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02090190 (2) - CITY OF CUPERTINO I I ' I* *"� ^ - ItU11.UINC DIVISION PERMIT CONNTRACTOR INFM ORATION: . wa F ' Bu Ng BECONOMY ROOFINGP:HMIf.$ -02090190 OWV:WA9TROHM 2988 NEAL AVE . APPLICA"-YI!3@t2002 IFZONE: (408) 615-7200 SANITARY NO. CONTROL NO, ARCIIITECfIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH Gm2 0 LICENSED CONTRACTOR'S DECLARATION '=OF Iherebyalummal l tun licensed under Pmvisionvof Chapter 9(eommenoms REROOF Job Description nae with Section 7110)9fDivision 3ofdm Businesimd Profess Cndc.and Ylicenm i.. in full farce and ells, 7� Ly a� s -13 tfes p®L1�_�1 ®® II ����mmraa ZO`avjW LncnsGj'I/.sy__}iI—Connoes II III `�O�a I{�ir�® OZ— Dam_ L Cantmflar CON f I"=—O ARCHITECTS DECLARATION Z,ad< I understand my plans shall be lied as public rttorJs 2�U2 X36 OCT 1 FLLOg Licensed Professional OWNER-BUILDER DECLARATION adua"j<y 1 Worth,aTrre Nal I am exempt from the Contractor's License Law fm the $5000 w_Oe following reason.(Scetion711713.Business and Pn,fcssionsCorm;Any City orcounty BUILDING K m ft. which re,mi a Permit to construct,alter,improve,demolish,or repair any structure _—y most its notaener.adorequires the appli,ant ltormehpermit to file asigneJ.statement < that he isLicendpursuanttolheprovisionsOftheCOmmiLicenelaw(Chaptcr9 3 @t4Dh�t©AQfl Valuation fir$ (commencing with Section Inks)of Division 3 of the Business and Pnrfcssions Curie)or Nat he is exempt therefrom and she hasis for Ne alleged exemption.Any violation of section 7031.5 by any applicant foe a pem,a,uthcu the applicant to a civil penalty or PN Occupancy Type not more than five hundred dollars($sln). 3 07 — INSULATION ❑I.as towner of the property,or my employees wish wages as theireade compensation, will do Ne work,and the swcture is not intended or offered for sale(Sec.]Mt,,Business 6 e im and Professions Code:The COmmclofs License Law does not apply to an owner of 602 - ROOF PL tiTi nS property who builds or improves rhemon,and who docs such work himself or shams his n employees.provided Nal such improvements ars not intended or offered for ale.If. 603 - ROOF BATTENS nmever.the budding or improvement is sold within one year of completion.the owner- 604 - ROOF IN-PROGRESS bander will have the burden of Proving that he did not build or improve for purpose of sal.). ❑1,as owner of the property,am exclusively contracting with lleceecd contractors to contemn the project(Sec.70 .Business and Professions Code:)The Contractor's Li. cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projecu with a contmnor(x)licensed pursuant o the Contractor's License Law. E]l am exempt under Sec. ,B&PC for Nis rcastm Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-inestue for Worker's Campen- 73705 ion,as provided for by Section 370)of the IaMr Code,for the performance of the rk for which this permit is issued. I have and will maintain Workers Compensation Insurance,as required by Section Xof the Labor Code,for the performance of the work for which this permit is issued. y Worker's CCo�mTm action Insurance carrier and Policy number art: mers : ,[td wie Policy No.: O�I'OL/t� CERTIFICATI:OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This.sectinn need not bacnmpined if the permit o for one hundred dollars(511X) or less.) I Beni fy that in the Performance of the work for which this permit is issued.I shall not employ any pe rsnn nany mann tu,a'U become snhi/cllothe Wnrkeri Cnm(ensation \ laws of Calih+miat Data Applicant +1 NOrICE TO APPLI :lr Iter m mg this cni.icate of Esc prion.You should become ind"es m me riser a Compensation pmv ons of the lama Crile.you mml Q Z forthwith complywo such penvisinns or this Permit shallbe decmcd mvnked. Z O CONSTRUCTION LENDING AGENCY (--i I hcrehy alarm Nat Nerc is aconxture lendinF aFcncy lnrthe perfurmancc o! (y' 7 she work for which this permit is issued(See.3197,Civ.CJ {t]Q Lerder's Name r_5 Zcorrects AddressV 0 I certify Nat I have read this application and state that the above inNrmation is0U correct, comply and withall yruthori county OWinmrsof and sum lawtrupongmQ w hiliWing tenured pro and hctehy auNonp rposemnmivcs of Nis citymcnmr upon the ahovc (We)a ce P"'ertysace for emnif an purposes. �" G (Wc)agrm m save,indemnify and keep harmless the Ciry of Cupertino against N liohi lities.judgments,toxo andexpp seawhich mayin nywayaccmeagaioetsaidCoy UZ in consequence of the Fronting of, per APPLICANT UNDERSTAN AND WILL COMPLY WITH AL1.NON-POINT Issued by: Date SOURCERP ULATIO Re-roofs S' nmare o Api lis, tic mmnm am I .ARDOUS MATERIALS DISCLOSURE Type of Roof Will the a plicam or future Wilding decupant sone or handle he aeolm s material as defined by the Cupertino Municipal Cute.Chapter 9.L2.and the Health and Safety Code,Section 2.5 T'av ��-,� t All roofs shall be inspected prior to any roofing material being installed. ❑Yes is 7�- Will the applicant of Id urc building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove emit hoamdous air contaminants as deired by the Bay Area Air Quality Management all new materials for inspection Dioriett E]yd., Nu I have mad Nc had rrtmcnundeChaPhili llcalth"ideery , N1525AJanJ 1551s.lundads noteumendy have it issmyres insibilityu,notifythemxmpanlnlthe myuiremcn¢wti bromrtnitsuaawofacemficatenflx army. Ignatureof plicanSn& D \ Cylion,uramhoriuJ cm a,e All roof coverings to be Class "B" or better Building Division 10300 Torre Avenue ' Cupertino,CA 95014-3255 ` Telephone: (408)777-3228 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 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: Ayo 57-4 UG( vm Address: ` T5 1;eroofing Company Name: 27;" P e Applicants Signature: -2-Date: ?U�D • Joe Antonucci (Chief Building Official) 6125/01