03010096 k C11'Y OF CUPER"1'150 , ». - "'
BUILDING DIVISION PERMIT CONTRACTOR N ORMATION
BUILDINGADDRESS; ROOFCO OF SILICON VALLEY PERMIT NO.
21765 HYANNISPORT DR 03010096
NEWS NAME: 844E EARLE AVE APPLICATION SUB DATE
SANDY RYAN & BRIAN FITZGERAL 01/16/2003
/) ZONE: (408) 795-3335 SANITARY NO, CONTROL NO.
/ ARCHITECffENGINEER: BUILDING PERMITINFO
t BLUG ELECT PLUMB MECH
0 0 0 0
w00 affirm
that
under
SDECons Of CON
n U F 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing Job Description
4c with S to{ren]1 it eff Division lnf NC Besirwsa olcssiuns Cak.and myliccnu is
mu to it 3 REROOF
M2K Dale gni _ j Codlmen " e REMOVE TILE INSTALL 50YR r���y5
=p~ptj ARCHITECTS DELI. ATION ' yr n ��I�Ii�
3 K U 1 land my plans shall be used as public records GG - U /jets D
tao Liccnred Pmfcssional FEB 0 3 2003
OWNER-BUILDER DECLARATION
rc <y 1 hereby affirm that 1 am exempt from the Contractor's License Law for the
i po following reason.(Section 7031.5.Business and Professions Calc Any city or county
which require,,a permit m construct,alter,improve demolish,or repair any stuaure
to prion.its issuance.also requires(bea applicant for such
ppipermit mfile asigncJ xtmcmem
ZaG Ihmheisliccnudpursuammthepmvisi.vanftheCommcurtsLianalaw(CM1apmrY Sq. Ft. Floor Area IU ion
rel— (commencing with Section 7000).1 Division 3 of the Business and Prnfnrsl.ns Codc)or $8590
y 3$ that he is exempt therm efroand Ne basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for apvorm,subjects the applicant to a civil penalty of
not more than rive hundred dollars($500). 35613 ApN Number umber 0 Occupancy Type
❑1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale fSce.70q,L Business
and Profcaamme Case:The Contactors License law does not apply to an mic.,or 305 - FRAME Required Inspections
property who W ilda m improve thereon,and wh.das such work himself.,through his
Own employees,provided that such improvements are not intended Confined for sale.If, 307 — INSULATION
however,the building or improvement is sold within one year of completion,the owner-
buildcr will have the burden of proving that he did not build or improve for purpose of 601 - ROOF TEAR OFF
sale) 602 - ROOF PLYWOOD NAIL
p 1,as owner of the property,am exclusively contracting with licensed contractors to 603 - ROOF BATTENS
ennswct the project(Sec.7014,Business and Rofessions Code:)The Contractor's Li-
censelawdoesnotapplytoanownero(property who Wilds or improves thereon.and 604 - ROOF IN-PROGRESS
who contacts for such projects with a conmacmrfs)licensed pursuant to the Contractor's
License law.
❑ I am exempt under See ,B&PC for this .on
net Dam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under Nearly of perjury one of the following declarations:
❑ I have and will maintain a Cenificam of Comsat In self-insure for W.rkcisC.mpcn-
satinn,as provided for by Section 37W of Ne Lahr Code,for the performance of the
work for which this permit is issued.
❑1 have and will maintain Workers Compensation Insurance,as required by Section
3]1X1 of the Labor Cade,for the pe,fmmance of the work for which this permit is issued.
MyWorker's Cnmpcnxati(n Insurance comer a" RI'ynumber art:
caTtic✓ STA-Y'2 FrI.UcP 1.204//,- 2C3
CERTIFICATE OF EXEMPT ,MOM WORKERS'
COMPENSATION INSURANCE
(Nis seCo.need oat W completed'I'M permit is Micro,hundred dollars($1011)
m less)
I certify Nat in the performance of the work fur which this permit is issued.I shall not
employ any person in any importer an as hr become subject to the Workns'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICAM':It,attar Maki ng'his Ccnilicae of Exemption,you should
Become subject to the Worker'a Compensation pmvisions of the laWr Code,you must
Qz forthwith comply with such provisions or this perm ilxhxll W deemed revoked,
'zz O CONSTRUCTION LENDING AGENCY
F l hereby affirm for there is a construction lending agency for the performance of
a > the work for which this permil is issued(Sec.3W7.Civ.C.)
W4
0 Lender's Name
z Lenders Address
U Q 1 certify that I have read this application and.stale that the above inlirmmtiun is
F-' cogen.I agree m comply with all city and county obl nanees and stale laws relining t,
Q U building conswction,and hereby authodm represenlalives of this city to enter upon the
fLL7 above-mentioned pmperamin inspection this Permit, ( 1
y (We)agree m save,indemnify and keep harmless the City or Cupertino against
h
liabilities,judgments,costs and eapcnus which may in any stay accrue against said City
U z in cnneyucncc of the granting of this permit.
'— APP UNDERSTANDS AND WILL COMPLY WIT?AIL ON-POINT Issued by: Date
S C R TION
. gnalu pph tc.ntmm,.t e Re-roofs
0
AZARDOUS MATERIALS DISCLOSURType of Roof
Will the applicant.,future building rweepam store or hanom imperial
as defined by the Cupertino Municipal Code,Chapter 9.12.and the Health and Safely
ale.Section 2553200?
❑Yes ^< All roofs shall be inspected prior to any roofing material being installed.
Will the applicam.t/mmrree building nec apart use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
emit mo,ordous air contaminants as dclincd by the Bay Arca Air Quality Management all new materials for inspection.
Diand"?
❑Yes lof. �
1 have mail the IMmodous materials requirements under Chapter 6.95 of the Calton-
ma lleaW&Safety Cook,Sections 255)5.25533 and 25514.l understand that if the Wilding /_/J —y.��
dos uncndy have a fee nt,that it is my responsibility to body the aeupam of the b t/
chem n ...beat¢ sofa Ccnificam 0.cupancy. 1 ID Of
�. p ant Date
auna dagent Dale All roof coverings to be Class "B"or better
Building Division '
oclo
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
Fax: (408)777-3333
CUPEDTINO
Building Depa ritment
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 sheathing 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: _ V0_J
Address: _ 217 6 0<� vn l I N, s'PIo-`1'
reroofing Company Name: Poo TCG
Applicants Signature. Date:pop
Joe Antonucci
(Chief Building Official)
6/25/01