01100149 (2) INO
CITY
ofcDPvaOr DIVISION PERMIT NF
CONTRACTOR IORMATION: `
BUILDING ADDRESS: PERMIT NO.
10792 W ESTATES DR WOODS ROOFING 01100149
OWNER'S NAME. APPLICryTION SVB DATE
ESPIRITU BENJAMIN AND DORA I 1020 HICKORY CT 10/29/2001
PHONE: (831) 637-5576 SANITARY NO. CONTROL NO.
7ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
.p BLDG ELECT PLUMB MECH
y Z LICENSED CON'TRACTOR'S DECLARATION Job Description
z_ I hereby affirm that I am licensed under provisions of Chapter 9lcommencing REROOF. P
mew with Sectihn]000)of pivision3of the Business and Pn.resslons Code,und my license
;s in full force�sand t.�� License Clp. �t�" 3�1 L;c,xm7- / T/0 ROOFS, RESHEET .7/16 OSB, 30 #FELT
coutrscr ADD 30 YR ELK COMP. SHINGLES .
ARCHITECT'S DECLARA ION
a O j [understand my plans shall be used i s public records
•taN
O O Licensed Professional
" off OWNER-BUILDER DECLARATION
m I hereby affirm that I am exempt from the Contract License Law for the
C Z< following ova (Section 7031.5,B noxi and Pmfesston Cod A y city r county
o which'claims perm t t .Bun 1¢u map de nal h t r pa y wcmre
w -pct t t ane al q the applicant for such Perron fl a signet statement
tot na t lanar ed p rsutlnl to Ina Pro+Minns of the Churnacmr License Law(Chapter 9 Sq',1FEt➢ ''loo ATe�a�3 M1 x '1";E'tl iA $8 7 anon
(c m ncng with S h nl700(dif Division Sof the Business and Professions Code) (, 411NV�' }Is ` tt n (_ 3, A.q 1.
or that he is exempf therefrom and the basis for the a1kgN disruption.Any violation 1
of Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penally' Occupancy e
of nht more than eve hundred dollars(s50o). 3 6 9VNN4nb®� P Y�'P
D 4as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044, 3 0 5 — FRAME
"f`oaness and'Profcssions Code:The Chromium's License Law does at apply m an Required Inspections—
owner of property woo builds or improves thereon,and who does such work himself 307 — INSULATION
or throught his own employees.provided that such improvements are not intended or
6 P ement is sold wdnin hoe Year of '- _ -' — -
chim,om la ro I :If,nnwever the building 6 01 - ROOF TEAR OFF ,t
complain.t n Ne owner bu Ider will have Ih burden of proving that he did not build or t ' 'Co
improve for
purpose of sale). 602 ROOF PLYWOOD NAIL
y -
BATTENS I erof the property,dn exclusively contracting with licensed contractors to 6O3ROOF
-.
License
construct the prosect(Sec ]044,owner
w nee o and Professions Cade)The improves
themons '
and wh Lawdoes not a 1 roan ownerof conuactho)oddssei nproveat,to the
6O4 — ROOF IN-P •i
rhe 1 '
and vectors nrectseL such prolens with.a property or(s)licensed pursuent.lo the ..... .._ - __ .._.._ ._.....,._._
El I a ex License Law.. -"' "— "'-
❑lame rcpt under Sec B&P C for this r<azon nti"
D oate : . ,, ..'. _ NOV 1 3 2001
WORKER'S COMPENSATION DECLARATION
Ihercbyso,
rmunderpenehyofp imyooeofthefollowingdechuarimr: BUILDING
01 huve'and will church.'a'Cenifcaoe of Consent a self-insure for Worker's
Compensation, as provided for by Section 37W of the Labor Code, for the
pert rmance'hfthe work f rwhich this pe t is issued.
m nd will itu tan Worker's Coupe info'Insurance,da mch iced by Section
.. 0]00 of the Lnbbe Code,for the performance of the work'for which this permit is
,. filled My W rk •s Comp ii' Insurance came end P I y rounk,ebi
11 ��.c
.. �Carner 5. •t.Pol 'N a�',5_O OV/V/r/.
.t'rCBRTIFICAT10N OF,EXEMPTION FROM,WORKERS
_s NSATION INSURANCE'
COMPS
a a rpn s s tion recd not be co'mpleoed if the permit is for one hundred dollars J-0
' (5100)or less) _
y P pemnt issucdl . . ..,. ,� ..._....__. ._,• ..
Icml thatin the K e fr askforco which
shop not employ any person in any manner so as io become subsea to IhrWorkers " 's• - " F' 1 ' '
is
C mpcnspl nLawsfCalifornia Data r -
APPbca 1 ..., ,
NOTICE TOANT If,after making this Certificate of
Exemption,youshould
lude,omic,objemntotheW kY'Cnpensatiop it Labor mussQQthu ihcomply with chprovisions or this permit shot]becenedravoked. _
. _.....__.. ._... _ ..__._. ... _ -... -
the
_ ... . _. :...,
- .. _ _ .
F:> a ,CONSTRUCTION LENDING AGENCY ; '` -1)
1 hereby affirm Ihi pe ' a ,deduct a lend gag y f IM1 perfoim nee
ijQ ,Lt[a`r N f h¢h th s P 't -Issue)(S" 309] Civ.C) ''
V_Z -Lind r Addres .. .__ . . i.. .. .. _
Q
I emfy to t I ha read mix uppl t a d st t tM1 uh alio a mfonnai 's
W F comet I grc<lo comply wnh all city a d ty ordinance, rel d late laws ting
car,.) tobuddmgchaswction,and herebyaulho}ixerepresentatives ofthis city toenter upon
r� the above-mentioned property for inspection purposes.
CS (We)agree to ss a indemnify and keep harms ss the City of Cupertino against
:r h
liabilities,judgments.costs and expenses which may any y me against said
U City in cons q nee of thegcould,of thisrat t - "
APPLICANT UNDERSTANDS AND WILL�C MPLY WRH ALLN POI
SOURCE REGULAGTEprt�m : Issued by: Dale
S gn t re of Appl cwVC m dt '. D�ait /•' Re roofs
{,HAZARDOgR,APSDISCLOSURE� Type of Roof
Will the apDl cent tum buddn ace tit pore
handle hazvdou tater] ,7 i
es def d by the C pita Municipal Cad Crap¢ 9 12 dd the Health tl Safety'
'�-
❑ves ( ^ a _All roofs shall be inspected prior,to.any roofing-material being installed .-..
F wn m ppllcanl o f ta building oec p t use equipment or devices which If a roof is ingtalled without first obtaining an ins eetion,''Fa roe t6 remove
em I ha and it cc tam a is as derin d by theBay Arta Air Quality Management g P g
District' all new materials for inspection. Applicant understands and will comply with _
all non-point source regulations
" I hive lead the lixatd . ani n Is requ rements code,Chapter 6,95 of the
Cal font a Hcabb&Safety Code Sections 25505 25533 ad 25534 1 thisharsurnalmat
If the building does notdmenllyhve a teat that yresponsibilityt notify she' - ' ��/'1.C//B /
cc pent of th nls wh ch mu t b m t pr r to iss a of a Ce ificate of "
Pandy .w'�_" 9 0/ Signature of plicant Date _
" ow �aumnd�e e ;• • .: All roof coverings to be Class"B" or'bet[er
_.,. .'_Date, .
OFFICE . . . . . .. . .. .. . .
Building Division
(/, 10300 Torre Avenue
nd la�x/ Cupertino,CA 95014-3255
IV. Telephone: (408)777-3228
CITY Of Fax: (408)777-3333
CUPEkTINO
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: wr.N G�amic a.. �, �
Address: l0 7 2 2-
Reroofing
Reroofing Company Name:
Applicants Signature: _ Date:
Joe Antonucci
(Chief Building Official)
6/25/01