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03010003 a CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTORINFORMATION: a BUILDING ADDRESS: ROOF MAX INC PERMrf NO. 22288 BELLEVUE AV 03010003 OWNER'S NAME: 656 EAST TAYLOR #1 APPLICATION SUB DATE KUO GENE K AND RITA Y 01/02/2003 (ZONE: (408) 738-4035 SANITARY NO. CONTROL NO. ARCHITECfIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH Op LICENSEDCONTRACTORS under DECLARATION Job Description 1 hereby affirm that I am licensed under Ind of Chapter n mylicense is p ' with Sec is TXXB adcfft(Dlvisieo Sof NCB cas end PnJessiona Code,and my license is imrml D eoderreel .� OVERLAY STEE ROOF oZ�a Li ass C— Lic.N r. A F u,f u�^ Da -L� C�ntract9999ffII FINAL O- 2 mm ARCHITECTS.DF A IO' a _ g y ag I understand my plans shall M use `Public records I_ Licensed Professional FEB 'p 6 7033 g OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Commena''s License Law for the W S p 0 following name.(Sectiun 7031.5,Business snit Professions Cook:Any city ar county �I�® f"� a'K$� which requires a remain construct,alter,impnsve.demolish,or repair any suucwre '�VI Fiyp prior In its issuance,also Inquires the applicant forsuch permit to Nc aligned slalmm�m qqmm< that he is licensed pucsuanuo the provisions of the Conuactnr's License Law(Chapmr9 Sq. Ft. Floor Area $12NN'5lfuatlon aF0 (commencing with Section 7")of Division 3 o the Business and Professions Coccur y,�$ Nat M is exempt therefrom end the basis for Use alleged exemption.Any violation of Section 7031.5 by any applicam for a permit subjects the applicant to a civil penalty of out more than five hundred dollars(8500). beP u Occupancy Type ❑Las owner ofine property,or my employees with wages ss their sole compensation, FRA will do the work,and me threaten,in not Intended or offered for sale(Sec.7000,Business — and Professions Code:The Cormsetor's License Law does not apply tu an owner of3 0 7 - INSULA'i'l ed Inspections Frostily who builds or improves thereon,and who does such work himself or through his own employees.provided that such improvements are not intended or offered for sale.If, 601 — ROOF TEAR OFF however,me building or improvement is sold within one year of completion,me owner. builder will have the burden of proving met he did not build or improve for purpose of 602 - ROOF PLYWOOD NAIL .te.l. 603 - ROOF BATTENS 01,as owner M the property,am exclusively contracting with licensed contractors to 604 - ROOF IN-PROGRESS construct the project(Sec.70,14,Business and Professions Cade:)The Commences Li- cense law does not apply to an owner of property who builds or improves Bremen,and who conlracts for such projecta with a contractor(s)licensed purauanl to the Contractor's License Law. I am exempt under Sec. ,R&P C for this reason Owner Dale WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of dm following dectaretions: ❑ [haw and will c airman a Certificate of Consenuo self-insum for Worker's Campen- wetton,u provided for by Section 37M of the labor Code,for the performance of the work for which this permit is issaud. ❑ 1 have and will maintain Worker's Compensation Insurance,as required by Section 371X)of the LaborCode.for the performance of the work for which this permit is issued. My esker's Compensation lnsunnce comer an obey number are: 'er. I¢TG s�yaib. Policy /Syo —110 CERTIFICATE OF EXEMPTI ROM WORKERS' COMPENSATION INSURANCE (This section need not nce,mplemd if the permit is forma hundred dollars(SIM) or less.) 1 eenify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as In become subject o the Workers'Compensation Laws of Calimmia.Dale Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must oz forthwith comply with such provisions or this permit shall M deemed resulted. OCONSTRUCTION LENDING AGENCY t~ I hereby affirm that there is a construction lending agency lot the performance of �i ;1� me work fur which this permit is issued(Sec.3097,Civ.C.) as Q Lender's Name a z Lender's Address V 0 1 eenify that 1 have mad this application and sum that the above information is W., (~ corers.I agree to comply with all city and county ordinances and state laws mlatingto O V building conwhichim,and hereby audionos,representatives of has city to enter upon the [V above mentioned property(or inspection purposes. (We)agree to save,indemnify and keep hmmlcu the City of Cupcnin,against y liabilities,judgments,cos is end expenses whi hmay in any way eccmc against said City U 7 in consequence of the germing it's f ths perm �) I F7 APPLI ANT UNDERSTANDS N31 D LL COMPLY WITH A ON-POINT Issued by: Date S E TIONS. r Re-roofs Signature drApplicartlCommetor,7 Dam HAZA RDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defused by the Cupertino Municipal Code,Chapter 9.12,and the Hoalth and Safety ,ML(Conde,Setom 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑sea �}Jo Will the applicant or future building occupant use egtiipatent or devices which If a roof is installed without firs[o taining an inspection,I agree to remove mit haxardnus air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ��a//,,// ❑Yes yBNo ]u I have read me hmablo,/us'materials requirements under Chapter 6.95 of me Cali for- ' or- ria Hcelm&Safety Grde,Sccdoos25A15, 533amd25534.Iu rstandthatif he building `•l - t t Q does nm curter ly ave a rano I,Na=il i my rcsponsiM1ility m dis the rccupanl or the spa a must alp n xssuancnnfacenificam Occupancy. Signature of Applicant Date 2_ J A roof coverings to be Class "B"or better Owne or malmnrcd agent Dam Building Division 10300 Tom Manue Gtiperdno,CA 95014-3255 Telephone: (408)777-3228 CUPS__ 'NO Fax (408).777-3333 Building Depaxnent 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 she so that the proper City inspection can be performed. IMPORTANT: 1. Flat roofs must have a minimum of V"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: K L4 v Address: .9 &/ e (/t= Reroofing Company Name: Applicants Signature.* ! - Date: / - OZ- 63 ' Joe Antonucci (Chief Building Official) Mum CITY OF CUPERTINO BUILDING DIVISION PERMIT WCO,NTIMTOWINFFOOa RMATIONe3 BUILDING ADDRESS: ROOF MAX INC PERMITNO. 22288 BELLEVUE AV yinAninnoA OWNER'S NAME: 656 EAST TAYLOR #1 APPLICATION SUB DATE /AkKUO GENE K AND RITA Y 01/02/2003 ONE: 4 0 8 7 3 8-4 0 3 5 SANITARY NO. CONTROL NO. ARCHI=IENOINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MUCH °C LICENSED CONTRACTOR'S DECLARATION °p Job Description I heroby 0).r' that I un Ucensed under pd Pmfem of Chapter 9(mmmem:e i. p with Su in 101KHnf Dlvislon3of Ne BeiBrens and Prufessiom Crbe.and mylicenwb "'3G3G3G< In mu(n a-ae�cet ✓ fl OVERLAY STEEL ROOF ;S a L Inca LIc.M ,Z, De ti` Cumrecl99(f . Fla- 4Lie;- ARCHITECI'S.QECLA A 1 j 1 understand my plans Nell he use public reemids DU Licensed professional iy OWNER-BUILDER DECLARATION B f I hereby.(Rtes that 11. exempt from the Contractors Co License Low for the t_D D following muss..(Section 7 o L5, t.alter. and w,de Professions Code:Any tiny st county 22 which requires n permit re construct,be pplicamprove,demolish,rare asig anyed eounure Frei prior mits issuances...also mquima troviruis,of fm such Coursormin Lt. I.M. smmmcnt that he is(commencing comencinwit pSection mdM pmVivisMn(offt theBYwWf aLlPonfedW(ChartersCode) Sq.Ft. Floor Area y512i�Mfgxatl0n �D (cmm a Is exempt Scmionat DO)and t f Division 3 ft al Business axe sed on.Any vi CsMc)or � that be m exempt therefrom and the bub for dm alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of -3 bAW t49WbeP Occupancy Type not more than five hundred doll.($500). 0 1.as owner of the property.of my employees with wages as their win compensation, will do the work,and the structure is not intended oroffemd for sale(Sec.7046,Business 365 wd Pofeulons Code:The Conuacmr's License Law docs not apply Me an owner of307 - INSULA ed Inspections property who builds or improv thereon,and who deeisuch work him elforthrough hie own employee,provided that such improvements ora not intended oroffemul for Wa if. 601 — ROOF TEAR OFF however.the building or improvement B veld within one yew of completion,the owner builder will have the burden of moving that he did not Wild or improve for purpose of 602 - ROOF PLYWOOD NAIL sale 603 - ROOF BATTENS 01,as owner of the properlyam exclesively contracting with licensed Contractors to 604 - ROOF IN-PROGRESS convect the project(Sea 7046.Business and Professions Code:)The Canusetofa LF cart¢law doss..apply m en owner of property who builds or improv Neeson,and t who contracts for such prei with a contractions)liaised pursuant in ft Contractor's License law. 0 1 am exempt under Sec. .B @ P C for this mason Owner Dat WORKER'S COMPENSATION DECLARATION I hereby arfnm under penalty of perjury one of the following declaration: 1 have and will maintain a Certificate of Consent to self-insure,for Worker's Compere lion,as provided for by Section 3700 of the labor Code.for the performance of tho work for which this Permit is issued. 0 1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 o(the Labor Code.for the performance of the work for which this permit is issued. My orkefa Compenution lnsunnee ceme'an lc numberart: 'er.S54re- FraaG', 11-cy .: /5-6115 Y/-ser^ CERTIFICATE OF EKEMPTI OM WORKERS' COMPENSATION INSURANCE (This section toed not be completed If the permit Is fortune hundred dollars($10) or 1e4.) 1 certify that in be performance of the work for which this permit is issued,I shall not employ any person in any manner an as to become subject to the Workers'Compensation Lawao(Califomia.Data Applicant NOTICE TO APPLICANT:IL after making this Centficate of Exemption,you should become subject to the Worker's Compensation provisions of the labor Code,you must 0'z forthwith comply with such provision,or this permit shall ire deemed revoked. y CONSTRUCTION LENDING AGENCY [—i l herchy affirm then them iso eototruction lending agency for the No(......f 6rt the work for which this permit is issued(Sec.3097,Civ.C.) aQ Lenders Name :D z LendefsAddmsa U 0 1 coolly that I hive read this application and auto that the about information Is � {T. F correct.I agree to comply with all city and county ordinances and slam laws mlMing to ., 0 U Wilding conswalon,and hetehy nuthndre repmuclives of this city no enter upon the {kl move-mendeoul Property for inspection purposes. Z (We)agree to Ove,indemnify and keep harnle4 the City of Cupertino against V) Iiabilities,judgmenW costs and expenses wht h maytnany wyeccruc agutat said Ciny / U 7 in consequence of the granting of th0 pennl. F7 APPL ANT UNDERSTANDS IN LL COMPLY WITH A ON-POINT Issued by: Date S E TIONS. Y Re-roofs Signature eff ApplumloCommociax-yg Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or(.tum Wilding occupant More or handle h4ndous material as defined by the Cupertino Municipal Code.Chapter 9.I2,and the Health and Safety Code.Section 3553](a)i All roofs shall be inspected prior to any roofing material being installed. 16.rC,j6rMtWnxC� ❑Yea .k-. Will me applicant or fumes building accupanl use equipment m device whichIf a roof is installed without firs[o gaining an inspection,I agree to remove ill ha4rdous air cuntaminwm as doffed by the Bay Ami Air Quality Management all new materials formitt? ❑YesIhave mad the ha4Mnusmemrialsrequimmenka under Chapter 6.95 of the Califonfie Healthtit Safety Code.Sections 25515, 533 and 75534.11 rsmnit that lithebuildingdors not Curren ly ban a moa L that it i my respo sibility to tify te ormpwt of the ✓qui n moat et poor issuanceorscenifnam Occupanry. Ignature of Applicant Date I—Z-,t�.a ��— Dale A roof coverings to be Class "B" or better