01090122 OF
CI BUILDI G DIIVIISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMITN0.
10433 GLENVIEW AV MARCO ROOFING 01090122
OWNER'S NAME: APPLICATION SUB DATE
L. GROSSMAN 43230 OSGOOD ROAD 09/28/2001
PHONE: (510) 656-6400 SANITARY NO. CONTROL NO.
❑tt0 O ARCHITEC)ENGINEER: BUILDING PERMIT INFO
.2 BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
m 2 I hereb firm the 1 am licenud under i ons of Cha 9 tcommencin Job Description
i y-p r a prov ai Ixer g
f-ul withSection]000)ofDni ans3oflbeBusinessandProfe.sionsCode.andmylicerom REROOF.
o� iia �uGrnmeanaq�e3q udx / T/0 SHAKES, ADD CLASS BBB
a o N Dat< kF�y*(J'� Comraemr
E HEAVEY SHAKES . (2ND STORY)
ARCHITECT'S DECLARATION
g1 u orfstr d my plans shall be urea as public records
zGo Littnsed Profcssionnl
OWNER-BUILDER DECLARATION
co 1 herchy affirm that 1 am exempt from the Contractor's License Law for the
?' following reason.(Section 7031.5.Business end Profession.Code:Any city or county
which m,.ima.perm,t.construct. improve,demolish part day suactu e,
Pnwt t. .al Nita the ppl rfar such Pemdu fk grra Statement. - ._..__- _ ... - .-_"_ -. ...."._ _.. .__
a 3= that ho u I mnscd pvn ant t 1hk pro m n f Ne Contmctws L In (Chapter 9
(commencinglh s t 1UOIll 'D I f 1ha Bustne d Ror ns Code Sq:`At Floor-Area.% ILI %j.l .� a[ion
. 7 6�i:1+ ��iAe._ 2 3 .2 tfa,� ti,f i,'.1 L:4.�S.Sx�}. � $450',7'
or that ti s c empt tbcmfrom uM the b f ice alleged<.mpwn Any violet on
-of Sttmon 103 LS by anY applicant for a pmniuubjeczs the.pplicent to.civil peneBy'
of..,mom thamfive hundred datlasi($50% 36APIM4P?bS0 i.:,'.<; :.` Occupancy Type
❑I,as owner of the property,or my employees into wages m their sole compensation, i
- - 'will do the work; ad the Swcture is not iatendel'ti, ficied for sale(Sec.7044;" -
'Business and Professions Cade:The Contractor's License Law does not apply to an 305 - FRAME Required Inspections
owner of property Wha builds or improzes thrnmn,.rd who aces wdh work himulf 1
or through his own employees,provided that Such improvements are not intended or 307 — INSULATION _
offered for sale.If,however,the buildingor improvement is sold within one
m mien.the owder4sulder will have e handlers a(en g year or 601 - ROOF TEAR OFF
co p pressing that he JW trot build w
improverarpar,meafsak.). 602 — ROOF PLYWOOD NAIL
_.._ _.._.._ — edSanctions,_ ._ to "—
❑1:as owner or tn<propenr:;m eadwaroely dartmmmg wird licensed to 603 --- ROOF BATTENS '___, ..... _.__
mistrust the project(Sec.7044,Business and Pmfessians Chep The Contmcmr's 6 04 — ROOF IN—PROGRESS
License Law does not apply to an owner of property who builds or improves thereon,
ural mho co Idmclsfor.such projecn with o economists).licensed pursuant.to the ._ . ...._ _.. .._ ..3.•
•. Conuactor's License Low.
❑l am exempt under Sec. ',8&P C for this reason Ir ` !'T r :;�❑
Owner.' Date
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury uric of the following declinations.
❑ I have and as proodoided far
byinearo of 37M lee Ltinsure(or Workers F0^ „A LE D
Compense and az prvirtai fin by Smion Cmns ad the Labor Code. or the LOIN\VII
_ performance of the work for which this permit is Toad.
ha'e end wilYma i m Worker's Cnmpe s i 1 §uren az requircJ by Sect"on OCT u ed M W bor Cod f the perforator"
of N ork f h h this pc l
D�
I'
la 1 8 20 01
rkefs C petwuon Inxumwe earn
a d P l y tubera .
Camc3 'vol
Policy
!n(C �'Od 7S5`7 -,T,t.t ,.,.e!"i•..4a.�,In s >_'.-___._.. .__. -. i)•'__ _—.._
p' , t RTIPICATION OF CX EMP 10 FROM,WORKERSu' -• - p-( � V�`. ,4 s�.rs ; BUILDING pt�
COMPENSATION INSURANCEr. .__-.. .,_
"mrii'sectlon need not tie 8oinpind if the permit is for one hundred dollen + ' i•�
($100)orlmss.) ••• L'i�'.1'
Jc nfY donut the performance mfdha oh'for which this cam.isissued.l '• _........ ..... .. . . .. ..__ _ .� . .. .. .... .
' i•.r; a i3':fits tr.. t - •-s
shall' un employ any lishousin in any manner to as m become subtem to the Workers ' t
NOTCEI O APPLICANT If after late
APplcm
ranking'his C nofide f Exemption,nCddh%you
midst -
become subject i ro the such p visions r t Provisions of the Labor Cda yo must '
Q 0 fonhwuh comply wnh such provisions w this ked
p Permit d do and revoked
AGENCY
lacrillbyi Mr.11c.1
is
nstracti.
madan
of the dirkrk far shhthis CONSc�UC(loud SNn3M7 CvC alit.;for the�rf'imance - .. .. . . .I' 1: •!,.1,`' 1•_ . . .".._ -
t.7 0 1 dimity the 1 have mad this application add state Nm the above information is
'rL [.. cortex 1.gree m comply with all city and mumyoNinanc<s and sine law.relating
0.0 building constmaion,and hereby inimmaae sepresentiivez ofthii city to arm,upon
[y the above-mentioned property for inspection purposes.,
,.t (We)rgrte to'ase:iademnify and keep Is ass he City of Cupenirio,against
rr V] liabilities,judgnrmx,costs and expenses which m.y.in any way acerae againxt said'
V_ City in cansequcnce of the granting of this permit.' -
'APPLICANTUNDERS NO WILL COME Y W17H ALL NON INT
SOURCE REGULATI S. -- O Issued by: Date
Signrawre of Appl' dmien "" +'.: t•-, ,Date. '. Re-toof$
HAZAR S MATERIALS DISCLOSURE `
r
Will the applicant or future building occupant st.or handle hadrom us mmerml Type.of Roof
.e defired by th<Cupenln Mmaicliciladde9.12.end the Health ad Safety ,v , t I r -
Code Rs 8332( 1 IS _ N3t4 i
O `t" t 4'S(•t^,s�
All roofs-shall be Inspected.prior_to any.roofing.material being.installed.
'Willtheapplicant or future building occupant use equipment ordevices which if a roof is installe'd,Without first obtaining an inspection',I'agree'.to'remove
emit hazadn'us air contaminants as defined by the Bay Area Air Quality Management
Dshbh - all new materials for inspection. Applicant understands_and will comply With
'e'ra wet �- ' all non-point source regulations,—I,.1 : I,,1.c•
I ha a hir&S.cy Cisdux erten Is r q imm<ne under Chapin 695' ,the ,S is
Calif mid Health ho'by Codes tmmasre0535533and255341miifij andtna ✓,{`_-
Ifthe bu ld ng din note tl hasea.euv r.tha if is as,responsibility to onufy the
aOcc u an f th rtmgmet htch must be met pow to is c f C<n urate of r L
p' Y G Signature of Appl' ant Date
/ All roof coverings to be Class "B" of better
ac
..OFFICE. - -
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
&CITYOF Fax: (408)777-3333
*UPEkTINO
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.
MPORTANT: -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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
Address: X33 �-
Reroofing Company Name: 0/A_L Go 4
Applicants Signature: Date: o/
Joe Antonucci
(Chief Building Official)
6/25/01