichor Code,for the performance of the
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as required by Section
370)of the labor Code,for be performance of the work for which this permit is issued.
My Worker's Compensation Insurance cart.erand Pol icy nu her art:
CarrierOSt0.4L�i.nl Policy Nu 0.)
CERTIFIC COMPENSATION ONFR WORKCRS'
COMPENSATIONINSURANCE
Olosseclion meadow becompleted if the Permit ix for one hundred dollars(SI W)
or less.)
I certify that in the Performance of the work for which this permit is issued,I shall not
employ any person in any manner an as to become subject us the Workcri Compensation
laws of California.Date
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the UIW,Cook,you most
OO foMwith comply with such provisions or this Permit shall be deemed mvoked.
Z ^ CONSTRUCTION LENDING AGENCY
r
Wj I for whilhrrm On,therei issued(Sec.3097,nding agency lonhe PeHormetue of
Qi theLe work for which Nix permit is issued(Sec.J09],Civ.C.)
GQ Lander's Name
7 z Lendcls Address
U O I certify that I have mail this application and stem that the above information is
Ua F correct I agree to comply with all city and county ordinances and stare laws mlaling to
O U building construction,and hereby aothodu mramsentetims of Nis city to enter uronthe
Ij above-mentioned property for inspection purposes.
a' (We)agree m save,indemnify and keep harmless the City of Cupertino against r
liabilities,judgments,costs and ex 11
In pensesmit, may in any way attme against said City
C.) ,'� in consequence o(Jm granting of Ibis permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date (4127
SOU ULATIONS.� t}
Re-roofs
SLgrour of Applican/cOntracvr Dau
DAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle hazardous material
ss deftned by the Cupertino Municipal Code,Chapter 9.12,and the Ilcalth and Safety
Cuda.Sec lion 255321x)'1 All roofs shall be inspected prior to an roofing material beim
Y. uyr P P Y g being installed.
Will the applicant or future building oecupanl use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
Doonct7
❑Yes Yrill Nx—
IhavemaJNehuraNnusmaterialsrcquircmcntsunderChapur6.95 o1the Califon
nice s not Co Safety Coda tenant,
it is
arnd255J4.l it)no rad Noe H.p building - 11 J
does not cutrcn0y haw a anent that it is my resrymsibility m no y the accup t nl'thc
mgeirements amm�atMmeym�,r�to ssuwceeracenmgamo 'cepane Signet of Applicant Date
Owner or iutoon.d agenl V ole `� All roof coverings to be Class "B" or better
4,41
Building Division '
10300 Tom Avenue
CupeSino,CA 95014-3255
Telephone: (408)777-3228
CI Pax: (408)777-3333
CUPEkTINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
I. 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.
IMPORTANT:
1. Flat roofs must have a minimum of VL"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: �O 1 w S )
Address: o I �(--�.S(J A C n
Reroofing Company N
Applicants Signature: Date: I d 3
Joe Antonucci
(Chief Building Official)
6/25/Ol