02010063 (2) OF
CI BUILDI G DIIVIISSIIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS. PERMIT NO.
` 7571 LOCKFORD CT MARCO ROOFING 02010063
OWNER'S NAME:- APPLICATION SUB DATE
RON CLEMENT 43230 OSGOOD ROAD 01/15/2002
/ PHONE: (510) 656-6400 SANITARY NO, CONTROL NO.
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O m z ARCHITECi(ENGINEER; - BUILDING PERMIT INFO
O BLDG ELECT PLUMB MUCH
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LICENSED CONTRACTOR'S DECLARATION Job Descnption
Ihemb a)ofDhmla3oftheBusinensed under provisionsofChapter,Code
COMP INSTALL COMP SH
fN ta with fell for000)of Dirisinn3of the Business end Prufesaiou ode,and cry license REMOVE TWO LAYER OF /
i ce E 3 is is fun force and ercpp[[ll p
:C <� License li 1 Lic.N l a �1'
:O� Date C—� Contactor
t a ta ti. ARCHITECT'S DECLARA ON
.5 1 understand my plans shall be used as public records
:nor-
i Licensed Professional
un� OWNER-BUILDER DECLARATION -
1 hereby 15sc that 11, exempt from She Contractor's is License Law for the
t i following reason permit
t "caul.5,Bnslt er and improve.
de m demolish.
Code:Any city or county $4510
I O is,rim requiresapermit toconstruct Iter,improve,demonin ore a mrany nmcturt
..pnoS 1 uarnce,also q the applicant for such pemSnoBleasigned seamen
(lint mencin sed Section
n m the pro i.Division
Ne of the Bncm/s and Pr lfew ons Code)
�`r., pp��xt����qqT�•q,�@g)�T y t 1 Valuation
toomn be
cfeing hSect 7000)ofthebHonatthe Bt"Id'iand Professions Code? j,��Y•x ti3iC�L tlCY,41L-•jt7,V y41s,k_�•� t�•' ' '
or Shut he is exempt.ey.p,li and the bays for the alleged eilmpoam Any l roman
-of Section)031:5 by any applicant far a permit subjau Ne applicant to a civil penalty ,�,6�� p
ofSmpthan
mnrenwananaueeanma(ssm). 30�xPN �'tC'HI'rlE •' Occu ency T'yp e
°1,asrofthe propeny,or my employees with wages as their sole compensation,
will'do the work;and the structure-is not intended or offered for'sale'(See.](Wq
Business and Professions Codve
Code:The Contractor's License Law does nor apply to an 601 - ROOF TEA64tiO lBrIspectioiislit
"-
ownerofpropertyWhobuildsarimprovestMreon,andwhodoessuchworkhimself 602 - ROOF PLYWOOD NAIL
or through his own employees.provided that such improvements art not intended or
-co
offend(a,tale:If.however.ildethe Il adwt admen of porsntold withinone year bt
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completion,the owntt-builder nava the burden of proving that he aid not Wild or 'n
improve for purpose of sale.). 604 - ROOF IN-PROGRESS
°1”as owner of the pmpety.am exclusively contracting - � -- _
with incensed a Contractor's to I:,,r ,.. t n
t c License
the project(Sec. to a Business and property
who
Coiter)The improves
tmrear.
..: and wh Law docs not apply to an owner with
propcnY woo builds se impmwes thereon.
.endwhon's Livens or Low,
Pmjass witheronpactortq.licensW Wmuam.m.the
' Contractor's License Law,, _ .. ._ . ...
111 am exempt under Set.' ,B&PCifordis reason
Owner Date F E B 15 2002
WORKER'S COMPENSATION DECLARATION
I hereby dorm under penalty of perjury oneof Ne following declarations: BUILDING
° 1 have and will maintain a Certificate of Com.s
nsent elf-insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work far which this permit is issued.
17"1 ave and will maintain W'orktt's Cumpenmtiohlic umnce,m required by Section
E]00 of the Labor Code.for the performance of the work for which this permit is
issued My Worker's Compensation 1 Insurance carrier Policy numbe a
�.. _ ....,. . . r.. _. _� ......_
Ce�'i s�� ' �� `Pulic No �- �Q 2� �.� .r i'1 qq 1 C`Fia ♦ m.:al{:1 .t,.t
'CERTIFICATION OF E(EMP`FION FROM WORKERS:' - 4 ! I'i' L Ov ek'i,. x i ;
COMPENSATION INSURANCE.
s'.• ..___.._.__.___ .__.—.
. . r1 .
('This eectiori tired not be compined if the permit is for one hundred dollars '• - S r'� f' t ',:j`Y 1',Is b
($1000mlem.)
I em Shat in she perfo arme of She ark f h ch this perm s n isaucd,I U t .. .•• 1'�
ihall rad employ-
any parson in any manner sou to become subject to She Workers
Compensation Laws of California.Dart
Applicant -_ . ..'... .•.:_ _ '.. _. .. .. ::. _ ._.. ... ..._ ._ ,... .._ .....
'
NOTICE TOAPo the Wnilin's OMParater 5miming p Cenincan,sof or Labor Code,you
youmuld' , .
becomeh comfy with
such pr Compensation provisionsdlthe Lamar Code,you must
Z 2 forthwith comply with ouch provisions or thislwnninhall bedcemed revoked. '
' 1-111.1--' 'CONSTRUCTION LENDING AGENCY I
I h by.flim Sha,thein m a cbnslmci on lending agency fm tine perfnrmm
r.n
' c
Q of
Leno k for wh ch th p S . slued(Sec 3091 Crv.C)_ -
6t der,,Natfie..o.., ....,. ........ : .::. _.._ _. ......,. . .. .... .. _
t,Z Lentle .Add s -
C.7 0 I fury
dean'
h I d thisapplication unit sine that the above fommmo is
far t..r c'orrtct
Is
to comply With all city and county ordinances and tam laws relating
to bald g nst t n ndh hereby eurho urcp smduves offing cty)o enter upon
y,W the mis e n e S led Property for inspection purpose
[L. yr (we)ogre S .a udemmfy and keep hariress the City ofC pe too against
VJ liab I t s judgmenu,c sa mod expenses hmh may' any y ccme agamn said
V z Ciry m nscquence of She gram g of s perm t I/
'APPLICANT UNDER$TANDSA , vel i. r N'RI ALL N�jONyQ Issued by: Date
SOURCE REGULATIONS rM_ t Issued
Sign vete of AppliwnUCo wnor Ua '- Re-COOfs
' ,HAZARDOUSM TI:RIALSDISCLOSURE
W:II the
applicant or forms Wilding acupant stole in handle hureadmi,matdd Type of Roof -
as defined by the Cupemn Mamdpal Code a t 9 12 and the Health and Safety x . _. ' t,
Code Scunn B5 2h41 s tl t 4rr1 a " i.a'•, ilJ�.� f �2y sl n( . I ;s}• .� _.••n•-.rr x. Ural ,t•. _. ._
°Y`a .-ATI roofs shall be inspected pnor,to.any roofing material.being installed.__
Will theapplicant future budding cups t sa eqa pine to device, hien' If a roof is installed without first obtaining an'inspecti6n,'I agree.to remove
emit hazardous air contaminants at defined by the Bay Area Air Quality Manage ant
Di:wen"• all.new materials for inspection. Applicant understands and will comply with „
°Y' ' ' ,al oo all non-point source regulations.,,
" I
have end the honrdou.'mamriils requ rem ns umtl r Chapterfi 95of the '
Cali knoll alth&SeelyC deSections 25505:25533 and 25534.-1 understand that �c+
iftheWldng does at currently have renenT that yresponsibility to notify the _11
�._ �f'7- ,QrZ
occopant of the requirements which..at be met Pnm m issuance of a CeniGeam of
Oce Piney
r _ Signa[ureofAp lican[ Date
_ _ .. _. _
ower a
Data All All roof coverings to be Class,`B" or better'
µ: ..
t: L OFFICE.
y Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY40 Fax: (408)777-3333
�UPEkTINO
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 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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: /
Address: .757 1 �-�i 6L CiII
Reroofing Company Name/:: /// altzlo 2&il�gIf 0
,
Applicants Signature: O — U Date: O 2
Joe Antonucci
(Chief Building Official)
6/25/01