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02090146 (2) ;CITY OF CUPERTINO - sufLDtnG DIVISION PERMIT CONTRACTOR INFORMATION: 'lbr "MLA CT OLD COUNTRY ROOFING PERMIT6 ,090146 TiMlV'AnHN K AND YUN W 125-B GROBRIC CT APPLICA]IfjN� S7R 002 PHONE: (707) 864-5557 SANITAR1Y7NO.L l// CONTROL NO. n-O ARCUICECDENG[NEER: BUILDING PERMIT INFO ❑ BLDG ELECT PLUMB MECH mZW L1 C= Z8yi LICENSED CONTRACTOR'S DECLARATION JobDescrt WALE® o z y i nemby slam mn,1 am licensed ander,owkion..f Chrpno 9 commencing REROOF F=tr9i with Section 70W)of Division 3 ofthe Business and Professions Code.and my license as ¢m lull forceand�gt z Z 73i DEC 2 7 2002 6 o.tap V License Lic,a C Dam a Commmor _ ARCHITECT'S DECLARATION - SI understand my plans shall be used as public records ad 0 Licensed Professional BUILDING a a OWNER-BUILDER DECLARATION el='�` I hereby af0rsn that 1 am exempt form the Convac,or's License law for the $15(] F 200 z< following mason:(Section 7031.5.Business and professions Code:Any city or county SCG co consumer, hnrr improve demol:.h pr Yst Imre which q permit n3^� pct t uu acct ,also«qu m,PP n,.1 'on'suchp'on' fl "'Po" summem. that he ehttnsed pais antmme pronsions alma Conuanor Lttme la ICM1apmr9 3,5 S�j1-5061@orOyDea, v Valuation ( tan yywnns.ztn t��xxu,roini:nn3nrme Bnfrpeganer is civil �;{,p,,,'V ,-tris-.tv:r t i11:M�f-,A.O:+.. or that rc i}2kerapt I co, 'cm and me basis for,he alleg J esemptiun.Any viola0nn - I -of Section]031.5 by any applicant her a permit subjeco dre applicant m a civil penalty of not more than five hundred dollars lS5000. 305APNYaAME Occupancy Type ❑I,as owner of the pmpcny,or my employees with wages as their role contpensarmn, 307 - INSULATION -will do mework.-rand-the Stmctm is am Intended or offered for sale(Scc 704T - lCe �In eclions Bu d P ores C l 'The Cnmme or s License Low does not apply to an "' owner of properly Who Wilds or improves thereon,and who does such work himself 602 - ROOF PLYWO D NA g L or through his own employees, budded that such improvements within not intended or .,_--__ •_ - slriedroranlz:Ir.huweven,renalldingt;rimPravemen,tsanle'wimih6n<y<a<ar " 6'03-' — ROOF—$ T ;.�;.� a :nvr'a%F.�o ompletion.me owner-Wilder will have the burden of proving that he did not build or 604 - ROOF IN-PROGRESS improve for purpose of sale.)i pI,es owner of fine propenY,nor cxclusivclycontracting with licensed contractors m 't ,1�'`^p�'.�'Ii".�•'. construct the pmjw(Sec.70JJ,Business and Professions Ccdc:)The Convactor's L,Cb .E<'1 pi Ir _ - License Low does not apply to an owner of propeny who Wilds or improves thereon, n tray License f Scc rls) hcensed pursuant.to,,he. .....- ... ......_._. _-. _..,..,___.......... _and, crmc wens for.such,pmlens.w,h t m C ansa Law, _ t. i ^ ❑1 a mptu UC" ,'B&PC for this t6� Owns ,Doie• . ..:,. .. WORKER'S COMPENSATION DECLARATION . . i,vr I hereby affirm under pcwl,y of perjury one,o(the following declarations:-- :! 0,1 have'and will mhlntain a'CeniOceie bI Consent ui sd4insure for Wotker's Compensation, as pmvided-for by Section 37W of the Labor Code, for the •perfoiniancebf the work for which oris permit is issued., 191 bye d'wlll'ine m Worker%Co pe i n Insumme,as rtqu ted by Section _ 37M of the Latin,Code.for the ki-fommnce of the wok'for which,his permit is No d My�W` kces C p, , n l m c me and Pol y be ere. - )Cam � (policy No:'(LL� �� F•-y: •I / s 11 �'ti.a.rhli ' If Y CERTIFICATION.OFE%EM"IGN FROh1 W RK RS fJ.A t C /,'ti t V I. 1 N 7 'l.i.'.. COMPENSATION INSURANDE (fr 7sediodneeJ nm W JomplemJ f ted Permit is for one hundred dollars 1' \ I t' • , l 1^;';'.^I',P,;i • 1 , t Ib mf mvi in,ne rf rata a of m k for wh<h m' t s u ed..l a I .. pe pe ' Ins Illnrn emP.loy u!IY Pe n n any m s m bchonm subyct to ma Workers C pe': t Lo" ,CII fi'(e .APP icant ..... 1 .. ...._. NOTICE TOAPPLICANT it uer'mak gats Ccuil care of Exempton,you'hold v "'• �'O " ticconie si:rjen io the Workers Con;pmuu,inn pnSvisions of the WM1ur CnJe'ydu must Q 0 fonho hot', crmalu,wire such provisions or,his permit shall be deemed revoked. s2.e� `i CONSTRUCTION LENDING AGENCY : - - ' `' the by ffivn,h t,h aeon true on lrnB'S by 'yf h Rfmianae ' >, of use work t -whicM1m pc t issu d(S l09] Cv.CI " 1 WRQ -I.ender'a Name•.•.. .,�_• . . .....�.., __ _ _ _.__ ___._._ . ._. _.._ _.__._. .— __...._ _.. _._ �}_� _. _ ._. ._. .._ -.. rider a Add r- UO T, } I ten fy,M1m 1 he read m. ppl ca, nd sus,h t m base mfammuon isks.F o r , I g 1 pIY th all city d ty d ¢.ad.,, smlafng Q�J ooWld g wiio ndh rthy sum n! -tat ve.9fmnn,y,oenter upon is ids a mcnn me p.,P nY f^r insp n on a cs. k`...a lWe)agree d mfy and ke ph: inlesx th City or Cupenino agm a - L tq lubili,ies,jadg ,encs J expo xs may in any way uccmc against vid City ib'conse cc of ghmin fm' it. ,iRPC1C,\ ND COMPLY Tr LL No- or Issued by, Date signaiurc of Apphcn� novaem,; '; :'!.•1 . :.Date Re-roofs AZARDOUS MATERIALS DISC SURE .. �; wil'rhe pplim t f t re Wddin , t handl iraratmn.mat 1 Type.of as defneo by the h CPnnoM iced Chapter 912,andthHealth andsfety' Code 5 t zssy2l ) ," ..t : f' .f 39t t -i" Ig,.w..11-,p ❑Yea ❑"°x' ' `' I All roofs shall be inspected priorto.a offing materia] befog installed.___ . Pr.. a Y q p Q yManagementIf a roof is installed' out firs[ob rot an inspection; I'agreB o remove Will the Icn,mft M1ld t .ee t 1 'ce which em t h mrd it o f t. d fi the B Are.A Il D mat all new material or i pection _ cant understands and will comply,with - 1 ❑v , ° " all non-point s rce gulatiot ' .it I I I lose read he h6andmi,materials 9 mem. taids,Chapter 6.95 of,he C rr in p Health&S fcty C de Seainns 25505 3533 nn 125534J rstand that if the building does not currently have a tenant.that it is my responsibility to noufy me - / L� - 'uccupmt of the mqui¢ntcma which must W mei Prior to issuance of a Cenifcatc'of 2. Occupancy.„q Signature-of Applicant. Dat,(— .. M Doc All roof coverings to be Class B”or'lieiter f Owner nr aumonzcQ agcm. f -OFFICE - ...-— Building Division 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 CUPEkTiNO 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: v (A 5 1 L- Address: 0 �C/1 Le-i C1 i Reroofing Company Name: C © Cit Applicants Signature: /~ Date: Joe Antonucci (Chief Building Official) 6/25/01