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01100067 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 10335 EL PRADO WY CALIFORNIA SECURITY ROOF NG 01100067 - OWNER'S NAME: APPLICATION SUB DATE ROSS KEISER 90 UMBARGER RD 10/10/2001 ,C HONE: SANITARY NO. CONTROL NO. (408) 363-6400 O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG .ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION z y 3 1 bomb Rem that Iran lic...,d under r Job Description ' jz p Ya pond Profession; mmccemse RE-ROOF :C6 with Section]1100)of Divisien3of the Rosiness and Rofesxiens Code,end mylicense ' is in full force and effyt. -.6 License Class_[_ ,.,e`� Lie.M Z 3 a Done 1p_ �_o S DEC to ARCHITECT'S DECLA ,O g 1 understand my plans shall be used as public records n O O :Licensed Professional - xx o OWNER-BUILDECLARATION 1 hereby affirm that 1 m11 pt f..the eonrs Co :renis Law for me Cg following a (Sectio 7031 5 Business andProfessionsimprove, dedemolish, Code Any city or county - — d ❑ -which ts permit to wn alter. mprove deermitt or repair any Material -1 QQ a $ 'P t t issuance.also q urn Ironm fm mchcero'tofile nseLaw Chapter 9 -- -. -.-_. —.__-.-. _ -_ _ .___ _. .. _ tnmh.AJ emFASect/mta ih0 Oro sof the theT p License Law(Chapter r a ^y Valuation (e mmen tagwrh Sau n'1Ig10)of Division Sof the BByspneu ar.O Profeecstons Code) 4y']Ji` i3 � 4i ATI or that he rs ekempt therefrom end the basis for the elldgeL cilmpriori,Any violation of section 7031.5 by any applicant for a permit subjeco the applicant to a civil penalty' Occupancy Type :of not mom than five hundred dollars($500). I�,µtq,[Ies., Y r..: +�r „. ❑I,ea.vaermf me property,urmy employenswithwagas as theirsolecompenam3 OApNion, 5 t'IC11lv1L will'do-the work and me associate is not intended or offered for salt-(Sec.7046; ' Business end Professions Code:The Contractor's License taw docs not apply to an 601 - ROOF TE1Y9 'Inspec[ifins' -- -`' owner of propcuy,Who builds or improves thereon,and who does such work himself 1 _or those his awn empJnyce:s.provided that such improvements are not intended or _ 602 _ ROOF•'._.PLYWOOD__NAIL...._..._.._._. :offered far sale.If,however.ttie building or improvement is sold within one year of I completion,the owner-builder will have the burden of proving that he did not build or 603 - ROOF BATTENS I "0 fmPro f puryo. r I > 6.04.-, r ,-ROOF -IN-PROGRESS El l a ne of the p port 7 am exclusively contmcbng with i tensedco linume m ( l - -- -- co nse the P J e(S ]066 Business pmalro er,who Cotler)The improves trenm'a ) , R a td does not apply t her of procerty who)buildsetmproio thereon .andwho,commas f h p Iens.wtth a cmxrnmor(s)1 ud pis em ta.the Contractors io L cense Lew, '•... /.. .. .. ❑1 xmto dn5 ' BR PC for this mason 0 nci' ° Dot Ell11 ` WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of pep ry on'e of the following dem cletions' j© ifi ' ea1 h e andwdlmam C eCmt iu elf far Worker's / omp,...tiom as provided far by Section 3700 of he Labor Cade, for the performance of the work for which this permit is issued.. ❑1 h e and 3700 ofthe labar Code. ode.nfWorhkerp'serfamou nce hWetNi I'enwwork f m which Bbdis peBmenttois issed My W A Compensation Insumncecamea d Policy Walter zz- em:; Cam rtzAaa'd l2y a Policy No 9�'-Q7� f` 'If f c -n j t s 1 r e,U CCIr' 'FJ r 7 'Y'i ♦ t :'.)i.t,i ivl m. t CERTIFICATION OP 6XEMPnON FROM W ftKGR ( `-t a ._... �, r n 7: "+1.°1 J_..)f .,.i 1 P e b... � t:•.•nr� n COMPENSATION MSURAN,CE... ”"� ' mita seceiori need nor Ee completed if the Permit is for one hundred ._._.. +.: I tired dollen ($100)or]a..) , .. j it is issued, .. __ .. -..... 1 wfrymithat a Performance of thework for thisa., C tt car amp y any ce o an,ma s ur ban a to M Workerx' NOTICE TOA ICANT:If. rt_, /P%ip �/ - Compe bon L Cal f APPI e t 1 ra, t�ponvision eLabo Cod .. .. .. .... ... . .. .... .. ..._... + _ after enkrthn n -�g�-- h IE e yy✓I Z becomebat to the W kens Com B�� P you must f. Q forthwith tom ly with such provisions ' p p Permit e e deemed resulted. CONSTRUCTION LENDING AGENCY t 1' ya g „ _._.. .. . F9gw In b III that them ac.martacto lend erg rya the peeform'a of the work for which th s� Permit s issued c 3097,Cie.C."Lend rs Name - - ._ (Se _ _,...• :P. . S - ._ _.. ..... ... Z LendersAddre s:' , .• .,, l. . . V:0 1 curdy that 1 have read this application aM stem that 0 hove information is fs„pa comes.I agree to comply with all city and county ordinances and state laws relating to Wilding consbunion,and hereby nonfiction representative,ofmiscity to enter upon L>a the above-mentioned property for inspection purim ars. , �-Oar (We)agree to save;indemnify and keep harmless the Chyoa Cupeitinuagainst VJ liabilities,judgments costs and expenses which may n any ay accrue against said V City nconsequenie of the grant ng of thsa t - APPLICANT,UNDERSTANDS AND WILL COAIPLY WITH ALL NON':POINTI SOURCE REGULATIONS ' - . Issued by: Date sig em of ApplicamfiC t a mrr;i„ :" ' ''Datp, j�"" Re-roofs - :.HAZARDOUS MATERIALS DISCLOSURE WII Bill-applicator an fumrebilding accupont state teofhandle funtiolon,material. :Type of Roof- _ as Codfiedioth Cupertino Mu opal Cede Chapter 912.and the Health and Safety - ':' Isis Code Section 25532(a) y' } -'i lY! a T f t [I yet,,, rt4 [J No�� ? 1t'i,i t 3i '. �.0 ] t - } i. <l FI ,.•,tsl:I:yi. t, , All roofs shall be mspeeted.prior.to anyroofing material.being installed. . . -------- Will theapplicant or ants building by t pe t use equipment li devices elliir, If a roof is inSt211ed-without first obtaining an ins ection;I a teeao remove entre haurdo r mmat or t i Belding by the B y Area i r e a1 ty ev agement g P ` g D.r t all new materials_for inspection. Applicant understands and will comply with ❑re, 11 No „` P g all non-point source re ulations: . = ;t 1 l rr;: nl. _ 1 have Health &Ser Iniety Cod s mated 1 reqs 25533 a order Chapterunderstand ede 99 of the Californiabuilding uil Health&Safety Cod 'Section 25505 t itis and 255341 a deer nd that tithe bis ld the mWot currently have em ant .Irene myssuanresponsibilityC ratify-the ctof Pa c most be nprior to is of Certificate / �- a Deco ant of the - q tmmmt wh chi Go gig ature of Applicant - - - . ... ... . ? t '. IP tit rrad li nt Dare. All roof coverings to be Class,"B"or,better ' l r, 1