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04080247 (2) CITY OF CUPERTINO BUILDING DIVISION PERMITINFORMATION, e ILDINGADDRESS: SECURITY ROOFING INC ......0408O247 WNER'S NAME: PERMIT LSBUEDAIB ONE: SANITARY 0. CONTROL NO. ARCHITECrIENGINEER: BUILDING PERMR INFO BLDG EIFL-T PLUMB MECH pap LICENSED CONTRACTOR'S DECLARATION 77s���,,,��,..,cciinn pprrtt p e 7 affirm that 1 am limed rears provisions of Chapter 9(commencing JOb �I�t1Qt1 _ ■ E tX! with guI Monday fDtWMontIwo lilanumidnde and visions or Ch@,end ylmenci is ■■Ri l�f�`A�Iv,4■nv'f/'/—'YL -_� 1°"°`°aen `S ��fo�y� REROOF W/FIBERGLASS SH Nib zOaunse w Co., — D luntlenund my pinARCHITEC17S DE s shalll he used as public record, SFr /0 2004 388 Uccnscd Professional OWNER-BUILDER DECLARATION BUIL I hereby moo aRtm Ia7 11. exempt from the CamactC's :Any c law for the p O which ng moon.(Section]0316.Business end improve. Wens Code:Any city or aunty s�$ which mquims a pctmic to cnnswcs alar.improv.dcmnlW,fir repair any emnulum ul F?i DING priorm itsmuna.ab"rmuites Ne applicant for such Permit In rile a signed summent €� the he is licensed potation,to the provisions afdm Cenmcmr's Uccoae law(Clopter9 Sq.Ft. Floor Area Valu tion $ (wmmencing with Section 7")af Division J of Ne Businessland Pmmrsiaa Code)or .. that he is asempt therefrom and the bub fu the alleged exemption.Any Noisdan of Section 7031.5 by any applicant for a permit subjects the applicant In a civil penalty of 3 gt bTftllm 41170 0 Occupancy Type rot mom then five hundred dollar(5500). ❑I.uownerof Ulo propmy,mmy cmploytn with wegn uNevsole mmpnation, will do Ne wads.and Nestomme is notimandad oroaered mrsale(Sec.70th,Business and Professions Code:The Conuacmra Ucense Law does not apply in an owner of Required Inspections n propywho builds mirepmwa Neon.end wh.dasoch wort hlmalf ochrough his awn employees,provided demsuch impmwmmctsam notinunded oroRcred forale IC however,the b ulding Or impmswment is to within ora wa of amoplathm.the owner- builder will hove the Wrdem of proving Nn a did sea Wild err impmw for purpose of sale.). ❑1.as owner of the Property,am caclu wely contracting with licensed mmmcmn Its construct Ne project(Set 7044.Southeast and Prof esiON Cade:)The CoavacmrM Li- came law does not apply in an owner of popery who Wilds or imposts chances,and who mmaM for such projects with acerin anor(s)Ilceued person,w Ne Commerce$ License Law. ❑1 am exempt undo Sec. .B h P C far Nis moon Dau WORKER'S COMPENSATION DECLARATION I hereby affirm under peony of pnjury one of the following decloations: I haw and will maintain aCertifieau of Consent to elf-maanc for WOrimesComma- .udue.a provided for by Section 3700 of the Labor Cade,for the perfmmnce of Ne wok for which Nis permit is issued. ❑1 haw and will maintain Worker's Compensation Inwrarea,as myuired by Section 37W orft Labe Cole.for the wrimourceaf Ne work forwhich this pooh is Issued. My Works ripen.don nam carrier and Policy number ye:_, l tinier. Policy No.:;W 6 & CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thb section need cwt haampleud true permit is forone hundred dollars(SIM) or Well I certify that in the performance or in..,it for which this permit is issued.l Mall not employ any peman to say mnner so as m became subjaua dee Workets'Compensadmi Laws of Cslifomis.Oats Applicant NOTICE TO APPLICANT.If,after making this CcNnesu of Eamption,you should became subjm in Ne Worker's Compensation provisions of the labs,Cade,you must O Z forthwith comply with such povismes or this permit shall W dented mwked. zO CONSTRUCTION LENDING AGENCY {lithe work fur which tide e,Vert We aomcal.lending agemv for the perimmanee of Isndcfs Namc parotin b itaurA(Set 5097.Civ.C) a7. z Len dare Address U O I aver,tat 1 haw,cad this application ntl sum that the above i0oma0"n Is U,t" cerrea I agree in comply wide all city and county ordinamv and sues laws mating to - O U Wilding construction.and hereby authorize mpresenudws of this city to color upon the [il a Ww-menlloned property for inspection purposes (We)agree to ret.,indemnify and kap heroines the City of Cupertino against N liabilities.judgments,cola nd gRh'm in oymysocox against aid Cty U Z in coaerri na of the 21041111 of this permit , APPLICANT UND ANDS AND WILL COM LY WITH ALL NON-POINT Issued by: Date S GUL NS. 9 � Re-roofs Si{nawm of ApplicnVCcumncmr Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the spplican,err fusses Wilding muupnt score orhndlc hoaadou martial defined by the Cupertino Municipal Code,Chapter 9.12,and the HedN and Safety ads,Section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed. ❑Ye 1 Will dee applicant or future building occupant use,egmpmeal Or havim which -If a roof is installed without first obtaining an inspection,I agree to remove �J mit hu,odoa air canumim' n JcfneQ by the Ba Arca Air Quality Management all new materials for inspection. District] / C)Yes �Id Ihaw mad the heallous nationals anticommunist unJcrChaPlor A95ofdmWilding nb Hcom&Safmy CaJe,SmMJ end 253N.1unhnmrW NetifNe Wilding /� V Jos nosy Imes• Na It1 mY mihiliay m tmdfY Na oauPnt of du req cntiwhleh to at prior oioo racatinamOroccopncy Signature of Applicant Date oWne,err ati acv<e Co.,aDelo All roof coverings to be Class "B"or better CITY OF CUPERTINO "- ** �•�F�p2`kr �%�" '"�°' ` BUILDING DIVISION PERMIT BUILDING BUILDING ADDRESS: SECURITY ROOFING AIR SYSTE �gMITN004080247 22086 LINDA VISTA PT. OWNER'S NAME: PERMIT ISSUE DATE DAVID & PAT REDTKE 677 KINGS ROW nR/';o /2oo4 ONE: SANITARY NO. CONTROL NO. (408) 971-1777 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION lob Description mF 1 Wrcby affirm that l am licensed under provisions of Chapter 9(comm uming p r< with Seco OI of Di to ofth,Bom Profcaluns Code,mlmylicen is <�EEE6 in full to enelffn ✓✓ ` REROOF W/FIBERGLASS SHINGLES 5'z in r Lie,x n f Cont HTECT'S DECLARPION I uncle Jmy PI Ile tlss rd, �G gn OWN m BUILDER OE CLARATION 1 Worcheymem affirm Net I LS temps from the Contractemom,Co LiArty Law for Nc li:4 whichinguiresa permit 71HL5,Buainer. and Pm.demols Code:Anycily Ormunq $ which inquiresapermit tomummTh Lpier.WProw,deermitt orerepair gany tweWre Fiy pdorWitscensed cram rc to the thovisiosofcant for such pcnn',LBicse,Lawdsuumcm NmWiaccevet Sectio 7 Ute (Chapter 9 Sq. Ft. Floor Area Valuation $ (cat M is exeming pt Satfrom and On Diwision3 of NC Business Profeson.Any Code)of .. Net W u exempt therefrom end Ne bssu for tW allcgal exemption.Any viousion Of Section 7031.5 by any applicator for a permit subjects the ePpfcenu0 a civil penalty of1•s00 QccUanC e nos muin Nen love hundred dollars(M), p y'I•yp Cl I,as owneroftheproil rty,urmyemployces with waguuJeirsole campenuslon. will do Ne work and Ne sesame is not in¢nded orofrered forage(Sec.7814,Business end Pmfuvou Code:The Contractor's Liana Law does not apply W in owner of Required Inspections propertywho Wildsor improves thereon,end who dosasuch work himselforduough his Own employses.provided that such improvements an not intended oroBared(mule,if, however,the building or Improvement is sold within one year of eompledon,the owner. Wilder will new the burden of proving Nat W did not Wild or Improve for purpose of Ole.). ❑1,as Owner of the propeny.am exclusively convecting with licensed Continuous W consumer the project(Sec.7044,Business and Professions Code:)The Contrearm's Li. cense Law docs not apply to an owner of property who build&or imprevv Neuron,and who contacts for such projects with aconuactor(e)11rwed pursuant W Ne Contractor's LicenseLaw. m ❑1 eexempt under Sec. .B d:P C for this recon Owner Date WORKER'S COMPENSATION DECLARATION 7hereby ll ma under penalty n,perjury one ofthefollowing dorlm`s ns: ` Ihaw and will for neCion 37 in of Cores"nam oro.sure fes Workers Comperee v1W\t anion,r provided fPe by Ss issued.3708 of the LeWr Code.for the performance of the work far which thus permit is issued. ❑I have and will maintain Weg eri Compev on Imufence,u myulind by Section 37W of the labor Code,for to perform.. worts for which this permit u issued. ZeY My Wor aL pen Ion In ens ori a Polity num rem: Cr C��PINS N • CERTIFICATE OF EXEMPTION FROM OR ER COMPENSATION INSURANCE. (Thu section need not W completed if Ne Permit is foronc hundred dollen(SIM) m less. 1 certify Net in Ne pefftemamx Of Ne work for which this Permit is heated.10.11 not employ any person in any memnerso as W Wrome subject to the Workers'Compcmatlon Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject m the Worker's Compensation Provisions of the Labor Gods,you mug .J O forthwith comply with such Provisions or this Permit shall be denoted invoked. 'z CONSTRUCTION LENDING AGENCY IWwbY e(Bms Nat Nem is a Construction lending agency for on,Performance of Uj em work for which this permit is issued(See.3097.Civ.C.) Wti Q Lender's Nam° z Lender.Address V Q 1 ttnee Na 1 hove mad this city an coon and tints Ng the sWw information msating is D, f' coma to WildinIgree to comply with all cityand county ordinances Of some lawsr upon gW V Weva-menngrocuonsod hereby ccaummrpems. utivu of Nis city to enter uPnn Nc t3] alevo-(Wdond property finemnify an Purposes G (wc)agree W outs indemnify and keep harmless the City accrue Cupcnit id City VJ inCOitiu,JeCof judgments.costsendeepensea which may in anyway ecemc egelnstuiOCity V z in consequence Of the tinguf Nispermio / APPLICANT U R DS AND WILL C ITH AL NON-POINT Issued by: Date - SOUR ATI NS. Q Re-roofs Sign u o Applican Wr RDOUS MATERIALS DISCLOSURE Type Of ROOF Will Ne applicant or future building occupant mom or handle hmardous mamnal ss defined by the Cupertino Municipal Code,Chapter 9.13,and the Health and Safety We,sec°°"zss32(.)? All roofs shall be inspected prior to any roofing material being installed. oyes Will Nc ePPiicent or future building occupant use cyuipmcnt or devices which If a roof is installed without first obtaining an inspection,I agree to remove curls haaardnus air conuminents u JcfineJ by Nc Bay Arta Air Quality Management all new materials for inspection. DimieR ❑Yes @#� IhawrcaJ Ne WrsNOune 25505. re33 and 5534.1 rCWpthrd.95 ifthe Califon no IMh&Saciy Code.Savour 25505,23533and 255th.Jundcrgand thmifJe WillingJhaw•mane Nat it a my rcupouihility b notify t e_up_,ofthe_h Meet he met Poor tomu nce ora Ccn feats of ttpan y. igna reof ApplicantOaJ agtnt Dae All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue 1' Cupertino CA 95014 Telephone(408)777-3228 CITY 0 Fax(408)777-3333 �UPEkTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: PH NE # GENERAL CONTR CTOR: FAX # I am not using any subcontractors: .I - J �`y1 ►� C Lb` Signature Date Please check applicable subcontractors and complete the following information: 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 r Painting/ Wallpaper Paving astering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile /n ' y /Contractor Signature ate Community Development Department Building Division City of Cupertino ` 10300 Torre Avenue Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 *UPERJT1N0 _- 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 minimum 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. �l J Homeowner's Name: A V j 6 b tk Imo"' Job Site Address: Z Zoo (F7,/ ( _('b,W- Roofing Company Name: A plicant's Signature: Date: =jC�—C7� \N�1DCXl i Gregeel Building Official Revised 1/30/03 Printed on Recycled Paper . an's CITY REROOF TING � a8 oZq7 CUPERTINO PERMIT APPLICATION FORM APN #3 (, / Date: J () v ° � -z - o Building Address: O Owner's Name: Phone#: yb - 5 - Wo Contractor: Phone#: License# Contact: J Phone#: Cupertino Business License#: •� 4 — 2.2 z Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑/ Wood Shingles ❑ Other(Specify) E7 Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ��O�S r\V,VnNe5 ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Polic Job Description: e_ c-\\ as to j; vsj7 dow•t\ +co ebn�qA ghNpayti.t,9 q \c g \ �lz' \ wood .C�o E w c. " R' Residential ©/ Commercial ❑ Fire Zone: Yes ❑ No Confirmed wit Tanning Deept if ~� there area estrictions: . u Cost of Project: Type of Construction: Occupan y rou �— \0 5t)co. rt i ca le Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING SEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING -,7