01110058 ctBUIOF c DPERTONPERMIT No CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
22086 HOMESTEAD RD GROMO ROOFING 01110058
tER'S NAME: APPLICATION SUB DATE
OM MOONEI 121 W WASHINGTON AVE 11/13/2001
L (408) 746-2075 SANITARY NO. CONTROL NO.
p O O ARCHITECT/ENGINEER: ' BUILDING PERMIT INFO
z _ BLDG ELECT PLUMB MECH
v i u'c. I—I LI L _J ___I
8LICENSED CONTRACTOR'S DECLARATION
;Zy°� Imiebyieffinn Oth lam licenadmichmiovi,mne.f Chapter 9(commencing Job Description
:twith Section 7")ofD'vision3oftheBusinessendProfession,Code an,license REROOF.
is in full forte and cff
zwa •Licensecrosa r.- 51 Lic.x_ 73 ?3Y T/O 2 COMPS & REROOF 30 YR. ELK.
'O d tU- Date Comractm
a c.y ARCHITECT'S DECLARATION
_ 1 and enland my plena shall be used vs public records
T
i d p O Licensed Pmfessienal
o OWNER-BUILDER DECLARATION
1 hereby alarm that 1 am1, .sumps from the Contractor's License taw for the
Cf Ito mem SectiontT5 Business dP f Code Any sty of county
a.co ° mlchrigasuaeeno reconstruct, p d It t ort a sig any structure
' print e x Im eq the it a Ire nmicense Law
w(Chapter t _ _ _ _a.
that tic secn. dpeauaa the n.of the Contractorsand Pr WwonsCer9 S Ft FIOOr'ATean n Valuation
(commencinge c th Sect n 7000)ofDivisionbJ of the Business and Profess ons Code) ( C' +9.
or that he is 31.5 b tanie7mm and the baste for the subjects
the eicmpuo o Any l violation t F h]Q07 nn
of not mo than
iv any hundred
sat for a Permit mbjects the applicant to a civil penalty
menet tens man rve nammd anhar,ast>v). APN Number Occupancy Type.
°1,as rofthe prupeny,or my employees with wages as Nei...)a compensation, 10 5 - FRAME
Rmiti o'tbed Pro(Profesmid sion,
scams is ulmcue'd License
a eredLaw for suet(Secappy town 3 0 7 - INSULATRi fired Inspections"
'owner of pro Professions Code:The roves ham's Licence Law due,netapply m an '' " `•�
orvthrcughhseownem66tWds Orimprovest mean.andw he vements assntintenwork ded or 601 - ROOF TEAR OFF
g ployees,provided that such improvements mi.1 ore not intended or -
q c 6r sa e.
.howeveret<bmve torimprovementn sold within one yevrof 602 - ROOF PLYWOOD NAIL
c:Smpinion.she owner-Wilder will have the burden of proving that he did not Wildor - -
improve(orpnrposenfxale.). 603 - ROOF BATTENS
❑Las an or Ne Psoc.7am Businessland PraedngwhhocrnaThe Connorsto .604' ROOF- IN=PROGRE.S'.S'..
License she preen(Sec ]Ica Business neu d P f ns Coca:)The Convenor,
ard,wi Law duce not apply t l et dpr pent' he)lids se mprosm thereon - '
.
Characters
Livens for ouch projen w th ro t a to Is).hcenscd.purxuam man.
I i
Comm�6ra L cense Lots
- -
111 am exempt under S ✓ ',;B&PC for this reason
caner 'D` . •. . � ��/
WORKER'S COMPENSATION DECLARATION
J l hcmby vRnn under penalty o(pelf ury one 6f the following declarations: - ✓✓✓
it ❑ 1 have and will inuimuin a Call Eemm of Consent inset f4sum 1'or Worker's
i� Compensation, ax provided for by Section 37W of the Labor Code, for the
performance 6f Ne work for which this permit is issued.
°I have said will remntam Warker's compensation Insurance,as requited by S«rice
37M of she Labor Code,for.the Performance of the work for which this permit is '
issued My Workels Cnmpe t dn'Immum a can cr and Pot cy a he
Cam r-1 Te 1r77k] yN OPolivy No.: I&Cf- /,("�' .; I'xryt he'd -�a gsbp •nht" . w 1 '. ' s:aLt.
', .v—EER TII KATION OP LXEFROM WORKERS'
ON INS
.-..._ _.. OMPF.NSATION INSURANCE'. ' %.., .,.
" .Ifnoaiecuon need not be completed if the pcmmt is for one hundred dollars - "-I - `] t: •h - ----
Is I0m)or less.)
:
. . _ .. ......... .. .. ..�.,_.-._.. .-... - ......... -_mow... . _
Ic tett'thnth perform ( r -hchthspe t Isue41 (^." •;i„ a »:1-_ .-.-«��._ w~i.,
ilial)not employ any
y p eom n aby'manner toso as to become xutiyct iolheWo&tri '
Comi,ic.steme Laws
of C I f m.Date'
NOTICE adi cie,he ANT I' fmhpa...gthis Cen hasofale of Labor Code,you ould
most
became subject m the Wurker's colons or sch provisions of the Labor Code,you must
Q O fanhwith'camply with such provisions nr this permit shall he deemed revoked.
_- .. . ... _-_ ._ _ ._ .. . _. . -. . ...
CONSTRUCTION LENDING AGENCY '; nC• ' ' - " '' '
1 herabireffine that th ''e consvummn lead ng agemcy,fmr the perrmmance
n(the work for which Na lateral, s issued ISce 3097Crv.C)
Q Lend. iNme ^. _ _.�.
Lend Address "
V1p Imnify that l have mad this application and statethanhe above information is '
W'F concel.11 agree to comply with,all city and coumy,ordinances and nate laws mlating
0 tar) to Wilding construction,and hereby auNonie repress tatves of this cityt enter upon
Ii7 me also nto dperfectlyf inspectionprpose -
-S (We)agree t sae indem ft' d keep Fairness the City of Cup tl 'pt est
r fp liabilities.judgment,c t endxpc w h ch may u any w t' gains,said
C.7 :7a. City to - 9 e of th g m g flu Ia s - e
AI'7f(CANT UNDER,STANDSAND WILL COMPLY WlTHkUNONPOINT' ]sSUedb
SO EGULATIONS y Date
Signemre of A11lialmOCeintichm � L nam - Re-roofs
I HAZARDOUS Wilding
occap DISCLOSURE
WiR the applicant or(came bis ld ng cecupv t store haMle hvurd material . Type Of Roof _ ---
Code.
❑YY N p stet'
defnM b the Cupertino My al Code Chapter 9 12 and the Hca1N end S
Sect on 253JNa)l v i_ } s•. y`• 1 r., r q q .'p'7 ken e t 1 i f s .' '. se f.
µ ,ti ...All roofs shall be.inspected prior,to,any.roofing material,being installed._
- 3
,Will the ppihme,Or f m,bolding occaptim om equipment ordevices which If a roof is installed'without first obtaining an inspection;I agree.to'remove
on hazardous I,aimitermants as med by the BayA lAlQ Quality Maagement
Daniel? all new materials for inspection. Applicant understands and will comply with
{� °Y s all non-point source regulations.' .
. ' b g hazard s mean 1 r.quttements under Chapter 6.95'6f On
Safety Codes.`Setiom 2550525537 and 255341 ndemaridnit n /
if th Ito(thread'the currently have a tenant,that my responsibility notify the - r
Celfm Health&
if the Wilding does not _
p q rem is which muse he i prim'(ensu ntt-f n C n ficete of ��—
U,ran m Eo '
occupancy t Signature of Applicant _ Date
� All roof coverings to be Class"B" or better '
get Dale. ,
%:;: - _ ,. '•-i-. . OFFICE..
• .,,,,,, Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333 .
ICUPEkTINO
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 1/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: X12-
Address: 14
Reroofing Company Name: �aoryo azooiiyc �Fz�.vcil �a ca4,z Yzd,
Applicants Signature: Date:
Joe Antonucci
(Chief Building Official)
6/25/01