02070073 (2) CI Butt OF
UDPERTONNO PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
10711 N STELLING RD T D ROOFING 02070073
OWNER'S NAME: APPLICATION SUB DATE
KHALID AZIZ 3540 MARGATE AVE . 07/12/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 892-8872
t ARCHITEC ENGINEER: BUILDING PERMIT INFO
w BLDG ELECT PLUMB MUCH
LICENSED CONTRACTOR'S DECLARATION
Z 4 to- 1 hereby officiation I am licensed under p ovisions of Chapter 9(commencing Job Description
°_tw wire Senior 7000)of Division 3 uflhe Businesspn�Prnrersions Code.and my license REROOF
mm n 'eaaerr t. T fes, _ 66 � REMOVE WOOD SHAKE, INSTAPP 40 YR. COMP.
M 6 License q Lica
S:
O i t-' D c Comm
G ARCHITECT'S"I TIO
Y S 1 undersand my plans shall be used as pub s records
pO Licensed Professional
so
OWNER-BUILDER DECLARATION
seat 1 family throat that 1 am exempt from the Contractor's License Law for the
tF-a a following reason.(Section 7031 s,Business and Professions Code:Any city mcounty,
C F o which requires a pemsit in eninstruct,alter,improve,demolish,at repair any nmewm `
aim .pdortosliceuodparamrt mmstneopkai offormchmcmiuoicense aw(Chpterst
mmimencirgnsmpursmon,7000pfrionsn3ofthetmnnrsLicenseLawonsCded S Ft..FloorArea
or thei He
with senicabod KK11of the cook
aome.1,pall xmJ Professions Code) r'O l;rk9 . JAc I.I,P Ll'.Z 11 t.`A! a UsallOn
or that Ne is exeMpt Ihcrefm'm'end the fiats for Ne alleged excm'ptinn.Any violation '
-of Section 7031.5 by any applicant fir u permit subjects the applicant to a civil Penalty-
-of aot more thim rise hit asked caRar,(S5m). umber '�. •.L• � . Occupancy Type
°1,as owner of the property,or any employ ces with wages as their sale compemation,
-will'do'the work:and the structure is not intendedor offered for sale(Sec.7011.
Bmincss and Professors Code:Tha Contractor's License law does not apply to m 3 07 - INSULAT 7 uired Inspections' ^
owner o1'property Who builds or improves thereon,and who does such work himself
or immufo nes own employee.. ended tam such imProst is sol are not inanded[
year or 601 - ROOF TEAR OFF
emlmd ran.the:If:however:the Wilding-or- .__ - emcm n fold he did a,), - -r -__ -- - O - ----
g or improv year o "�
'catnpleean.meawner-bnimnwBlnawmebmmetarpmsingthatnediem„nanJar 602 - ROOF PLYWOOD NAI�L� �' t• `
improve fmpnrpose of sate')' 603 - ROOF BATTENS
_ oCa:owerottnePrapnr.aa;exciai�ir�otretingwimuaneJemtacm;ton 604 = ROOF' IN=PROGRESS _.. ..... ._.__ . . .__. . _ _
_ nswct the project(Sec.7044.Business and Professions Codd The Commerce's ,
License Law does not apply to an owner of property who builds or improves thereon, ”
'_ .-rod.who contracts.for such,projects with a continuous) licemaid.pursuan m the
Comm axe pt uncle Law.
'- ❑lam<sempt under Sec. • .B&PCforthisreamn .
Owner - 'Date A F—
WORKER'SCOMPENS,\TION DECLARATION II— A�
1 hereby affirm nder penalty of perjury one of the following Jeclamtiours:
° 1 have and will minimum a Certificate of Consent to self-insure for Worker's AUG 1. 3 2002
Compensation, as provided for by Section 3700 of the Labor Cade, for the
Performance of the work for which this permit is issued.
❑1 have and will maintain Worker's Compicannion Insurance,as required by Section BUILDING
37M of the Labor Cale.for the performance of the work•for which this permit is
issaetl My Worker's Compensation Insurance tamer and Policy number arc
\S' Pr IPotry / i4-a1
t51 ❑ CERTI ICAT NOF F.XEM hRDM WORKERS( f '^ i, - ktsa. t sIr Is,,
COMPENSATION SURANCE Sirs '
•(ITif section need not be competed if the permit is for one hundred dollar -• 1 +
(S 100)or lea.)
_ -- -"''py y any personein any manner,i as to r whiidburn, object m the Workers
1 ampl that m the on
say risme the work for which this 1 e usual,I .` I+,, .t„h��•f; •
Curetrat employ
Curitiba aatinn Laws of California:Date
A,Tt
.
NOTICE TOAPPLeWcxk If.Co making this Cision% e orexemption.you ahaulst •.a
become tonmplyyv lWuch Is.s.ma tion lithe Labor Cale,you must '
z ) pensa Pntvtsmnno
O O
forthwith comply with such provisinre or this permit shall be Jeretoed revoked.
Fa4 ` CONS'TRUCHON LENDING AGENCY - - --' - -
1 hereby uRmt that there is a constmelion lending agency for the performance -
s. •of
nd the work for which this perms is issued(See.3097,Civ.C.I
y.c < N —_. -
foinder,Addre,s .+ I..
U O l retry tot 10- re d m'. ppncat v 't m i n n r f is
4zs t^r courser 1 agree in comply with'II city and county,ordinances and state laws relating
O V to huddng construaionsnd hereby author representatives ofmsesty to enter upon
the aWvenoentloned pr+l+cny for inspection purposes.
(We)ag,mm.eeve,inJannifyand keep ham,lcss the City of Cupertino against
VI liabilities,judgments,costs and expenses which may in any way acerae against said
Q Z City m onset¢nce of the granting of this Permit.
APPLY A;1' INIJI:RsZIN DS AND WI LL CONI PLY WITH ALL IN ON DINT ! ' �*•�
So ug - N 7 �,.,-L Issued by: Date TO
1,101'rI at Appneanbcont Date Re-roofs
As can ti the Cu rump Munici al Code,Chapter 212.
H ZARDO MATERIALS DISCLOSURE
Willtfc upplimnt ser future tem,ottmptn store orbondle nazant material ._.Type..of Roof_..__.__ ._ . . _.. . ___....._... ..,. -"_`-
r p p pand me Health and s'ny,
Cnd OcVe. 25532ta1 t'-°No - t t s f . .s s xi_ � ' {
" - ` Alltroofg shall be inspected,prior to any.roofing material being installed.-
Will life IPPI conot building occupant use ex,ciparican or devices wn cf If a roof is instal led''without first obtaining an inspection, I agree to remove
emit haianda.,air cont nd... Jcfined by the Bvvy'AltAir Quality Management
Divormol all new materials for inspection. Applicant understands and will comply with -
°Y all non-point source regulations.
I have read the nisamous materials requirements under Chapter fi 95 of the
California Health&Safety Code,Sen'tous 75505,25533 and 35534.1 understand that
tithe building does not currently base a tenant,that it is my responsibility to notify the (�
«copmt of th rc mems which must W met prim to issu nce of a 'nificate of /' `-l�V
OeeuPaney. / -
2 Jp 2- Signature of Applicant Date
owmer nr mmorkad agent Dam All roof coverings to be Class"B"or better'
OFFICE - - .
Building Division
,
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
i CUPEPTINO
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: k6jt t A Zi -z-
Address:Address: P o l l N S I e i 1 i cl r1 d
Reroofing Company Name:
Applicants Signature: Date: v /12 /y z
Joe Antonucci
(Chief Building Official)
6/25/01