Loading...
09050025 CITY OF CUPERTINO �• QRTIfIN' BUILDING DIVISION PERMIT : • PERMIT NO. BUILDING ADDRESS: 21131 GRENOLA DR TNT ROOFING CO P11tM1T LS6UE DATE OWNER'S NAME: S A CONTROL NO. 'NE: (408) 277-0800 BUILDING PERMIT INFO ARC HII cr/ENGINEER: BLDG ELECT PLUMB MECH Z ed C LICENSED CONTRACTOR'S DECLARATION Job Description U I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is ti in full fora and effect l 5 RE—ROOF REMOVE COMP SHINGLE INSTALL 3 0 ILB FELT Lice Lle INSTAL 40 YR 24 SQUARES Date Contrac.' —^ ARCHrrECT'SDECLARATION a 1 understand my plans shall be used as public records Dtu I'O Ly Licensed Professional L. OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the O O following reason.(Section 7031.5,Business and professions Calc:Any city or county v Pi which requires a permit to construct,alter,improve,demolish,or repair any structure Valuation prior o its issuance,also requires the applicant for such permit to file a signed statement Sq.Ft.Floor Area z< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter r $8975 xa (Co..encing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ofE32627801-3 APN Number not mote than five hundred dollars(5500)• . 00 0 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structum is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Conlracoes License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). O I,as owner of the property,am exclusively contracting with licensed contractors to constmct the project(See.7044,Business and Professions Code:)The Conlracor s Ir- cense Law does not apply to an owner of property who builds or improves themon,and• who contracts for such projects with a contractors)licensed pursuant to the contractor's License Law' B&P C for this mason ❑1 am exempt under See Owner Date WORKER'S COMPENSATION DECLARATION I hereby aftirtn under penalty of perjury one of the following declarations: have and will maintain a Certificate of Consent to self-insum fix Worker's Compen- ,ation, s provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ve and will maintain Worker's Compensation Insurance,as required by Section 00 f the Labor Code,for the performance of the work for which this permit is issued. My Worke Co pe lnsu res c�a and Policy number are: Grier Policy No... ERTIFICA OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Workers Compensation provisions of the Labor Code,you must ,'Z forthwith comply with such provisions or this permit shall be deemed revoked. Z O CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of (3!> the work for which this permit is issued(Sec.3097,Civ.C.) (res ALender's Name az Lender's Address U 0 1 certify that I have read this application and state that the above information is cored.I agree o comply with all city and county ordinances and state laws relating o 0 V building construction.and hereby authorize representatives of this city to enter upon the > Lhaa above-mentioned property for inspection purposes (We)agree to save,indemnify and keep harmless the City of Cupertino against E trA liabilities,judgments,costs and expenses which may in any way accrue against said City V Zin consequence of the granting of this permit. Date i O Cr ►4 APPLICANT ERSTANDS AND WILL COMPLY WITH ALL N-POINT Issued by SOURCE U ONS. ,( I/L_ V GGG Re-roofs Signatum of Applicant/Contracior Dao T of R oof HAZARDOUS MATERIALS DISCLOSURE Type Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Cale,Section 25532(a)? / All roofs shall be inspected prior to any roofing material being installed. 0Yes )�No Will a roof is installed without first obtaining an inspection, agree to remove ll the applicant or future building occupant use equipment or devices which t hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. .strict? ❑Yes 00— 1 It mad the hazardous materials requirements under Chapter6.95 of the Califor- nia Hca & afcty Sections 25505,25533 and 25534.1 understand that if the building docsAt cu ndy h ve a tenant,that it is my responsibility to noul'y the Occupant of the Date rc"iimmc h' riorooissuanceOccupancy. Signature (Applicant All roof coverings to be Class'"or better Owner or authorized agent Date CITY OF CUPERTINO afV_l REROOF CUPEkTINO PERMIT APPLICATION UJB APN #32,(0, 24 0/3, dC) Date: S I l Building Address: Owner's Name: � �� �,� Phone #: 61% - z HOA: Yes ❑ No ❑ If yes, provide letter from HOA Contractor: T-iA--j- j_� Phone #: y u L 77- FCA-) Fax #: (65 - ZsZ 3 Cupertino Business License #: Contractor License #: Type of 11.Zoof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof X Asphalt Shingles /&-Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: 52���� c { SfjI � )`t Ll iz-VOP ��ILrA Residential Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet inc'.ex. Valuation V_\ I Have Read, Understand and Will Comply witY. Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO -a, REROOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE , Seismic Residential B 1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissicn Fee j 1BSEISMICRE Seismic Residential B 1 BUSLIC Business L icense B Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 .� Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on r,:-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 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 b-ltilding inspector when the re-roofing 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) Pre-inspection and/or tear off app:-oval. 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 a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/ "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 on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: Job Site Address: Roofing Company Name: ' r Applicant's Signabfre: �\ — ' Date: Greg Casteel Building Official Revised 07/30/08 Community Development `""ai 10300 Torre Avenue t. E Cupertino CA 95014 Telephone(408)777-3228 CIV OF Fax(408)777-3333 -UPEkTINO Buildi�n De artment JOB ADDRESS: PERMIT �11-115 PA QoS-O S/ OWNER'S NAME: PHONE # `'5�;.3J- L GENERAL CONTRACTOR: ti FAX# I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile �' Owner/Contractor Signature Date