02090036 CI BUILDING DIIVIISSIIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10400 LINDSAY AV JIM KRAUSE ROOFING O2O90036
FYTV,TA HASAN AND TAN TEN-TZE 2310 DIANA AVE APPLICa154/FD7r2OO2
(� PHONE: (408) 779-0704 SANITARY NO. CONTROL NO.
OZZ ARCHITECfENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
z€W. u —I 1' "_l u
ss.. LICENSED CONTRACTOR'S DECLARATION
Z o'h'= 1 hereby affirm Ina I am licensed under provisions of Chapter 9(commencing Job Description
p:50 with Section]00O)ofDivision 3ofthe Business and ProfessionsCode,and my REROOF
Q YfJ is in III < ��1�'L S � [j�.9 Lei
tt z u 6 Lice.u CI c Lia.M J " �9 g'�V 4wr
❑a O Data Cc "Ave or
A.Q ti, ARCHITECT'S DECLARAT O OCT
I undersmnd my plans shall be used as public records
6 p O Licensed Professional 2OO
OWNER-BUILDER DECLARATION
I hereby.(Sinn 11. .Burin from the Contractor C s License Low for the 1 1'�®Y�� 6 4 0 0
w l/
Z
T
C
following awn.(Section]OlI 5 Business and P
g Professions Code Any my o county
❑ wit h requires permit t construct.alter,improve,demolish, fi carrepair any Structure
..,p 101.Issuance,son rt9 theapplicant ofthe uchpermuoiense aw(Ch m. - --.Q�,� g ._
(cormeat Ini Is liefirsitidRiii with
punutm('othe prfDsmrtsof Ne the Business
peens.Liveins,Coe) y„f y y3.6Sa-F,10 IG10pr Oar, f < f Valuation
or thei he is
Seco o]O)l0of Dinaon3ofea Business ridims.Any vi Code? 1 l/iX \,r J .1N IAT701' s I
or Na he Is 313 bt IhertfmM and the basis for ube cts jaidthe.pentane.Any l anuan N.
�s1�eeF5;ssa,�x,,L{.s.vsss-�a t
-lot not un ]03136y any,ppli doll fora Parrot subjects the applicammacivil penalty 305 TlVINPNL
job normorc than fro hundred dollars 185001. APN y:'.nv'r,< Occupancy Type
°I.as owner oftha amparty,or my employees with wages as their sole compensmion, 307 - INSULATION
-will do ework-end'the swcmre'irnorm,ended'orortercd'for Sale(See:71 u1: - �jg'�]Ins '
IBIn
u s Nnd'Piofex s Code The Co as t LicLicenseLe does net apply toe 601 - ROOF TEA pectionS 11' >LJ' `
owner of property Who bunds or improvesthereon,and who does such workn If 602 - ROOF PLYWOOD NAIL
-or through his own employees,provided Not such improvements- of -ed I r _..... _ . '
.. -
._..__.
t ---,.pRa d'fd ale Ifti ,the holding or m rovmen,is w N n ori.year of 603. .--_ ROOF_-BATTENS
compleS the ne b Ider will have the burden of proving that he did not build or -
improve mrpurpoeeofsalel. 604 - ROOF IN-PROGRESS
O 1.as own.,of the m n ---..-----------------'----------------'---T” ...
G T c p pc Y.
'connmct the project(Sec.]0",Business and Professions Coda:)The Convenors ,,, I,;. 5'Is'P
LI
License Caw dos not apply loon owner fl progeny who builds or improves thereon, "-- "'
and.wctors License
(Law.; .I.j- ,1iN c41",r(q..lianud.pursuant res.me. .____.._._--._..._._____—___._.__.._.-__._-...._..____.______...
01 am, -------
Contractors LiI ad Lew;,.. ...
°lent exempluMer Sec."'a' s's' st -`' i B'ffi P C,for misreaSo it D �1d�C1'6AIfti:
0 U t .., ...r
WORKERS COMPENSATION DECLARATION
:1.;. I hereby.(firm under p rvflq 4 hadurY one aflme following declamtiom:--
° 1 Kiva'and will manmfn o'Cenifimte of Canunt io xaif-insure for Worker's
Coinpcnsotion. as provided for by Section 3700 of the Labor Code, for the
performvnce afiih'I,work for which this permit is rimed..,
' s y Aasiol'ins once srcic 'by Section
Lrvrker M Worke a C m Ion Iv' Inc work bleb tNs permii u
_( g d Policy ti ober
h e d 11 maser COMPENSATION SUR
]00 free Wlwr Code for lit perfo a of
My iuonc ley c ryr
I't_:CERTIP XEMPf1O R�S—b WORKERS S" � i.l�� 14e.�„rv�'f,3t1k l.l�tt. it �x'f)r ST:
S ANCE
h, II fThw secmin need not be cdmplaed if the permit is for one hundred dallan
(5�fpl m�css 1
l, I t(tfythv, n the Performance
Nt Isi iuA,ICjpo
\C.shelnot emplaAny m any manr u to bedomeycct o1FeWoen'
ws fC.1fomiv.Data'
A hent pl,�s i (!•i •-•pi 1,
11' •
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___._.___. ._-. ._.. .--_ ........ _ _ .... ._- ------
r!
-- . .._... _...- ._
t NOTICE..TO'APPLICANT eWorl:esuompenktinp endicme of Exemption,yoy U muld "^\ .4. r' Is l.'•t..
become subjanolhe Workers Compensmian provixions bf the Labor Cade,you rdtdt '
ZOforthwith comply with such provisions or this permit shall be deemed revoked.
s Vy s+i',e ^.s'Ts:' ' f' CONSTRUCTION LENDING AGENCY -" •-
RFeI"rj Ih rebY ffm Ntm nttun Ip d' yag n<Yf rNe pertisrm ce - .. .
0.;Q Led Nme"'h'chm p t si d(Sec l09]Civ C1LL.,�,.-y..Y.-. .. __...... ................ .. ......
;D"'z Led sAddrcsr a ch i.•Cts S`rUS I:I
V[� , 1 candy Nat I have rcod thu appl¢atton end vvm that the above informal on is
�T+'F. cdrrnm;Pegrcc to comply with all city and county,orylinunca qnJ sore laws relating
Os�j to building conamciion;and hercM1y iuthoiiie ieprcsematives of this city menmr upon -
i'� ry the ubove-mentionN pmpeny for inspection puHmus.-,
;.4 lWtj agree io save,Indemnify and kmp harmless the Cty of Ctipenino'igiinst
W li brie 3 dgmems,cosy M expcnsu h ch m y n any way asxme again t avid V`�
V Z City m<onsequ ce of the gopting of Ih s permu '
grPLIGANT UNDFRSTpNDs,q coMPLVw ALLN Date
SOURCE of li kT1ON5 ".� Y' Issued by.
r Signature ofAppl canUComocmr.. "l 1 *Dam Re4oOf5
,s, HAZARDOUS MATE IALS DISCLOSURE
N i),Ne app i At or future diilding occupant sin o handle hmuolnnts truunel a e of Roof. - - - -
as defined by theCupcnm Maalnpal Code Chapter 9 12 and the Health and Safety
Typ } I
_All roofs shall be inseyyc��t qq
C.de,Secimn 2557 1($), , ' 't , v sa 4 s b h1 d`i -G sl o f : ;{t Iltis: V'I St,
� p ed.pnor-to.any..roofmg.matertal being installed. _
W II Ne appl canto Pomrt hu Idt g pant use eq p t d qe h ch r
emth d ' nm mI in as defined by thea yAreaAirQuality�Managemenl If a roof is mstalled'wrthout firs obtaining an mspeenon I ogre
' t to a to remove
D stoat I all new materials for inspection Applicant understands and will comply wnh
- -
Y ;.•,i,.° i,' ;' T', .,j all noir point source regulations,, -;; +
1 have read.the h vrdous mem 1 rtquvem m der Chapterb 95 of Ne
P y ons Z5505,25533 and 8534.1 a derst d the, _
"tIXme nm of tit ms not c mol a' e I rant Nat t ,y responsh I,y t t fy site
Cheutul HghhffiCode Sh ti In tp to nc In" Tinto(
Safety
comea
Occ un
S J Signature of Appltca --_ _ - - - Date
O neror Nonud ag 1 ,'f „e All roof coverings to be Class B of better I
OFFICE- . .-.,
Building Division
i
10300 Torre Avenue
CVerdno,CA 95014-3255 tc,
Telephone: (408)777-3228
C PEkTINO F= (408)777-3333
Building Department
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
completed. when the reroofing is
I 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.
S. 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 inspectio'r can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of W,per foot slope and demonstrate that
there is no ponding.
2. An IC-B.0. 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:
Address: /0 VOD
OLA
Reroofing Company Nam;e:
Applicants Signature:
Joe Anionucci
(0-def Building Official)
6/25/01