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04070159 (2) I' CITY OF CUPERTINO � BUILDING DIVISION PERMIT MCO�NTR' OTORM I xx r BUILDING ADDRESS: ANTHONY ROOF SERVICE PE""N64070159 127 HUNTERSTON P PE OWNER'S NAME: IthOT f55lIB DATE JIM DUPORT 910 S MCGL ONE: SANITARY NO. CONT0.0L N0. (408) 265-5147 ARCHnERYFNGINEER: BUILDING PBRMITINFO BLDG ELECT PLUMB MECH 0 0 0 _cc LICENSEDCDNfitACIDR'SOECLARATION Job Description y w FF 1 hereby affIrm Nal I are licensed under provinces of Chapmr 9(commencing `� widiSection 70f10)dfOivinon JafNC Businecaan f, Co do aMmyliceve is Licenlm clef a .x REROOF �J " a5 are AR HITECTS DEC N ��4 .ao © Ky undersand my Prises shall he used u Pru orrisu. OyU V� 30� LkensedPnafcssidnal OWNER-BUILDER Intrust." f DECLARATION dilly ct 0 1 Mmhy o(Soc that 11. escmpe from Use Contractors license Law for Nc R _p O which rouon.sonil n comm,eL Owl. aM --tw iues Code:Any city ao countynde x m� whish mqulrta a Permit m cnnamcL elmr,improve,dcmnlixb,dr repair my strucnum _Z"> priarmi iyva .alymGalRltMappllCNtlafNhp tmrlkabigCdLaemenl ValvallGn ZiC NUM¢licence.)porauammNcpmvisiaesofNcConuecmrsLkcnmisw(Chapmr9 Sq. Ft. Floor Area thammeneint wish Sectio er and fr basis f r of lk B ej exemption. Any vi CMc)of i _ that k u exempt Ikmfrom and Ne bub far the alkiW ammpuon,Any violauw of Section 7071.5 by any applicant for a Puled subjcots dee MIAluent to a civil penalty of Occupancy Type not mom Nan Biaw hundred dollen($5007, r wi L u demo of tk peauree ser my employcas with wages u Nei(sale compenemess' will ridthe rwims and Ne he Com ianotinwww«oBarNrmwa(Sec.tooan.wner Of Required Inspections and Professions dis to The Contact ..Liana Law does not apply lf rt owner of q p pmpemywha builds ori d due mthereon,aMwho dotstill work moll fser Ba ngh his how.,.we buiprovided NUsuchim I-sold itartnotNendcdmoBued Bantle.If. however.we Milt ser den of proem is sold within one yen of completion,IM owneo- Milder will love tae burden of proving Out he did nm build or impmae for purpose of sale.). 1.uam de.of Ne Property am eaeluively contracting wish licensed untracmm to esa cotct me project(Sec,7044.Busmen add Pmfmdam CMc:)The Codaacmrs U. nae Law dors not apply to an owner of property who builds or impmaes theman.and who contracts for such projects wish a contractor(s)licensed pursuant m Ne Contractors License Law. l a,uemPr under See •B&PC for Nis moon Owner Date WORKER'S COMPENSATION DECLARATION ION hereby al,.undereon pty of perjury aro of Ne fallowing declankmc ❑I have and will maintains Ceadnmm of ordow,se aelf imure far WorkehComper- snkm•u pmvidM for by Section 3700 of she Label Code.for tae performance of tae work for which this permit is issue& ve ❑I haand will maintain Worker,Compensation I.cc.u required by Section 3700mf Nc Labor Cade,for Ne pedoomanee of Ne work forwbich Nis permit is Issued. My Warkcrs omp dwdddon,su(m at and Policy number see: Cartier.�dliry Na.:934 CERTIFICATE OF E%EM ON FROM W00.KE S ^ COMPENSATION INSUR tThivsatian need mtkrnmplcmd rade parnn is(nr chundmd dallars(SIWI or lass) I cutely Wt in the performance of um work for which Nin permit is issued.l9ull not. employ any person in any manner se as to become subject to Ila Wmkcta'CompemWan Laws of Canromia.Date Applicant NOTICE TO APPLICANT:IL after making Or.cumncem of Exemption,you aboard become subject in Ne Worker's Compensation previsions of Ne Labor CMc.you rota .J 2• ruminant,comply wish mach pmvicou or Nis permit"I he deemed rtwohcd. ?- CONSTRUCTION LENDING AGENCY �-r Ikmhya'and"n us"'isawmwniam knintagaea yfortheperfurmaxt( p$> Into work(.,which this permit is issued(Sec.3(197,Ch,.C.) W Q Lenders Namc 0. Lcndse,Addre U O 1 Mmfy Nan I lase lead Nin application and mm Na IM about information On ty F curtail 1 agree to comply with all city and,county orNoamaa and sum laws mladnt to OU buon-mrouloneddnand hereby auNorimmossea. ni rs of Niscity reenmrupnn um ra W aMve-meneigo Property for inspection purposes (We)agree N ave,indemnify add keep haamlus Ila City or CuPenino against nFw y liabilieu,judgmcnts.cost and cape•..s whim may in any way accme agnnat to City U z in consequeace of the grunting of this permit Da APPLICANT UNDERSTANDS A ILL COMPLY WITH ALL NON-POINT Issued by: SOURCE ULA 0 l 7 Re-roofs signs arnppEoHAZ ( - am T of Roof HAZARDOUS MATERIALS DISCLOSURE Type Wlll the Cultmt orfmun building accuhanummor handle harallsad Sada) u dcBnM by um Cupenina Municipal CMc.Chapter 9.11.and Ne Haslth and Safety Crain,Saeon 25532(.)7 _I All roofs shall be inspected prior to any roofing ma, nal being installed. ❑Yu No If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future Wilding(Welpant use equipment or dcricrs which emit barardnm air contaminants U defined by we Bay Area Air Quality Management all new materials for inspection. D un7 ❑Yu --1/1 NO 1 have mad Lk coo ow mamriala oweirmards order Ckpmr 6.95 of the Califor- ninHeal,&SafctyCode,Seen.25505,M533 and 15534.1 undenmed uwifdm building v r a does rot currently Lamm a ou unL Nat' my mspmerry ufy Ne=upset of Ne "M mmc We be ordr"ofacemifkaOccupancy. Signature ofA 'cant Date ` Date All roof coverings to be Class"B" or better 70wocr or authorimd ages Community Development 10300 Torre Avenue Cupertino CA 95014 t Telephone(408) 777-3228 CITY Of Fax(408)777-3333 �UPEI�TINO Building Department JOB ADD SS: PERMIT Yj /' ? - �4 `—art/ aY 07 0,1 OWNER'S N PHONE GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 60 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 T: S v d ea-, Septic Tank Sheet Metal Sheet Rock Tile o actor Signature Date Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 OU CITY E(�T I N 0 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 minimurn 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. Homeowner's Name: y /'7^ Job Site Address: I 02 7 &C-4 ��L Sa-V IJ �- Roofing Company Name: ✓!� c� 1� '� A plicant's Signature: Date: Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO algDF REROOF J �� • CUPERTINO PERMIT APPLICATION FORM APN# Date: ey 6�- 2-1- o,// -6� Building Address: aj�z �U 'l� S a.✓ L Owner's Name: Phone�zz #: i OF1 - 7 Contractor: Phone#: License#: LC-2 7 �s 3 Contact: Phone#: Cupertino Business License#: 0 3 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles 'ffi, Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# To be Removed ❑ Provide Mfg.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ JobDescri tion: ��al of / S 3 cc OS � - �C /4vo pvc61 e Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Plannin there are an res ns: C ect: b� Type of Constru t n- Occupancy gr p: Qty. 'f A i le Fee ID Fee Description Fee Group 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 • 26�3 �