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CYBUI OF
c DIVIISSIIOrvNO
PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO,
20705 VALLEY GREEN DR # 6
ROYAL ROOFING
01100121
OWNER'S NAME:
APPLICPTION SUB DATE
APPLE COMPUTERS ACC.
1345 VANDER WAY
10/23/2001
PHONE:
(408)279-2332
SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LJ LJ
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing
TILE RELAY IN
with Senior 7")ofONismn3ofthe business and Pmfx.i.nsCodemdat, heenm
&
is in full fame. rte 3L
- e
1/2 CDX & 30 LB FELT.
Liccnve a.", Lic.N
Dare Comracmr
ARCHITECT'S DECLARAT
1 un0 .mod my plans :Hall bcysM as public mcoNs
'
Line Han
BUILDER DECLARATION
I hart soar 1 em exempt from the Conuaaor's License Low for the
following reason. (section 7031.5, Business and Professions Code: Any city or county
which rc s a permit to construct, olmn improve, demolish, or repair any structure
'q nae, also mqutma sheapplkmt fmsuch pemnino fika signed statement.
Four am iian
_ ... _ _. _ _. ._ _ .. .. ... .. __ ___ ,_._.__ _ ____ _- _ _
1 .$q,-F;�FloorrAren� t {/ y;�.
I_.{max as i`'1
Valuation
tloth{;ddicen wthnd Sixtdntldt00) of Divisionody 3 lmBConomamm ane ielawrms Code)
Code)
the Budpmsan�ire.An
ee9eito Saarefro or
t
li and the M1avis rh the alleged a tion. Any violation
or andthe basisvi
or tat
or Net lie Ik 31.5 byttroy
pltit
of SaGod ]031.5 by any applicant fora permit subjects the applicant to a evil penalty
sip
ornm mart roan five numrta dollars (ssoo).
APN Number
- . ., Occupancy Type
711. as owner of she propenY. or my employees with wages as their sole compenmsion,
305 FRAME
will do the work, and the structure is not intended or oRemd for sale (sac 71 .
Business aoil Profession, Cade: The Contractor's License Law does nm apply m m
3 0 7 — I NSULAT t
IIQ@Jf3ired Inspections'
owner of property Who M1ufids or impowas themon, and who does such work himself
601 — ROOF TEAR OFF
or through his own employers. provided] Nat such Improvements arc not intended or
Wool forsale. If. however. he wilding or improvement is said within one year of
NAIL,:.,., -
6 02 - ROOF PLYWOOD dr;
ompletion, the owner -Wilder will have the burden of proving that he did not Wild or
improve far parpnmafsele).
603 - ROOF BATTENS
-oi:a:o:netartne properiy.amexchmively. contracting with licensed nunsmdors to
604.'__ ROOF IN=PROGRESS' .: ,:, :i,',:' , ....
construct the project (See. 76tH. Business and Professions CWa:)The Cmudeat",
License Law ddoes not apply to an owner of progeny who builds or improves thereon,
and who .such projeets with a contractors) licensed pursuant m the
contracts for
V .
law, , .,
pt under
01 am
❑IamexcmwndcrScc. r•s: °� � ,B &PCfid, this rtason
• ,ell yin .
Owner' • : •. Date` ` •1
�„ _,: � • .DEC
I
RATI
- WORKER'S COMPENSATION DECLARATION
RK
/
iii
1 hereby affirm undcrpewlty of perjury one ofthe following decimations:
O/
O 1 hive' and will maintiin a Certificate of Consent to mlf-insum for Worker's
Compensation, as;provided for by Section 3]00 of the Lehr Code, for she
performance ofshe work for which this permit is issued., „
° I have and willtmaioiain Wdrkcris Compensation haumnce, as sequimd by Section
17 'athe Labor Code; for she pcdormonce of the work'foPwhich this permit is
o of ry number pr<
su O M W rk ' C t o 1 sure c ca a nJ P
Y Pe
^
I N
a y
ger NdJunro policy'.
-
i -1.'•,r..).:; h'.,.'•,
? t 1\ �1
( GLRTIFIGATIDN OF EXEMPTION FRAM' WORI(ERS"
l 1
` j t a
` NINSURANCE'
COMPEN.... - ,..._ ,.
..~._.._...._.______._......_.._.__.__...___._..._�!._..J _.._.._...____ ..,,____ _.__..___. ._—
mus seiiiun and not be' min lemd if pennd is for one hundred Jona
for which th. perm t 'ssded 1
,shoe 1 e n fyihat m aW ped ce shso
4 1 w
t t, Ili:,''Cit )
m as m become sub)en to the harken'
shall not employ m . -
•U
is Datanner'so
Laws of California
Comps. nLows ofC Ifomia.'Dete
Appliedurn,
NOTICE TO APPLICANT. If, after making this Ceniftcam of Exempfion, you should
b'acomesubjecs m the Worker's Compensation provision; of she Labor Code, you must
hatio4ith comply with such provisions or this permit shall W deemed revoked.
1 s `CONSTRUCTION LENDING AGENCY
` 1 h mhy alrrm that Nerc ¢ o B nsw t I d"n gc cy f the pedormame
of ih o k for h ch th perm t a ed (S c 3097 "'
, 1
larder's Name 's•'" ""'
lander',,Address - - '
, _'-C: t,
�. I nenify that 1 have read this application and state that the above information is
'
corr'eav I agree to, comply with all city and county ordinances and slam laws ¢dating
to Wilding construction, and Hereby authbdu mpmsenmtives of this city m enter upon
the above-mentioned property for inspection purpose
I (We)eime'io save;mdcmnify amt keep harmless the City of Cuperime, against
liabilities, judgments, costs and expenses which may in any way accrve against said
City inconsequence of the gmium, c f Nis perinn:: '-
APPLICANTUNDERSTANDSANDWILC pLYWITH AL6NONdsOBNrn
'.t "'
Issued by: Date
y
SOURCEREG .AVL TIONS. 5
$t of ApphcanV .amara r 1 Dmc'•
Re -roofs
,'� t , r.ZARDOU$ MATERIALS DISCLOSURE -
.: boll the applcand rfut ,Wilding dominant tihandle M1avarduus mat nal
:. Type of Roof.. _.. •...._... .. .....__. ..
as defied bytW Cupertino Mu tc 1 Code Chapter mal thHlth and Sal
ode Section 255320e1
code.
_ -• �'t „ \'it ,.
f lis 3s f t ss !`a.
II s1.I 'ii (
°Y°: -' i N6 ,: f1.
.. f°.t5�_A'st
_..All.roofs shall be.mspected.prior.to any. roofing material being installed..... ...
• + wntn applicant -,o fumrt Wilding actin t use p t devices'` min
-
If a roof is installed without first obtaining an inspection; 1 agree To remove
em t h d " cans m dints d fined by Ne Bay ma A Q ality Manag ent
Din ct]-
all new materials for inspection. Applicant understands and will comply with
n
all non -point source regulations.' :.,, , t,•„
`a'tw I M1 e read'bc'h zud m un 1 re'ammesns under CWgcr. 65 of she
California Health & Safety Codc: Sections 25505, 25533 and 25534. 1 understand that
if sae Wilding does not cuncn Pi have a tenant. that it is my rcsponsibifisy to notify the
occupeof of the m4iiinecom s• which must W.tmt prim to issuance of a CentGcam of
°" °° nv1. t "i' • •• •
gnature pplicant Date
All roof coverings to be Class "B" or better
ow mmanzee rho. '—
tifffit ..
'z: OFFICE -..
a
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
CITY 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 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: fipO ('d, R,
Address: 2D7o� Gcce.-, o/f. Vgll.e4 (ween #
Reroofing Company Name: R ra..4 Roo
Applicants Signature: - Date:
Joe Antonucci
(Chief Building Official)
6/25/01