02010050CUPERTON
CIBUt OF
CONTRACTOR INFORMATION:
} PERMIT
BUILDINGADDRESE
PERMIT NO.
10420 BUBB RD
REINHARDT ROOFING INC
02010050
OWNER'S NAME:
APPLICATION SUB DATE
BRADFORD FINANCIAL
8250 ENTERPRISE DR
01/14/2002
PHONE:
SANITARY NO. CONTROL NO.
5107137014
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
L7 L--
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing
owith See to. ]OW)ofDivision 3ofthe Businessand Prore,winsCode ,and mylicense
RE -ROOF 4PLY BUN
in full come and of t.
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License Clns / Lice 1
Dae Chaff
H CHITECf'S DECLARATIO
g I understand my plans shall be used as public records
'
Licensed Professional
OWNER -BUILDER DECLARATION
1 hemby affirm that I am exempt from the Contractor's License law for the
a following reason. (Section ]031.5. Business and Professions Cade: Any city or county
❑ which rcgnires a to construct, alter, improve, demolish, or repair
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permit any structure
_,prim m its issuance, also requires the applicant for such permit to file a signed statement
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Valuation
- Nar,M1Fislicensed pursuanttothe provisions ofthe CommetarsLicense t w(Chapter 9'
(commencing tN Sectiotr]000)of Division of Nc Business Professions Cool
and
or that Wit exempt therefrom and the basis for the alleged excmptiun. Any violation's
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of Section 7031.5 by any uppherfro for if permit subject, the applicanuo a civil penalty
of oot more Nan five hundred dulhrs (450011.
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'rs `y Occupancy Type
°1. u owner or Be ptopich, or my employees with wages as their sole compensation,
3 9:7-!NSUEATIGN
'-will'd 'the- k and the". not intended or offered -for' sale -(Sec' 76Lt:'
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601 - ROOF TEI q 'Inspections
Bu. es. d Pmfessions Cade ThContractor's License Law does not apply to an
owner of property Whobuilds or improves Hereon and who does such work himself
or brought E own employees. provided that himprovements intended o
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_.,__...___6.02 r._. ROOF.- PLYWOOD
offered t timprovement-- ` W
If, er the building have of Y or
icompletion, the owner bu Icier will have the burden or proving that he did not build or
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603 - ROOF BATTENS '' '
mprove mriorimss mf sale.).
ROOF. IN -PROGRESS.."....
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01 as .f the pmpcny am cacI.si elY t g i I h Iimnscit- contmcmrs m
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construct thepmj ct (Sec.7/W It rte. and Professions Cady) ThCmark r',
License Lad t apply t owner of property who builds improves thereon
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' . and h co tr o.f such Impnos ,vsh . vactar(sl 1 c s tl pursuant. to the
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Cot t L Is
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° 1 exempt order 5 B& P C f this reason
owe rale
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WORKER S COMPENSATION DECLARATION
I h rcby aWim d pc Try of pe j ry on of rhe follow ng dcclamtions:-
° 1 have end oil`m rmum a Certificate or Con¢m to self -insure for Worker',
2
Compensation, as provided for by Section 3700 -mf the Labor Code, for the.
perfummnce of the work for which this permit is issued,,
_ ° 1 haie and will maintain Workers Compecssation Insumnce,'as required by Section
3]00 of the Libor Cade, for shot pcAorma of the work for which this permit is
fuel My WorkerCompenxminn Insurance carrier and number are:
ePolicy
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CEROF EXESIPTION FROM'WORKERS:'
_• s
'" ` '' COMPEM1'SATION INSURANCE``'" "'
'f (Thr secrmn need not be complemd if the permit is for one hundred dollars
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.S IN) or less.)
Icnlfy than tti per fu m... .. �.wr_'
.,eof the work for which th.,pe lsss dl
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'hall not employ any Persian in any manner so az m become subject to she Workers
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ComApplicant n laws nr Calif ornia, Dam '
o ld
. NOTICE Tjec Cisionse (Exemptionl,yoyou
bccomesubjenm Curopemakingth'
tto he tion provisionsll the Wtior Chile, you muss
utoour
Workers Colons
it or
Yontiwith comply with such pmvisinns or this permis shall be deemeJ revoked.
D " CONSTRUCTION LENDING AGENCY
1 hereby off, that th Is a construction lending at for the performance
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'of be wok forwhich thispermit issued (s c 3097: Civ, C,) P.
'Lender's Address'
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I ccnify that 1 have mad this application and state that the above information is
'dofreer I agree to comply with all city and county ordinances and state laws relating
m building canstrumion: and hereby authorim represcbmoves of this city to enter upon
p the above mentioned property fm inspcchan purposes.
(we) hgree to silve, iadenumly,and keep harmless the City of Cupertino against
7 liabilities, judgments, costs and expenses which may in any way accrue against said
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Cu in co f she granting of IF permit.
LIC ITU Ur'RST-,CDS ARD WILLCWIPLYM HALCXON-POINT
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Issued by: Date
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sig fApp l c nUC r cm " I Date
Re -roofs
HAZARDOUS MATERIALS DISCLOSURE '.
III du ppl cam future b'Iding ace -part store.1hhdl ham' Nn mtdl
c def '
of Roof..
d by Ne Cupcn M n c pal Code Ch pt 9 1] d Ne H IN d Saf ry
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Codc scoot SSi (a)+ F i, t r ltd
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All roofs shall, be inspected, to being
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II h ire t f t eb'id iof circuit ecqu p to ateivice, which
em harard ort t d fined b3 th Bay Arc. Air Q y M ag ent
prior any roofing.ma[enal tngtalfed _ _
If a roof is installed without first obtaining an inspection; I agree torremove
uin "_all
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new materials for inspection Applicant understands and will comply with _
all -- - -
I h e d the h d roamhal, lrequirements 'on Chopme 695 of the
Safety Codes Cm old25531,moi d and that
CaleI
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non urceragula ons.:,,.,:_
if, ,heif.,d
f th h lel' g dtxs no tl h e a I m th i s my re cin mobility la t notify the
mu.d ifk
of the mrcmen¢ h ch t issuance
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t p or to of /aCert ficae of
.- ���_
Signature
of Applicant _ _ Date _
All roof coverings to be Class "B" or better -
ow a�m0 tgent Date
a a-
.. � OFFICE..._..