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03070151 CITY OF CUPERTINO --.A y "=res xkuiaa-d '� Fav BUILDING DIVISION PERMIT CONTRAC*T.OR�INFORMATION aminwcADOREss: ADVANCED ROOFING TECHNIQUE ERMITN°03070151 0766 CARITRR DR \ OWNER'S NAME: 1179 MYRTLE DR PERMrTISSUEDATE ACATTLAY MARK "E` (408) 249-4937 SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLD° ELECT PLUMB MECH 0 0 0 0 LOO LICENSED CONTRACTOR'S DECLARATION Jb Description F 1 larnby affirm that 1 am licensed ends,provisions of Chapter 9(Comtio men ng P �" with Section]IXMI (Division Sof NC Busi d Profcssinna Code.armd my license is ^y in funfnrce�: t0471 1L,14? p �� njs� REROOF Lice Cle/ C^� f Lic. L Date 'f—t a Cunt ARCHimcrs GScLR MMNJUL 2 9 2003 �i 1 unrst deand my plana shall hu mM Ili,used public we 3 a Licensed Pmfnasinnel 5 OWNER-BUILDER DECLARATION BUILDING t e f I hereby affirm that I am exempt from the Contractor's License Law for the r.O O following reason.(Section 7131.5.Businessand Professions Cole:Any city or County y S Pi which requires a permit to construct,sent.improve,demolish,or¢pair any structure prior In is asuentt.atm requires the.pplitrm for such permit to rile a signed statement that he is licensed pmLice temem to the provisions Of Conctor's nse LAW(Chapter 9 Sq. Ft.Floor Area Valuation(commencing with Section WM)of Division 3 M the Business and Professions Gbe)ur .� that he Is exempt therefrom and the buts for the alleged exemption.Any vinletion of 37532007 . 00 Section 7D31.5 by airy applicant for permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more Nan five hundred dollars(5500). 0 I,ss owner of the Property,or my employee with wage u their mle compensation, willdothework.and the structure is not intended oroffeud fmulc(Sec.7044,Business — EA Reg aired Ins actions end Professions Code: The Cdn ,or's License Law docs not apply to an owner of 307 — INSULT 1 ON p property who builds ar The thereon,and who does much work himself or through his own employees.provided that such improvements art notimendeil an offered fm sale.If. 601 — ROOF TEAR OFF howevu.the building or improvement is mid within oro yes,of completion,Ne owner- builder will have the burden of proving the,he did not build or improve for purpose of 602 — ROOF PLYWOOD NAIL sal`')' 603 — ROOF BATTENS I]1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Profudoes Code:)The Consomme,U. 604 — ROOF IN-PROGRESS cense Law does not apply to in owner of progeny who builds or improv thereon,and who contracts for such projeeu wide a eomrAcmr(i)licensed pursuant to the Contractor's License law. 1 Am exempt under Sec. .B&P C for this moon Owner Date WORKER'S COMPENSATION DECLARATION I hereby grunt under penalty of perjury one of the following decimations: 1 have and will mainain•CCAMCAIe of Consent I.self-in oro for Worker'sCompen. n,As provided for by Section 3700 of the labor Code.for the performers¢of the work for which this permit is issued. ❑1 have and will maintain Warkefs Compenutinn Insurance.as,squired by Section 3100,(the labor Code,for IM performance of the woh for which this permit is issued. My orker',Compeua,ion lnaumnm cart:,,end PPal'iq t/y�mMr aa: "cr,��a� --,.L Policy tsyr — CERTIFICATE OFEXEMPf1ONdERDMWORK S' COMPENSATION INSURANCE (TTlsmatim nod not be completed firm permit is i.e.hundred dollar(5100) or has.) 1 certify that In the performance of the work for which this permit Is umcd.I shift not employ any Person in any manner An,ss to become subject to the Workeri Compenmion Laws of California,Daa ApplicaM NOTICE TO APPLICANT:If.after making this Certificate of Exemption.you should become Subject,o the Worker's CumPCnsation provisions of,he labor Cnde,you must .J O forthwith comply with such provisions or this permiuhtll M deemed revoked. Z"" CONSTRUCTION LENDING AGENCY I hereby affirm that there is a Construction tending agenry fm the performance of Ci the work for which this permit is issued(Sec.3087,Civ.C.) 6iQ I ndcr's Name Z Lender's Address V Q 1 certify that I have read this application and state Nat the above infotmatiun is ' V,P corm .l agree to comply with all city and county ordinances and sate laws mining to O V building conswction,and hereby mNoria¢prssnlniv or this city to enter upon the tT7 shove-mentioned properly for inspection purposes. f5. (We)agree m save,indemnify and keep homeless the City of Cupertino against fq Imbilities,judgments,costs and expenses which may in any way Accrue against said City V Z in consequence of Ne granting of LW permit. APPLI DERSTAND D WILL COMPLY WITH AI.L,j,'Ogl-POINT Issued by: Date SO EREGU ATI°N5. �C,/y] Re-roofs SigF licantlContmotor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof thepplicant or future building Occupant some or handle huardous mattrial ss dee Cupertino Municipal Code.Chapter 9.12.and the Health and Safety Cods532(x)? All roofs shall be inspected prior to any roofing material being installed. o Willapplicant or future building occupant use equipment or dev, which If a roof is installed without first obtaining an inspection,I agree to remove it air conmminarm ax dcrined by the Bey Area Air Quality Management all new materials for inspection. st 1 have mad lie haurdousmaarials mquimmenu under Chapter 6.95 of the Collier. riallen" Safe ade,Secuuns2505,25533 and 25534.1 undcramed mhaifdee Wilding Ices not sat y ha a¢rent. t it u my aspouihility m nndl'y the Ponteuof Ne mquirem awhich uR le me or iauan"of a Ceniricme of Cccupu Signature Of Applicant Date 7_ (8^0 ad agent Dare All roof coverings to be Class"B" or better Community Development Department Building Division r City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 U PE TIN 0 Fax: (408) 777-3333 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: C, Job Site Address: © � �' C--oma(` V Q--f` E . Roofing Company Name: ck V4- c- Applicant's Signature: Date' '?,f Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO REROOF l CUPEkTINO PERMIT APPLICATION FORM APN# Z Date: Building Address. 107GC6 C_4.�;( r ✓e�,r Owner's Name: Phone#: q A C- 99Co- 12� � Contractor: p Phone#: License#: V �� t C'i Contac Phon • Cupertino Business License#: 2'.3 Y--0 4 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof —Asphalt Shingles 'Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: Residential E�7-- Commercial Fire Zone: Yes ❑ No Confirmed with Planning there are anrestricts Cost Project: ype of Cnstru on: Occu an=group: (� �[�r Qty tf Apifficqb�'d Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING CT- BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING