03070189 CITY OF CUPERTINO
BUILDING DIVISION PERMIT .CONTRACTOR INFORMATION
U BLUING ADDRESS: WINTER ROOFING INC PERMfT N003070189
OWNER'S NAME: 151 WYANDOTTE DR PERMIT ISSUE DATE
NE' 4083638052 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
=oo LICENSED CONTRACTOR'S DECLARATION O O O O
x l hereby affirm that I am licensed under provisions of chapter 9(commencing Job Description
n<i with Section 7MB of Division 7 of dre Business and Professions Code,and my license is
D�w in fcracclac,all effect. +m C4:ir
i Lieen elnaL�_Lie.. 7��91 REROOF
¢^o Da¢ .2'-d ComnnorL2l1 Y£y L>Ty
Fu ARCHITECTS DECLARATION AUG O 1 ZOO
K 1 understand my glens shall M usedapoliticJpoliticrecordscrecords
O y Licensed Professional
OWNER-BUILDER DECLARATION
a P 1 herehy.]firm mBUILDNG
at I.m exempt from the Contractor's License Law for the f
p D following means.(Sudan 7031.5,Business and Professions Cole:Any city at county !AA
S�1llAA
lu m which requires a permit to construct,alter,improve,demolish,m repair any structure
Fiy prior to its issuance,also mquims the applicant for such Permit to file a signed statement
-
hour act,becroce!purmara to ft provisions o(the Contractor s License Law(Chapter 9 Sq.Ft. Floor Area Valuation
rcll-er (commencing with Section 7000)of Division 3 of the Business and Professions Cade)or
i V 9 that he is exempt therefrom and the bud for Ne alleged exemption.Any violation of 32620133 . 00
Section 7031.5 by any applicant for a permit subjects the optician,to a civil panl,y.1 APN Number Occu ane Type
not mom man five hundred dollars(5500). P Y YP
I,as owner of the property,or my employers with wages as their sole compensation,
will do the work.and the strveae is not intended or offered for late(See7044,Business 3 05 — FRAME
and Profession Code:The Contractor's License Law does not apply to an owner of Required Inspections
property who Wilds or improve,themon.and whod«aauch work himseltor Nmagh his 307 INSULATION
own employees.pmvhled Uaa such impmverarai are act intended eratfered for sale.It. 6O1 — ROOF TEAR OFF
however.the building or improvement is sold within one year of completion,the owner.
builder will have the burden of proving that he did nor Wild or improve far purpose of 602 — ROOF PLYWOOD NAIL
sal..).
❑1,as owner of the property,am exclusively contracting with licensed contractors to 603 — ROOF BATTENS
consumer the pmjeer(Sec.7054,Business and Professions Cine:)The Contractor's Li- 604 — ROOF IN-PROGRESS
team law docs not apply to an owner of progeny who builds or improves thereon,and
who contracts for such projects wit a contractors liusucd pursuant o the Character's
License saw.
❑1 am exempt under See. B&P C for this reason
Owner - Date
WORKERS COMPENSATION DECLARATION
1 hereby all..under gc..try of perjury..of the following drelantian:
have and will maintain a Certificate of Consent to self-insure for WotkaesCemNn-
-on,as pmmdcd for by Section oro of the labor code,for the Performance of the
wink fro nth mice peons,is issued.
have and will maintain Workers Compensation Insurance,as required by Section
37W of the Lahor Cedc,for We performance of me work four which this permit is issued.
My Workers Cn pensation lrgyµantt anis and Policy number are:
Cartier: t/VI Policy No.: _
CERTIFIC TE OF EXEMPTION MOM WORKER
COMPENSATION INSURANCE
or leas.)(This section need not Wcompleted if the permit is for one hundred dollars(SIM)
I ecnify that in We performance of the work far which this permit is issued.I shall not
employany Noxam inanymrmac asyhCcpn^c sAct to the Workers Compensation
Lawn of Califon' Dam �t L (,a/ f C
Applicant ��-r� �
NOTICE T0, :IWAl a mg this Cctoficaa of Emon n m you should
become.Wjec o the Worter a Compensation previsions of the Labor CMe,you must
.J O forthwith ply with such provisions or this permit&hall be deemed mvoked.
z� CONSTRUCTION LENDING AGENCY
I herehy affirm Nat mem is a construction lending agency for performance of
LYi the work fur which this pconal is issued(Sec.3197,Civ.C.)
a Q lender's Name
=z Lender's Address
V Q 1 cenify Nrt I have rad this application end aux Nat the&bow informulun is
Gs, F torten.I agree to comply with all city and county ordinances and sure laws relating to
V building construction,and hereby aumorfn mpresemalives of Nis city to enter upon the
erty
�a abovoms,j.d,dna,scar for adc.pcuon porch may
t„r (We)agree to save,indemnify and ecg harmlcs,the City of Cupertino all
t�zN incenseajudgmcthcgmtsia othis s t. may in anyway accmc againsLsaid Ciry
lin COnuqu ec hf the Frnntin a(Ihis it.
APPULIC RLGO DERST SA WILL COMPLY WITH ALL NON-POINT Issued by:'soDate
Sfit itof pOaWCO Its _ `Dat Re-roofs
HAM US MATERIALS DISCL URE Type of Roof
Will the applicant os future building occupant store rehandle haacous ma¢dal
deroed by the Capetian Municipal Code,Chapter 9.11,and the Health and Safety
Code,Section 35533(x)?
❑Yea All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future banding occupral use equipment or devices which If a roof is installed without first ob inning an inspection,I agree to remove
at hire dour air mnaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
Imqui
mner9
0 Yea
lhavcmad Ncha,ardcrosmawrialsmquim nsundcr .Chaporti.95of Nc Califno- x-77
ce Heath&BalmyCokc.Suvun 8505,25573 d853a.1himaLfnd Nmifthebu.rula, -- _ , r� 7
cs not a w,, M1avc&anent thin i,ism c once 'sty.tonnuly,M rxxupanrof Nc /
riawhie m the
cc
ofs Cc
Qcupancy.
Sigq ty e ofpplicant Date
urautho nedage t LDatc V All roof coverings to be Class "B"or better
LCommunity Development Department
Building Division
1+ City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
U P E kT I N S Fax: (408)777-3333
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: E)44
Job Site Address: ._ ��j/ T41-ct C2
Roofing Company Name:
Aplicant's Signature: Date:
• Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF
CUPEICTINO PERMIT APPLICATION FORM
APN # Date:
Building Address:
Owner's Name: l Phone#:
L
Contractor: Phone#: License#:
C tact: Phone#: p Cupertino Business License#:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles le`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.
• I Have Read, Understand and Will Comply With Cu ertino's_Tear Off Policy: 0'
Job Description:
Residential g/ Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are any restric ' s:
Cost of Project: Type of cti Occupancy group-
nt
A li ab e Fee ID Fee Description Fee Group
BPERMFEE Bld PerFees BUILDING
BENERGY Ener BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
W,2 -2667
i � 7,