02080034 c>BUILDING DVSIONO
IiSINPERMITCONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO. -
1155 KENTWOOD AV N P CONSTRUCTION 02080034
OWNER'S NAME: APPLICATION SUB DATE
RAM CHINCHALI 416 MARTIL WY 08/08/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 942-0520
G Q ZO ARCHITEC)ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
iia CI LJ CJ O
LICENSED CONTRACTOR'S DECLARATION
5„E Job Description
D Z_ I hereby )of that 1 n 3licensed under provisions of ns Code.taidanyliccass
(commencing
F_t is infllforce"4efDivisionJoftheBmincssendProfesionsCade,endmyliccnu REROOF
area a d,Beat. I i�1 A L E
eE IE
se 6 License Class Lic.x
3 a F Dale Contractor
ARCHITECT'S DECLARATION
] 1 understand my plans shall he used u public records DEC 1 0 2002
T
fz O O Licensed Profesxional
o. z OWNER-BUILDER DECLARATION
I hereby M.the,1 nm exempt from the Convactor's License Law for the
1:i followinjimason.(Section 7031.5.Business and Professions Code:Any city or county BUILD �O
SSC which requires a permit construct.alter,improve, an
demolish,or repair y muctim w
osis C3$ Potois suanm,also gires themplmm
ent for such peusw fideasignwm
edment
a. - tiler he is licensed punww Toth,provisions of he Cornerstones License law(Chapter 9 (# q t�Or,,p.�ea, Valuation
(c menng with S Ti lki'd of Division J of the Burney end Pryfessim,Coder y '1' 'I 13,55% ;\Cl ft ' [1,y'['S'kfl,1rb•i'
.,in.,he Is exempt therefmni'and the basis for the alleged exemption.Any violation .. t
of Section-7031.5 by any applicant for a permit subjects the applicant to a civil penalty 1,F' P
of at mon,than five hundred douars(ssoB). 3 0 5 APNMM4 e c c e tau Oecu aneY TYP e
111,as owner of The property,os my employees with wages as their sole compensation, '407 INSIT177,12IOhl
,will do the work;'and the structure isnot Intended or offered for sale'See:']04J; -' -- -” - -' -- -- -' f---
B imess`and'Pre(e ns Code:The Contractor's License Law does not apply to an 601 - ROOF TEARegfDb'0 Inspections
owner of property Who builds or improve then:on,and who does such work himself 602__- ROOF _PLYWOOD NAIL
or through his own employees.provided that such impmvervenm sm not intended or
-,offered for md,.If,howev&:the euildidg or improvement is sold within one year of --"— --' -' ""' -- - ---_--
completion,The own,mIder will have the handed o(provingthat he did net build or 603 - ROOF BATTENS \'•%T"'' ' �a�'n�'rt "'•
improve for purpasenfase.). 604 - ROOF IN-PROGRESS
owner - - - - — -
- -- -_-- - tint
_ - d,assownerPrthe property.am exclusively contracting with licensed Contrmrsm ,I.,,. Cls
nswa the Project(Sec.1064,Busies and Professions Cade:)The Conlactre 'v ^
License Lai does not apply m en owner of property who bunds or improves thercun
-- .-and wbo.go racts for such prnerts.with n commanr(s)licensed pursuant.to the ... ....... _.-., ,. _ .. . _.._ -------
C t s rs L,mv eta ....... ._ .,._._...
❑IWff,rept unddSJ 1Bis &PCfor shsrtason .f:T l7. .. .
er 1N / �'
WORKra6:&2J ENST'iiJ) D LARATION
hereby M. nd r,pcnehy of pe ry nne of the follow ng declarations:
❑ 1 have and will maintain a Certificate of Consent to self-insert for Worker's
Compensation, as provided for by Section 3100 of the Labor Cale. for the
performance'of'he work for which this permit is issued.
❑I heend will m Imam Wo ke'i Compemalma Insomace,as onamind by Section
3700 ofiee'Lobos Code,fordo performance of the'work for which this Pt is
C -imid My W.1ma'sCmailinitnum lnsurnme c merond Policy numberure, `
\11 k 1n - .. t u
. . Came '(" T I tat Put i
t XEMP
-CERTIh7CATT N OF ETION FROM WORKERS"
e ` COMPENSATION INSURANCE
s-:._......_....
... ecce..... ince ..,,tine. . ..- ecce. ..—...___.______...__. nine.-e ._.__�. ecce_-_••_,_
W."*I flhi"aeeuod need acts he completed ifthe permit is for one hundred doth, Ail, � "' " -.� - : (-'='':'I�'tili7:;Vl\�
(S I W)or less.)
Iced fyA(it the performs ce orthe wo kfwh Sh th apenn nit issued: c- t i Ili J last F - _
shall not p y, y Perma r m m ecttq 4 WarFlrt
o mo
�n
Crepe t of Cel f mp � er-/L s+-
'Appl¢ant�Wi/N
N.TuFE PO the ART:Work H' fmrnihmgeM�lmff,h Exemption , u Id
Q ObreA�if-s ble m Ili Workers r s Compensouon pro Worry of the lobo Code,you must
nhwtiti comply with such provisions or this pemit shall be deemed evoked.
CONSTRUCTION LENDING AGENCY
a, 1 he by afflina tat there is a constartardiondreg agency for the performance
`Under of thm,workf M1ich this Permit is issued(S In
] t Ch,C.)
=.z LandersAddrasys'
V Q
Irenify that l have mad this application and state that the oboe information is
tL.;•e.i c beet 1 agree to comply with hi all city and my d' i e f d state tc laws enter
uT ng
Q f,) a building-cons ctadd hercbyau,honx«pe representatives o(th \ymrnter upon
tW "heabove men dpmpenymnify and pryoses._ -
^.p,• �(We)ogee ts revs,indunni(y and keep handless the City of Cupertino ageinn
h ,bahtiwes dg em costs and 5 pen hich may m any way accme egamst said
U Z Cry n nee fthe gr Ip fN Proton.
';A Li T11104T\ and DWIL CO PLY I'm ALL NON( 11'
Sr I x a TIONS / ( f 0 Issued by: Date
Alit
r_1$i1ra,mo Appl- nnCo mr. i- t Re roofs
HAZARDOUS MATERIALS DISCI OSURh' "
W ihc'ml,ma r future bu Id hg ace p t ii handle hnzaN anp aI ,_,Type,Of.ROOf.
les dein Y the Cupenmo Music/py.Code Chapter 9 12 and Ne Health and Safety' - - - -�" '�
Cnd. OY 1
n255321a) til tHNa t - 'j es e,. s�
_- '4. t
All roofs shall be inspected.prior to.any roofing material_bemg installed
wit theppl canto future b Id g p t axe,q pm ,_..,devices which: If a roof is inm
stalled without first obtaining an tipect]on 'r- agree to remove
emu huad contaminants asdefned by theByAA Qm ty Mang t
District? "' all new materials for inspection. Applicant understands and will comply with_
-t; 0YC5 all no-- intsource cations.
bc.itty o f Ne t Same C( Sectio s 255 ,25553nts u d 5 4.1 ma 6.95 id
I I h a amrh�hu dons„aten 1 y dieof
p wYw m
y Jand25334 Ise drn dllit �Wy�' /`/ / \ _
- lfth b Jogsn, sere at nanT thattis mY rtPo ib'Ily ton Ify,he' """' - -' h" _ ecce _. ,a" ,P
p ge f cAf ate of . .
authors:- - r 01! a ,re of Applicant All roof Date.--
F q p to ss enc,o
! Gbw.C. �
D neva coverings to be Class B or'better I '
.: t . ': ,..._ecce .. . .__ .._ _ ._._ _•._ .
OFFICE
r
r- >
Building Division,
10300 Torre Avenue
4 Cupertino,CA 95014-3255
Telephone: (406
hone: 777-3228
)
OCIO Fax: (408)777-3333
CUPEI�TINO
Building Department
Subj ect: 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
Wand 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.
r a) Spark arrester installation.
S. 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 V"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: . Ayr kCNIWO" AC
Reroofing Company N NP C.mNSTX We 7i On/
Applicants Signature: czls�l Date: P/7/02—
Joe
°1—Jo Antonucci
(Chief Building Official)
6/25101