01100035 t CITYBUILDING DIIVIISSIIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
21154 LAURETTA DR WAGNER ROOFING CONTRACTORS INC 01100035
OWNER'S NAME: APPLICATIO;q SURD TF.
TANG HUI—TSUNG AND MEI—FAN S 12242 SARATOGA—SUNNYVAL RD10/ 052001
PHONE: (408) 777-8331 SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFQ
�y O BLDG ELECT PLUMB MECH
N<� LJ L-1 L.J L1
LICEy4SE
- I hereby¢Pram Nm IDam InCONTRACTOR'S
nsed undderr provisions aichapter 9(commencing Job Description
?ytu0s with Scaion]00(l)afDivisionJnfthc Business and Professions CWe.and my license REROOF.
4 x s= is in un roroe and erred. REMOVE SHAKE INSTALL 40 YR.
e m ice Class Lic.g r
odF Date eamren°r CLASS "A" ELK SHINGLES .
i 3 n y ARCHITECT'S DECLARATION
t`
0, 1 u W<emnd my plans shall b used as public records
T
i d o O 1-iccnx0 professional
- = Oat I ma exempt
to DECLARATION
to I hereby.St thin I ..Business
from the Conuacmi s License taw for the
t>-o following reason.Section]031.5.Business and Professions Code:Any city or umme
Ho which rtquhe perm t t s ct. Iter. top < demolish u epai any structure
ounty
6 -=its it requires.the applicant farsuch pumnto file.aimedLaw(Cha(Chapter
wt n a licensed p er t t me ororo or N<co Contractor's l.,enx law(Chapter 9 , ,} S Ft Floor Area uation
(cotruntKng with Section 7M)of DivisionSof theBussn,.empion.An vi case) LC..S.. -f\. �)L•. k-"I s.a.�1?.�a .s.{j\: $110Y�
or that he is exempt Ncefr.m and the basis for the alldged efempuon.Any violation
of Section 703 IS by any applicant free .it subjects Or appit.,to a civil pemlty
of act mnrethan five hundred d.IlarslssOpj. 3 2 6Alft�TTIIVO 1 ' Occupancy Type
❑I,a owner o1 the property,or my employees with wages as their sale compensation,
will do the work.and the structure is not intended or offered for we(se¢.7044. 3 0 5 - FRAME Required [ns actions" '
Business and'Pmnotfessions Code:The Contractor's License Law does napply to an Q p
owmr of pmpcny Who builds or improves muco,and who does such work himself 307 — INSULATION
or through his own employees.provided Out such improvements arc not amended or_ -
'offeree for sale.If,however,the Wilding or improvement is sola within ons year of 601 ROOF TEAR OFF
complchum,the owncnW ilder will have Ne home.of proving Out he did not Wild or
impromfmpurpoxofsse.). 602 — ROOF PLYWOOD NAIL
01,as Ownerothe pmpeny.omeaclutamiyouctractiagwithiimmundmuauamau, 603 — ROOF BATTENS
maauun the project(sec.7044„B.simo,ana Prorecvons Code:)The Com.mior's 6 04 - ROOF IN-PROGRESS
-�
License Law does not apply to an ownthere
matter of properly who Wilds m improves on,
end who contracts for such projects with a cionomwo,)licensed pO,mril to the t
Contractors License law. ,
I am examm under See ..B&PC for Nis nmson - sf
whatDate
WORKER'S COMPENSATION DECLARATION �e VALE®
1 hereby aft under penalty,of perjuryone of the following decimations:
❑ 1 have and will maintain a CmiEcate of Consent to elf-insure for Wmicrs OCT 1 6 2001
.� Compensation, as provided for by Section 3700 of to labor Code, for the
_ petfonnance of the work for which this permit is issued.
❑1 have and will maintain Workers Compensation Insurance.as meta ed by Section BUILDIN
3700 of the labor Coda,for the perfotame of the work for which this permit'is G
issued.MyWorker's[ pen:to 'I cm
surance rcr and Policy numrthere
cam S'-f4te '•�wAl� PoLcy No .ZY oon43lC .:3 t -L r ',(T-dr.r': ”.
s'CERTIMCATION OF EXEMPTION FROM WORKBRS',I t. '•!.e !. n k`, s tl � - Y { _
COMPENSATION INSURANCE,'.:
rl'M1is scnion nccJ nm he completed if @e permit is f r one hundred dollar s i ' I s) .I"'11 '1"•
III visor lets.)
I certify that in the pe in my m nn the work for which this petit n issued,l -
Comen employ any penin to any manna w ss to become subject to the Wmken'
Compensation Laws of California,Dae.
NPOplucam
TICETOAPPLICANT.If,afar making t Exemption.
this Certificate of Exemption.,sshould
manal
Qbecome subject to the Workers Compensation provisions o(the Labor Code,yin muse
forthwith comply with such provisions or this petit shell be deemed revoked.
CONSTRUCTION LEN)NG AGEI4CY'
"I herehy affirm that dice is a construction lending agency for the.perfdrmsnm '
�- of the work fm which Nis petit is issued(Sm.3097,Civ.C.)
Pe (� Lattdu's Name"
L embn s Addresr"'
V 0 1 cenify the I have must this application mad am tut the above U.S...is
f+a Ey correct.I agree to comply with ail city and county ordinances and state laws relating
0'U to Wilding conswction,and hereby authadm epdsentatives of this city to enter upon
the above-mentioned propend for impaction fyandkeep
purposes.
(we)agree m save,and expenses
k hi hamay in ma.my ityway.
.o com against
against _—
L to city in co sequence casts and c g ifflo which may in any way¢cense against said
V City in consequence of she Starting of this petit. _ y�
APPLICANT UND STAND r/NDsy_J L��L COMPLY WR'HALL NOWPOINT' Issued by: Date �Q^S�l//
SOUR .G IONS. t+•�•�^ !n Q
Signpedr.ofApplimaUCimunw orRe-roofs
HAZARDOUS MA AIS DISCLOSURE 'r
Will thert,lisnartor future bit Ing occupant are or hood a braccurtoses ttutaiel Type of Roof
Cade S❑V sorapel 'sMuml Code outlets 9.12.and the Hf ilth end Safety i f: - 1 s : tl- 15i W�,
is
No t
All roofs shall be Inspected.Prior-to.any roofing material being Installed.
Will the applicant or future Wildingmropanl use equipment or devices which If a roof is installed'without first obtaining an inspection;l agree to remove
emit haurdous in,contaminator as defined by the Bay Arta Air Quality Management
Dismct] all new materials for inspection. Applicant understands and will comply with
❑v<a �IJc .. all non-point source regulations. ,
f hale read the haaadous'mo¢tialsmequiterm nts under Chapter 6.95 of the ,I '
California Hemb&Stony CWe,Sections 25505.25533 and 25534.I undersand that /
Ruhr Wilding does nolcumcmly haventenant,Out it ismy,responsibility tomify the
occupant of the requiremema which must be a prior m nsuentt of a Cenificaa of
°""p'"`y' Sig ture of Applicant Date
Own r imhodaed egret /.to All ro coverings to be Class"B"or better
I - OFFICE
1 I
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
ICITY OF 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 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: -7�941 6— k1a y $' 1 wel S
Address: 2 / �`� �-� r
Reroofing Company Name:
Applicants Signature: -y- Date: to oS 6
(11
Joe Antonucci
(Chief Building Official)
6/25/01