01090046 CITY
BUI DING DIVVIiSSIIONNOIPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
10661 CARVER DR WESTERN REGION ROOFING 01090046
OWNER'S NAME: APPLICATION SUB DATE
JOE DILL 231 N 12TH ST 09/12/2001
PHONE: (408) 360-9111 SANITARY NO. CONTROL NO.
`
giw0 zQ ARCHITECT/ENGINEER: BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
i t o L-1 1_I 1 _t
LICENSED CONTRACTOR'S DECLARATION
;Z_'� I newhyuffrzmtna l in,fimmedunaerp...ideas of Chapter 9(commenting Job Description
I_t with Seentn]WO)ofDivisio Sof theBusiness and Professions Code,andmylicense RE-ROOF TAR AND GRAVEL
is
1lfaree FINALED
m0 Liceme Class Lionq \l>
Date ,��N'O\a Commnnr .
I e,m0 t, ARCHITECi's DECLARA
g i undemund my plum shall be umd as public recoNs SEP 1 9 20 01
Y
1 a'O'�O .Lidens. Ptafsional ..
Oe,I,mm BUILDER DECLARATION"''
i n hereby.(Sect to 70 am overlap. dP Commences License Law fw the .. .
tom_ followingrdnen. emit1 ]o316,Businessandose,demolish,
Curio;Any city m, mywhic
BUILDINGS4480
I O moot rty perm s construct,eh p dIcromt or repair
any someone
.pn to ri se q the pili rf hpentdt toil a dsute nem.
than .rrf,.itpveti..0tnpoos f0 Cmra smr Cc I Clatter T Ta. , Valuation
(mmmenamg. tin stet ]fNNU of DI ' 3 at the��usincu and Rpfq nsCmel F"�},". p a'3.�7e y<,,l �j"af'''t I
of that or rs 313 t therefrom and the basis for the a11F'ed eke.ttt t An �' •' i
v g p y violation
Of Semion]01136y any applicant faapemdt subjects the applicant ecivil
o❑f Iri,aazmowoltetwthoafn thfieveProhupncdnrey,d odr omllYarsem16p5lo0y0e)e,swithw�ges.tneir sole compenpsaantieolsay 3 0� N NI5bccOccupancy Ty
pe
— N.CT
I 'will do the'wwk;'and the structure is nofintenaed ur offered for let,(Sm 7(sg4, f
, -
'-Baiinea's"nna-'Professions Code:The Contractor's License Law does not apply m an 6 01 — ROOF TEMq*FtPInsPecticns;t'''�' '
owner of pm may Who builds w improv.thereon,and wince does such work himself
or through his own employees,provided that such improvements am not intended or 6.02_ -ROOF PLYWOOD NAS L
-oRc cd for sale.IL how..the Wilding improvement is sold within arc year of -
ga'tmpro" 603 ROOF BATTENS
completion,the awrter-Wilder will haee the When of proving she he did nm Wilda — `" " " 'i" ""' ^ •'
improveforpurpareofaam.). 604 - ROOF IN-PROGRESS
cou sac Ther of p(Sm.7( ,Business
a wmm<uog with Code:)The omme m
License s The oes no ISm II.a Busmesz and Professionswhbuild,
Code:)The Cantheme,
License Low Jas not apply m an owner with
pro mdo who bullas nn lm urear thereon, '-
;'. = . and.who.mmmns.fasuch projects I +!c .IE '
p J with o.conmemrts).licensed pursuont.m the:
Comrenols License Law.. - __.._-__._._.... .._....... ......__..... --.___ ".__.. _.___�._ . .._._.__ ... ._.."
qU :
❑lath exempt under Se '
c. ' ..'. B&PCfor this reason i •�T jr•, ,(-;;j�::-
Ownce Dae
'WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of pergmy one of the following declarations:
0 1 have and will lnainiim'o Cenifc5tc of'Consem to self-insure for Worker's
_ ;Compensation, as, provided for by section 3100 of the-Whor Cade, for the
,perfornancb of the work far which this permit is issued.
❑Ih 3e"B will ordirmin WActtv Comp ns t .Iowauncc :impaired by Sailor
3]00 of the LOWr Code;for the,performance of the work.for'which this Permit is
rssued,My W"imloot C .7e .m Insure m" t r end Pol y numbe :,y
Ca�ee . I' islrc No.( a�•uaa�:� rri - - �__... ._._.�-,. _n --- ..Y_ _ ,
ER ATION EMPTf0N FROM,W {.r sn.' 1 t I', is :F. t il) i:`s. •..>,;.. 1 ...`la ` ! , ...ti I
h, ' COMPENSATION INSURANCE 11 -
`'' Clh ilct on rimed nm be completed if she permn is fa one hundred dollars ' " '• (+• J t
($100)or less)
i y . ,
-`til F ._ .. .._. _........... . .... - ._ .. .... ..
,y t I certifythattin the performs c bf the.s rk f h o'tin s pe t s tssued I - �"-- - '• '
shall t employ salt'per n In nY nn s - t Wcomei ble t in the Worken �• '-I'r 1.+,' '..)'•fI - '
t A knot-' APPws of Cohf Di{` - r
V - _ t. . . ,. . -....
o Le
; '+NOTICEbj LICA TIf frermakingthsCcn Certificate nitron;you should' i. 416 it
becomesubjc6l to the such sComprns5bon,manProvisions haoRhe Labor Code,you must
Q 0 fonhwish'complyw�it6 such provisions or this permit shall be deemed resulted.
^Z' CONSTRUCTION LENDING AGENCY' " oc,C!'4, v11 -
.I"' ^ 'I h rtb pffnn that tin construction leading
0.. yagency forrheL -1 -. t dp
oRhe k fo -h ch tin s pemnn l' d It c 3119] Civ.C) r.a'a v ,
y'Q'_.Lendels Na 'e w_....,, ,:.. t. ... ".. . .
Loodel'sAddre.T_ 1
pa¢cI centfy that 1 h read tin ily ad on and stem the the above,I...]an is
cl egme toply with all city and countrt,aNinanc<z and state laws relating
Y, run Wilding consutinid.:and hereby emnorize iep senmtiv.of this city to ether upon �,/®/J/'4/.�--�
bav a tinned Progeny for inspection Purposes
—
.W (W 1 gree io sa d mmfy and A e0 ,less the C ty f C peninb against
W,
It.b l a s Ju meats,c t d expenses h h may m any w y c against said
tJ ly City m con rice of tin gram ng of shi L COM' -
APPLiC 1LD�EpRDST�A$NOgAND WILL COMPLY WITH ALL NDN-POINT""- Issued
"sOVR III YY 1 :� r , ; ., Y� Date `7
>: stgnmu,a, m.M.:.; Date Re-roofs
US' ATERIALS DISCLOSURE (.
y,}
ill the pppbmm infirear,hall,fing occupant store or'handle throurach,
us indterail. Type of.Roof:
as defined by the Cu xitom Mun c 1 Code Chaps r 9 12 and the Health nd Safety
.a _ � - -
I Codas coon 25,�", s 'a
A
°Y " r f 1 '{ "{ f` All roofs shall be inspected poor to.any roofing matenal.baing stalled..
frem� wu m ppl- t rat W 1a g path use aqui t d vtpea wroth If a roof is installed'Without first obtaining ap'inspeCtici i,I'agreedo'remove
rah N u 1 tin rat refined by the B YArta A Qu 1 ty Management ,
03, ctl Hass read''me naxadoas mater ,.•all new materials for Inspection. Applicant understands and will comply with
'{ °d "° p• all non-point, urce regulations.
als hegmrements'und Chapter'6.95'of the
Celrfomti Heald&Safety Cod.sections25505:25533a 25534..Lundersurathin.
if tfie geilding does pot currently haveetenent.that it ismyrtspinsibilitytonotifythe \ -- - -- -
'dccoccu, - of mann hteh m it be m t pool to iiia race ofd Cmificate 6f
Signature o pp ice ,. _. . ._ -anDate
Owner qr t ,, ••;, r Dole.. All roof coverings to be Class`B"or better,
OFFICE —
, .. ,
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
• Telephone: (408)777-3228
CITY O Fax: (408)777-3333
CUPEI�TINO
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/"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: .)0Q
Address: �Uo
Reroofing Company Name:
Applicants Signature: Vrl Date:
WA
Joe Antonucci
(Chief Building Official)
6/25/01