The URL can be used to link to this page

99090053 00E�> PERMIT APPLICATION FOR CITY OF CUPERTINO NUMBS INSPECTION DIVISION PERMIT EXPIRAnoN REROOF PERMIT (408)777-3226 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 1880 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. • BUILDING ADDRESS/7 I 7� nAfL4 Col d fll RESIDENTIAL COMMERCIAL OTHER OWNER'S HAZARDOUS FIRE AREA. ate,E� YES ❑ Irf�yas— Imdareland that a Class A NAME C asvemWy is required. � NO ElInutall I.C.B.O.I p� ADDRESS «�� : /n�f CM�ol DQ(✓E EXISTING ROOF COVERING PHONE 'ZSZ ISO - NUMBER OF EXISTING COVERINGS I CONTRACTOR'S NAME I�-f—l�»S K—�M�+ (KL1 TO BE REMOVED TO BE RETAINED ADDRESSTYPE OF ROOF n O � 3�jrZ,TSf COVERING CITY 8 ZIP C EXISTING _ PRONE 252- 5120 BUILT-UP ROOF LICENSE O NUMBER 4_140qR ASPHALT SHINGLES LICENSED CONTRACTORS DECLARATION O Q� I hereby affirm that I am licensed under provisions of Chapter 0(commencing with Section WOOD SHAKES 7 7000)of Dlvision 3 of the Business antl Professors Code,am my Iicenee Is In lull force and effect' WOOD SHINGLES License Claes C �3 9 Lk.Numbs ��f� ' q g qq OTHER (SPECnF Date / t Contractor OWNER BUILDER DE LARATON PROPOSED 8 I hereby affirm Ihel I em exempt from the Const for a License Law for Me allowing reason. (Sac.7031.5,Business and Professions Cade: Any city or county which requires a permit to construct,alter,improve,demolish,or repelr any structure,prior to its issuance,also requlres the BUILT-UPR F d�p applicant for such permit to fila a signed statement that he Is licensed Pursuant to the provisions �`�`�` O JJ of the Contractor's License Law(Chapter 9(commencing with Section 7W0)of Division 3 of the �� I 6661 O ' Business and!Pralesaone Code)or that he Is exempt therefrom and the basis for the alleged ASPHALT SII TLE� ❑ a exemption.Any violation of Section 7031.5 by arty applicant for a permit subjects the applicant to II�f a chat penalty of not more than live hundred dollarsI` 01,as owner of the property,or my employees with wages as thetr sob compernatlon,will do WOOD SHAKF,� lie work,and Me structure Is not Intended or offered for safe(Sec.7014,Business and Proles- sans Cade:The Convectors Uceram Law does not appy to an owner of property w1 ,builds or WOODSHINGLES - Improves thereon,and who does such work himself or through his own employees.provided that ❑ such Impra,ehl are not Intended or offered for sale.If,however,Me Wilding or Ingro hnent Is said within one year completion,the owner-builder will neve the burden of proving that he and OTHER(SPECIFY) �{..xa's��• TL� not build or Improve for purpose of sale.). ❑1,as owner of the property,am exctueNely connecting with licensed conhaators to construct the protect(Sec.7014,Business and Professions Code:The Contractors Uconse Law does Trot PROVIDE I.C.B.O.REPORT NO. appy to an owner of property who W Ilds or Improves thereon,and who contracts for such projects with a corarmtors)licensed pursuant to the Casual Lkeraa Law. ❑1 em exempt under Sec. ,B 8 P.C.for this reason PROVIDE MFGR.INSTALLATION SPECS. r owner Data WORKER'S COMPENSATION DECLARATION APPLICATION DATE VALUATION PERMIT FEE I hereby affirm under penalty of perjury one of the folbwing tleclaratlon: �/�� (�f� 1 have and will maintain a Certificate of Cement o seffdnsure for Worker's Compensation, Building I ll V as provided for by Section 3700 o1 the Labor Code,lar has perlormarroe of tine work for which this _s^ permit is Issued' C7 Seismic Vv ❑1 hese and wig maintain Workers Compensation Insurance,at; qui restored by Section 3700 of !/ / / I) O,'� Iia Labor Code,lar the performance of the work ar which this perrNt is Issued.My Workers !!! Comimmuni kn Ina mance carrier and Policy number are: TotalcTIRM Carder S'�1QY RAIJ Policy No.c6l "'9 aI4 �y' 363 PERMIT AUTHORIZATION DATE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION permfSURANCE 100)o �/ /i (This eectlon need rot be completed g the permit b for one hundred dollars($100)or lass.) 7 I Cal that in the performance of the work for which this permit is issued,I shall hot employ sm any person In ery manner so u to become sit ria to the Workers'Compensation Laws of Calr All roofs shall be inspected prior to any roofing material being Kahle, x installed. If a roof is installed without first obtaining an Date g qY Applicant inspection,I agree to remove all new materials for inspection. NOTIc TO APPLICANT: II,after making this Certificate of Exemption,you should Wmme Applicant understands and will I with all non Olnt .subject to the Workers'Compensation provisions of the Labor Code,you must forthwith comply PP comply y P with such provisions or this permit shell W deemed revoked. source regulations. I mrtlty that I have read this application and sate that the above Information is daneat.I agree to comply with all city ad sway ordinances and state Tawe reeling to Wilding mnstrucllon,and All r �coverings to be class"C'or better. hereby au#*dxa repressamadws of tis city to enter upon Me above-mentioned property for in- (We)spree K more,Intlemnlly and keep harmless the City of Cupertlm apalnst Ilabilities. Judgments,costa and expenses which may in any way accrue against said City In consequence SIGNATURE OF APPLICANT DTE of Me granting of this perl PRE-INSPECTION: PLYWOOD: IN-PROGRESS: INSP. DATE INSP. ' - DATE INSP. DATE TEAR OFF INSPECTION: BATTENS: FINAL: INSP. DATE INSP. DATE INSP. DATE NOTE: OSHA APPROVED ACCESSTO ROOF SHALL BE PROVIDED FOR INSPECTION O F FICE ICOPY INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO • BUILDING PERMIT INVOICE OPERATOR: karenb Sec: Twp: Rug: Sub: Blk: Lot:36633001.00 INVOICE DATE. .:...: 09/08/1999 REFERENCE ID k ... : 99090053 SITE ADDRESS . . . ..: 11660 REGNART CANYON DR SUBDIVISION . . . . ... CITY ...... . . . . . . .: CUPERTINO IMPACT AREA .. . ...: OWNER ..... .. . . ...: WALKER JAMES G AND LINDA T ADDRESS ....... . ..: CITY/STATE/ZIP . ..: CUPERTINO CA, CA 95014-4830 CONTRACTOR . .. ....: WILLIAMS, THOMAS LIC q 6341 COMPANY ...... . . . . : WILLIAMS ROOFING ADDRESS .... . . . . . .: 10314 LAS ONDAS WAY CITY/STATE/ZIP . ..: CUPERTINO, CA 95014 TELEPHONE .. . . . . . .: (408)866-9442 FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE --------------- --- --------- ------------ -- BPERMFEE P 277.00 0.00 277.00 BSEISMICRE P 2.20 0.00 2.20 --------- ------------ ----------- 279.20 0.00 279.20 VOICE ID DESCRIPTION VOICE ID DESCRIPTION n FRAME ---------------------------- -------- -IN--SU--LA-T--I0-N-------------------30] INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS �e O619 - d3S Q • CITY OF CUPERTINO - BUILDING DEPARTMENT RE-ROOFING POLICY 1. Prior to permit issuance, you must agree to comply with U.B.C. standards and manufacturers specs on re-roofing. 2. New roof coverings shall not be applied without first obtaining all inspections and written approval.from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All types of roofs shall be inspected prior to any roof being installed. 4. In order to receive a final, you must complete steps 1,2, and 3. I. Pre-inspection or tear-off approval 2. In-progress inspection approval 3. Final inspection approval a. Operable smoke detector verification 5. If plywood is installed, a plywood nail inspection is required. • 6. If any roof is applied without first obtaining an inspection, you will be required to remove all new material down to the sheating and a building inspector will inspect all sheating at that time. L IPORTANT: 1. Flat roofs must have a /4"per foot slope, or demonstrate that there is no ponding. 2. I.C.B.O. reports axe required to be on the job site at the time of inspection. If you do not have one, contact the building department. WE UNDERSTAND THE ABOVE POLICY ON RE-ROOFING AND WILL COMPLY WITH THE POLICY. HOMEOWNER'S NAME: �t 1� OfI2kJW_ ADDRESS: I�(vG0 rL�gnav{ �' nyo� AeluE RE-ROOFING COTMPNAY NAME: InJ t L-r 44kxy E2�14 APPLICANT'S SIGNATURE: I � n • - D CITY OF CUPERTINO SEP 8 1999 BUILDING DEPARTMENT By Re-roof7winword