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03100030 (2)CI'T'Y OF CUPERTINO ' "w m BUILDING DIVISION PERMIT CONIRACTOWINFORMATION d BUI LDING ADDRESS: OLD COUNTRY ROOFING PERMIT NO. 03100030 OWNER'S NAME: SCOTT MCKTNNEY 125—B GROBRIC CT PERMITLSSUEDATE 34E' (707) 864-5557 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT' PLUMB MECH En 0 (� LICENSED CONTRACTOR'S DECLARATION her of errs (cose mmencing 1 nerenyarumtent1amf ��SCjp�� Job D9'�Iaid err Division3 ortheed nde andvisionsiofCCade,,andco wirdscI ey the Rdunderpra.ixiasa Code. and my in rml dery t. (o a yg� REROOF D=�` �ereLARA IDN ' DEC 1 0 [003. 1 understand my plans shall he used as public records Licensed Pmfesla..I OWNER -BUILDER DECLARATION 'Y BUILDING 1 hereby .firm that 1 a exempt from Be Continent's License Law or the o aso Professions Code: Any city county following reason. ](I3L5 after, and emdan sae, demolish.s ct, improve, e which Tits as s a permit re cores hIUMB t. fi repair any structure the applicant forsu prior a its issuance. also requires the the applicant for such permit m file a signed wd natemcm That the islicensedwrsuam or the mo conusintasandPo<anons Sq. Ft. Floor Area Valuation Code) or of Division 3 the Business and professions aWe) or (commencing with ScmrOn?IXn of Division Nat he is exempt Nertrom and Ne basis for Ne ellcgce exemption. Any violation of d the 3263 7 Section 7031.5 by any applicant for a permit subjects the applicant hn a civil penalty of APN Number Occupancy Type P Y YP not .Ora Nan five hundred dollars (S500). 0 t.us nerofthepmpeny,ormycmploycuwiNwgesulheirwIeeomNnution, will do the wutk..nd the structure is nof ntended eteffered retards (SO,. 7044. Basin., and Professions Code: The Cnnlmcmri License Law docs nut apply to an owner or 3 05 _ RAME Required Inspections propenywhobuilds orimpmvesthereon, and who does such work him.ulf or through his 307 - INSULATION own employeesprovided that such improvemesta me not intended or offered for sale. If, 601 - ROOF TEAR OFF however, the building or improvement is sold within one year or completion. the owner. . builder will have the burden of pmving that w did not wild or improve for pu ase of 602 — ROOF PLYWOOD NAIL a.1. 603 - ROOF BATTENS ❑ 1. as owner rf ct property, . B exclusively contractingficnwith licensed contractors to come Conmmod. Li shoes jctapplytooan.wusmrssanenywheionsds 604 — ROOF IN -PROGRESS or improves La an of property who wilds or improve twrcon..nd. acme Law dao not apply with u for such projects with a contractor(a) licensed pursoam to the Canuamor's a a Chance LO Licenselaw. ❑ I am exempt under Sec. , B & P C for this reason DauWORKERS COMPENSATION DECLARATION NeI wby affirmnder penalty of perjury ane of the following dcelararions: immave 1 .nJ will maintain a Certificate of Cement to ulDinsum for Wurkcr'sCumpcn- ution, u provided for by Section 37M of she labor Code, for the performance of the work for which this permit is issued. ❑ 1 ban and will maintain Worker'a Compensation Insurance, as required by Section 37(1(1 of the labor Code, for the performance or the work for which this permits issued. My Wnrk Y old nsabon Inssunurance, canricr and Policy n urnixer aryG.9 C. l CERTIFICATE OFEXEF1MON FROM WORKERS' COMPENSATION INSURANCE m aissectionecru not wcomplctcd ifthe Permit isforonehundred Jnllaw(11(X1) less.) 1 canary that in to performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject o the Workers Compensation Laws of California. Data Applicant NOTICE TO APPLICANT: IL at making this Certificate of Exem prion, you should wcome subject to the Worker's Campcnsation previsions of the IaMr Code. YOU must forthwith enmply with such mrivisiam or this permit shall IN, dermad mvaked. CONSTRUCTION LENDING AGENCY 1 hemhy affirm that there is a constmelion lending agency for the Performance of Be. work for which this permit is issued (sec. 3097, Civ. C.) Landcr's Name lender's Addma, 1 certify that 1 have read this application and slow that the above infoommom is torten. 1 agree to comply with all city and county ordinances and state laws mdating to building conswction, and hereby authors a mpme ntatives of this city to enter upon the above mentioned pmpeny for mcdowion Puymss. (We,) agree to can, indemnify and keep hvmlcss the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City A—>L/ in Consequence Of the granting of this Permit. APPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date UR E - ULATION'S. e 3 a3 Re -roofs Type of Roof gnawr orApplicaN ZARDOUSMATERIALSDISCLOSURE w Will the applicant ser future building Occupant store or handle harardous material defined by the Cupertino Municipal Code. Chapter 9.12, and the HeaIN and Safety ;�ic,, ln, Section 25533(4)? p Yea Na All roofs shall be inspected prior to an roofing material being p p Y g g installed. If a roof is installed without first obtaining an inspection, I agree to remove Will thea applicant or future building p equipment or devices which pp 6 accts ant lou it narardnus aircpnlominanB defined by Ne, Bay Area Air Quality Management all new materials for inspection. (]Yes Nu I have mail the harardaus materials myrinne.ly umU,,Cmp.r 6.95 olow Calder - ria Health A SafetYCOde, Sections 25A15,25533 25534.1 Beef BNe, and undersand wilding docs not currently bare, a wnant. that it is my mxpomibility in notify the oeupant of the myi lowhich manual poor toissumterOf. Caracateofacupancy. Sign tureofApplicant Date 0 3 D-3 All roof coverings to be Class "B" or better agent authmi,ed Whe Building Division 10300 Tom Avenue < Ctipaaino, CA 95014-3255 Telephone: (408) 777-3228 p F= (408) 777-3333 CUPS TING 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 LC.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: C Address:/'030( C-KZc: � o -ice ti Reroofing Company Name: C co u rrL4_ d�R O o r i G Applicants Signature! �t pa �� Pate: / 0 - a- O ^` Joe Antonucci (Chief Building Official) 6/25/01 r i� CUPERTINO CITY OF CUPERTINO REROOF v / 0 0 e_-)3 P1PRMiT APPi YCATMNI VMIM Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees APN # BENERGY Date: 0- 03 Building Address: BSEISMICRE / 030/ CC-3-1 ON ��C I ✓ Owner's Name: Seismic Commercial P _ ne # Sco-rr- I"UNc Plan Check Fee 0 30G 5363 Contractor: Phone #: Q9 c,b' License #: O47 C,00 NTV_A FS, 3 00 (o -4 3 / Contact: Phone #: Cupertino Business License #: C� `f 0 b' &� 'F-3 00 I go 081� -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 X Other (SpecifyV-Git1 CLE SHS K�C o Other (Specify) Number of existing covering ❑ Provide I.C.B.O. Report # To be Removed o Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu rtino's Tear Off Policy: Job Description: (_� eM o ✓ , C-)41 •3T I 'V b (K Cry) t- /V—, S l- 7n-se-cr /U 15, T;1� o S6 3 o t_k rzv -d- C --4-K, 6�0 GD .417 Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if E there are an restrictions: Cost of Pro' ct: E v Type of Construction. Occupancy group: 5 rbc- moo f 0--.;,>--3 Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING • z.3 3 6S 77.s"Z'