02120040 (2) I� CITY OF CUPEWFINO +, ^
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION
r BUILDING ADDRESS: WING' S ROOFING INC PERMff NO.
7593 PEACH BLOSSOM DR 02120040
OWNER'S NAME: 561 RUTGERS ST APPLICATION SUB DATE.
Aek YAK TANG 12/10/2002
(HONE: (510) 481-3818 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
�00 LICENSED CONTRACTOR'S DECLARATION Job Descri tion
u 1 hereby affnm that I am licensed under povisiom of Chapter 9(commencing P
Z with Section RggB M Division 3 of Ne Business and Pofessmos Code,and my license is
r^< in full fume and p
zo�� Liennac clyr Lm.« ®' 69A��.3 REROOF
Ovz,� Dam n lis Canvaam ASPHALT S HINGLES,•J
G^mQQ�� ARCIHT=S DECL ATION 'C.:�Ij S Ii
K @–t 1 undcruend my plans shall be used as public records 1]lt I
gLL�al!` 1 PYA
3 u. Licensed Professional •
t OWNER—BUILDER D[CLARATION
K20 1 hereby affirm that I am exempt from the CanunsCo :Any c Law for tM
w,.p O following mason.(Salton Roe ,, hor,and Improve,
demolish.
Code:Any tiny or county
$� which requires a permit m cnnNrrwl alter,improve,demolish.nr repair any structure
Fzl: prior to its issuance also requires themplicann fnrsuch permit to Ekaaigued etamment
< In.,Wislicensed mauaintothe povismusofthcConunctor'sLivasclaw(Cover 9 Sq. Ft. Floor Area Valuation
�p (commencing with Section 7001B of Division 3 ofibe Business and Professions Cade)or $3850
$ that be Is exempt therefrom and the bssu for the alleged exemption.Any violation of
Secdon 7031.5 by airy applicant fora permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars($5130). 36611141 . 00
-
❑Lssownerof the properly,or my employees with wagesus their sle compensunn.
wi11dothewoh.andthes t.isnotinwndedoroRcredforsle(5x.7060,Business
orb Professions Codm
e:The Commcrlam
s Uarse w does not apply an owner of 305 – FRAME Required Inspections
property who buildsor improves thcreun.and whodneasxh wants himslfor through his
own employees,provided thatsuch improvement,am not intended oroRered for sle.If, 307 – INSULATION
however.the building or improvement is sold within one year ofeampletion,the owner- 6O1 – ROOF TEAR OFF
builder will have the burden of proving that M did not Wild or improve for purpose of
68le.). 602 - ROOF PLYWOOD NAIL
❑I,as owner or the property.am exclusively comoscung with licensed contractors no 603 - ROOF BATTENS
construct the project(Sec.7046,Business and Professions Code:)TTM Contracmts Li.
ceose law duos not apply to an owner of property who builds or improve.thereon.and, 604 – ROOF IN-PROGRESS
who convects for such projects with a contactor(s)licensed pursuant o the Contractors
License Law.
I am exeCmpt unddelr Sec. .B k P C far thisrecon
Goner •5 7/�-1-4 Data 2 O ^® 2--
WORKERS
--WORKE.R'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I hese and will maintain a Certificate of Consent m ul0insu a for Worket.Compcn-
suon,Is provided far by Section 3700 of the labor Code,for the performance of be
wad,for which this permit is issued.
❑ 1 have and will maintain Workete Compensation Insurance,es required by Section
3700.1'the Lebo Code,for the performance of the work for which this Permit is issued.
My Worker's Compensation Insurance carrier and Policy number art:
Carrier: Policy No.:
CERTIFICATE OF MEMPDON FROM WORKERS'
COMPENSATION INSURANCE
(This action need not Necompleted if the Permit is fmonc hundred dollars oIO(E
or to$..)
1 cenify that in be Performance of the,work for which this Permit is issued,I shall not
employ any person in any manner an as to become subject to the Warrior Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
became object to the Worker's Compensation provisiaus of the Patin Code,you must
OO forthwith comply with such prnvisimn;or this Permit shall W deemed revoked.
z ^ CONSTRUCTION LENDING AGENCY
[–r I hereby affirm that there is a construction lending agency for the performance of
(Y, ? the work far which this peon it is issued(Sec.3097,Co.C.)
GQ -endo.Name
:D z lender's Aildress
U O 1 certify that I have mW this application and sure that the above information is
D. F correct.l agree to comply with all city and county ordinances and sum laws relating to
O V building construction.and hereby au'ola MPM=nutiWI of this city to enter upon the
W shove-mentioned property for inspection purposes.
Ow)agree to save,indemnify and keep harmless the City of Cupertino against
Tdq liabilities,judgments,costs and asperses which may in any way scree agamet said City
V in consequence of the starting of this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
RCERE.pULATIo .
16 li� / Re-roofs
Signet�o}�1 an m m
A' RDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant atom or handle haabous mamrial
as defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
cMe.Scion.25532mT All roofs shall be inspected prior to any roofing material being installed.❑Ye. 0 N
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
emit hasatdous air contaminants in defined by the Bay Arca Air Quality Management all new materials for inspection.
District?
OYcs ON.
I have mad the harardnus maien.la rcquirementa on&,Chapter fi 95 of the Cali kid.
.is Health K Safety Cale,Sedans 25515,25533 and 25534.1 understand thus iftho building
docs not ..in have a anent that in is my maptsmibility,to notify tbe occupant of the
remcntswht hrouabemctprioftoiesuaoceofn Ccnificamof cupan Signature of Applicant Date
caner ar m rP f get Dam All roof coverings to be Class "B"or better
Building Division '
10300 Tom Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CUDC_ 'NO 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
•
S. 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 above policy on reroofing andwillcomply with this policy.
Homeowners Name: N C
Address: - r L (D r
Feroofmg Company Name: I I[ ` S lnf(e, l /Vy
Applicants Signature: Date:L--'
• Joe Antonucci
(Chief Building Official)
6/25/01