02050088 (2) CITY OF CUPERTINO '" - '=• -BUILDING DIVISION PERMIT CONTRACTOR INFORMAT ION:
'12,1192 ORES PERMIT NO
2`192'g HYANNISPORT '_DR '. WING' S ROOFING INC 02.050088
DwJ
NWA.NG * 561 RUTGERS ST
HONE , SANITARY NO. CONTROL NO.
!S NE (510) 481-3818
is Z 'ARCHII ECT/LNGINFFR:. ,.,:" - t r - - - BUILDING PERMIT INFO 1
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BLDG ELECT PLUMB MECIi
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r -.,LICENSEDCONTRACPORSDECLARATION ' fob.Description
Z. Ihercb}.�idfnm thetlaml eryaepdrprm Bonsor Chpte9(c mencng RE-ROOF
pith Bee 7d10jof� i b3 ftheP sia dPrmesii Code dmy license ,'n u !
fY IsIn f1 ar6e' dec :j�• ...
rcN Chem in.. 1 .__ . ..:... ..... _...� e._. .: v,.. . .
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I a Q Iii , r ARCHITECT'S D. RATI i -t
y 5 I uiMersmnd my plans shall be ussd es public rtcords t '- - — " -
3 E:O O 'Licensed Professional _
i ' .. ..OWNER-BUILDER DECLARATION
y of
` 1,herebi m that I am exempt from the Contractor's License Law for the y5`8200
which l
fella ng lessor,(Section 7031 5 Business arm P fe.s oni Code Any city or county .. ..
O ich mcm rea permit t construct,alcor,matter,demolish m repair any stmeand
IB than to its isintaude,iihorequires the ppla nt for such permit to file o signed statement
e. _ 'that p i,hct-wdpurrint tolhepinavelonsoftheCauddroduchors License Law(Cheger9
' (commencngwlhSau n7000)ofDiviion3afibe0 sine ane Professions Code) r +' '1' 3 �ff15�m�r} a-, i -'Valuation•
ix . :.y:'• to - r . . ) t,t
_or Nm he Is exemPf ihemfrom and the basis(or Ne alleged exemppnn.Any violation sl .1 3,
of Section 7031.5 by any applicant for a permit subjects the upplicvnt a civil penalty c
. .6r nm morer,annvehundreddollars(55W). m 3054P�*I?$iR�@SE ,. P:w,t`.". Occupancy
Occupancy Type
307 - INSUL `
'OI{gs`owner ollM1e propenY,ser my cmpinytts with wages ns.,heir cola campenwtinn, ATION "
—will'da'the'worK nad'the stmnure'Is net Intended'or offered for sale(Sec.7094;' - 6O 1 — ROOF TES , ' S.:is'Cif
'Busincie'and Professions Cade:The Contrector's License Law does not apply mon J� nspectlons:-
ownerofpropcnyWhobuildsorimpmvesihcreon,anJwhndoessuchworkhimulf 602 - ROOF PLYWbOD NAIL
w or through his own employees.provided that such improvements are not intended or
' rofered'foisale:If.however the'building or improvement.,cold within one year of .-.. -_-._ ..-6.03.._-'ROOF" BATTENS... .,.. _ _ __'
ci-ompl( n ,im ae Wla 'nn to lmmn (pro mg mm neaa tbaua ar ROOF IN , PROGRESS
p Trp .,taxa Hale) - `pI �,�r.LYh�
nn 7 r C _
win f the p npeny lits cly sera t ng,,,ith «n ed c i tors In —
cz:
s S c o w t the project(Sec 7044 B sine and Prof"ons Ced 7Th Contractor's
l
Llcc seLa does not pply t m her fpr perry who bit Ida o mprovcs thde r -
f,v. ., d ha co irpCii.f6r such protects with a co traefor(Q 1censed:pursuant to." N
Connactor L u Li
I ameWxmpi under Sec I l B&P C for his reason
t
�!'nn.,i1{£..• ORKER SCQM,PENSATION DECLARATION.,5i;,i WILDING
1
hereby uffnd underpenalty of peri ryode of the following'declaretioos:
.1, - ..
r0.1"hove nnd'will'meimain'v'Cmifcem of Consent lo'sclGinsurc for Warker'a
r mrapensmian, as pruvided-for by Section-37W of the Labor Code, for the i
performanceof the work for which this permit is issued.. ' -
)t ❑1 have and will nivintairi Worker'.,Compehseiion Insurance,ei sequined by Section
of ih LaborCore fo fl perfmart c th f work for which this permit is
?e W d My W k pe I x vwec e vnJ Pal cy a nh
CAT[ OF E%E ION i~4Lti — ll sit 1.
•^b' ` '''COMPENSATION INSURANCE r '
-'-`9^"fUrs"u`ciionneed not be completed ifthe pemiitisforonehundreddollars
.u •. i. ..
i' I It .I 1 1,.:.. .
"s Ic nfYd ai inheninan eBnitIre'Ivor' to become
l' issued,1
Cmia not employ any person m any mune vs to became euhlem m the Workers
CnmApplicant'' Lawsof California.Dau'."
rNOTICE TO APP LICWaikie's Commrsafidng his Certificate 6f of Labor ion. .yond must ;-
•bccumesmm1 to ythe Works/s Compensation provisionstinthe
eemed revoluyou maxi
Z.Q O �fdntiwitb comply witti such provisions or this permit shall M deemed rtwked.
s ... .. __ .._.-.--.. .. .. -__�
�' ns'CONSTRUCTIONICNDINGAGENCY ' "" 't' i..A''.
timidityff int that there s a c.6t ct ae lend' gg agenby(r the pe form ncex' , t{
a" sof the ark far whteb this petmn ig inuea(Sa 3097 C v.C) 4t .� A
.... ..._ ._.. _...
tti. Z Uri Addrte.
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V Q. �'t'7rn IumfJ thatlhas r4dthi'appli�ml avid sWC that the aboveinformation oing �—
tL Ir meeq 0 egrcety comply w th all c ty and cnunty.o d n ccs and ate¢le s relating -' —
0 U sin bmldtng co nmction and hereby author ze rcpresenmtives of tht8c ty to her upon """' r — ^• - '
r� .rhe alio a minncJ p pony f r inspca nn pit po es.,`
:y (W)agrc<los dem fy and keep harml the Cny (C`perltnd against ..
V] liabiluie 1 Jgme,ns, ¢and a panus h ch y.n vny y accrue against said 1
C,7 Z City m c seq encc of the grant e f thi pc t - ,\J Vy
"" 'APPLICANT UNUFRSTANDS AND N'ILL COMPLY'W7fH ALL Nb POI
s uxcF E<m toles 5_ 610Issued by: Date r
Re-roofs
^ HAZARDOUS MATERIALS DISCCOSURL.
:(f wul me pph t r t b la' g p m't rc'n dl h aaaa material .Type of Roof.. .... ...+ , .. --.
os def ed by th Cupen n Mun¢pql Code Ch pt 9 12 a d th 11 hM1 and Safety
Cod Se tio 255.12d)
❑Y v N 1R fh 1 1 Sll a r. T .. 1''3
�" All roofs shall_be inspected poor to any roofing material-being installed.
mu inw11 the ii limo t funme building occup t se equ pment rde a. hich vIf a roof is installed without first obtainm an ms ecnon I-a res to'remove
.1h s a c ntnm n rats as def ed by the Bay Area At,Quality Management g P
iatnet all new materials for inspection Applicant understands and will comply with
❑Ye r No 'all non-poi I so rce regulations p
a 1 have rcudlthe hazardous named.I requ ramems under Chapter 6.95 of the
'Cnbfomia Hevlth`k Set,, Code,Sections 25505,25533 and 25534.1 understand that i-
--
dihebtolding don not cem mly have.tev t Chant is my responsibility to notify the' - U- ---
cupant fthe regaircm is h ch man be m t pd.".- isxua ce of a Cenificam o : V
^`nP y)� ignatureofApplicant Date
Olne mimmite Sea, ID;te All roof coverings to be Class B" or better
t , ,
OFFICE
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