02030136 (2) CITY
DIVISION NO CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRESS: PERMIT NO,
1464 JAMES TOWN DR WESTSHORE ROOFING COMPAN 02030136
OWNER'S NAME: APPLICATION SUB DATE
CUEVAS RICHARD M AND RUBY D 5869 WINFIELD BLV 03/25/2002
" (408) 629-2100
PHONE: SANITARY NO. CONTROL NO.
00 ARCHITECDENGINEER: BUILDING PERMIT INFO
BL ELECT PLUMB MECH
J [J 1='l L�
y 2 LICENSED CONTRACTOR'S DECLARATION lob Description
i z:G 1 hereby affirm that 1 am licensed under provisions of Chaprcr 9lcommencing P
whh s[[co�nn]ono)ar Di�ia;nn3orme Bnrir�.�a Pmressianscme,.na m11 y license REROOF.
+xls6 is infiu&XB ane /' " T/O SHAKES, INSTALL OSB & 30 YR.
O e Licenssoo44llus Lia.p
oayrj - SDECanMC ar 30 YR. SHINGLES .
1¢LLO I—ii ARChall ba a DEC A ON
any � I understand my plane shall he used as public rtcoNs
i a p O Licensed Professional
OWNER-BUILDER DECLARATION
R 1 hereby affirm that 1 am exempt from the Contractors License law for the
C?< following reason.(Section 7031.5,Business and Professions Code:Any city or county
F S O which requites a permit to commuct,alter,improve,demolish,or repair any structure
a�i3$ •prior to its issuonce,.lx requires the.pplicam forsisch pemat I.fileasigned natetrcm,
that he ii liceruad punumn to this provisions of Ne Contmet&&Litems law(Chapter 9
(rommencing,with Section 7")of Division 3 of the Business and Profe Cade d .f I q'- n s "'� - ation
S F[�FloorArea�
rnyvi ) ,.i.`.•. tw.'Se..). s_ ;�;�' • $65�b'
ar that he is eumpt thercfrbm and the basis for the all gad exmieioii Any violation
-of Section]031.5 by any applicant for a permit subjccu Ne applicant to a civil penalty- Type
or oat mars Nan five honored draws tasom.
36 'bvCk93b�f0 Occupancye
❑1,as owner of the proprny,lir my employees will,wages as Nair sole comiatmatinn,
will do the work;and the structure is not intended or offered for late(Sol.7654;'
Business and Professions Cada:The contractors License Law does not apply to an 305 — FRAME Required Inspections
owner f property Who builds or improves thereon,and who does such work himself
.1min®r
o
or endl r his own employees.provided Nat such improvements are not intended or 307 - INSULATION _
arnpleor'cele. xerbuilr,theWildingmurdenofprovnsthawithinnotycldof 6Ol — ROOF TEAR OFF . •.
compldion,the ownervbuilder will have the burden of proving that he did not Wild or
improve farpurpaxaf,da.). 602 - ROOF PLYWOOD NAIL
_ . ommu _
Olsmowner of the property, exclusively contracting with licensed The Conform,', — ROOF -BATTENS.. •. i�!' 'I '.'
construct Lathew
project(Sec ]044,Business d my w ons Codc)The Co Branco a :
License law does not apply man owner of property who builds or improves Nermn. 604 — ROOF I N-PROGRESS'
c 'e „end who wnuacn for ouch projects with a.conwnar(s)liceved wmm
Pun . ahe .. .... .. . .. .......... ._.. . ..._._ _. ..-__._... . _
01 las nils License Taw.
1 am exempt unser S.
';B&P C fortis ream. ! ,
=a Owner. . , Data '. E®
_ WORKER'S COMPENSATION DECLARATI FINALON �o
I hereby affirm under penahyofperjury one of the fallowing ded.Wbmo : rt
❑ 1 have and will maintain o Cenificmc of Consent to self-insure for Worker's APR 0 1 2002
Compensation, as provided for by Section 37M of the Labor Code, for the
Performance of Ne work for which this permit is issued.
'- ❑Ihave and will maintain Work at"Complained..tax..ree,ssW,.ihedbysac'ion BUILDING37W of the Lator Code,for the performance of the work for'whi<h Nis pewitis
Cera y c ¢Cnm s t "nd Pobcy number arc'
' rasa d M �Wk( �pe n rate :rte
f [6f (_(titer V 'Oslo) 1
RTIPICAf10N OP EXEMPTION PROM WORKERS"' 1'�r i a t..�t 7. ., _t�.,C, ,
(This scciibn need'a-'be completed if the .it is for one hundred dollars
(51001 or less.)
o;,1 1 c employ
Nat in the perform tt f the ort for which Nu ct to the An Workers 1
shall not employ any Person to any manner so m to become subject to the Warken
Compensation Laws of Celifomia.Date '
NOTICE TOAPP
PP nt "
APPLICANT mnkin6lhsC nifwroofEe prion your should
Z become subject the Workers Compensation provision;of the labor Code,you must
Q 0 forthwith comply with such provisions or this N mii shall be deemed revoked.
�" '• CONSTRUCf10N LENDING AGENCY ' ' '• n -t'.'. '
F r " 1 hereby affirm shot Nero is a conswnidn hoeing agency for Ne pertotmance' n
> of Ne'workfor whicti Nispennit is issued(Sec:309],Civ.C.);_ "'
P,°=�; LenJc sAdd
'V'�" 1 ccAfy thot 1 have real this application and¢mm that the above
ran is
�T+.[r correct:I agree mpnmply wiih,ell ciry and county ordinances and amm lows relating
.0" to building conswction(.nd hereby aoNonze reprcsenmtives of this city men ter open
� rJ] the abovememioned propcny for inspersion purpoxs.+
ii (We)egra to save;mtlemnify end peep harmless the City of Cupertino egeinst
rp li.bilities,judgments,costs plod nperaus which may in.ny way accrue egeinst said
.U 7�. City consequence of the gmnang of Nis rat I " ' -.:
CANTUNDBRSTANDS AND LCOh1PLY WTTHALL NON PO INT"'
uP R�ruLAno g ..3 -f�— Issued by: Dale
si re�atA�cam1Ct - Data" Re-roofs
esd HAZA US MATERIALS DISCLOSURE
Will Neapplicanto future building poem arm m.handle hainabi mallaim -Type;Of:ROOF .. ...
.: . .
efined by Ne C pens o Municipal Code Chapter 9 13 a d be Health ad Safuy - - t
Cede.'Sea 255320) / t e '.', 5 (1 ,- f 5 i t •. .
❑Yes ',�• i� oyi( '' E is s s µ ^t(r art -
' ° All roofs shall be i' ' ted.prior to-any_roofng,material being-installed. _
.I Will In apPil as future Wilding occupant seegmpmentorde ices which If a roof is installed'without first obtaining an ins ection; I agree to remove
emit hazard a r coat.- n t def by the Bay Area A Quality Management g P gr
7ietrici7 will comply,with
QI,:
Np '_ P Applicant1.
a_a WdNn dor&serer code Sections 2555 33333e ahl all non po ntrso�urca cegul`acho S A lican[understands,and
f'i 1 have read the hazardous materiels requirements under Chapter 695 of,Ne
•
fommH dN y25534 Iityaemend that _
g soot currcnd he.atenanr Natn is my responsibility tbnotify,Ne
oacupatn of h trqultemcros which must.be t poor.to nsnance of Cmmcne of
anp 15'a Signature of Ap 'cant _ Date _
Usti a r.pthprixdntt, All roof coverings to be Class 'B" or better
m
OFFICE
Building Division
10300 Torre Avenue
jr T� '/ 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.
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 V"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 abo2,—
e policy on reroofing and will comply with this policy.
Homeowners Name: I�-c.,-
Address: �� y (- -e <g�f a AJ V �'
Reroofing Company Name:
Applicants Signature: ate:61,
• Joe Antonucci
(Chief Building Official)
6/25/01