02070202 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20045 CEDAR TREE LA MAI ' S CONSTRUCTION 02070202
OWNER'S NAME: APPLICATION SUB DATE
DANG PAUL AND TRAN TRACY H 359 N. PARK VICTORIA 07/30/2002
PHONE: (408) 202-4875 SANITARY NO. CONTROL NO.
F ARCHITECr/ENGINEER: BUILDING PERMIT INFO
uOi Ct BLDG ELECT PLUMB MECH
day 1 - i [- C7 L:J
LL.. LICENSED CONTRACTOR'S DECLARATION
G i Z 1 hereby afRrm that 1 am licensed under provisions of Chapter 9(commencing Job Description
with Section 7")of Division 3 of the Business and Professions Coda.md my license REROOF
F, is in full force and a t.
at i< License Class Lic.p
Kp U
Data Commror
w 3 LL rn RCHITECT'S DECLARATIO
�y I 1 understand my plans shall b,used as public necrosis
so z p O Licensed Professional
OWNER-BUILDER DECLARATION A �
I hereby affirm that 1 am exempt from the Centocor'.License law fm be JAN2003
F following reason.(Section 7031.5,Business and Professions Code:Any city or county $2500
(]
SFO which rtquirtv a permit to conslmm alter,improve,demolish,or repair any stucturt
Iwj3^�_pdmaiu issum,atso rtquirtsthe appEcans for suchpemtitmRleasignedaWmmenlME Us. - --- -that Pd is licensed reasons,to da:provisions of the Contractors License law(Chapter 9 -,..s • l�`�s, F, �IOOr,p,�ea,.,,. . Valuation
(comoicisurg WSeciion,]11001of Division 7 of the Bµsiness and Professions Cade) v. tp• yrJ,lC- -41�y,�t•`U,U.rY'a:.e dill iL'a:
or that he is esmdpf therefrdn and the basis for the alleged ekfuptmil.Any violation
-of Section]071.5 by any epPlicsm(or a permit subject the ......civil penalty
-
.of not more than five hundred dollars(S5010). 3055 AFNPkM42 > Cvn \'rp Occupancy Type
El 1,as owner of the property,or myemployee with woges ns their ole emn asrtian, I
s - .__. _ .....__...___.... .
Businewill doss
the work,'and'the incomrude:n Contractor's nonnam Licen ol7 redaw doe sno appl(Sec7094,' pect
+owner of an party nom Cade:The License law does not apply m an 6 O 1 - ROOF TEARegDIE�Inspections,
+
owner of progeny Who builds in improves It such and who eats such work himself
or through his own employers.provided that such improvements ere not intended or 602_- ROOF PLYWOOD_ NAIL
offered for eels If,however,the Wilding of imlldvemeneis fold'within one>'euf
o -'---- --'---- - - -- - ---'-- --�- - -�"-—"�--'--'-"---
603 -µROOF BATTENS
completion,the owner W ilder will have the burden of proving that he did not Wild or '
improveforpuryeseafmle.). 604 - ROOF IN-PROGRESS
-- - -- " - - ---- - .... .-...-- - --- --- ._. ..-- - - ' ------ .._.. - --'----------------- ------ .-.._.........
O 1:ser mare,0 the Poison,eon exclusively contracting with licensed contrscm,s to 1+"!:t"'4;P:';�',;,t �'.f)
construct the project(Sec.7064.Business and Pmfcasions Code:)The Cmmracar'a ;•LUC 1;1 F'
License law docs pwt.,Ply.suc to an owner th propetymus who Wilda m improvers an ,
_.and whsee,Licca for such project wilh.o conteclmorg licensed pursuw.o
�oo�m'mu Licrnu law. _
='n2 p.{arrr eaempl under Sec: '' � -!�' �� '�'B'&PCfor Ni.teres ;vh L)r3�Ci 1�)I;O!1
(Z ". .. .1. J .._
I ORI R COMPE TION DECLARATION
IhertbY M.under Penapyof?!!'imYoneafNe following declarations:...
❑ 1116,and will ."Cersifm9ie of Consent to IelOinsune for Worker's
Compensation, as provided for by Section 37W of the Labor Code: for the
'perfmmonedof the work foowhich this permit is issued.,
❑1 brum said will m mtmn Worker's Compemat o'imurance,as required by Section
317 jof the Letter Code,for the performm
ance of the work for which this'peul is
'-7. ted:MyWorkers Compensation Insmanc rar,ier'and Policy number a¢:
(renter. f1g:'p. ttJ.. .. Y.•:f Policy No� .,, . o , ..lda•,.y.•_
"0", 'CERTIFICATION OF EKEMPTIONFROMWQRKERS}_ Lt ♦1. els
' - COMPENSATION INSURANCE�- s
l`'obiavvdrn need not be cnmpleaJ if the permit is for one hundred dollen =,• \ '!r'L.il' ,, lYC\;
($100)or less.)
. that m time perfomarwe f Ili wo k f' which Lha perms r Is ed:1
1 w(y
C II ofemployan p�, o 'r to b t the Workers
Com .orlon Iw.ydF If U G/'' '-
._APPhcant..
N APPLICAN e Wor IL oft pennon this Cen lease of Evempd n you should
Q Qbee ublen m Ne Worker Compen at n p v of Ili LoW Cad y o must
fon Ilicomply with inch previsions o his Permit sholl be deemed evoked
. . ...
'I'•'C0NSTRUCTION LEN DINGAGENCY
ai S 1 h rchy itllmp that the c n t e[ 1 ding ugencY for Ilba peHormr ee'
4
of nth rk for when this Permit - d(Se 309] C C)
6Wi Q Lender Name,'. . + .. - --•"
�_ Icnd ,Addrcsa. l •• r.ri" 1. t.11pi n'1P -
C.7 I comfy,that 1 heve rad Ws NPOcatian and sum @pl the above information is
fS:E., cotactaI agree to comply wain ell city and coumy ordinances and state laws relating
P:u �o.Wilding construction.and hereby euionze representatives of this city to enter upon 4
yys�.-rte
:to
above-mentioned gdpenY for insea omit W Noses..
L.6s (Wel-agree to save.ndemnify end keep harndesi the City of Capenino•against
tr V1' liabilities,judgmenu,cosu eptl agorae.which may in any way scams egsivt sew
'I �Z. City'in consequence of Ne gianting of thls Permit.',
_ ''APPLfCANT,U.NOERSTANDS''ANDWILLCO\IPLYWITH'ALLNON- -�,1;. Issued by: r Da
yw
Sf URGE REG IONS "- :'•L't: :f s:bC
reufApPlimm(Comractor:•l!•'1s ':r.: y " Re roofs
HAZARDOUS MATERIALS DISCLOSURE
" . Will Neo 1 c t o future Wd ant store or handle haeardons maarul
a, ppi Ty. pe,of.Roof.
e deRned by Ili C perm Mu Cade Chept r 9 II and the Health and Safety r J
Code S�eci os 33532(x) >r p�lv 11 If \ ny: - I e. a-f t lo°I r fol A-' .
1
All roofs shall be inspected prior to any roofing.material being installed...._
Wil th pplc t mmrcb jiap a p F eequipment ,a n n If a roof is installed'without first obtaining an mspecaon'4'agreerto remove m
'eon hes '. a col I Is sed edb m . Arc Apr telt Management,-
all new materials for inspection.- Applicant understands and will-comply with
Y O Y
mnnn❑Ya ( No _.._
1 he
aquinemems come,Char a,d65 afw all Iron-point source regulatkons
rtad�ma haurtlo s oaten Is m Ne
Cal
Vand.Wilding
does
of cur Code havSece
am 25505.25533 itis and 25536 I undersand
?fO0.pear.f dompotc currently renammmrimmyresponsibility,.Caniolfyth '- -" -
occupant o/Ihp,rtqu remora heli mu s tr mit pdm m pssuanae of s Cenifeal f Gf per ee-r(' '6
y' _Signature of Applicant a e
wan or.uthariam agent - ate All roof coverings to be Class."B"or better - '
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
` Telephone: (408)777-3228
Cl 0 Fax: (408)777-3333
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.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4"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 of inspection
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: -7/ 1-1XLQ f �bA 4a—
Address: -0e Co j�;��r!?
Reroofing Company Name,, / l�S
Applicants Signature: 4�2�2� Date: �2 a�Q –D `?
Joe Antonucci
(Chief Building Official)
6/25/01