02100147 (2) CITY OF CUPERTINO `
BUILDING DIVISION PERMIT :`,CONTRACTOR INFORMATION.
L BU D 4)9k NDA VISTA DR YORKSHIRE ROOFING PERMITNg.2100147
OWDMAWRANKLIN 7275 NATIONAL DRIVE APPLICATr61PgIFTR2OO2
IFONE: (925) 484-1900 SANITARY NO. / CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLOG ELECT PLUMB MUCH
pKZ O O l� l�
i 00 LICENSED CONTRACTOR'S DECLARATION IobDescri eon
ZF I heathy affirm that I Am licensed under pmvisinna nI Chapmr 9 fcommenctng REROOF p
< with Section 70(0)(if Division 3 of the Business and Professions Code,and my license is
< in full forte and if L'•
ZOIa4 Licenac Lic.N 7
OZ Date Cnnuzctor
ARC all Ix,TS DELLA r O
� I understand my plans shall he used as public records
OaV
3 a Licensed Professional
Ct=y OWNER-BUILDER DECLARATION
ContrON
to 1 hcrcby Affirm that 1 em exempt from the Comranrns License Lew for the $13764
m_p0 following reason,CSeadon 7031.5,Buxineas and Professions Code:Any city or uanty
e $(<i which requires a permit to construct,alter,improve,demolish,(ir repair any structure
pd.,o its issuance.also requires the applicam far such permit to file a signed smteaem
£�£�<
that he is licensed pursuant to ft previsions ofthe Contractor's License law(Chapter 9 Valuation
C�p (commencing with Section 700)of Division J ofthA Business and Professions Code)or
Nat he is exempt themfram and the basis for to alleged exemption.Any violation of
Section 7031.5 by any applicant for a Permit subjects the applicant a civil penalty of PNN Occupancy Type
not marc than five hundred dollars($500). 307 — INSULATION
❑I,as owner of Bte property,or my employees with wages u their able compensation,
will do the work.and the structure is not intended or offered for sale(Sec.7044,Business f�B( �fa(y
and Professions Code:The Conwcmrs Lt..Law does not apply to an owner of 602 - ROOF PL 1VH7-L nS
property who builds or improves thereon,and who does such work himselfor through his
own employees,provided that such improvements arc not intended or offered for was.If. 603 — ROOF BATTENS
however,the building or improvement is sold within one year of completion,the owner. 604 — ROOF IN-PROGRESS
builder will have to burden of proving that he did not build or improve for purpose of
salt.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
Conswct the project(Sec.70W,Business and Professions Code:)Th,Contractors Li.
ceree Law does not apply to an owner of propeny who builds or improve thcmon,and
wheL .for such prejecu with aconuactor(q liunsedpurauam rodm Convumre iEU
Limnselam Law.exempt under Sec. ,B&PC for this reason
OwnerDateWORKERS COMPENSATION DECLARATION
Iherchy affirm under Penalty of perjury one of the fallowing declarations: ....
I have and will maintain a Cennicate of Consent to self-insum for Workers Cbmpea
sound,u provided for by Section 3701 of Ne Iatur CMA.for the performance of the
.,it for which this permit is issued.
fhave and will maintain Worker's Compensation Insurance,As required by Section
Ul of the Labor CMA,for the performance of the work for which this permit is issued.
My WorkersC en alibn,naurantt carticr and Policy numberere:
Cartier._=•�Poliry Na:G`t T( ^O
CERTIPIC TE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need nut hecumplcteJ if the permit is foron,huMred dollars(SID()
or less.)
1 certify that in the performance of the work for which this permit is issued.I shall not
employ any person in any manner An As become subject o the Workers'Compensation
Laws of C.1ifordo.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Cenilica t of Exemption.you should
become subject to the Worker's Compensation provisions of me labor Code,you must
OO forthwith comply with such provisions or this Pertain hall he deemed revoked.
Z CONSTRUCTION LENDING AGENCY
[—i Thereby affirm that there is a Conswction lending agency[."he pC'rmrraneeuf
IX 7 the..,it for which this permit is issued(Sec.3097,Co,C.)
A lnu`5'Namc
a z Lender's Address
V 1 certify Nat I have read this application and slam that the above infomution is
(•' correct.l agree to comply with all city and county ordinances and state laws misting to
Q V building construction,and hereby authndm rcprcunmtivcs of this city reenter u(nm the
Wabove meminned progeny for inspection purposes.
G(WO)agree to save,iodemni fy and keep harmless the City of Cupertino against
,w Vl liabilities,judgments,costs and expenses which may in anyway accmc against said City ^//&i�
V Z in consequence of the granting of this permit. (/
�+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL N?gLPjNT Issued by: Date
SOURCE REGULATION,
�2 Re-roofs
Signature of ApplicanUContm for Dale
HAZARDOUS M TERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant score.,handle hvallous material
As defined by the Cupertino Municipal CMA.Chapter 9.12,and the Health and Safety
Code,Section 25532(a)''
❑Yes u*`_ All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
li,
all hazallous air minumodan¢as defined by the Bay Area Air Quality Management all new materials for inspection.
istrict? l� '
Yes
I have real the haaaNnus materialsmyuimmenB under Chapter fi.YSof Ne Celifog
ull mg rccentthe
mquircm• +M mus mcl,,,di' uu=- ofeCtnificwuol ... Signature of Applican Date
, Day L All roof coverings to be Class "B"or better
wner oramhomcd cm Date
Building Division
10300 Torre Avenue
e Cupertino,CA 95014-3255
coo Telephone: (408)777-3228
CUPERTINO Fax: (408)777-3333
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 above policy on reroofing and will comply with this policy.
Homeowners Name: _ / iL a/-V�
Address: Z// V 7 —
Reroofing Company Name: 4
Applicants Signature: Date: lel a -7—
is is ..^
Joe Antonucci
(Chief Building Official)
6/25/01