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02080074CITY OF CUPERTINO REROOF 0 ?.-,o e 00 -- 7 � APN # o Date: 14 -0-ols Building Address: ati as L Owner's Name: Phone #: tom 401) Contractor: License #: _rxv-& -160-5:5*7 . Contact: j Phone #: Applicant/Contractor: fe�, UbA6,x G Fax #: Building Permit Info: j Blq& Elect Plumb Mech Job Description: Residential: �Zx-o toy -t \t'e k -, Commercial: Sq.Ft. Floor Area: IlSqXt :� Architect/Engineer- Valuation: Type of Construction: Y�ff I Occupancy Grow Qty. if Annlicatde-\ 'Fee. M Pp.- nPcnr;nt;nn *P^.- r"r^71" ��M � rysl� ---- -------- ---------- Bldjz Permit Fees MAWAN BSEISMICRE Seismic Fee Res BSEISMICOM Seismic Commercial F HK- i 1j ��M � rysl� ---- -------- ---------- a 110, 6 E d � FS Z W < OZ40 g X wv_m� X Hae P�A 8=1 r -Ar -_4 r L44 b CITY OF CUPERTINO BUILDING DIVISIONJ.-IONT" 0 PERMI. BUILDING ADDRESS: 125 LAURETTA DR PERMIT NO. 02080074 TM" Mzo "AO'97ffn 0 0 2 PHONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT 114FO BLDG ELECT PLUMB NMCH LLD L:_J LLJ L_J LICENSED CONTRACTOR'S DECLARATION Job Description I hereby. affirm that I amlicensed under provisions of Chapter 9 (commencing REROOF with Section 7000) of Division 3 of theBusines d Professions Code, and my license a d "to' is in NbI fo e ec fu e. L �ARC — — — On Con 00 / I understand my plans shall be used as pu lie records c, as . Ile . Xta Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county $18300 which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that"he Alicimsedpitirsuarit t6tlie provisions of the Contractor's License Law (Chapter 9Valuation (commencing with Section 7000) of Division 3 of the Business and �rofessions Code) '44 or that he is exempt therefrom 4ml the basis for the alleged, exemption. Any violation of Section 70313 by any applicant for a peraut subjects the applicant to a civil penalty of not mom than five hundred dollars ($500), 3 0 5 APNI#Iff Occupancy Type 01, as owner of the property, or my employees with wages as their sole compensation, 307 - INSULATION will- do, the work, and the structure is not inmaded'or offered for sale (Sec: -7044, Business and Professions Code: The Contractor's License Law does not apply to an 601 - ROOF TEARe(jalfia Inspections owner of property Who builds or improves thereon, and who does such work himself 602 - ROOF PLYWOOD NAIL or through his own employees. provided that such improvements are not intended or offef�d for sale. If, however, the building or improvement is sold within one yew of 6 0 3- ROOF BATTENS completion, the owner -builder will have the burden of proving that he did not build or improve for purpose of sale.). 604 ROOF IN -PROGRESS 01, as owner of theproperty, am exclusively ctmr wing with licensed'ctintractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and Who contracts. for.such projects with a contractor(s) licensed pursuant to the, C.ntractoes License Law., 111 am exempt under Sec. B & P C for this reason Owner ^ Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: C3 I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued., 0 1 have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued, My nation Insurance carrier and Policy number are: A, P No 0 X -CMITFICAM �OF *FRM p. EX�W KERS' WOR "TIO 1, t COMPFNSATIO IN UPANCE 7" {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 Anil 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 be6me subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (See. 3097, Civ. C,) Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said Asu 74/ try oc Cuty,1 onsequence of the granting of this permit. P U'M C UNDERSTANDS AND WILL COMPLY WITH AkL4NNOWPOINT S RCE _U1 Issued by- Date ign pplicant—lContracti7i w- - -Dare 'ph' Re -roofs HAZARDOUS'MATERIALS 15,I)CLOSUR-E ill the applicant or future building occupant store or handle hazardous material Type of Roof as defined by the Cupertino Municipal ode. Chapter 9,12, and the Health and Safety Code, Section yes i;t 25532(a)? 0 All roofs shall be inspected prior to any roofing material, being installed., Will the applicant or future, building occupant use equipment or devices which . If a roof is installed without first obtaining an inspecti 6n, •I agree to remove emit hazardous w d by the Bay Area Air Quality Management District? r contaminants;red all new materials for inspection. Applicant understands and will comply with 0 Yes 0 all non -point source regulations. I have read the hazardous materials requirements tinder Chapter 6.95 of the California Health & Safety Code, Sections 25505,25533 and 25534. 1 understand that if the, building does not currently have a tenant, that it is my responsibility to notify the occ ntof the requirements which must be met prior to, issuance of a Certificate of el Oc p cy. of Applicant' Date I All roof coverings to be Class "B" or better e &T n ri�fr authorizegent OFFICE— Integrity Roofing Name AA 0P -o Date 1829 Charmeran Ave Job'Location "URCI to DR San Joss Ca 95124 City Co V i� is }i ;e 4,08-225-9263 State e- AL i^„ ci S o (q- Lic 760557 _ !'Mone [tee' 3 ''a 3 (iCtl �� Bus'� sc;uares SUBMITT'AL' Roof Removal Ca a Pitch one Story Two Story F , 60 __. Starts /\ r a 4 kip -T Ridge 19 Valley 1 112"Jacks 2" Jacks ?� m `3" Jacks a �1'DI I OY 16 4- Vent 8" Vent t r J 8"Vent .. ti$-— yZ4- 10" Vent x f Simpson . I� R 'tb} i _fiODE' S N N 4" x 8" Oval j NosirxJ ly"1b U`3-71, 131 Step Shingle #4€ tiqje 4t �` rip est & go at afterafigro lI Roof Valley vitY O Viz # w z q�lg�a RUOf t i liVaii k :; i3�))2 p.xc4� „%Lnki L�Fyyy'�is#cam{,b@8gd�4 - 'w� -ho -Ai€s �;,= gutters' Ca: 8 n 08' 0' > K to LOW,- Down spouts 11T=echnical Specifications CedarLite Size and Coverage. Individual Tile nominally 13-1/4"x 13". At 3" minimum headlap, approximately 120 field tiles will cover 100 square feet of roof area. Weight in Place: Installed weight per square approximately 560 lbs. 900 Ridge Tapered Rake & Hip Eave Starter Shake / Slate Split Shake Size and Coverage: Individual Tile nominally 16-1/2"x 13". At 3" minimum headlap, approximately 88 field tiles will cover 100 square feet of roof area_ Weightin Place: Installed weight per square approximately 596 lbs. Size and Coverage- Individual Tile nominally 16-1/2"x 13". At 3" minimum headlap, approximately 88 field tiles will cover 100 square feet of roof area. Weight in Place: Installed weight per square approximately 596 lbs. 3 Side 3 Side Hip Apex Flat R4i Ridge Starter 3 & 4 Way U B Espafta Size and Coverage. Individual Tile nominally 17 x /8. At 3" minimum headlap, approximately 89 field tiles will cover 100 square feet of roof area. Weight in Place: Installed weight per square 90* 3 Side 3 Side Hip Apex Flat Rake Ridge Starter 3 & 4 Way Size and Coverage- Individual Tile nominally 16-1/2"x 13". At 3" minimum headlap, approximately 88 field tiles will cover 100 square feet of roof area. Weight in Place: Installed weight per square approximately 596 lbs. 3 Side 3 Side Hip Apex Flat R4i Ridge Starter 3 & 4 Way U B Espafta Size and Coverage. Individual Tile nominally 17 x /8. At 3" minimum headlap, approximately 89 field tiles will cover 100 square feet of roof area. Weight in Place: Installed weight per square approximately 590 lbs. Trim Hip Starter Capri 3 -Way Capri Capri Apex Trim Hip Starter Capri 3 -Way Size and Coverage: Individual Tile nominally 16-1/2x 13". At 3" minimum headlap, approximately 90 field tiles will cover Member of A14k Cemmi#ee For e or N AmdDnlb A MON-PROFIT CORPORATION* Ip ST TILEINSTITUTE ff.AFARGE A joint -venture Of j�Rbb _F1 N G Capri Capri Apex Trim Hip Starter Capri 3 -Way Member of A14k Cemmi#ee For e or N AmdDnlb A MON-PROFIT CORPORATION* Ip ST TILEINSTITUTE ff.AFARGE A joint -venture Of j�Rbb _F1 N G i HHO A it; s. :W ' H is m 11, ,, ,41 1.1, a tl L; 3, - gA M I F 9 .St PS UYx i6 u s.4 A 7, �El s 9 Jago$x�r:e='z .g2z0a 14 5 i 7Z I L; .St PS UYx i6 u s.4 A 7, �El s 9 Jago$x�r:e='z .g2z0a 14 5 i 7Z I gA .St PS UYx i6 u s.4 A 7, �El s 9 Jago$x�r:e='z .g2z0a 14 5 i 7Z I CITY OF CUPERTINO CONTRACTOR INFORMATION: BUILDING DIVISION PERMIT BUILDING ADDRESS: 21125 LAURETTA DR PERMIT NO. 02080074 IMP B MM O APPLIC0 8 N�1472002 TE PHONE: SANITARY NO. CONTROL NO. CI CI O O ARCHITEC!/ENGMEER: a BUILDING PERMIT INFO BLDG ELECT PLUMB MECH <E 1=1 ,'l- LICENSED CONTRACfOR'S DECLARATION Job Description z _ o :nt� Ihercb ffrm that l am licensed under r a provisions of Chapter 9 (commencing wiNSection]OOO7 o(DiviaionJof Ne Businc dNofexiom Code. and mylicense is in fur o REROO LpS3 IFg f OU Liceme rile L' . 3 u kn H Dam Coal ARCHITECT'S DEC TION 1 understand be lic AUG 2 2002 N my plans shall used n pu records p Licensed Professional OWNER.- RDECLARATION BUILDINGw 1 greasy elf that 1exempt from the Constraint'sLicense Low for Ne following reason, (Section 70315 Business ted P f sionsCal Any city or county $18300 O which requiresape , r wn alt p demolish. em li h or repair any structure - prior its I q ma applicantf such Permit toflea ,tined statement Na he yl'cens 1punumin6 Ne prori of the ConuactorsLtt se Law (Chapmr9 (c mmenc ng with Section ]t]W)of Dwntonlof Ne Bus ss dP '=-,arta Code) Valuation '[, �.lrs i -t ^_W. j"J!_••Rs'3cl) 1f 1.1'.,'-1 Y 1�..\. ar thathe a exempt l'sn' and th< Buis for rhe I egempdon. Any violn,oa a(_ LN, -of Swtinn]O7L5 by nny applicem fora permaarapt Nets"Reard, sl Ovdisenolry ofnot micro Nan Bve huntlrcd dollars ISSW). .Tin�.M APN ' 1 i.<1b" s. 3O5 naelfial� Occupancy Type ❑Lasownerof Ne prolKny, or tar employees with wages a a their sole compensation. 307 — INSULATION i will do' the work;' and the stratum Is not'imcaded-or offered for sale (Sec. -7044, Business and'Professiotn Code: The Contraztor's License Law doea not apply m an 6 01 - ROOF TEA e�&�tl Inspections' "- t1 ' owner of property Who builds or improves Ncreon. and who does such work himself 602 - ROOF PLYWOOD NAIL oruidfor through his own employed provided Na[suchimpmvemenu arcnot intended or ;compldfoneale.IChowcvei the bdiavete7improoe that within nod year of -_._ _ ,",_.. - _,_.._ - —.. --- ROOFBATTENS ,.. ... ',completion, on, th= ase or sale.). will have the burden of proving Not he did not builds prior, improv=mrvarp.aeerame.l. 604 - ROOF IN -PROGRESS �_ z Ol;uawner of Ne propenY•am exclusively conrrvcsing with licensed <onuazton ro ""_,.....__ _.__._ __ _ .___.__.. _ ._.. - esion be project ess r (Sec. SA, Businan d Profession Code:? The tn Comnor's ` - L License law does nos .,,Iy,. anowner of property who builds improves thereon, - .. and.who ..j wiN.arontrudot(s) licenud.pursueas, .to.Ne. s ' 7 _ Contractors License Ln rs License Low., ❑lata exempt under S'c ;gyp'&PCfor th srt'oxm - Owner Dom "- "' WORKER'S COMPENSATION DECLARATION ie I hereby affirm under penalty, 1.of perlury, otic of Nc following declarations: El 1 have'end will maintain u Cir,, icaut of dmauiii'm selGinsure for Worker' s Compensation, as provided for by Section 37W of the Labor Code, for the - perfommnce of the work for which this permit is issued. ❑ 1 have and will mainuln N'oher's Compensation Insurance, as ¢quired by Section - - '37W of the Labor Code. for the performance of the work for which this permit is -MY ' sand. Worker C n i n Inmmne carrierand P Y numbe etc ., ..q� r1. ' {ai .'. v,.(; PRRaaKKN.��JtQs �� 'ti�A.l l-IXl •, ..., ._"-. �l �3 t , IV Fkk,,! elo r. I, 4k�1;Vl �'1i t C TIFlC ION OF E%Eh(Pp@p'€FIbM WORKERS) COMPENSATIOFKfINNSSURANCE '' .'v)t�tl.�.i; Craig ' Qh' on recd not be completed if the permit is for one hundred dollars (S1 W) or less.) .P ., I con, y that inthperformance of th wti k for which dit, remit is'issued, 1 'shall „ 'r• 1, '' " -' not employ any person in any m n as to become subject to the Workers' `, .la can mmion Laws of Culifdmi.. Date' pppp.. ___ ... _.. ,. alter NUCisions of oayou should +Nceome APP Lis _ -_... _.. ..___. .. .. ..._.. _. .. .... _ �. ^:f u becomesubject Work1L Compenking Labor Code,you most most this Worker's Colons pmvisionsofedee Q 0 forthwith c mply with such provisions or this perms shall be deemed revoked.' comply or this ed F' CONSTRUCTION LENDING AGENCY - 1 hereby fBrtn Nat there is a con t coon lending ag ncy f the Pcrfonnence ' - t ' of N work for which ths crout is issues (Sec. 709], Civ C) 0. O _ ... Lenders Name y •. ` :.. ..u• ..-.. �. Lender's Address 0 it ;. ,'•..--. ro,id this aappl' t suitstate thath h' f rmat on is tha1gava y and county rd relating0'U ob dg dhrebyuthor W ef gc boe[ representatives of this cirywenmr upon ah bomndproperty for inspection p rya 11i��- 11 'r_ V1 (W )agree ,ave indemnify and Ae p harmless the Oty of Cupertino a{e �.) I bat u . 3udgmems end expertwhich.may in a y y rte egainx said expy said C wZ fcosts [y quem of N gm ung of Nt pe t MAPF cT UNDERST NDS AND WILL COMPLY WITH q(LNOp'-PONT •/ty/V`/ C kCE 1 EGULATIO ', \, wo1 / - ,pplicanuContnctor Issued by Date . Igo �' Date Re -roofs v - HAZARDOUS MATERIALS DI CLOSURE " .,, 11 the applicant or,future budding occupant stat or handle hatandonst tax= I -9.13 Type of Roof, ti de! d hy; he Catania. Mtaiicip00t Chapter d he Health and Safety ,C d 5 u9 25532(el r X17 Ye I. NI o ;s w-, 9'y" a Will th pphcem o f m building occupam x equipment devices which All roofs shall be inspected prior.to any roofing material bemg.installed . _-_.. _. If a roof is installed without first obtaining art' inspection;'I agree to remove d db th B Area Art uah Marta cine Dmnn ser costa Y Y Quality Management `us all new materials for inspection Applicant understands and will comply with ... a El Yes o is rc uiremen ' I h vc mad the h ra do requirements and Chapter 6,95 of the ._ • ._ 5 "- ^ - _ all non -point source regulations,,; ,. ,;, Clromi Health'&Safety Cost. Sections 2550525533 and 2553) I ndemmnd that ,f the Mulatta{ doesnt ormatly have a tenantthat it is my responsibility to -notify the' bcc r of,the mqu tenets which most W m r pno, to nuance of Cenifcam or� p ey, n e of An e of A licant�D PP.. _ — rte tamn.r a ant ." All roof coverings to be Class "B" or better