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03090070 (2) ' CITY OF cupmrrtNO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: 4 BUILDING ADDRESS: WINTER ROOFING INC PERMIT Nb 3090070 B;a�ARD Ply N R S NAM PERMIT ISSUE DATE 151 WYANDOTTE DR IF "E: 4083638052 SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH io0 LICENSED CONTRACTOR'S DECLARATION L� O O O E�r IMmbyaffrmdatIamlicensedunder provisions orChapter 9(commencing Job Description ¢w with nn 70W) f Division S of do Bµa cav and Profcssiune CoJc.and my license is ) inf 1 nn and off t, v nq z u« a Clazn ser.a_;tZ G REROOF F11V�, �� tFo Da C 1r1-1 1 I RCHITECI' A f a 0 xlanJ my plans shall c used as bim re x SEP 2 91003 boy Licensed Prol 'fessiona :' g OWNER-BUILDER DECLARATION 3 a 1 hereby affirm that 1 am exempt from the Contractor's License Law for the � p ', ^ G 0 following ream..(Section 7031.5.Business and Prefeasiwu Carlo:Any city or county <w� which requires a Permit In construct,alter,improve,demolish,or repair any atrocities ^i y pdocto its ismance.atm mquims me applicam homes permiuo file a signed su Com., _ r that he is licensed purmentmthe pmvisinmofthe ContractoriLicense Low(Chapter 9 Sq. Ft. Floor Area Valuation - 2 (commencing with Section 7")of Division 3 of the Business and Professinm Cam)or that he is eeemPL therefrom and the basis for the alleged exemption.Any violation of 35618020 . 0 0 Section 103 L5 by cry applicant for a permit xubjcw de applicant to a civil penalty of .DPN Number OType nut more than lin hundred dollars(SSW). -' -- - --- Occupancy p y. ❑1,as owner of the pmpeny,of my employees with wages as their sole compensation, will do the woh,and Ne structure is not intended or offered for sale(Sec.7064,Business 3 05 and Professions Code:The Comments Licenae Law must not apply to an owner or — Rec uired Inspections property who builds or improves Burnam,and who does such work himself or Untruth his 307 — INSULATI VN Own employees,provided that such improvements are not intended or offered for sale.If. 601 — ROOF TEAR OFF however.the building or improvement is mid within one year of completion.the owner. builder will have the burden Of Proving Inas In did not wild or improve for purpom or 602 — ROOF PLYWOOD NAIL ilk.). ❑1.Miner of me propertmmrs y,am exclusively contracting wish licensed ntracto 603 - ROOF BATTENS Construct the Project(sec.)o4a.Business and Professions Code:I The Conuaam's Li- 604 — ROOF IN-PROGRESS conte law dors not apply to an owner of property who wilds or improve Merton.and who commute for such Projects with a eonuactor(s)licensed pursuant o the Conuactora License Law. ❑ l sm exempt under Sec. ,B&P C for dis memo Owner Dan WORKER'S COMPENSATION DECLARATION - 1 hereby affirm under penalty of perjury,one of de fallowing declarations: I ban and will maintain a Cenifcate of Contain m self-ieum for Worker'sCompen- sation,as provided for by Section 37W of the ravem Utica Code.for the Performance of the work for which this Knorr is issued. ❑ 1 have and will maltreat.Worker's Compensation Insurance.as myuimd by Section 31W of the laver Code,for the Performance Of the work for which this permit is issued. My Worker's Com nsalion lneu m carrier and Policy no%" n r: Policy No.: 'O CERTIFICA OFEXEMPnON FROM WORKERS' COMPENSATION INSURANCE (This section need not wcompleted if the pernil is rnr one hundred dollars IS HXB as less.) 1 rectify that in the performance of But work for which this Permit is issued.I shall nut employ any Wrenn in any manner in ex In become subject to the Workeri Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:IL it,,making this Cenifii of Exemption,you should become subject to the Worker's Com nunnation pmvisions of the Law,CMC,you most �0 forthwith cnm,ly with men fornvisinme.1 Us.perm its hall be deemed revoked. z' N CONSTRUCTION LENDING AGENCY 1 hereby amrm that brie is a construction]ending agency for the Performance of la the work for which this permit is issued(Sec.3891.Civ,C.) YQ Under's Name ,Z Under's Address J 0 1 sentry that I have read this application and sum shat the awvc information is y f' Center,I agree to comply with all city and county Mi nantts and sate laws rotating to �U building construction,and hereby authorix,miresemxtivn of this city to enter upon be above-memioned property for inspection Purposes. y y (We)agree to sarc,indemnify and trop barmier the City of Cupertino against rn liabilities jud menu.costs and coderams whic maylnanywayaccmcagainstood City JZ inconsol 0 orihcgnnli.g.ft ' rte'. " APPL UNDER TAND D LL COMPLY WITH ALL NON-POINT Issued by: Date SOU S Si ami rAppl'mil unit Idr D M' Re-roofs / HAZARDOUS MATERIALS DISCLOSURE Type of Roof III be applicant or forum building occupant sire or handle havardous mutual d nod by the Cupertino Monte al Code,Chapter 9.12,and the Health and Safety sertiOn 25532(a)p All roofs shall be inspected prior to any roofing material being installed. ❑Yes Will the applicant or future building Occupant use a If a roof is inst led without first obtaining an inspection, I agree to remove cap 6 p 4vipmcm or devices which g it w>ardnua air contaminants as defined by do Bay Area Air Quality Management all new mater Is for inspection. uicn / ❑Yes e I have real wraNnusmatermosmqui ants under Chapter 6.95 or tire Califor. Ma Hcabh&Safclt Me.Sectors 2550. 553 J 25534.I understand dm if do building docanot runcm Mauston'.reran. I aponsbdhy to notry Iw reconam Or de �G O ne 'mmcnu,wh'h est afire arecofa Ccmficam of Occu cy. Ignatu Of p a Date Dwnerorau tan',rd1kii D„e All roof coverings to be Class "B”or better Community Development Department Building Division City of Cupertino 10300 Torre Avenue +.,, .. CITY OF Telephone: (408)777-3228' Fax: (408)777-3333 CUPE_—INO 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: Job Site Address: &? SD �p�.faf'p� CLCL(® Roofing Company Name: A plicant's Signature: Date: • Greg teel Building Official Revised 1/30/03 CITY OF CUPERTINO 073REROOF CUPERTINO PERMIT APPLICATION FORM APN# Date: Building Address: /G O Owner's Name: Phone#: t Scrip _ Contractor: _ Phone#: License#: Contact: — G Phone#: Cupertino Business License#: (J — 7,6 Type of Roof Covering: Existing: Proposed: 13 Built-Up Roof 13Built-Up roof ❑/Asphalt Shingles Asphalt Shingles Wood Shakes ❑ Wood Shakes Cl❑ Wood Shingles ❑ Wood Shingles 13 Other(Specify) ❑ Other(Specify) Number of existing covering ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will ComplyWith Cu ertino's Tear Off Policy: ©� Job Description: wad lel as&T Residential Uji Commercial G Fire Zone: Yes ❑ No Q-� Confirmed with Planning Dept. Cost of Project: there are an restrictions.' Type of Construe ' Occupancy up: / Qty, if A lie 1 Fee ID BPERMFEE Fee Description Fee Grou Bld Permit Fees BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BPLANCHK BUILDING Plan Check Fee BUSLIC BUILDINGBusiness License BUILDING 23 n z7. 7