02100068 ' CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION::
BU11211c3A91SEsAMULET DR MCCARTHY ROOFING SERVICES PERMITN®2100068
ostySAR$MR EDWARD L JR AND LILLI E466 (A) REYNOLDS CR APPLICATITVMgry 2002
Ak
ONE: 4 0 8 4 3 6-15 6 0 SANITARY NO. v / CONTROL NO.
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ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0
00 LICENSED CONTRACTOR'S DECLARATION Job Descri�p /� I
8 1hcrchy ))Rfmthat 1amric B-under provisions of,Coul i9(commencing REROOF y—III •!ALE
�' withllfome n effi fDivision3nf the Buxi^�x�and RofessionsCWe.nnJ mylicensc is
in full force end effc .pi�p 7uC
Li ass D .J fo Lic.YY
F,2,:n Dau Conuacmr MAR 0 5 2003
ARCHITECTS TfAT[ON
p-1Ca understand my plans shall M used as publicemords
dO�U
HLL03 Licensed Professional BUILDING
OWNER-BUILDER DECLARATION $12100�`v�a f [hereby affirm that 1 am exempt from the Contractor's License Law b r the $12 1 0 0
a i Q O following reason.(Section 7131.5,Business and Prnfcaiinns Code:Any city or county
x m which requires a permit to construct,alter,improve,demolish,or repair any structure
F3orpoor to its issuance,also requires the applimid for such permit In file a signed statement
x That he is licensed pursuant to the provisions of the Comraaor:s License Law(Chapter 9 3�6Pi3�ob6Al@� Valuation
Fm (commencing with Section 7000)of Division 3 of the Business and Professions Code)(it
a
that he is exempt therefrom and Ne Was for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of PN'N Occupancy Type
not more than five hundred do][..($50% 3 07 - INSULATION p y YP
❑ I,m owner of the properly,or my employees with wagea as their sole compenaation,
will do the work,and theawcture is not inboard or offered for sale(Sec.701 Business 681 REIEIF T
gp1 11
g
and Professions Code:The Contractor's License Law does not apply to an owner of 602 - ROOF P SYVV nVAcpE7ns
property who builds or improves thereon.and who doessuch work himself or through his
own employees,provided that such improvements are not intended or offered forsale.If, 603 - ROOF BATTENS
however,the building or improvement is sold within one year ofcompletion,the owner- 604 - ROOF IN-PROGRESS
builder will have the burden of proving that he did not build m improve for purpose of
sale.).
❑I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.701 Business and Professions Code:)The Contractor's Li-
cense law does not apply to an owner of property who Index or improves Hereon,and
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License Law.
❑ 1 am exam t /dey'�ec. B&P C fonhia re on
O r ✓ Date
WORKER' MPENSATION DECLARATION
1 hereby affum under penalty of perjury one of the following declarations:
I have and will maintain a Certificate ofConsem to self-maure for Worker's Compen-
sation,as provided for by Section 37W of the Labor Code,for Ne p mrmancc of the
work for which this permit is issued.
❑ I 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 Worker's Compensation hum aGnce carr�Iie//repnd Policy number am: n
Carriers.Jfa.1F`i+-,i�a'�'Pulicy
CERTIFIC OF EXEM OM WORKERS'
COMPENSATION, URANCE
Cous section need not Mcompleted if the permit ix for one hundred dollars 01 W)
or less.)
1 ccnify 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 WorkersCompensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:11,swimming this C&nilicale of Exemption,you should
become subject to the Worker's Compensation previsions of the Labor Code,you must
O 0 forthwith comply with such provisions or this permit shall he deemed revoked.
E' CONSTRUCTION LENDING AGENCY
[-i ice+ I hereby affirm Nat there is a comnuclum lending agency for the performance in
CG r7 the work for which this permit is issued(Site 3097.ON.C.)
a0 Lender's Name
z Lender's Address
U 0 1 certify Nat 1 have read this application and state that the above information is
W H correct,l agree to comply with all city and county uidimu ces and sum laws relating to
O V building construction.and hereby autherim representatives of this city to enter upon the
W ahnve-mentioned properly for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
t,y Co) liabilitiesjudgments,costs and expenses which may in any way accrcc against said City
V Fzin-t
APPLICANT
eofthERSTANDS Ae grand 39 of tND WILL�OMPLY WITH ALL NON-POINT Issued by: Date
SOURC G ATI
ate-roofs
t ApplicanU nRDO Dam
/y ARDOUS MATERIALS DISCLOSURE Type of Roof
/ Will the applicant or
future building occupant stoic or handle hazallous material
as defined by the Cupertino Municipal Cud&,Chapter 9.12,and the Health and Safety
Code,olYCe zss3zfayrNo 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 inspection, I agree to remove
mit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
Dixuict?
Dyes No
Ihave&Safet Nchavard&uanta505, 553req3.d25534.rements dcr Ch wdt.95ufthe beddiCarrier-
101
g / ��-
IiaHealth&Safely Code.Stt0ons25505,25533 and 25534.1 undersand that if the huilJing � �O f%
tires nm cunt have a tenant,thm it ix my resp+mihility m notify the acupant of th
'N
d'
ywM1ich bum tar ln' cc ofn CertiBenmo 'cup er. Sig at of Appli Ot ate
G `ti 96 All roof coverings to be Class "B" or better
wnc,laawhormel agent Dau
r
Building Division
i
10300 Tose Avenue
Cupertino,CA 95014-3255
Telephone: (408) -3=8
0 Fax: (408)777-3333
,CUPERTINO
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.
I New roof coverings shall not be applied without first obtaining all inspection
Wand written approval from the building inspector.A final inspection and
approval shall be obtained from the building inspector when the reroofing is
completed.
S. 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'A"per foot slope and demonstrate that
there is no ponding.
2. An LC.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
Address: 2�3 9in
Reroofing Company Name• tzeu --,
Applicants Signature:
Joe Antonucci
(Chief Building Official)
6MI01