Loading...
R-4007 (2)/we ft a PERMIT R- 4007APPLICATION FOR CITY OF CUPERTINO NUMBER REROOF PERMIT INSPECTION DIVISION PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED (408) 252-4505 EXT. 228 WITHIN 180 DAYSOF PERMIT ISSUANCE OR IN DAYS FROM LAST CALLED INSPECTION. BUILDING BUILDING USE )ADDRESS C U CaJ RESIDENTIAL COMMERCIAL OTHER ER'S %HAZARDOUS ROOF NAME FIRE COVERING AREA CLASS EXISTING ROOF COVE ING ADDR S NUMBER OF EXISTING C0 ERINGS PHONE tC� ti I 1 1 CONTRA TOR'S n (C ;/1 TO BE REMOVED TO BE RETAINED TYPE OF ROOF COVERING NAME C Y l ADDRESS CITY a ZII' �/rnn Iv • O - I XISTING w t/ BUILT-UP R F PHON LICENSE ASPHA SHINGLES NUMBER "L tt WO SHAKES LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensee under provision. of Chapter 9 (common m9 Section 70001 Division 3 P).p�f(99.{0.�, ODD SHINGL with of of In. a".ins .nd coa., and mY Iiwns in I ane a fact. 'G 'tel L Licm)a leu Lic,NumOer Vl Date DDECLtor OTHER SSP I n^ OatI -BUILDER OEC LA RATION ` / \ \/ I hereby affirm that 1 . aaemm frim the Contractor's License Lew sty reason. (Sec. Business and Pltar, i n.pr Coad: city .1 PROPOSED countfollowy Or county which permit, o req a permit t0 oli alter, improve, tlamorsucr repair any a, prior issuance, alsure prior to in wen also reown+ theapplicantto BU T- OF !/ ile a sign to rile a •rosea statement the, that hi a licensed pursuant to the the 7000) of the of the Contractor's License Lew (Chaise. (comm enciny with Sacbon pt tion t7000) 3oftand Professions or Ins he is here [ham Division 301 aha star pH S CE fr ..d..mli.d.Cod from end the th Any n .1 S tot the .11 aaampts vt penalty by applicant the ant to applicant for • permit w0ja<n Ina applitent [o a civil penalty ' of7031 not or not more met raw hundred 'h erty, W DS KES ❑ I, r my e.1: owner Of [M1h property, or as [Hair ale pro employees with ti he tenee compensation, will tlr the work, and the structuren$Co is net intended s offered for )ala (sac. Som, Business ane Code: The oomprovesi License WOO SHINGLES f praplom Lm mho not apply toe of property who builds improves memos, who or to nes own employees, provided ,M1rt such work not sanduch roes ed or are not intended or int unn dl for cele. 11, however,oowner OTHER PECIFY) .1 iemen[e building or improvement a fold with one year pr the owner year will have ma burden of proving mu n. em no, Naim or improve for ovines that of build purpose PROVIDE I. REPORT NO. ❑ 1, + Owner the property, s with licensed ,%08 ow c.lu 044. Business an to construct the prolan, (sec. Business Jso entl code The Ira for'• of property Code rne not apply m anowner and doeswho Octs PROVIDE MFGR. INSTALLATION SPECS. or impc ves The outLicense co, wM10 builes orimprove) with and contracts for such projects with J pr a contractors) pursuant t, puny Jo, ,o me Contractor's Lica( Law. Cont amlam,, ❑ 1 .m ..am,, dna.. s.n. e.aP.c. for his owns ppLICATION�DATE VALUATION PERMIT FEE Do,. WORKERS' COMPENSATION DECLARATION " I. �/T /\ BUIIdI I hereby erferm that I have J certificate of consent ,o sell //�� U v tificm. of Work.,. Compensation In+urance, or <eniliad copy thereof (Sac. 38, L.D. 00 �yr✓,. Igg l i Seismic Policy Nb!-i-Va-„mpen�"S:F.4rnvl-FS Car till a c t'i ltal py is w�'[ru�r,Die. Cao. LV/- Total py is mp lion division. I �(N� Applicant �KTE` PE AUTHORIZATION DATE F X`if CERTIFICA"SST--E��GYVO�FGEVXEMPTION FR�M WORKERS' N COMPENSATION INSURANCE C (This section need not be Completed it the permit is for one hundred dol Hip I11/00) or Ism.) ' Icertifythat in the performance of [he work for which this permit is� shelln eo e, 1 ell not employ Person in any manner s0 as to become subject yllwilikk thorkers' Compensationion ion Laws or California. to ma W Dale ant NOTICE NT: 11, this APPLICANT: Biter of Epion, you rCod De<oma su bract ,na Work ori should Workers' Compensationof me o nsati n provisions Lebon edea, i h such rovisi ns man forthwith comply with each provisions or this permit All roofs shall be inspected prior to any roofing material being shall be tl(mae evoked. ed r I cmafy tee' I has rhea mie applecpion ane $Hite that the above informs Installed. If a roof Is Installed without first obtaining an Had if w. correct. I mor.e m ng con with .II hand andher county ordinances and to [action, a hereby fixe proem bof Inspection, I agree to remov II new materials for inspection. iv his city of this city m anter upon the above mentioned property Ipr inspection enter Property �/I purposes. purpo (Wel agree )ave, indemnify and keep ma City of Cupertino ( �1V.3/�/ ���� q_4�� s. t, ane gXPaM( wham may in mY way enema against ., Which iiy SI NATURM�F APPLICANT DATE said ce of i consequence •wisp sem City in <on(arm<e or me granting at this permit. PRE -INSPECTION: PLYWOOD: IN-PROGRESS:- N-PROGRESSINSP. INSP.DATE INSP. DATE INSP. DATE TEAR OFF INSPECTION: BATTENS: FINAL INSP. DATE INSP. DATE INSP. DATE NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION SUBJECT: REROOFING POLICY FOR THE CITY OF CUPERTINO BUILDING DEPARTMENT PRIOR TO ISSUANCE OF PERfvBT AND INSPECTION PHASE. 1. Prior to perruit issuance, you crust agree to comply with U.B.C. standards and manufacturers spec's om reroofing. 2. New roof coverings shall riot be applied without first obtaining all inspection and writleriapproval from the building inspector. A final inspection and approval shall be obtained from the building inspector wheu the reroofing is completed. 3. All types of roof shall be inspected prior to any roof being installed. 4. In order to receive a final, you must complete steps 1, 2, and 3. l,) Preinspection or tear off approval. 2.) In progress iuspcctiori approval. • 3.) Final iuspecliou approval. a.) Operable smoke detector verification b.) Spark arrestor iustallatiou 5. If plywood is installed, a plywood uail iuspecliou is required. G. If any roof is applied without first obtaining a'r inspection, you will be required to remove ail 'rely material down to lire sheathing and a building inspector will inspect all sheathing at that lime. WE UNDERSTAND TILE ABOVE POLICY ON REROOFING AND WILL COMPLY WITH TM, POLICY _. HOMEOWNERS NAME: P ADDRESS: REROOFING COMPANY NAME: APPLICANTS SIGNATURE: • CITY OF CUPERTINO BUILDING DEPARTMENT Rerool/wimeord Cittl of curerti"O SMOKE DETECTOR CERTIFICATE OF COMPLIANCE 1 understand and comply with Section 1210-a of the Uniform Building Code. Section 1210-a requires when repairs to a single family dwelling exceed 51,000, a smoke detector will be installed, mounted on the ceiling or wall in each sleeping room and at a point centrally located in the corridor or area giving access to room used for sleeping purposes. If existing smoke detectors comply, no new detector shall be required. I understand the above requirement and certify that we now have sm Ike detectors installed that do comply. PERNUT NUMBER: HOMEOWNERS SIGNATURE: DATE: • winword/smkdet (n t-11,56 0 (r O COLI - 4 Q 0 -7 W,