04030197 (2)CITY OF CUPERTINO
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INP'URMATION
BUILDING DIVISION PERMIT
.aCONTRAOT—O
BUILDING ADDRESS:
>
GHADIR SARLI
PERMIT NO.
04030197'
OWNER'S NAME:
GHADIR SART-1
PERMIT ISSUE DATE
12
NE:
SANITARY OL NO.
ARCHITEC ,ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
JOb DDSCrIpI100
1 hereby apb m Net 1 Am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division J of Ne Business and profession Cod", and my license is
eBeLL
License
REROOF (GARAGE)
Class Ue.A
Dam Contractor
ARCHITECTS DECLARATION
I understand my plana shall W used As public records
Licensed Professional
OWNER-BUILDER DECLARATION
1 Wrchy affirm that 1 am exempt from Ile ContmeneYs License law for IM
following reason. (Smtion 7031.5. Business and Profeuinu Code: Any city or county
which requires a Permitm cetuuuc4 alter. impmce. demo ish. or mini, any s.Ctam
prior m ins issuance. also requires the epplicul fo, such permit to file a signed matemem
License law(Chapter 9
Sq. Ft. Floor Area
Valuan n
that he i. licensed puranllothe proviaiov of the Contractor's
su
(commencing with Section 7000) of Division 3 of the Business end Prefessiom Code) m
that he Is exempt therefrom and Ne buts for Out alleged excerption. Any violation of
.A,ps��,s�7�� y,
3 nJ FTO W1I5er0 0
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the APPIMAOI m A civil Penalty of
not mom than five hundred deltas ($500).
❑ L As owner of the property, or my employees with wages +their sole eompeutdon,
Required Inspections
will do the work, and the structure is not Intended or offered for sale (See 7044. Business
Act apply m an Omer of
and Professions Coo: The Cunuacloes License law does rown
9 P
thatuchimprve who mcnsuch work ntended oroffeortlwugh his
Ownenywho yces, provided not for vie. If,
awnem,the
)r'
e/ J
esr.fCml.red
gori pro,mempmwm wuare
Wilding withinot gess of compue rite owner-
however, me building m lmprowroving
Mal for
builder will have Ne burden of proving that he did not psi10 or impmw for purpose of
sated.
cenuaiong with:) The Cconu¢inn m
❑huOwner ofct p.pcny, BusinessAnd Cade:) Conbumr'a Lid
the
not (Sec. 70th, Business and Proproperty
CC//111, U li 11
who Winat
omem Lconsumer
chess law does not apply to an owner of property who builds impmw Norton, and
es po
rs
who for such projects with aconlrecmrtU licensed purstum m the Cormearthors
se Laces
Licence Law.
Mason
lame pt other Sou .Bk PC for this moon
Owner k Dau
I.ARA70N
I hereby AM. under pews rfA ng dularadana:
I law and will maintain aCeniOute of Coucnt to ul6insum for Warkeh Compcm
sadon, as provided for by Salton 3700 of the labor Code. for the Rrformanes of IIx
work for which this permit is issued
❑ I have and will maintain Worker's COMPenutlan Insurance, u required by Section
37W of Ne Labor Code, for Ne performance of the mm: for which this permit ls issued.
My Worker. Compensation Inclusion. cartior and Pullcy number an:
Carrier,Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(MIsseenon need not bocompleted if the permit Is fora cbundred dollsss (Skil)
Or tC3L)
1 cenify that i m pert ,muco of the work for which Ni. Permit B Tuned, I shall not
empl"y any ,Ape y a mrmumbecemesubjecllo Neworken'C"mpenulion
Iowa of Cali mit.
ApplicZT-
NOTIC PL AI : 1 t knq Ihj Cc rob l a remption, you should
become .0 jsct m the Worker's Compeualbn Wo taloa of Nc LAW Code, You must
forthwith comply with such provisions or this perm�i smrilI um revoked.
CONSTRUCTION LENDING AGENCY
I horny Alum Met Nom H lending agency for de perfurmence of
s ed (Sec.3
Inc work forNa which Nu pntnil u issued 151.3119'1, Civ. Cd
1 L.enthcrs theme
Lender's Address
1 cenify that 1 haw mad this Application end sure Nat Ne above Information is
r coma I &ICM he comply with all city and county OrunaMSa and Sax lam misting to
building construction. and hereby aulhodm represenutiws of this city to enter upon Ne
ahwc ncd mnysaw, for Inspection
lac, ha.
(We) to end keep the City of Cupertino against
(We) agree m saw, and
expenses may in m
i liebili gmcnu,eosa And espcnsos wnich maY to anY way acme Against aid City
itoo ce of the grmu of this Perris
a AP IC UNDERS 0.9 AND IL1 MPLY WITH ALL NON-POI
Issued by: Date
S R LA 0 �L
rQ
Re-roofs
at f I UC n m Dem
x R sa sc osuRB
Type of Roof
Will the applicentm ulum Wlldinswcupentstommhandlchun ous..MdsI
As defined by the Cupm mo Municipal Code. Chapter 9.11, and the Health and Safety
cwe.Seeline15531(a)7 1
All roofs shall be inspected prior to any roofing material being installed.
❑Yes $ No
If a roof is in ailed without first obtaining an inspection, I agree to remove
Will the epplicam or fulurc building occupant use equipment or devices which
mit Nurdnu Air commmmanu at defined by the Bay Amt Air Quality Management
all new err Is for inspection.
D'uvin7
❑Yes
�i
Ihav readth artlnusmterielsremommenuundcrCNpmr695of the Caliror
/,
/ 3 — 1 7_Q`}
nia HeAlth Safety otic, Sccdou2 505.13577 tnd255J4.l undcnlammd Nuif Nc Wilding
-
I L 1
Jma not c ow a tenenL tit is my spomibility m nodfY Ne occupant of Nc
—�
re Areme ni n n m ce �tacrningre eron� r. �, /
`1
' Igga o tics Date
}
All roof cov Ings to be Class "W or better
owner nr eutherized ss t D,m
W
rc
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
OB ADDRESS:PERMIT
o5 4l I c vL�e27'Son/ �� e ueeRj'iNo
#
l
WNER'S NAME: H A S
PHO 9
GENERAL CONTRACTOR:
FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
y Owner/ tgna a Date
66
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
eet Rock
ile
r ' 31 2-3/0
y Owner/ tgna a Date
�CITY OF
UPEkTINO
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408) 777-3228
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 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 on inspection.
I understand and will comply with the above stated policy on re -roofing.
(r
Homeowner's Name: H A bf4 r ! Ap L l
Job Site Address: �S �P C U L y e.12 Ucj /✓ D Y
Roofing Company Name: S E L
A plicanYs Signature:
Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
Date: '3-23-0
n
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APPLICATION FORM
/7 /
U�o-3
it s
APN #
r6'
Date;P '
Building Addre o5-6\
U L b+ -rsa N 'D V f EKT-1 /l 0
Owner's Name: H lJ �' I\
S -AR/ -1
Phone #:
CL4DU �1;16- 4�
Contractor:
Phone #:
go9)Cj a6 -76a
License #:
Contact: i
G i'1h� l ,R
Phone #:
.S,q 0- t 40V 31S —2 -9 L
Cupertino Business License #:
Existing:
Type of Roof Covering � � � I ��
Proposed
❑ Built -Up Roof
❑ Built -Up roof
Asphalt Shingles
❑ Wood Shakes
P<Asphalt Shingle
s�AR 23 2004
O Wood Shakes
❑ Wood Shingles
❑ Other (Specify)
❑ Wood
❑ Omer OF CUPERTINO
(tW)
Number of existing coverings
❑ To be Removed
❑ Prove p� (p(p
❑ Provi p
e`�,j nssttaQau ec
I Have Read, Understand and Will
Comply With Cu ertino's Tear Off Policy: ❑
Job De§cription:
V�
+44
�po Q & NA A,Gt E blit /} (,F—
4C
Residenti
o ercia ❑
Fire Zone: Yes ❑ No ❑
Confirmed wit anrt a t. if
there are an res 'cti s:
Cost P j!,C �a ov
Type of Con to Occupan gr)k.
QtyA�
An6licabl\
Fee TD
Fre T)ecrrintinn
Frr (lmnn
BPERMFEE
Bldg Permit Fees
BUILDING
BENERGY
Energy
BUILDING
BSEISMICRE
Seismic Fee Res
BUILDING
BSEISMICOM
Seismic Commercial
BUILDING
BPLANCHK
Plan Check Fee
BUILDING
BUSLIC
Business License
BUILDING
4 2,�1_9 2-/