Loading...
04080057 CITY OF CUPERTINO -r,{�?"r,f.� fir" "mss ' �g�*"a*��g♦ �+ " BUILDING DIVISION PERMIT A+R✓},sg• 4^��! ,© 1vAf# IQA� ' BUILDING ADDRESS: PERMITNO. OLD COUNTRY ROOFING 04080057 9927 TWTT-TA14T 2T tPERMIT MUE DATE OWNER'S NAME: NE: SANITARY OL N0. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH u00 LICENSED CONTRACTOR'S DECLARATION w 1 hereby affirm that I am licensed under previsions of Chapter 9(commencing Job Deserip Z with Section] of Division 3 of Me Busincv and Petfe tuna Code.and my license is HNALED ^may imm�romre _ ueg *� REROOF W�COMP . neo L;.edG.mmamrff AUG 1, ARCHITECTS DECLARATION 1004 I understand my plitm.mll be used as public notal, Licensed Professional BUILDING OWNER-BUILDER DECLARATION i1 hereby alarm Nat 1 am exempt from Ne Convector's License Law for the 00 following.....(Section]121.5,Business and Prufessiom Code:Any city or county K>I( which requirea a Permil to construct.alter,improve,demolish,or repair any structure Fzy pearl,,i¢issuaneu,also requires the applicant forsuch permium file aligned statement Z< Nat hemptunsed pursuantta me pmvisi.mnf Ne Convectors License Low(Chapaug Sq.Ft.Floor Area Valutlon zt$ (commencingwim Section](10)of Division3.[the B.,mentnd Pmfcssinns Crede)or 3.. Mat he u exempt memfman and Ne basis for Ne alleged exemption.Any vlolallod of Section 7031.5 by airy applicant for a permit subjects Ne applicant o a civil pcmlty of 31VN1'bp_R*gr00 Occupancy Type not more Nan five hundred della.(55003. r ❑I,es owner or the pmpeny,or my employees with wage.as their sole compensation, will do the work.and Ne swcme is It intended or offend for sale(Sec.]840,Business and Professions Cade:no Cam.tmrs Lt...taw does not apply to an owner of Required Inspections propenywho builds.,improves Ncrean,and who doessuch walk himodror through his own employees,provided that such improvements an not intended or.B.red forsale.IL however,Ne building or improvement is sold within one year of completion,Ne owner builder will have the burden of proving mat he did not build.r improve for purpose of sale.). ❑I,es owner of the property,am exclusively contracting with licensed contractors to , construct me proper(Sec.7844,Business and Profundi...Code:)The Comments Li. came law does not apply to m be,of property who Wild,or impmn.dere..,and who contracts for such projects with a emin.1.1(s)licensed pursuant m dm Convaemr's License Law. l am exempt under Sec. ,B&P C fm this mason Owner Dan WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury,ane of the following declantims: I ban and will maintain a CeniOcaue of Cement to self-insum for Worker's Compere sound,Is provided for by Section 311 of the Labor Code,for me performance of tiro weak for which this Permit is issued. ❑I have and will maintain Waher's Compensation Insurance,as required by Section 3700.f the labor Code,far the performance of Ne work for which this parenil is issued. My Workers Qompensaa Imumnce carie,and Polic nu �aq�' Y 1L Paltry RS 7'y ' Oar _(!131111IONNFROM WORKERS' COMPENSATION INSURANCE (This secure need net W completed if the Permit is foromchundred dollars(1110) or Ian.) I certify 0.11.the performance of the work for which this Permit is issued,1 shall not ..ploy any permm in any manner an as 1.b.ome subject t.the W.m1o'Compedsa0un Laws of California.Date Applicant NOTICE TO APPLICANT:Ir,afar making this Ccnificam of Exemption,you shnuhl WLonn subject to the Workers Compensation provisions of me labor Cndc,you most - .J O forthwith comply with such provision o,thio Permit shall W deemed revoked. CONSTRUCTION LENDING AGENCY HI bnmhy affirm Nat Nem is a cunstreetidn lending agency for Ne Performance of p$ti dm work for which Nis permit is issued(Sec.3097.Civ.C.) W�Q Lender's Name z Landers Address V 0 1 ccnify that 1 have read this application and sum Nal Ne.hon information is U,t-" corned I agree to comply with all city and county ordinances and seem laws elating m OU building c.nswction,and hereby summit.oprennmives of this city to enter upon Ne W ab.vcmentimood Property far inspection purposes. G (We)agree to an,indemnify and keep harmless me City of Collards..,.last titA liabilities judgments,costs and expenses which may in any way eceme .lost said City U z in consequence of Ne granting of this Permit. APPLICIc���KKKKKPPPPPP'U RSTANDS AND ILL COMPLY WITH A NO DINT Issued by: Date SOUR Ea TONS. G" —G s/' Re-roofs Sign Gra of App cam/Com.cmr /)'/Dam `/ HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will me applicant or future building occupant store or handle hazardous material ax defined by the Copan!..Municipal Code,Chapter 9.12,and me Health and Safety ..eats Eeoti.n 25532(a)? ❑Ya .Jrvo f 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, it hazardous air contaminants as define by the Bay Area Air Quality Management all new materials for inspection. strict? ❑Yea 6n I have read the havardous materials requirements under Chapter 6.95 of the CalifonG�/J�� /�/+ Id..s Health&Eafcty Code,oustu. ]e,itison,mind25534.1 to earl ntl Notif Nc building a„/ t &Soley huts a rentor Net it is 55 responsibility to Lerma Ne o,if ft t nr the �� 1 oi�u' en rich u be met prior to is adcc of a Certificate of Occupancy u �a 9 Signature of Applicant ate w orauthmixedagent 't Dan All roof coverings to be Class "B"or better Community Development r: 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Cl OF Fax(408)777-3333 �UPEI�TINO Building De partment JOB ADDRE PERMIT# 933 flu Co(Ar+ U OWNER'S NAME: MAXt Lae, PHONE # 110$- -ql) GENERAL CONTRACTOR: ftAFAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information F� SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing G y� Septic Tank Sheet Metal Sheet Rock Tile e /Contractor Signature ate Community Development Department Building Division aoX City of Cupertino 10300 Tone Avenue Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 4UPEkTINO Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 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 re-roofing 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) Pre-inspection 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 a proper City inspection can be performed. IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " 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 on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: )-nn, K L_( LC' Job Site Address: 19 9 3 '�- TV11 C..-J G )t'r C O U Roofing Company Name: 0L'7 CC'©UIV-I—LA4 BOO F toJC Applicant's Signature Date: Y 16/O /u • Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO REROOF "��� CUPEF CINO PERMIT APPLICATION FORM APN# 3 3 �/ Date: F/6/0y Building Address: l 3 Tw ► c 1G/ Coin Owner's Name: Phone #: Contractor: Phone #: License #: C tact: Phone #: Cupertino Business [cense #: e55 7� 3 rF Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. AsLI Have Read, Understand and Will Com 1 With Cu ertino's Tear Off Policy: ob Description: r::Z, I-r d 1, Cs X�cSTI LS9 N o F- /NSTlq-z-L o S6 -22 0 —ec: -- '. 1 r � W I f a J Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: Cost of Project: Type of Construction: Occupancy gro 001= -3 Qty. if A 1' ab Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING