02050097 CI BUILDINGON UOPE72TPERMIT CONTRACTOR INFORMATION:
BTL81 94 RftLISSA CT WAGNER ROOFING CONTRACTO FSMIY'k 02050097
Gv��TH`TOMIO AND KIMI 12242 SARATOGA-SUNNYVAL Agb`ffYfg't�002
PHONE: (408) 777-8331 SANITARY NO. CONTROL NO.
a s Z ARCHITECTIENGINEER: BUILDING PERMIT INFO
z w BLDG ELECT PLUMB MEC14
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.irtf?-, LICENSED LICENSED CONTRACTOR'S DECLARATION
Z„G anon, halamfeponsof
commencing
REROOF Job Descriptiontion
w wimebony�1ofDivision3otheBosonessandProlessionsCode.and my license full force
T O SHAKE, INSTALL NEW 50 YR. ELK
YO i V License Clan, Lie.a A9�r
Date CDntmcmr FIBERGLASS SHINGLES W/OSB 430 UNDER LAYME
3 O G, ARChell bCT'S DECLARATION
1 understand my plans shall he used as public records
i� :,q "'4%a,��
3 E5p o Liamcd Profits sirnal
OWNE&BUILUE r..the RATION OC
1 naso .soc that I am exempt from he Contractor Cock:
:Any c Law for the 13 2002
F Z< fallowing reason.(Satire 7031.5,Business and P a.demolish,
Cale:Any city s county
I O which require a pernit n vire,use,alcor,m,orsuch
demolish,Fi repair ed uwaurc
a. pct mus nee rs <qo .Pr ppl cem the Cot permn to Benne Law(nzmmem
mann licensed pursuant the Provisions of otheBmme,Lances'law(Chapod9 S Ft.FloorfA�p�� p1 $93�ua[ion
Ian mm� Byers Section Asa the basis
demdProfessors Code) + x I% s jq', y,' 7 LD I1tllG,t'
of that be is 3E5 b themrmm and the boar for the subjects
the 'adman to Any l violation t
-of Seunuethan vanydreddllfor apernitsutjamtheaPPliamtoacivilpcnnhy-
•rrnm corm team live hameme emlrrs(ssoo). 342/1"�)ffiu1nlfdl0 •- .: Occupancy Type
❑1,as owner ofthe progeny,or my employees with wages as their sole compensation,
will-do the work,and the srvcl u<'is not intended or offered for sale(Sec.7f , 305 — FRA= Re ulred Inspections
0 Business and Profession,Coes:The Convenor's License Law docs not apply or an Q p
weer of property Who builds or improves thereon,and who dos such work himself 3 0 7 - INSULATION
or drout,th his r y< provided th t such urprommem,am not intended or
sold within br _601 ROOF-TEAR-'OFF
off ted for sale If,er ,'ever,the bu have
the
improvement pros year — _ t
impowcifor theomiif,ullJer will have the lwtucn of proving that he did not build or 602 - ROOF PLYWOOD NAIL
improve for paryo,e of xafe7.
603---ROOF—BATTENS -- -
❑IasnwnerofthepmpcnY,amexdus IY co"coat g with licensed contractors to ,A
Construct the project(See 70t,lBusiness and Professions Crd<)TheContractor's 604 - ROOF IN-PROGRESS •
License Law does not apply to an owner of property veno huild,or improves thereon,
and who contmn fou-such Frojen,.with a conuucmr(s).licenced pursuant to the.
Convector's License Law.
Olam exempt under Sec: .BAPCfor this mason
0is
'.a, Date
WORKER'S COMPENSATION DECLARATION
1 hemby M.under penalty or perjury one of the following dalandions:
❑ 1 have and will'mainliin a Certificate of Consent of self-insure for Worker's
\ Compensation, as provided for by Section 3700 of the labor Code, for the
performance of the work for which this permit is issued.
O I haw and will maintain Worker's Compensedon Insur<hcc,as required by Section
3700-of the Labor Code,for the performance of the work for which this permit is
issued.MyW rrkcyr)-C/yy pc t 'Inxm c d Policy M
Ce a _.N.��Y.T IIiJ/V 1 Pol' ...-
,CERTIFICATION OF,EXF,MPION FROM WORKERS”
., -:... -... '.. COMPENSATION INSURANCE"'NCE"'• "c.: <
.-,_, ..I .,.' � __.
... .....,. ,i-,_..,- ._ ._____-....., ,.___...__...._...... .______.__
QMbis'scmisim head no,be completed if the permit is for one hundred dollars
HIM or Ins.
`{ffnfoy his
er pef of the work for-which this Ixrmti.i isuJl Yes. II,I sl '
itiull nm emplloy any p m in ony manner so uslubccWjeptl4 the Workers' s'
i Cnmpenzot�ion I�dw Cali�e'Da a"� /4 /O
;NOTICE TOgnt.ICANC If,ager making this Cenifieate'of Exemption.yoq shouud'
•Z become subject the Worker's Compensation pmvisioni of the Intior Code,you muit-
Q O forhwit6 comply with such provisions or this permit shall be deemed invoked. 'I
CONSTRUCTION LENDING AGENCY
- I h by ff- thathconstruction lending agency for the performance -
nfth work wh'ch,Aip t'.iouel(S .309] Cv C.
_ .._...._.._ .....
_ .. _,._... ..- ..
.L Landers Add s.
V 1 caddy that 1 h e mad this application and n t thin th abo information is
LasC E... i6rren I greetrcomply with Icahn' ry ordinances tam laws enter
upon �.,.'. .
Q, Lei tab e - en.t d dh hereby authorize of this city to ¢ pan
9LeiL. thebode emt dp pendfinspectionadd purposes
i st
Z, (Wjudgmemscostindemnify ana kaihamyina.the Cnyofcupe against
aid
Z, liabilities,judgments,costs gran i n ofdhup crus may in any way aarv' against said ^ `
City inconsequenceUNDERSTANDS
R the NDS AND
D NhiLLL CO •.
APPLICANT UNDERSTANDS AND H' ,COMPLY WITH ALL NON. I. Issued b Datey
SOURCE Y
Sign r ApplicamUContra 1 .^a - Re-roofs /
- HAZARDOUS MATERIALS bISCLOSURE
Will he tipplilam in future Wilding mp tsmrc or handle taciturn,material , Type of Roof. _.... .. . _.. ... - .. _.. .
r as d f cd by.the Coportim Municipal Cod Chapter 9.12. the Health and Safety
Codd Seci on 235320 _z d .' • s 7 r .. .:.: t' . .
Cl " • ", t' olvol,( •:'All,roofs-shall be.inspected.p;ior[o any.roofing_material being.installed
Will the pid t Or future Wilding c t use equipment or dcvicas which If a roof is installed without first obtaining an inspection, I agree to remove
corst him.rdiniserconi mains as defired by',ha Buy ArcuA QaIty Management
Douro^. � . . all new materials for inspection, Applicant understands and will comply with
OO ❑ve, , per ;., - all non-point source regulations., - -
C I W cad he Wood.us materialsWood. qu - t. u der Chapt "6.95'of the t
CiAibrni.Health&Safety Code Sections 25505 25533 and 25534 1 understand that _ /r ^rj
if theNiId gdocs not currently have at t that it is my po sbibiy m notify the i l/
Oc p nt f thee h h must be net prior to i. <rf a Certificate of
ceup-my. _ ...
Si nature o_f Applicant ' Da
..tWnzW g m,,'. q m
All Too Overmgs to be Class "B" or better
Own
OFFICE . ... .. .. . _.. _ ..
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
e 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 YV 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.
a p
Homeowners Name:
Address:
Reroofing Company Name:
Applicants Signature: Date:
Joe Antonucci
(Chief Building Official)
6/25/01