02070195CIsuoNcDVONO
CONTRACTOR INFORMATION:
BUILDING IiSIiNPERMIT
BUILDING ADDRESS:
PERMIT NO.
7433 STANFORD PL
GROMO ROOFING
02070195
OWNER'S NAME:
APPLICATION SUB DATE
MIRANDA YEUNG
121 W WASHINGTON AVE
07/30%2002
HONE:
SANITARY NO. CONTROL NO.
(408)746-2075
u ARCHITECT(ENGINEER:
BUILDING PERMIT INFO
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LICENSED CONTRACTOR'S DECLARATION
Job Description
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I hereby affirm 1 am licensed under provisions of Chapttt 9 (commencing
withSation7OW)ofDiofsion3oftheBusinessandProressionaCWe,andmyliccnse
REROOF
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is in full force and efrec
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ARCHITECT'$ DECLARATION
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1 understand my plans shall to used as public records
AUG 0 5 2002
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Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the C°mmcmr'x License Law for the
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following nm vu. (Section 7031.5. Business and Profeesiwu code: Any city or county�Di
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Or repair y swmm
which req permit t construct. alter. improve, dem ish an
$ 4 3 5 0
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earctors law (Chapter 9
Out to t cFissal pureso requires theapplicant for such Contrarmiuo Ble ene La (Chapter
that he n ed pursuant to the provisions si of the
ifs, ((�� ��j��pp
Or ar r
Valuation
(commencing lh Sen ]Big) of h oil P Code?
cing ) 'spoor the Bmmasandmn.A.,
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or that n exempt tnertfrom end the aper for the alleged <5emppon Any vlo
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natty
of Section any applicant a permit wbjar Jrc applicant to °civil penalty
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Occupancy Type
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!of nntmnretl,anr�ehandreddnlmr(ason).
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❑I, as Owner Of the property. or my employees with wages as their sole compensation,
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601 - ROOF TEA&eg0ieg Inspections''"
-will do the'work; and the strucmre' is' not intended or Offered far sale (Sec. 7W.
iBuiibai and Professions Code: The Contractors License Law does no, apply to an
ownerof property Jwhod«s such wotended
orimped
602 ROOF PLYWOOD N_AIL___
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employees that uchim intended or
or through his Own employees. provided that such improtissol are wbutithin
-�dUereeti le however.-thewnWilding p emenru sOo :lion nue year or
eompl i , thencrbu Id ill have the bud of that he did not buil) or
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-- - 603 - ROOF BATTENS
mpmo,fimparpoeeofeala.).
604 - ROOF IN -PROGRESS
OLuownerrojectpmpeny,p to
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usineselyton tubing.. CWcnudcomncton
oniwn the project (Sec. Business aro Profusions
or The
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ills wNContractorshern.
License law d«x not apply to an owner of propenY who builds Or imProvcs thereon,
to a
:..,wm1
ctorsl. licensed puuanLto the
who,cxmRxox fm,such,projccr.wiib. a.contmrs
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Contractors License Law.., • C
exempt ire PC reason
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Owner •- .' "'Date" '•. .r .
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WORKER'S COMPENSATION DECLARATION
I hereby aRrm under pcnehy Of perry y,one of rhe following declanliom:
❑ I have and 'wJl'mainumn'a Ceniecaie Of Consent to uluinsum for Workers
Compensation, as provided for by Section 37W of the labor Code. for the
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'performance of the work for which this permit is Issued;
have andwill mainrm Wi6hr s Con,vemonon insurrai required ny Semon
/3YW of the Labor Code far thximmarnince of the work'( which this permit. is
I°eu d My W k Ps C mpens t on hommin and Polley ber are 1
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Cart �%7 /. Ff/Cs�a:�t Poli No y.J-/i �
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rst CERTIPICATION OFEXEMPTION FROM WORKERSi, .",
m" t"' COMPENSATIONINSURANCE
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;n ''iThYsenlon need noth�complaedif dle permit ii forore hurorM dollerx
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(SIM)..r less.)ML
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;,le nfyth i'ndi prhmer riceof di_okfr htchm psmutsrsmeJ1
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"shall not employ any fever in any manner m as to int ome i, blcn to the Worken
Com nsauon favfC if 'Dat'
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I' NOTICE TO APPLICANT If far, making this Certificate ofEcmpt on; you should
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become mblect to he Workers C pensm o peniotsimn, of the Labor Cada, you must
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forth th comply with such provisions or this permit shall to deem J evoked,
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'.:i is+`'CONSTRUCfION LENDING'AGHNCY' t ..'t
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;'•"'"'I hereby'ifEnn Outrtherc Is it coniwcdou lending'aBcncY for the pcifonnance
miNa work for hchth.pe is sued(S 3091 Civ, C.)
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Und Addiessi
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II certify that I have road t y, o t Nota bo information s
far. t,,,
all pylic
d .t t I ws ng
relatives
torte t 1 g t, comely th II city andori
f erar
soWilding .unction ndhnbydmho reprhentadvex fth sty incineration
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she abo e P P°.
e t neo property finspectionkeep
Wel agreelows indemnifyadra, nJkeph I..i the
e Ogeiaid
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h ch may in any y aga net said
) dg encs, co t. ay.."at'n
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Cliabilities.
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joining of thea
City TUNDeof the UNDERSTANDS AND
APURCI \ UUUERO�ffSUDSAVD WILL COMPLY WITHAf.LSf Piller "'
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Issued b r Date " (�
OURCI.9�tI.ATIOM1S 1r /` -f"/ SOL
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Re -roofs
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HAZARDOUS MATERIALS DISCLOSURE
Wll'theapplicatorfum h'Id'_g p isto'm hmoletuiW&matenzl
.._Type..of Roof.
:a� defncd by the Cupemn Municipal Code Chapter 9.12. and theHealth and Sadc y
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Cnd $ 10 25$32(1 (til �ri I S�
are It 'r: tJ ) Nn, ;, , , ra
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p]I roofs shall be inspected pnor_to any.roofing,material installed.,--
;f Iwntole pplTanto Co.. tbuld' g clot - N p to de , which
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If a roof is installed rwithout first obtaining an mspection;'I+agree to remove
emit h J worm t dined by the BayAtenAirQualityManagement,
all new materials for inspection. Applicant understands and will comply with
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all non point source egul'atwns .
ran the
ion 1. req nrirm,33. send Chhpmr 1i.9
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and
ec x25505 25533 and 255WP .rand that
Cql f r Health & Safety Cute $ria
lb .a
s rely l ay
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Jotave
if nOt have tenant Out rs my rt ponsrbd
Occup Wilding Of the es no, mnii whieh't. ai h met t a m rs5u ce St a Celli ate of
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Signature of Applicant ate
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All roof coverings to be Class,"B" of better ,
n r or authorized agcm t �_�',' Date
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OFFICE....—
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CITY OF
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Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
IMPORTANT:
1. Flat roofs must have a minimum of VV 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 Zs: y s L� 'v C -
Address: 7 Y 33 -C IFd a r P
Reroofing Company Name:
Applicants Signature: —' Date: 7130 '� 1 Z
Joe Antonucci
(Chief Building Official)
6/25/01
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.
6.
If plywood is installed, a plywood nail inspection is required.
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 VV 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 Zs: y s L� 'v C -
Address: 7 Y 33 -C IFd a r P
Reroofing Company Name:
Applicants Signature: —' Date: 7130 '� 1 Z
Joe Antonucci
(Chief Building Official)
6/25/01