02080032 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMITCONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10605 LA RODA DR WESTSHORE ROOFING CO 02080032
OWNER'S NAME: APPLICATION SUB DATE ,
PATRICIA CHANG 5869 WINFIELD BLV 08/07/2002
PHONE: SANITARY NO. CONTROL NO.
{ (408) 629-2100
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MUCH
yz
LICENSED CONTRACTOR'S DECLARATION
z 5 EI Job Description
O Z_0 1 hereby a01mt that 1 am licensed under provisions of Chapter 9(commencing REROOF
rr,4 t m with Section]000)of Division 3 of the l cs and Professions Code,and my license
bre Y is' PoI Dice and effect pz ^s -s
ec C< Lic Class ��3 1 c.» (Lf+ l
ayaee'O a.G DatC Ar
F pTRCHITECT'SW� LARA 1 1 (Y-k
Sa 0 1 undersand my plans shall be used as public recoNs
til p O Licensed Professional -]
OWNER-exempt from
the RATION
u I hereby mason.(Rim that 1 um exempt from the Conions Co :Anye Law for the
?< following mix, (Section 70315,Business and Professions Code:Any can or county 613711
F❑ wh h q ire a perm t t t ct,alter,improve,demolish. r repair any sr emrt '7
a3Po -p t ,'issuance, I g rethevalm"ntfor suchment"LBense Lassi Bbstatement
that he u'came"
pursdant to 0 pmvigions of the Contmno(s License se law(Ch pt 9 Valuation
(coin 'ng wi(h Section
700 um of Go'sion J of the Business and
Profession
Cad) 'k�'s 7�J t 6, I3Fl,3�g 9°.:,F1 P,g f _<j;1 �•¢ Q,
or that he is exem�it thercfrom'anA the buses for the ellegetl,cxemPuon.Any nlolaulon
porm,
—of Section 101 LS by any applicent for a permit sabjeen the applicanuo a civil penalty
of not mere than five hundred'ohms m.) t 3 0 5ALN Occupancy Type
D I,as owner m the property,or my employees with wages as their sole compensation, -107
"mended or offered for sale(Sec.-7t W, —
"'Blind 'tM1 'work;and the structure is - - '-
iB P
'rtes,and CodealThe Commcmr s License taw does not apply to an 601 - ROOF TEA>5R13 Inspections,
owner of property Who build.,or improwas thereon and who does such work himself 602 - ROOF PLYWOOD NAIL
or er for
h' f,employees.providedin that such pr mPent is sol rentintended ._ .._ ._. _._. ------
completion,
_ _.___._ .......
:bfftrcd'fonsale.'If;h the wibudding Pr Semens , old wthdone y bf - "----- ' "- -
603 - ROOF BATTENS %'t•
cmnplption,the owner bu Ider will have the burden of proving that he did not build or
improve for 604 - ROOF IN-PROGRESS
r I as owner_r the (Sm.
7 am exclusively contracting with da:)Th Contractor's to
_ conswci the project(gee.]044,Business and Professions Code:)The Commreon,
License Law does not apply m an owner with,
property who builds or seimproves thereon,
". .,and.wkens farsuch PmlecLs.wuh a.contractor(s)licensed pursuanLto the _ _.. . - ._... _-__..._.._ ..._._. _._... ...
Contractor'sex pt on
S
::. p c��B&P Cfrthis reason ,
❑lam exempt g
= G wrer D,e SEP 1 0 2002
OT R� KERS COMPENSATION DECLARATION
1-1
I hereby affirm under penally ftvomiry,me offfiefolloavir,declarnt o
/' • ° 1 hove a id still m rot in a Certircatc of C.nsieit'm allpitisture for Worker's BUILDING
t,..,
Compensation, as,provided for-by Sect 37M of the-Labor Cobe, for the
performmice of do work ho which this permit is Issued.rl
..
❑I have o d will'm rain Worker)Comp s tion lin rtq vad by Secu.a
3700'ifthe Labor Cock,f she,performand of the"work f r whl h'this Permit is
C MyWrkeisC ii,puomece cgrrier �ICY by e:'1 � y„ •,
COMPEN .]4k'h1�000�kT l ..- .. _ .....
P n n
B y Z f y- n
CBRTIFICATfON OP,EXE0 N PRO WORKS 6 �. t .+. Y ..x. ,.'.t k' ..of,,
SATIO NSURANCE a 1'
......c . ,�. >.. ...
+: ..__..
(Thtssedtion need not becompleted if the pcimnis for one hundred'alio, i
1$100) ries less.)
1 c mf'hat the n n an o f the 'k f whin Nu Perls t o ke 1 1 .p;
yy
'shall c inho, ows Pe o any man r s as m become ub)cn to the Workers', -
"C rope au n Lows oFC I f rola:Omer
Appacturit
becomeNOUCTO APPLICANT If Cmaftemaking im, Certificates f ofExemption,oal you should
+•,
become subleci to th W kel C mpensauon Provisions of the Labor Code,y i must!
0 forthwith mply with such provisions it perms shall be deemed revoked _.,....,, - -.,
r. 0 ...II .. .-.._ ...
� ._
a, CONSTRUCTION LENDING AGENCY
r
I h by alarm hot themmin mica n lending agency farthe Itrf'r t. l
int Q
of th k for which thispiano,'.issued(See 3097,Civ C) - `
—L dr'Name .,.•.... ..t, r..,..:' ........ .. _...__.-.- ._. _....
F ., 'fstl ,Add .. _.. . . _� _..... .. - ._.. ..._.. ......._. .
V 01 canary that I have red this applicationand state thanhe abuse intina t n is, /
:U t.•i correct.l agreet comply with all ciry.and county ordinances and state laws testing
�-V Imbuilding co t u n and hereby authorim,npresenfiniviasfth'city,to em r port,
;rhe.1arle-ralmi.madp e.ony for inspectionkepuha sec
(W)ogre't e d roti pe and keep hamay i the C ry of o p ngai ga said
!A Cliabilities,)'gine sa e tl pence which y, any way sconce,ago d said
V Cry sq c or the g nt gofm t ..
AP[LICANT UNDLRETRxOS NO WILLCOMPLY'WITH ALL )N-POINT
SOURCE REcutinnoNs17, /; --)_O Issued by: Date
t of Applicant/Cont pm ':'' ;Date Re-roofs
-HAZARDOUS MATERIALS DISCLOSURE i
,;. ` W II th PPIi ant f mrc M Iden accu nt to h nAl hnz
as def d by th Cup n M ipal Cogd ChIwapter 9 12 and the H b❑h"uasnewwritil Type of Roof. ..... ..,
ad Safety . t . .„....
'Cod Sct on 25532(,) 1:, i 'r a' 4 f-1 1✓ sl
All roofs shall be inspected pri6.to.aay.roofing,material being installed
wnthP PPI ant rrJi r2,buildmgacupantuseteywp a to eas which' If a roof is installed[without first obtaining an inspecti6thiTagree to:remove
I deli ed by the Bay Arta Air Quality hlanagemem
em t hoz d s au comammi t as
I n e reaall new materials for inspection Applicant understands and will comply with
all non-point source regulations
95 of the
tf the ns Itling Jx the hazaMou maienal reyu remenisund Chapt r 6
.DecoP ant of the r&$ f ty Co'e esio 25505 25573 and 25534 1 understand that
i Y
s plot currently hap a s sans that it s mY respo b I ty to not fy rhe / ns
egmrcme r wh ch'mun heane11 t PH.irI tuatice f n Cenlficate
0 y dY: i i.,.
S ature of Applicant at, _
rte arrhonaea gent y .,flea, All roof coverings to be Class B or better
.-,.OFFICE,.._. _..
.. _ .,
Building Division,
�. .
10300 Torre Avenue
Cupertino,CA 95014-3255
` Telephone: (408)777-3228
= OCIO Fax: (408)777-3333
CUPERTINO
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 Y"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 abovepolicyon reroofing and will comply with this policy.
Homeowners Name4- Pc�,�dl GC e�
Addy: _ 6605 LO( t�okc� , �c�Po✓ ���8
Reroofing Company Name: _4 �4e-3�Slno l2 F-<3 o �c.v\,@ J hC
Applicants Signatur�M� Dater ��?^6Z
Joe Antonucci
(Chief Building Official)
6125/01