03010028 (2) CITY OF CUPFKI'INO eq ""•` t `' t� • '
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:,
I BUILDING ADDRESS: CONRAD ROOFING SERVICE PERMir No.
10509 N STELLING RD 03010028
OWNER'S NAME: 332 PHELAN AVE APPLICATIONSUBDATE
ROBERT KUNZLER 01/07/2003
PH ONE: (408) 294-7615 SANITARY NO. CONTROL NO,
ARCHITECrIHNGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
O ae2
�Oa LICENSED CONTRACTOR'S DECLARATION Job Description
I Washy affirm that I am licensed under provisions of Chapter 9(commencing p
with Satian7f)( Divimn3 the Business and Professions Code,and my license is
� �, in tun term
der",,. REROOF
ZOe1� Liccnu Class 3 Lic.M f- Z�
Fi�q Dain n,mraetor T/0 SHAKE, INSTALL 7/16" PLYWOOD &
ARCHITECTS DEC A411
�Q9U I understand my plans shall he ureJaip hlieremN.s 30 YR. ELK SHINGLE FINALED
LLai
Licensed Prnfevsional
ol_
j OWNERBUILDIiRDECLARATION JAN 2 1 2003
se Py1<X I hereby tiff rt that I am exempt from the Contract Licdmse Law for the
4600 following reason O,cdoa 703 L5.Business and Professions Code:Any city or county
3 6� which requires a permit to consumer,alter,improve,demolish,or repair any mrunum
�S< pnor to its issuance,also requires the applicant for such parrot o rile a signed statement
F� that he is licensed pursuant in the provisions of the Contractors lice ns,Law(Eupinr9 Sq. Ft. Floor Area MUDMG
(commencing with Secdon 700)of Division 3 of the B uslnees and Professions Coda)or
that he is exempt Nemfrom and the basis for Ne alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN NumberC Type
mol more Nan five hundred dollars uNIIp. y yp
❑Las owner of and p c tions or is employees with weeds az their Sole compensation,
will pr fewon,endo: he,Comisnotintendedurawdo for sale(Sec.7144,Business
and Professions Code:The Convacton.License Law does not apply to an owner of Required Inspections
properly who builds or improves thereon,and who dab such won himself e onhrough his
however.then,ping or improvement Sahimprovem nts.wthin ne our ofdof mpleemd for Ownerr, 305 — FR.A[V]E
builder thehuilthebrenofprovighat ed id noneyemofimprootion,theower- 307 — INSULATION
builder will have the burden of proving Nm he did not build in improve for purpose of
sale.)' 601 - ROOF TEAR OFF
❑L as owner of the property,am exclusively contracting with licensed contractors to 602 - ROOF PLYWOOD NAIL
construct the project(Sec.7144.Business and Profession Code:)no Conuactori Li.
cense Use does not apply to an owner of progeny who builds or improve Nelson.and 603 - ROOF BATTENS
who contrecufie such projects with a Cumuli licensed pursuant to the Commelin"s
License L 604 — ROOF IN-PROGRESS
ew.
❑I am exempt under Sec. .B A,P C for this reazun
Owner Data
WORK ER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of Ne following dechroulm s:
I have and will maintain a Cenificate of Consent to self-insum for Worker'sCampen-
sstion,az provided for by Section 370(1 of the Labor Code,for Ne performance of the
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,m required by Section
3700of the labor nde,fe Ne donations,of the work far which this permit is issued.
My Worker' mnca carrier and Policy roumnher�am:� /� — G a 3
Caricr: Policy Nn(,)_(J I,L_L_
CERTIFICATE OF MEMPf10N FROM WORKERS'
COMPENSATION INSURANCE
(This section need not M1e completed if Ino permit is foronc hundred dollars($100)
it,less.)
I certify that in the performance of Ne work for which this permit is issued,I shall not
employ any person in any manner M n to M1eeome subject n the Workers'Compenation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:IL after making this Ccnilicatc of Exemption,you should
Weems subject to the Worker's Compensation provisions of the Labor Code,you must
OO forthwith comply with such provisions or this permit sball be deemed invoked.
z CONSTRUCT ION LENDING AGENCY
[-+ 14 I hereby affirm Nat there iso maraetion lending agency Orr the smrlornance of
6i M the work lir which this permit is issued(Sec.30S7,Civ.C.)
Ltl Q Lcndcr's Name,
Z
0. Le der's Address
J
J P 1 coney Nat 1 have read this oppilation and bull tem the above information is
0 (r cortcng agree to comply and with all city and county ri imamsf and slam laws relating to
0 U
above-mentioned
end herebyoinspection
purposes.rescmativcs of Nie citymenmr uta+n the
r [k1 aM1nvc-(We)hign property l it inspectionl
(We)agme m save,indemnify and kap harmless thew City of same
against
Uy in
liabilities, of ore
of thisesweicb may in any wayaccmc against said City
V z A consequence of UNDERSTANDS
of this permit.
..r APPLICANT UNDERSTANDS AND WILL COMPLY WI7'li ALL NON-POINT Issued by: Dale
SOUR UL 1 NS. )_�—O�
/ Re-roofs
Signature of ApplicarDao
HAZARDOUS
US MATg ocampSDISCLOSURE Type of Roof
Will the a Cupertino
or(Muni building e,Chapter
stem or handle Health
anmaterial
az de.Section
by the cupeninn Municipal Code,Chapter 9.12,and the Hcahh and Safety
crxld. [:1 Yes 25332(¢)' All roofs shall be inspected prior to any roofing material being installed.
[:1 Yes r)No
Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mit hvardous air contaminants m dchned by the Bay Area Air Quality Management all new materials for inspection.
D'soto?
❑Yes ❑No
Ihave read Node.Sections
M505.2533ensis irand nS ndcrChrkeend an if
Wilding
f.
rias not
rently an aSadnn255(13smyrmu125534.1 un notify me
the Wilding
I/
does nm currently ha.c a tenant.Nest it is my responsinility m notify Ne mcupnnt of Nc
require m hi at he met pnorto couance of a Ccmfiati, Qeap'y. ignatureof Applicant Date
-7-�3 All roof coverings to be Class "B" or better
Owner or emhonzad agent Datc g
. Building Division '
10300 Torre Avenue
• , Cupertino,CA 95014-3255
Telephone: (408)777-3228
*C10 Pax: (408)777-3333
CUPEPTINO
Building Deparent
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.
IWORTANT:
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: /•Cl
Reroofing Company Name: Q—
Applicants Signature: Date: O 3
• Joe Antonucci
(Chief Building Official)
6/25101