02070071 OF
a CITY
I BUILLDING DIVISIONNO CONTRACTOR INFORMATION:
-�. PERMIT
BUILDING ADDRESS: PERMIT NO,
22772 ALCADE RD T D ROOFING 02070071
OWNER'S NAME: APPLICATION SUB DATE
SON TRINH 3540 MARGATE AVE. 07/12/2002
PHONE: SANITARY NO, CONTROL NO.
(408) 892-8872
a O O ARCHITEC rENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
r. LJ ILL]
y�6
z 5 y LICENSED CONTRACTOR'S DECLARATION Job Description
I hereby aRrm that I am licensed under provisions of Chapter 9(commencing
Fytu9 with Section 7000)of Division 3 of the Brayand Professions Code.and my license REROOF
is in full fo�/a of t Q. o 2
s� < Liee eCXs Z Lie. c3�R REMOVE COMP. INSTALL COMP.
a�3 Date Cenmml r
AR H ll be u e as ATION
understand my piens shell he used as mu"
c records
p O Licensed Professional
OWNER-BUILDER DECLARATION
to to I hereby affirm that I am exempt from the Contactors License law for the
1z'jE 6 following reason.(Section 7031.5,Business and Professions Code:Any city or county
which requires a permit to consumer.alter,improve,demolish,or repair any structure.
$ prior to in issuance.also requires the applicant for such prmtit in file a signid matement
tbatbp is licensed pufmlvp in she provisions of the Contacmrs License La.(Chapter 9 ,`;Z Y +Sq.yCI F'rroor;Area,-v t t`1, Dation
(commencing with Section lbGB>,of Division3of the Btlsjnea arta rSofftafom cone) t.�?..Lia I"' i,AI_a P.. /:"n Y'ha\-A. TZ 4,h M:
or that be is exempt therefrom tlnd the basis for the vllig d etemptlon.Any violation
-of Smfiun]031.5 by my applicant for a Permit subjects the applicant to a civil Penalty
of not more than Eve hundred dollars(5500). m _ .. , ,., Occupancy Type
13 I,as owner of the progeny,or my employees with wages as their sole compensation, 305
B1093
unte the work.-and the ode:The C not sanded e e Lawered for sale or apply
7044;'
B and scry Who
Cade The Contractor's License Law s such rot apply m an 307 — INSULAT I wired Inspections
owner of progeny Who builds or provided
t thereon,and who encs such work himself
ormrough his own employ,.-me uildin thatsuchimprovements vols arenas intended r or 6.01_--....ROOF._TEAR—OFF____,._. .__
"Muerte fon avleflf:how<ildeor i building er improvement n sthat he
one yam of
"completion,the ownervbuilder will have the burden of proving that he did not build or 602 - ROOF PLYWOOD NATL'" ' '
improve for purpose of sale.).
-tr -_a__W -- ..._.__ _ i --- - ---_ c .. _ ._ _ .. ._ .6 03_._--_ ROOF,_BATTENS- - -_ - -
�1.zs owneraf tAe progeny.em exclusively contracting with licenud contacmrsm 604 - ROOF IN-PROGRESS '' " '
_
construct the project(Sec.7f4L Business and Professions We:)The Contractor's , ,,,
y ..
License Law does not apply to an owner of property who builds or improves thereon,
_ ._and who contracts for,such projecta.widt a camacmrs).Heeneed p....no to the.
C s License Lew.
C1 am am excexempt under Sec." ;.8'A P C for this reason
Ohne[ Den ' '
"WORKER'S COMPENSATION DECLARATION
Y. '•'pm 1 hereby affirm under penalty of perluryme of the following decimations:
❑ 1 habe'end will maintain a Cenifi me of Consem a self-insure for Wmker's
Compensmion, as pravidM for by Section 37W of the labor Cade, for Ne
performance of Ne work,for which this permit is issued.
❑1 havdandwill mhiniuin Worker'i Compensation Insurance,as required by Section
3700 of the-1 Labor Corte,for the performance of the work for-which this permit is
issued My Wig C rope ti n loons<cam<r and
lPolicy'lumbo
Gxpmer al Plc I Yo2 I I It ` 2 s ' ., .•,.,m.._...._...,.
K f ICEnffrcAT N OF EXEMyPTTp��N FROM WORKERS '.. n �i Y 9 k;
COMPENSATIQNdNST. '
- ,`P ✓an need n t he corn letad d thereddoll1 cenifyth8t'n rh perfmmonce of the wti i'is wed.It. ' d shall not employ any person in any manner so athe Work
Compensation Laws of California.Dane
NOTICE TO APPLICANT:If,after making this Certificate of -phon,you should
O Qbecome subject to the Worker's Compensation provisions of the Labor Cede,you must
7onhwnh a tplY with such Pro inions or this permit shall be deterred mvokW.
CONSTRUCTION LENDING AGENCY o ri
fora .........-, .._ .. _-... -. __ ._. -•, s. 1
W-nesof the work for which this Permit a sued(Sec 1119]Civ.C 1 - .._._.. .... __.
Q Lecterns Nab affirm that i-construction lending a nc for the rformance _ - - - --
Y 8 B Y pe
-z Lend Add
1 ob""that I have read this application and sate that the above information it /^ I
'_F correct In
tme TplY.with all city and county ordinances and state laws calming /G t
OPV ]o building canmaction;and hereby authorize repre ntmives of this city m enter upon
tai rte. Abe u "n¢nrioned property for inspection purposes._
FiL (We)agree to demmfyand keeph rmles's the Cly f C psn'nu gainm
W
liabilities,judgment,cost,and ex,sonact which may in any way accon,against said
(J..z., Qty a U umoc of the grant ng of this perms
:APPLI A USDERSfANDSAND WILL COMPLY WITH LLN N+POINT r, O V
sbuR r'- n< s " 7 IZ dy Issued by: Date
,V. Signa"rc tlA PlaanUCo ear ',;"" : Dat: e' Re-COOP$
'
„HAZA OUS MATERIALS DISCLOSUR
t l
Will the applic t rf t rcb (ding occupantstoren handle hazunlobs ten al _Type of Roof,
•as de(im d by th Cupenmo Mum ctp I Code Chaps 9 12, d N Health and Safety t ». I. Y�
Cod Section 255321aj t v�-i, t n , r"j ti „s.+ " st w t a a t.a•i_
❑Ys '. f .ONo .. I T f l,.
_ All roofs,shall be.mspected prror-to.any roofing matenal.being installed._ „
w,ll m,appl t rfittare bu wing occupant «equipment or devices which If a roof is installed Without first obtaining an inspection;Iagree to remove
ems h';W
zallou.airmmamman,,a "fin dby theBay.A� Quality Management
Dish q P all new materials for inspection._Applicant understands and will.comply with
❑res , No' - ._ - '"all non point sou�ce regulations, '
California Health&Safer Cade.Sections 25505.25533 and 25534.1 understand
o(hat �, __ ._..
'I have rind the hazardous materials rc unaments under Chapter
Safety ndeismnd that _ _ _ _ _
,if Ne bullets tlxs not currently haven tenant,that it ism nmbilit to notify the , p2
captain of t e re u'emenu which must W met piior to issu a of a C difmme of -"
ne.pvncy. -
Z
^ Z p'j, Signature of Applicant _ _ Date
Zr Dare All roof coverings to be Class"B" or better
_ - - . ..,. - .. OFFICE - _
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY O Fax: (408)777-3333
i CUPEPTINO
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 I/a"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: 17,i MA
Address: -2,2 A A I ca
Reroofing Company Name: T D R oo f i u o
Applicants Signature: Date: 7 I o 2
. Joe Antonucci
(Chief Building Official)
6/25/01