02050132 (2) CIKo DIG DPERONNO PERMIT CONTRACTOR INFORMATION:
1ff4It`'DI)PPR`tSIDIO DR JIM KRAUSE ROOFING PERMIT NO. 02050132
Ot'MMtTY JOHN K AND PATRICIA N 2310 DIANA AVE ACf'5cf�2 )PTI`U2
PHONE: (408) 779-0704 SANITARY NO. CONTROL NO.
G p0 Q ARCHITECT/ENGINEER: BUILDING PERMIT INTO
yu p BLDG ELECT PLUMB MECH Z u L=1 IUJ C J I—=)
QC
LICENSED CONTRACTOR'S DECLARATION
'S�z [hereby affirm that l an,licensed ander of ter 9(commencing lob Description
ra pro,isiansn p e REROOF
?y_rw is is recd«1000) fD'vi on3oftheBusinessandProfessionsCode.and myliccnse T/O SHAKES RESHEET• 1/2 "CDX, 30 #FELT
Y J is in fall IrV and a I ce /
Littntt Cla "h"
i LL E.N Dam r_�d� �— cnnnacler j 5 COMP . SHINGLES
ARCHI I LCr'S DECLARATION,/
O 5 I undemaml my plans shall be used as public records
i i
n,LittnseJ Yroleseional
OWNER-BUILDER DECLARATION
I, 1 hereby.affirm on 1 1. exempt from the Cocoons Co :Any c Low for Inc
3< following reason(Section]OJLS.Business and Professions Code:Any city or county
an x O which require..a permit a construct,aper,improve,denmlish,car repair any swmurc
to S pari to issuance.also req theapplicant for such pumiu fl ignMsmmment .. _ __ _
ma .he, licensed pun a t1 IM provisions of dsc Contractor L Law(ChapmnJ r9 Sq.-FC-.Floor Area .• ; , . a anon
Un c g with Section7000)of Division 3 of the Buync. dP fevsone Code) � 'f ,•�\
or that he is exempt therefrom and the basis for the alleged exemptmn.Any violation '
of Section 703 LS by any applicant for a peaul subjects the applicant to a civil penalty
of not mom than rive hundred dollars(5500). Occupancy Type
❑1,d ownertribe property,car my employees endewages etheirsolele Sm.smion,
will do the work,and the ode:structure is not intended ore Law for sale(Secy to a,'
'owner orand property
Who b Code:The rows th or's License law does not apply m an R� fired Inspections '
owner embuildsorimprovesatsuch,andwhod«s such work nedm 307 - INSULATiCJ
ciIhrodghhisownemployees. buildinmalmphImprovemmldorenotone,yaror 601 - ROOF...TEAR,.OFF
-'oRered for tale.IL hbwevci.the building orilnprovemem is wIJ within one year of� - � � � �� - _. .. . .. __ .. . ....._ ...- -.._
completion,she ow nem-builder will have the burden of proving that he did not build or 602 — . ROOF PLYWOOD NAIL
impro.e far lalmna(ir nam.). . .-. -.60.3 ROOF—BATTENS.. ... -_. .
co Lasowner thefirthe p(Sm.lam exclusively gw with contractors
nnla[I,p 604 - ROOF IN-PROGRESS .-
construct the nto nt Ism,]044,Business pro Professions who
ills or The Contractor's
and who
Law docs .f apply man owner of proMtty won builds se improves thereon,
.and whons Licas.for , projects with ammmnor(s7 licensed pursuant m.me __ ._... ..._ .. ..... .. _ ._ .- _. ...-. _. .._._ .. -.._.. -..-._. .._.... - -.
_ 01 in axe Li<cnm Law.
❑lam exempt under sec' � '� '.B&PCfor this reason
Owner Dare
WORKER'S COMPENSATION DECLARATIONF' RTzPatell
"' I hertby affirm under pcwly of perjury,fine of the following dmlamtinnx:
a ° 1 have and will maintain a Cenifaae of Consent m selbfnsure for Workers JUL 0 9 2002
sem/ Compensation, as,provided for by Section TINT of the labor Code, for the ,1
performance of the work fur which Ihis,permit is issued.
�have and will maintein\Porker i Cood'"caiion Insurance,a>required by Seninn
W of Ne L ivu Cade,for the p@rformantt of me work for whmh This permit is �1 III ����.y
iso cJ My Wmk rs C pe. t Inrvr c er anJ Pul¢y h re: V 1.
Career "m
cy n .�-oJ •Gb OO�1� s"'j, S f :3 _ 4/ .)r.^'I ,
q
CATION
OF EXEMPTION FROM WORKERS'1" - - K, - )�• - .I•' I s'
COMPENSATION'INSDRANCE .. ...._----- ---
(Ibis section need not be roinplcted if the remail is for one hundred dollars - '- - I .
(SI00)or lets)
I c ipplathanin the perfoay mann
the work forwhichthis ppmlil e i Warm I ., ,I p.
shall nm empmy any person in any manner so as to become subject m the Workers'
Compensmion Laws of California.Date
..Applicant. - You
.-.. -. . ... ... _ . _
NOTICE TO APPLICANT:IL Compensation
r vision of or Labor ion,youuhmuld
st , -
becumesubjecttothe such pr Compensation permit shall the Labor Code,you muss
z Q
forthwith comply with.. previsions or this permit shall be deemed rcvokeJ. '
Nt. ` CONSTRUCTION LENDING AGENCY
a'5�. '-`1 hereby affirm that theca is a conslruciion lending agency for the perforiaance
fi7a.., of the workfor which lh perms 'Waco(S
y. 109];Civ.Cl
� Leder Na'e' . -... , .. ....,. - .. ._. _. .. .. __ ..-
�.z Lender s Addrtss . , .) . .
V'0 1 cenify Ihm 1 have read this appluntimn and state that the above information is
W..F.l correct.I.......comply with oil city and caumy ordinances and state laws relming
�.V to Wilding construction.and hereby authorise representatives of this city to enter upon
} fzl the above-mentioned property for inspection purposes,
F y (we)agree to now.indemni fy and keep harmless the City of Curti 11gainst
(Z) liabilities.judgments,costs and expenses which may in any way accrue against said V v
V Z City in conuqucram of the great in o permit.
APPLICANT UNDERSTANDS :DS RL'CO . LYMTrHALLN,`)`PO/)/kJ 1' Issued by:
r Date
SOURCE REGULATION$: cS/�-I/ -�'
Signature of Applicand/Coaract Dome Re-roofs /
HAZARDO 5 MATERIALS DISCLOSURE
Will�hc applicant or future Wilding kcupstrat store or handle Invocations mammal Type of Roof
as defined by the Cupertino Municipal Cod Chapter 913, d theHealth and Safety • • I.
. . a ..
Cbdd Section M32()1 ,
•°Yet ` `• �C'"�. :,'. . = �t" .I„ j ' _ _All roofs shall be inspected.prior to any roofing material being installed._
Win the pylic I'or b.micharlding warrant equipment or devices which If a roof is installed without firs[obtaining an inspection,,I agree toa-emove
em t harmandous ina,vionarrimmusdefned by do,Bay Area An Quality Mew.iniacen
Dot'? all new materials for inspection. Applicant understands and will comply with
p °Y f °i`� - all non-point source regulations.
4I antic read the cty Co s mammal 505 23533 Sand Chaptere 95 of h
Calf Health dtosn four Code Seninn 25505 2553a yie,, of I understand the
area Wld gdoanac currently nate tlh tl smyrcp bitymnIII the
armorer,a free rcq�°'� h M1mustb tp anis' f Cnlfcjre of - _
if °".p' // S�` 47—
A/k,
Z Signature of pplicant _ Date
:.. ...
owne,praapindadd—�nr�. . Dad, All roof coverings to be Class "B" or better
OFFICE
.''
g
Building Division
10300 Torre Avenue
Q Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEI�TINO
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 Y4"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: /� L�
���s �n
Reroofing Company Name/:
Applicants Signature: AS Date: -51-2-/ a 2-
Joe
Joe Antonucci
(Chief Building Official)
6/25/01