Loading...
06060215 CITYOFCUPERTINO ":n c +s, "+" P++^k BUILDING DIVISION PERMIT coNTRACTQR INFUI,tMAT10N BUILDING ADDRESS; PERMIT N'04060215 04(]60Z15 OWNER'S NAME: PERMIT ISSUE DATE KIM NAROG ONE: SANITARY N0. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG EIPLT PLUMB MECH 0 0 0 0 L_pp LICENSED CONTRACTOR'S DECLARATION 'pI jo I hereby affirm them 1 am licensed under provision of Chapter 9(commencing Job Description pRaaw� �w �� with Section 7")of Division 3 of NC Business and Professma,Code,and my license is yl w L)wea{Yg InMir ame.ndeIf -7 REROOF i Z Damn4, I) F913"se CI C nrmcsar .aYmARCHITECTS DECLARATION ONTRACTOR: MICHAEL BLAIR .1111- 1.17 2004 .atq 1 undersand my plans shall W used as public records D U n ;0 as LiccsucJ Pmfasional p�UI DING OWNER-BUILDER DECLARATION 16 1Y{� ii @ I hereby affirm that I em exempt from the Contractor's License Law far the O D following moon.(Section 703 1.5,Business and Profcesione Cade:Any city or county $tai which requires a permit to construct,goer,improve,dcmeltah,or repair any sweum prior o its issuance,also acquires the applicant for such permit to file a signed statement £ flout he is licensed purment to ft provision of the Common's Ucaugge Law Chapter 9 Sq.Ft. Floor Area Valuktjojno 0 0 w+ $ (commencing with Section 7")M Division 3 of the Business and Pofcuio.Code)or Nat he Is accept thrafron and this hub for the alleged assumption.Any violation of Section 7031.5 by aro'applicant for a permit subjects the applicant In a civil penally of APN Number Occupancy Type not marc than Bm hundred demon($508). ❑Las owner of Jrt propeny,amyemployca with weguutheir role compmsenoq 3'571076 ' 0(] will do the work.and tha sesame is not intended or offered for safe(Sec.7044,Bushws Required Inspections and prolamin.Code:The Contractor's License taw don amt apply w an owner of q p raptly who builds orimprovu therman,and who docowchwarkhimself arthough his own employees,provided Nal such improvements are notlnwn led oroffered!orale.If, however,the building or improvement is gold within one year of enmpledon.the owner. builder will ham she harden of poring Nn he did not Wild or improro for purpose of sale.). ❑I,as owner of Ute properly,em exclusively contracting with licensed canmemrs w cansmuct the project(Sec.70x4.Business and Profusions Code:)The Contrecwr's I.A. ' cane taw does not apply to an owner of property who Wilds or improve human.and + who comrscui for such projects with a conuacwr(q licensed pursuant to the Convectors License Law. 0 l am exempt under See. ,B&PC far this won Owner Date WORKER'S COMPENSATION DECLARATION I lowly&firm under penally of perjury arc of the fallowing declaration: I ham and will maintain a Confliction of Consent to ac161nsurt for Worker'sContra- gatian,as provided for by Section 3700 of the labor Code,for to performance of the work for which this permit is iuuN. ❑1 have and will mainmin Worker's Compensation Impurance.u raf ired by Section 3700 of the labor Cade,far Ne performance of the wok for which this permit is issued. My Workers Compensation Insuence carrier and Policy number art: Carrier: Policy NO.: + CERTIFICATE OF EXEM PIION FROM WORKERS' COMPENSATION INSURANCE (Tho sectionneed not hecompleted If he permit Isfaronc hundred dollars(SIM) or legs) I certify that in the performance of the work for which this pcmnit Is issued,I shall nut any in try mannerouwtrso bjectmth 'o ' Lawsoi on cation Laws of California.Date Applicant `—�� NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should became object in the Worker's Compensation previsions of the Labor Code,you must .,O forthwith comply with such provision or Nis Permit midi be decreed revoked. zCONMUC1ON LENDING AGENCY [ti Thereby affirm thin thane b a construction lending gency for the perfurmancc of {Y+ the work for which this permit Is issued(Sec.3097.Co.C.) Lender's Name Lender's Address U Q 1 certify that I have read this application and saw that the.bow infomnadun is U.F comm.I ggme to comply with all city and county ordinances and suite laws misting w DU building construction,and hereby eutharim rtpresemadvcs of this city to enter upon Ne f47 abovmmentiuned properly for inspection purposes. (We)agree to on.indemnify and kap harmless the City of Cupertino again' r, liabilities,judgmcnw,costs and expenses which may In any way game against and City U7 in consequence of Ne granting of this permit. ^• APPLICANT UNDERD W COMPLY WITH ALL NpNPOlrrr Issued by: Date SOURCE Re-roofs Sig tart al ApplicanUConuanor Data HAZARDOUS MATERIALS DISCLOSUREType of Roof Will she applicant or future building Occupanumm or handle have ous material as defined by the Cupertino Municipal Code,Chapter 9.I2.and the Health and Safety 'idnipow.S'"' s3z(a)7 All roofs shall be inspected prior to any roofing material being installed. 1)'es No Will Nc applicenl r falart banding aaapant am equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove Wait ho.rdous air conte inane as defined by the Bay Area Air Quality Management all new materials for inspection. Duaria7 [3 Yes o \\ [lover,arl theha nusmaterials requirements under Chapter 6.95 of the Califor. ( J �' L' nigH.Ith&Safety Cad,Sec6a.35N5.35533ud25N.1unJ wild Natifthebuilding D dors not currently how a tenant,that It is my w i ty w notif y the occupanm of the mquircmcnw whichm met 'or 'ssi ce a CerdOcase of Occupancy. / S'jpppture of Applicant Date y e 1 4"7 All roof coverings to be Class+'B"or better Owner or eat 'red age Dec Community Development Department Building Division t> City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 OUPEkTINO 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: `� fA-RO Ct- �2. W YS tzA.�.l%tpO V Job Site Address: r_z Q— Roofing Company Name: L ai -T tl A plicant's Signature: Date: I V \�t/�S1NOW Greg teal Building Official Revised 1/30/03 Printed on Recycled Paper 1 CITY OF CUPERTINO o Z l REROOF • CUPERTINO PERMIT APPLICATION FORM APN# 35 I 0 ? (D Date: vLA D VI BuiIdin Address: OwneriC I e: M 4 © !RLI k — y LLQ Phone #: Contractor: Phone#: License#• MIGF � Z 2 S — (o557• 50-7503 Co tac v/ Pho e#:l dCupertino Business License#: 2�i5—C95S� �3 -c�52 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes /o 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: ❑ Job Description: i 0 y (�� v I of -5;1 (t-J A L/c O S,3 � s Co Residential 3 Commercial F1Fire Zone:/ Yes ❑ No ❑ Confirmed with Planning Det. if there are anrestrictions: LI Cost of Project: Type of, t ction: Occupancy group: ooc� "o Dv PC !✓5L Qty. ifs"' A litab e Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING zea