Loading...
03080051zzC .. y V�1 O :Dz UOu. _ CU [r d Uz CFPY OF CUPERTINO r ��, BUILDING DIVISION PERMIT ONTRCTOR INFORMATION CA nuaglNc nOnaess:SAIZ ROOFING reaMlT lvo03080051 21584 LA PLAYA OWNER'S NAME: 2951 REMINGTON WY PERMIT ISSUE DATE ,MACKERROW DONALD E AND MARY R 08/12/2003 (408)275-6566 SANITARY NO. CONTROL NO. ARCHITECrIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH t_7 l� 0 (� LICENSED CONTRACTOR'S DECLARATION Job Description 1 bunchy affirm that 1 am licensed u do provisions of Chapter 9 (commencing wish Sccllon7 Bof Diviaion3ofthc Bt�and Ps re Iona Co an yliccvc is mmBm a d. t_ , REROOF Lice,, sn Uc. X Da Cumraclor FINALE® AR NITECTS ATION ' do lams sh Tic rccnrJs `/`pas Prat AUG 2-.82003 abntl OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the Following reason. (Section 7031.5, Business and Profenio. Code: Any city or county which requires a pemtit to construct, alter, improve, demolish, or repair any structure$17000 poor 111 its imuanee, also mquims the applicant for such Permit to file a signed statement Sq, Ft. Floor Area Valuation that he is licensed pursuant o the provisions of the Contractor's License Law (chapter 9 (commencing with Section 7000) of Division J of the B usinus and Professions Code)it 35623014.00 Nat he is exempt therefrom and the basis for the alleged exemption. Any violation of APN Number Occupancy Type Section 7031,5 by any applicant for a Iwai t sobjeeta the applicant to a civil penalty of not marc Nan Bvc hundred delta,, (S500). ❑ I, is owner.floe property, or my employ.. with wages as their sole comp ft When, Ins will 6. Ne work, and theelmnure is not intended molfned for sale (Sec. 7051, Businessd and Prefcsames Code: The Conten ora License Paw Jou not apply to a owner of 3 0 7 - INSULARApeCh005 property who builds or improves thereon, end who does ouch work himself., through his own employees, provided that such improvements are not intended or offered fornle.If, 601 — ROOF TEAR OFF however, Ne building or improvement is writ within one year of completion. the owner. 602 ROOF PLYWOOD NAIL builder will hew she burden of proving that he did not build or improve for purpose of - .to). 603 - ROOF BATTENS 1, as owner of the property, am exclusively contracting with licensed contractors to 604 - ROOF IN -PROGRESS construct the pmjccl (Sec. 7D61, Business and Profcasions Coley The Contractor's Li. cease law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects wit a consiscsor(s) licensed pursuant o Ne Con eacmM1 License Law. I are exempt under Sec. . B as P C for this moon net Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penally of perjury one of the following deelarnions: 1 haw and will maintain a Certificate of Consent o seP6insure for Works s COarri anion, as provided for by Section 3700 of the Labour Code, for she performmme of the work for which this permit is issued. I ban and will maintain Worker's Compensation Insurance, as required by Section 37M or the Labor Came, f r Ne performance of the work for which Nis permit is issued. My orkefsC p,s on etkanttstud/,p�3ligmiT� am' Q mer: I"No1%_/�( CERTIFICATEOFEXE PTIONMOMWO KERft S' COMPENSATION INSURANCE (This section need not he cumplemd Kthe permit is for one hunJmddNlars (SIM) ,it Etas.) I certify that in the performance of the work for which this permit is issued, P shall not employ any perwn in any mantar sn u to become subject o the Workeri Compcuation Laws of Califnmia. Date Applicant NOTICE TO APPLICANT: If, after making this Cenlfieale of Exemption, you should become subject to the Worker's Compensation provisions of the Lishnr Code, you muss forthwith comply with such provisions or this permit shall bu deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that Nem is construction Pending agency our the performance of duework for which this permit is issued (Sec. 3M7, CO, C.) Lattice's Name . LcnJer's Address U 1 certify that 1 ban read this application and sate that Eric above infotmatiun is Correa P agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorike representatives of this city to enter upon the flwvrmentioned rusticity for inspection purposes. and keep hay in an w City of Cupcnits against liailiti(we). m e I. costs end expenses which may in any way accrue againOsaid intvo� (sju .,me m cast, and in consequence of the granting of this permit. APP NT UNDERSTANDS AND WELL COMPLY WITH ALL NON -POINT Issued by: Date 50 ATPONS. Re -roofs Type of Roof KillmIrre of Applicant/ContractorDea HAZARDOUS MATERIALS DISCLOSURE Will Ne applicant tar future building occurmt atom or handle hararduus material defined bytheCupenlno Municipal Cde, Chapter 9.12, and ftHealth and Safety d.. section a5532(an immricil -All roofs shall be inspected prior to any roofing material being installed. a roof is installed without first obtaining an inspection, I agree to remove Will the applicant of future building=upon( use equipment os devices whichIf Ps hazuNns air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. ❑ Yes [j I have read Ne hanaN )us materials mquimnenm under Chapmr 6.95 of Ne Califor. nia Health&Safny Code,Scctiuns25505,25533kvd25531. 1 understand thmifdv: building - Jtes not currently haw a amain. that it is my rcaponsibility b study the tcCupwt of Jin fflnature of Applicant Date qct nvawhich must bemet IfyIaCertificate Or Occupancy All roof coverings to be Cla�s' or better Owner tar..flumind again Da i i f CITY OF UPEkTINO Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 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: it t// /4611- &A P_0 -u:2 Job Site Address: A11 Roofing Company Name: Aphcant'`Z` ©3 9 eel Building Official Revised 1/30/03 Printed on Recycled Paper 1 aCITY0 iCUPERTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM APN # ' r 6C Bldg Permit Fees BUILDING ✓Z Energy LLQ %Z O Building Address: Seismic Fee Res BUILDING BSEISMICOM wner's Name: BUILDING Phone #: Plan Check Fee BUILDING BUSLIC Contractor Phone #•� License Con act: Phone #: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ It -Up roof Asphalt Shingles Asphalt Shingles Wood Shakes - ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) Nu er of existing coverings ❑ Other (Specify) ❑ Provide I.C.B.O. Report # To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Com ply With Cu ertino's Tear Off Policy: ❑ 70 Description: '/ u ` S� /2— L ! %J Residential Commerc' 1 ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if there are any restrictio Cost of Project: Type of Coru tion- Occupancy group: 7 boo. o ,Jfr Qty. if AuoliaCble Fee ID i / t Fee Descrintion Q__L� Fee Grnun BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING 7