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01100111 (2) CITY OF CUPERTINO BUILDING DIVISIONpERNIIT CONTRACTOR.INF.QRMATION,c' BUILDING ADDRER :, PERMIT NO. 10885 DRYDEN AV ROOFCO OF SILICON VALLEY 01100111 SUBD1�? UGHTON ROBERT G AND MAR 8443 EARLE AVE A10/19/20A01 PHONE: (408) 795-3335 SANrrARY NO. CONTROL NO. 00 ARCHITECT/ENGINEER: BUILDWG PERMIT INTO w- BLDG ELECT PLUMB MFCH f-_l I=1 C_1 L7 LICENSED CONTRACTOR'S DECLARATION m 1 hereby affirm Nat I am licensed under provisimns of Chapter 9(commencing Job Description with Section 7")of Division 3of the Business and professions Code.and my license REROOF. Dis fsucll Ctolamsse ane�t� y 3 REMOVE SHAKE, E, INSTALL 1 2e PLY &i�Na LiccnLir..x amcommem, 50 YR. T.L. DECLAR�` 3 I understand my plans shall be used ax publi rtco0 Z a y O O Licensed Professional OWNER-BUILDER DECLARATION 1 hereby a(Brn that 1 1. exempt from the Conor s Co eLicense A Low for the I G following reason.permit t construct,, Business and improve, de Professors Cade:Any city or county which coquina a permit re construct,applicant improve,demolish,or repair any atmcmre a3 _pnwto iu issueeee.also rtquiresthe eppikux forauch permit fileesigred uetemem. that hrj is li¢ndW pbfaaMt ttj thb p7ovisions of dse Conua[torr Licenu Law(Chaper 9 .. , IS ,,Fr•FIOOr-Area'v v ^, (commencingwiNSmtion7000)of Division3ofthe 9ufineMM pnd Pmfassions Code); (_,{�.+' �' ,.1 f9.d ij1:l r_..�;.,,. r.ti x_a li.?'a' $110t��uation or Nat he is exempt fteleftb'm'ind the basis for the elft,B eYematiox.Any violation -of Sermon 70315 by any applicant for a permit subjects the applicanuo a civil penalty .arnot munthanfive hundred daua.(uo(1). 356ARAt9wi o Occupancy Type 0I;as owner of the uparty,or my employees with wages as their sole compensation. 'will do the w.A,'and the'smemre is not intended or uRcied'for"sole(sec.7044; 305 - FRAME Required Inspeetibns' I" Busmen and'Pm(essioda Cadeua :The Concmr's License Law,does not apply to an owner of properly who builds or improves thereon,and who does such work himself, 307 — INSULATION I or through his own employees,provided that such improvements arc not intended or. _ ____I_ .ofcind for sale.If,however.Ne building or iinprvetneni is sold within one year of -- "- corpletion;the ownerWilder will have the burden ofpmving that he did not build or 605 - ROOF TEAR OFF-' 6 :t*;';tP' � •'(';�9 ¢ d improve for pumox or nle.). 602 - ROOF PLYWOOD NAIL . -._,-mb - with - - .. . ... 603 -_.. ROOF BATTENS . .. —.... .... - " "OLnsawnaMjec properpam aduslveland Pnctlsions lic:)The omremorsto � .1�1,i •:;,j;k,,', , cthe onstruct Busmenand Professions Cmc:)Thewes the., 604 — ROOF IN-PROGRESS ,r:I License Law does nm apply man owner of property who builds or improves thereon, :.. an d.who contracts for such projata.with a contractors)licenxd.pua unnt"m No- ...... . .. ... .. .._ _.. ._.... . . . _..i . Co tramp W _ ._. _.-_.. _. _. ......... .... ._.. _ ._ .._. f ❑l om e ept !"1r ee T,e @ P C for this reason �� - Dwner pate ' ED WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations. OCTa 3 L 90p� ❑ 1 h'W'and will'immusin*a Ccnificate of Conuni to self-insure for Worker's Compensation, as,provided for by Section 3700 of the Labor Code, for the 'perf ci pf the work for h h thio perm us asued.I BUILDING ❑1 h e d will maintain W ram's Ca pemeu o Irsurdnce,as required by Section 1v 3700 of this'Labor Code for the performance of the wo k for which this pcmut,s i- ed My W Ys llmpen Eynon I Vuna tem Pnl bcr Carrier.X PolicyN' r, 02' (� Ole, (/, / ).r, y, t \ F 5 1 CERTIPICATION OP ID EMf10N FROM,WORKF,R5 4" .%( t W.k. + .. (.I-t f.4 I,S G�f)S I' COMPENSATION IN SURA NCE ,., t,_ " mus senlun need twi M campinW if the permit is for one hundred dollars c"'°� t,�''"�r)`s s l (SI W)or lesaJ ...., . ,... .......... ....,..,..., ....- } r . I cem(y iharin c perform c 'f the k for which this Omit is issued,1' „I corn not employ any person to any menntt so as io become sublat io th2 Warken" Compant,- laws of California: Osie` t t PNOTICE TO APPLICANT If,after mAir, his Certificate of Exemption;you should; t Q � Become subject to the Wo kerCompensation provisions of the Labor Code,you must , forthwtth'complywith such provisions or Nis permit shall he deemed.,.IW. ; .F:,y, .[„�SN.nfc.-'e•,+„v CONSTRUCflON LENDING AGENCY..':•-.. ....' ,-�. ( . I _'_ C>. Leader' " ' Name' th t thcrt is a e nstmct on le d g y f th perfomt ce o s•f; Mrt0 R Lethe work for M1^h tht rmu s slued(Sec 309] C C 7 In:enif thetlheve tad thrsa licauon end sate th _ ... -_. _.... .. ... ... .. ... _. .. . .. ._. . _. .Led Adarcu' , 3 y pp et the above mformauon is ' �.I', 'coriect.I ripe m comply with all city and counry ordinances end state laws rclmi is t), ao building ronnruction:and hereby huthonze iapr2sematives'ofthis city to enter upon• Ne above-mentioned prope_r)y for inspection purposes. I Wel agree to saJa mdemei(y and kebp hamilev the City of Cupertino against - In liab 1 t 3udg ts, u aM xpcme ti h mry n anY w y again t said City h- x ce of Ne gram ng of the - iAPPLICAi f4 .�NDS ANDW CWL OMPLY WITH Aj,L NON-PoINT' Issued by: Date SOURCE .Signal r fAppl^can✓C t oi :,” .Dt Re roofs F ,,.HAZARDOUS MATERIALS DISCLOSURE { wll dm epplicont taunt Wld',occupants Handl hezalloua tnamnel_ :.Type Of Roof.. a,dernW by)hsc Calcium.Mmicill Code Chapter 9 12 e d the Health ad Safety su� [ - y Code ❑Vas 2515321 )o y"kt b Pit, s .1 L� 1 "� I . C.{ " nal it '' i({ '4i vyJl 41 1 t e"=.i ,,. n t t sG All.roofs shall be inspected prior to.any_roofing.material being installed... ------- home, _ w,n to applic tor. building mep mt use equipment or ae [e n n.. If a roof is insialled Without first obtaining an,inspeetion';'I'agree'tore-move on thazard anconmm nanisasd fin do th Ba AreaA abt Mmcswhict , ou. y all new o e ials for tns action. Applicant understands and will comply with . Dtrr[n p "J'i ❑ter�I �Ni all non i S urceiegMilos ;,,:F_„t - , I ha mod the he'ws m renals W u n is under Chapter695'af the It Califin is SIN'&Safety Code Sections 2530525533 dna 85341 understand that � 7©/ ' tf Ne bmld nga otcurently hoe a tenant thatna yicp tblity to notify the', - bee p m f th tem which t W met p tb is uanee of C n feel f Oc panty- s _ Signature of Applicant Date F scoverings g . _ "w—baa n 77=- pate”, All roof covens s to be Class B'or better ! _ t OFFICE- alm, 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. 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 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: Address: /o g!s Reroofing Company Name//: OG—CD Applicants Signature: TJ C--� —� Date: /c, —i —o i Joe Antonucci (Chief Building Official) 6/25/01