02110115 (2) CITY OF CUPEWFINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION •,,
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BIB > *ESWHEATON DR JOHN WONG PERMITN02110115
owp j(DITIPT::WONG APPLICATT11SyRiWY 2 0 0 2
ZONE: SANITARY NO. 7 CONTROL NO,
ARCIHTECT/ NGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
00 LIC ENS EDCONTRACnOR'$DECons Of CON Job Description
mP I hereby affirm that 1 am Ofthe
Bu under provisions obs Cate. 9(commencing p
t; R wiNllloonndrififDivisionJnfNCBusincseand PrnfcaiomCodc,add mylicenuis REROOF
R in full lithe and effect.
Esq"a License Class Lo.r FINALE®
21 Date GimfECL
As Callao..do
. DECLARATION
I understand my plans shall he used as public recnNs
�a Licensed Prife,00mal MAR 0 5 2003
y
OWNER-BUILDER DECLARATION
�a 8 00 I booby affirm that 1 1. exempt from the Contractors eLicense Ac Law for the BUILDING�9 000
i a❑O following neon.(Section ttn t I am xempt from
he Coninaa Erase:Any city or county
n$� which requires a permit sea construct,alter,improve,ddmolish,or repair any structure
NZapnnrto i0s iamewc,also rcyvires the applicantlot such permino file a signed statement
Iba,he is 1werised Inimuam to the IF wisimoof the Cunua,hr's License lnw(Chapter 9 3*612 MBaAli Valuation
�$ (commencing with Section iOk)of Division 3 milk Business and Pmfessinns Ctme)or
that he is exempt therefrom and Ne basis for rite alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects Ne applicant to a civil penalty ofPNN Occupancy
not move man five hundred dollars(S500). 307 - INSULATION Type
❑ I,as owner of the property,or my employees with wages as their salt compensation.
will do the work.and the swctum is not intended or offend for sale(Seo.711,14,Business
and Professions Code:The Carlin is License Law does not apply to an owner of 6 0 2 - ROOF P n"cfipps
property who builds or improves thereon,and who does such work himself or through his
ownemployees,provided that such improvements me notinended orofferee fnrom.If. 603 — ROOF BATTENS
however.the building or improvement issold within one yem ofcompleuan.the owner. 6O4 — ROOF IN-PROGRESS
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively convecting with licensed contractors to
construct the project(Sec.7M,Business and Professions Code:)The Cunlncam's Li-
cense Law docs not apply to an owner of property who builds or improves daemon,and
who contracts for such projects with a cimractnrp)licensed pursuant to dte Convutoi s
License Law.
❑ 1 no exempt under ce. ,B&P C for this resson
Owner Dan k 5 f 9 J Z
WORKER'S COMPENSATIO ECLARATION
I coy e0idm under penalty of perjury n of the following declarations:
1 eandwillmaindainaCenifinnofC n ttoulGinsunforWorker'sCompen-
n,as provided for by Senion 3700 of t sodr Code,fm our performance of the
work for which this permit is issued.
❑ 1 have and will maintain Worker's Compensation Insurance,as required by Section
3701 of Ne tabor Coble,for the performance of the work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy number art:
Cartier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not he completed if the Permit is forma hundred dollars(S101)
ser less.)
I ccnify that in the perl Orman.of the work for which this permit is issued.1 shall nil
employ any person in any manner an ss to become subject to the Workers'Compcneminn
Laws of Celifomia.Date
Applicant
NOTICE TO APPLICANT:I1;after making this Cemificam if Exemption,you should
become subject ed the Workers Compensation provisions(it the Labor Code,you must
OO forthwith comply with such provisions in this permit shal lM deemed revoked.
Z � CONSTRUCTION LENDING AGENCY
(—t I he reby affirm that there is a construction lending agency for the perlimmtncc if
�
i the work for which this permit is issued(See 3097,CO.C.)
Q Lender's Name
r7 Z Lender's Address
V 1 ccnify Nat 1 have rear this application and stem that the above ins+rmmiis
w (~ building I agree it)comply with all city and county ordinances and entre laws upon
ng t tl//' ✓✓JJ
D V building construction,and hereby euthoma reprenfati
sevcs of Nm
is city cmcrurym thee
r Gst above-mentioned property for inspection purposes.
d (We)agree to save,itinerantly and keep harmless the City of Cupertino against y
.F„ N liabilities,judgments costs and expenses which may in any way accrue against said City
U in consequence of the granting of this permit
r7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR •RECUR TIONS.
kI I by Re-roofs
Si a of ApplicanUContracuu IJmc
HAZARDOUS MATERI S DISCLOSURE. Type of Roof
Will the applicant m future building ret store or handle hvaNuus material
defined by the Cupdair.Municipal C • haptcr 9.13,and the Healthanti Safety
C we,Semiom z5533(a)7 - All roofs shall be inspected prior to an roofing material beim Installed.
❑Yex No P P Y g g
Will dim applicant or future building occupant use equipment ser it vices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hvardous air contaminants u defined by the Bay Area Air Quality Management all new materials for inspection.
DiAriCt1
❑Yes 0 N
I have read the lot ardous materials mquiremems under Chapter 6.95 of Ibe Califor-
maHealth&Safely Code.Secfiom 25505,35533 and 25574.1 understand that ifthe building 44
does nm emically have a moral,than it is my rx,anxibility m notify tae taeupam of 2,-1
requirements which must he mel prion issuance Of a Certificate Of Occupancy
ature of Applicant Date
Owner or amhorind agent Date roof coverings to be Class "B"or better
- Building Division
10300 Torre Avenue
R Cupertino,CA 95014-3255
Telephone: (408)777-3228
CI 0
CUPEI�TINO Pax: (408)777-3333
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) Pinal 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 V"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: vJ o
Address: W�4 1�g--rL >2
Reroofing Company Name:
Applicants Signature: Date:
Joe Antonucci
(Chief Building Official)
6/25/01