02090014 '.CITY.OF CUPERTINO
r.'BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADD ESS: ' PERMIT NO,
228'30' 22840 'RIDGEWAY DR 02090014
E: APPLICATION UB DATE
O6RM
bIDGE OF CUPERTINO HOA 09/04/ 2002
PHONE: SANITARY NO. CONTROL NO.
Y:
j'00 ARCHITECOENGINEER: a BUILDING PERMRINFO
ypp a.. BLDG ELECT PLUMB MECH
Z O N Z v' t L ,�. •LICENSED CONTRACTOR'S DECLARATION Job Description
O z 1 hereby aptm N i 1 am licensed under puvisions of Chapter 9(comm :ng RE ROO F p
M Section 70,130)of Di t on3ofihc Business and Professions Cade.add my license @�■
-I Liom l force end l`pst3 li C y FII]`FIs A L E 13
oYs m sc 1.¢enx Class ✓ Lle N b .J
Dm Contras
ARCIII TECT'S DECLARA' ON 1 'f �]
t-�O'g •r'4 1 d tond:nyplans shvlbbe used as public xcords" JUN 1 O 2003
ou
�a�'s
i p L;eenxd Professional`OWNER BUILDER DECLARATION
u�'-R LL ;�-�ma hereby eRrm Not 1 am exempt from the Convacmra Liunx Law for the G BUILDIN\7
C?O fall ng rtaxn (Sttuon]Ol 13 B mess end Professions Code Any c ry or
county $71795
wh h q e e Parma to earl.t n Icer,improve,demobsh,or repay any
structure
�$ pp mai antt,Nsa ray :rex th eppbcam forsuch permtmfleaatgnedsmt m. - - - _....._... ..... -...
Nat he.t§bceffsetl pars wuoth pro tonsof Ne Conmactoh Liocnx Lew(Chaps r9 �, N I '3 „Qv.�&tO�l(ToDa ,r; t•tr Valuation
(comm a ng wuh smyo TQ00)of Drvivon l of the�mmcv and Rofesvoas Code)
br Nat he is comp tlmiefrom'ond Ne bans for the alleged exemption Any
violation
-of Seniors]0)LS by any vpplis-adt far a permit subjects the vpplirant to a l annually- t
)of noomort Nan five hundrcJ Dollars(E500). 305AEN f1Ipr 'i w_-l.r:rr ;> Occupancy Type
❑1,os owner afihe properly,lir my emplayces with wages as their sole compensation, 307 INSULATION 1p�a, !
-will'du'the Bork:and the'nmcmre'is nm imm�dedror'dRcred'for sale'(Sac']044,- - 601 - ROOF TEryGtr(I(gp IDSPBCIi0I1S'8"-''
'eBmomi'mi Pmtcram Code:The Contrxtor's License Law docs not apply m an
owner of property Who builds or improves thereon.end who does such work himself 602 - ROOF PLYWOOD NAIL
in I'm got
o his mvn employees.provided than such improvements arc not intended or _ _ _
compldfon wle.urer eld tneb avec pro mmisxld wnh•none ycaror' 603 - -ROOF BATTENS .:. n,, c
completion,the owneobudder will have the burden of proving Nm he d d not bis ld or -
improvemrparpuxorxale.l. 604 - ROOF IN-PROGRESS
Ohowner oNeP Pe nm uvelYcunmctingwith
m.ct the proct(Sa.700.,Bdginss and Professions Codes The Cinricu '. -.r—....__.._.-
License Law does not apply to an owner of property who builds or improves intention,
`•� � .and who'commcts.for such.Projects;wip,a contmon0t).licensed pursuam.to.die ------
0
C t t Lcensely I l asl:ft 1 _ 's i
B z ❑1 c ptundcrS 0&PC fonhisrtamn ,, , I '-:. '71'i
x
r Owner' I "'Dat' •,.. '
s'.'-,' ="".4"" S. "'WORKER'S COMPENSATION DECLARATION
-1 hembyeRrm underpe tyofperu
ry,nc of the follsmving decluations:--
❑al have and will maintainf'ar Certificate of Concent to self-insure for Worker's
Cmmpacnsution; as�provided for,by Section 3100 of the Labor Cade, for the
z. pufonnvnee of 46e work for.whlch Nispermit is issuedt h)'
q{I hwe•ond wilrmvntairi Woike.Compenwiion lnsunnce,ai iequited by Section
9]110 of the Labor Cride for the phformance of the work for which Nis permit is
is x d My Worker Com n t In mn cart er and Pol ty umber are
Carter � of yN 2S62 -O r k A 'a
s .',CERTIFICAfIONOF,E%EMPTIONFROM.WORKER4I', �1 +�••• _ .x
-t w••`.•�_ """COMPENSATION INSURANCE°1" '
(This seninn oced'tnt he eompined:(Ne permit is far one hundred dollars + '
(SlOot or less.) 4
gip- l ,it,fgg'Ihtin:hep Inn- am tr w' to comhdin,ubectn'tsss dI I �l•tll v LIr AI_
Mail not BiL any person In any.manoar en as to become suM1)en in the Workers
CompensationLaws of Calf Dam
-..... .-__ _.. o
NOTICE TOctto he AN'I:If.C.6pemiumnprCimbms eaf ExemaCudc, should s'•.':'t"n: :o •au )
Q Oties me sue. n-th Work( C mpchsmmn pro fth Lvdu Cade y a .t
P nh uh c ply th h p t. ns or thn pc t hall b.dee ned k d.
%!CONSTRUCTION LENDING -
C 7ZIh mhy which th h tp re aconswn nn lcnNdg agency fo the,performance - -;� . . t . ..
,
of N 1 farhick Parma is issued(Sec 31191,Civ.C.)
Under,Address t I
-�,d Icertify that l have mad this application ad state thank Wve information is
FL �: c;imci 1 ii,ma in comply w nh all city and county. Nmonc s and mm laws relating
S.) to building c t ctio and herby au0iom prt a tatives of this city t mer upon _
the abo c meat died propeny for i mage'liam puganes
d keep h ,-. -
(We)agree to sateidemntfy anarharmless Ke Cuy of Cupemno againv VV
V7 liabilities,judgments,costs and eapenxs which may to any way accrue against said
V Z Cityy i co scq n e of the grant g' anti. -
APpLtCfr4TC UNbERSTAN DWILT COMPLY OpHALLN N
sol CHROIN •''
rc1.CAT1oNs '"*q .•.�' y, Issued by- Date
Sigmtorp•af ApplicmVConmfvor:';' "t;' ,h:' i ` ;.•,': �'W Re-roofs
':A< :FJAZARDQUS ATERIALS DISCLDSURE I t '
.„ °Wil the ppl¢ant orf wrc building ottupant von or handl hareNous mvensl
TypeOf ._ .... _s ->_..es _.n- . _ -- s r•..__,
s deE ed by the Cupentnn hlumapel Cod Ch Ater 9 @and the HeaIN end safe,, -
Code Seclion 15532(al: u a s 1 � . n j' n ^-i date. f;§?� a q ls'•,l :I �. t.'j
prior-to
..All roofs shall,be,>nspected prior_to any_roofmg material,being.installed.
wu N Ppliram orf t rcbuddmg a p i rympmem a< r.which If a roof is installed without first obtaining an inspecti6nr1'agree to remove
inn hazaN car conummams m defined by pe Bay Arca Air Qualtry Management
Dta en all new materials for,inspection Applicant understands and will comply with
% ,, „h;, I. „�t p , ' all,non-point source regulations..,..;,,,:, . n;; ,• . . -�
I by a read the h zvNs it seri cyu t under Chspt ti.95 of the
Calf off<alth&SafetyC le Sc tions 25505 25333 d235]4.t d s udthat
if Ne bold glees not cummlYh ate vmlhat t s yr gance, yt mify the -/j:�
od<upant ohhe.requirtmenu hch uit be t p f ss arise of e C it ficam of / �/T-
�_-g /NSD
7 Signature of plican[ _ .- _ Dale
- - --. .. _
nc
owner nr awnnnud eg P ,l, ,DAll roof coverings to be Class B" or.better
__ -._•.'OFFICE-. _
Building Division
10300 Torre Avenue
' Cupertino,CA 95014-3255
Telephone: (408)777-3228
C 0 Fax: (408)777-3333
CUPEkTINO
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 4"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: 1�.. ✓� //,,L�, -z9 ;LIv1�J
Address:
Reroofing Company Name:
Applicants Signature: Date: q o
Joe Antonucci
(Chief Building Official)
05101