03020092 ' CITY OF CUPERTINO "`"'t`
BUILDING DIVISION PERMIT CONT1tACTOOR T�NFOIiMATION
BUILOINGADDRESS: SAHLIT ROOFING PERMIT NO.
10441 E ESTATES D
aF'S NAME: 10451 DAVISON AVE PERMIT ISSUE DATE
RANCIS WILLIAM E 02/21/2003
NE: (408) 255_550(34 SANITARY NO. CONTROL NO.
ARCHmiC(ENGINEER: BUILDING PERMIT INFO
BLDO EI-F.CT PLUMB MECH
`I00 LICENSED CONTRACTORS DECLARATION O 0 0
uM 1 hereby affirm Net 1 em licensed under pmvabons of Chapter 9(commencing Job Description
with Section 7001))of Division 3 or the Businca. nfc•inns Cm! and Iiccvc is
' infall f m EROOF
124 License CI Lie M
- Data cont XISTING 40 YR. COMP .
ARC ITECTS DE ATION ���
��� 1 unsrtmd my plans shall W used u puM1lic rao
0 Licensed Professional
OWNER-BUILDER DECLARATION MAR 0 3 2003
C I hereby.(Sero that 11. exempt from the Comns Co :Any c Law for the
0 0 which mi,ims n.(Section ID3I.S,Bualmss and improve.
deslom Code:Any em or county BUILDING
$
which its bots a Permit ser construct,altar impmu,h Permit t fi crepair
a.q any structure
primmslicar ad purtuminthe Wvisions or
sucContractors
mflcasLaw(nod tsumem
6
(that comm
lming cdpuMlaNlOtMofDivi0N 3oAn fthennwtor6LlYn6lsionsCapler9 Sq.Ft.Floor Area Valuation
E thnmmmrcixemptAth ttrm,na)o)theirsison3orall.ilessinsim.mid r Any
$12240
3—
that little exempt Oemlrom and the bub for Ne allebetl eumpllon.Any Woladon of
Section 7031.5 by my applicant fm a Permit subjects the applicant to a civil penalty of APN Number Occupancy TI
ml more thus Bu hundred dollars(350a). - P �' JPe
❑I.uownmoflhepmpany,mmyemploycmwio"guutheirsni<eompemWm, 36913048 . 00
willdo me work,andthn s.unum b notinmMed or.nemd rorsale(Sec.7W4,Business
and Profesiom Code:The Conmcmd License Law mm ant apply to an owrcs of 305 — FRAME Required Inspections
propeny who builds.,improua Nemon,and who does.aah work himself.,through his
own employw.provitlod mu wehimproaemanuan not lnleMW mortend fmnk.If. 307 — INSULATION
however,the building or improvement is veld within one year of completion,the owner.
builder wi0 hats Ne Writer of internal,that W did not Wild or impmu for puryo¢.f 601 - ROOF TEAR OFF
"Ie')' 602 - ROOF PLYWOOD NAIL
❑1,as owner or Ne propcny,am exclusively contracting with licensed contractors to
construct Use project(Sae.7044.eusima,.nd Profeus.as code:)The Conuumr's U. 603 — ROOF BATTENS
cone Law dots not apply m an owner of property who Wilds or improves Merton,and 604 - ROOF IN-PROGRESS
who contracts fmiuhi projects with a mounctou(s)liesmai0lintrousat in the Commutes
N eau law.
mcmpt u B A P C Ire Nis maven
Dau
WORKER'S COMPENSATI7RATI,
N
I hereby anion under Penalty of poduryallowing declantiom:
I hats and will maintain a Certificate ofConnure for Woher'sCompen-
satlon.u providutl for by Sectum 370.of the for the Performance of the
work for which this permit Is issued.
0 1 hats and will maintain Workcrh Compemadon Imurance,u required by Section
3700 or Ne labor Code.far the,pertormantt of the work forwhich Nb pcomit is issued.
My Worker's Compensation Insurance carrier and Poli urebcrsle:
Carrier• Po _
CERI'IFlCATE OF EXEMPT[ OM WORKERS
COMPENSATION INSURANCE
mrs auction need not W completed if im Permit is foram hundred dollars($100)
1 ttrtify N sk
rformentt of the work oo�reWshai���tIW,I(ns'spRe,mit b issued,I Nell not
employ any r; a. _ ff'/i lY/•/�Workers'Comw
pctlon
Leis of Coil �
Rh i
N 11 E AP CANT:If,a making Nb Certificate or Esemption,you Amid
become subject to the Worker'.Compensation previsions or the lahm Code,you in=
.JO forthwith comply with such Provisions or this Permit mailW deemed revoked.
z y CONSTRUCTION LENDING AGENCY
'(~ 1hereby'Mon Nat Vert 1$0commmti.n lending agent'for the pefformanx or
C r Ne work fm which this panni is!aided(Sec NN7.Civ.C.)
Q Lender's Name ,
a z Lender!Addmas
U0 I ttAfy that 1 hats mad this application end We that Nc above infmmalim I.
it, H comet.I ague m comply with all city and county ordinances and sum laws relating m
OU building construction,and hereby sumori o mpmsenulins of this city in enter upon the
I21 ah.v>mentionod propertycosts
for imPenses purposes.
„ gy (We)aSm.m tau,indemnify reit keep hexed.Ne City of Cupertino against
I,iZ li,mmseem. cm.tnessrtsand expenses which mryinAny wayamuc agelnn mid City
U z I.
APPLICANT
of DERST ng orthis WILL
I
^ APPLICANT UNDERSTA EAN W�COMP� LtiYi1TH ALL NON-POINT Issued by: Date
SOUR ERE J�
Re-roofs
Sr'inu of ApplicaHAZDau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or furore building mmupantsmm or lundle haysrdous material
an sfncd by 1W Cupertino Municipal Cos.Chapter 9.12,and the Health and safely
ode.SD .n2ss32(.)7 t� All roofs shall be inspected prior to any roofing material being installed.
ache
If a roof is installed without first Obtaining
an inspect'
ns ection,I agree to remove
Will the applicant or future building occupant use equipment o,devices which g P g
him hour oI'cemboammen u defined by the Bay Ama Air Quality Management all new materials for Inspection.
District?
C]Yes No
I heti mW me hvsrdnus maurialsrtquirtmcnts under Chepur6.9Sof the Celifor
nia FfenlNA Safely Code.Sudo_255.5.25533and2553d.Iansrnwd Nulrue Wilding
ser not cmmntly have a brans,Nn it b my mapomiblllty m notify the Occup.,of
requirements wane he
c fc.m afottuPanry Ignature of Applicant Da[
r or admorud agent Da All roof coverings to be Class "B"or better
Community Development Department
Building Division
City of Cupertino
' 10300 Torre Avenue
Telephone: (408)777-3228
CITY OF
Fax: (408)777-3333
C U P S kT I O
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 statedpolicyon re-roofing.
Homeowner's Name: G/yl L L lAo4A
�,y9ivG��
Job Site Address: /6/ Z/ ,/ t!57 -TC5
Roofing Company Name:
A plicant's Signatur Date: 63 013
Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper