01110074L CITY OF CUPEKT1NU
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
7874 ROBINDELL WY
OWNER'S NAME:
CHUENG
W 00 ARCHITECTIENGINEER:
a
ts.ae
O M = LICENSED a CONTRACTOR'S DECLARATION
: n = G 1 hereby affirm)f Division
1 nm licensed under provisions rad rfe of nsChapter Code.
9(rommecense
= t with S<ction ]0001 f Division 3 of the Business end Professions Coee, roti my liana
Is in full force and c q f
n w a Liana CFJI,ss �/ 1 Lic.10 -! L
' p_ U Date
/,p_(�-- Contractor
I O Fri ARCHITECTS DECLARATION
g 1 anderaand my plans shall be used as public records
I ce c O Licensed Professional
CONTRACTOR INFORMATION:
PERMIT NO.
01110074
1
BLDG ELECT PLUMB MECH
REROOF. Job Description
T/O SHINGLES, ADD 30# FELT &
30 YR. COMP. SHINGLES.
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OWNER -BUILDER DECLARATION
Issued by: Date
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1 hereby eTion that 1 am eamnpt farm the Commemir, License Law for the
HAZARD US MATERIALS DISCLOSURE'
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(allowing reason. (Section ]on Business and Code: Any city or century
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�p e of Roof • - - -- -- - - - - _. _
- as calmed by the Cup. o Municipal Code, Chapter 9.12, and me Health and Safety
Cod Section 25532(sl+
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rProfession,ere,deli
construct. any asmaum
which nequhes a permit re rore,dre alter, improve, demolish,
❑Yes' o' :•
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All roofs shall be. inspected.prior to any roofing material being. installed.-
earepairg
file
priamieissuance. also requites she applicant for cash penniuofleasigned xtneram
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Ft: Floor -A ea, P s•- . ,.,
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$ 4 9�3b3 ation
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tnath4islicensed pumuant to The provioonsofthe Comructor'sLicense Law (Chapter 9
Section ]000) Division 3 Buyirmaa Professions
1 have mad she requirements ander 6.95 me
(commencing with of of the and Code)
or that be is Been j i thertfmm and she basis for The alleged i iemytion. Any violation
t4;'a j j 1 ;, . 1 , j +v.. i d ''t
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the building dao not currently heveamnan6 that is my msponsibiliry to notify the
' of Section 7031.5 by any applicml for a permit subjects the applicant to a civil penalty
of no, mart than five hundred dollar, (asw).
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• � " Occupancy Type
°ccaptive
❑ I, as owner of the property, or in, employed with wages as their sola compensation,
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ll roof coverings to be Class "B" or better
'will 'do'The work, -and The'shuclum is not intended or offered for .ale (Sec. ]Baa.
Business and Foliations Code: The Contractor's License Law does not apply to an
3 0 5 — FRAME Required Inspections'' ' -
owner of properly Who Wild, or improves therta, ®td who don such wad himself
3 07 - INSULATION
or through his own employees. provided that such improvements am not intended or
offered I., W.: le however, the hmMmm
ing of bop eat is sold within no year of
,- _
601 - ROOF TEAR - OFF __
completion, the owner -builder will have the burden of proving that he did not build or
improve for purpaseofsale.).
602 - ROOF PLYWOOD NAIL
- .....
ql: as nwnerpmjec property, um exdusivdy contras ontrmmrs m
h�iCods:)
603 - ROOF -'BATTENS ._...._....-
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ssi ns The
mnaw<t me project (See, ]a4, surmnt aw Profe::mna Cade:) The cpnmamrs
604 — ROOF IN— PROGRESS ' '.
- . -
License Law does not apply to an owner of property who builds or improves thereon,
and.whocontracts forsuch pmjcce.wuh a consmctor(.$) licensedpmsuont.to me
License law.
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El Icon exempt
❑lameaempt undo Sec.' .B&PCfee This roan
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Dwner Date
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WORKER'S COMPENSATION DECLARATION
1 hereby M. under panahy of perjury ane of the following decleromm:
❑ 1 have and will maintain a Cenificate of Consent to atf-imam for Wmis ria
Compensation, is provided for by Section 3700 of the Labor Code, for The
Performance &TW wad fir Which this permit is Issued.
-
have and will mainmin Worker's Compensation Insurance, as sequined by Section
' -
3700 of the Labor Code, for The performance of me work, for which Ws Permit is
issued My Wo crs Compcp�mio Insurance canis and Policy number art: '
.Palic
No.: /GO SSS/—_-
t ,CERTIFICATION OF EXEMPTION FROM.WORK RS'i
l. �', ' rs'� M1 .-.� ss
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COM
ii seaian n<W .1 be, PENSATIONf TION INSURANCE
mi. one
he Permit
complethundrtd dollars
d!s '
' +''`
(SI00)or less.)
1 « rt f chat in the Performance of the wad for whab -fins iIs
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shall t e ply any perun in my mann aro n to become jeer r the
Co pe m n Laws of Cabinda.. Data
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Applicant - -
NOTICE TO APPLICANT If, Nar making this C<mficatc f you
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become subject m the Workers Compensation provisions ref the ba'C
Code, yo u
fonhwith
comply with such provisions or this permit shall M d ed .yoked
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CONSTRUCTION LENDING AGENCY
1 hertby aRmi mat mem Is a construction lending agency for tha perfornac e
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of thework for which this permit is issued sec. 309], Civ. C.)
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Lender's Name ,:. _.... -.. ... _ .. _i
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Yodc'r's Addmss •'.
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1 cenify that I have mad This application and state that the above information is
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correm. I agree to comply with all city and county ordinances and naa laws relming
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to WndmgennswnioM1pert M1 for inspection aauposeneuvea of me my .enter upon
me above-mentioned propend for fyanke purpose,
mify and keep harmless to he Cityay aCusm reo egemm
rWel agoe s, isvcas and
City in co judgments, rose and frog of i which They in my way eccoe against said
in consequence of me granting of this permit. ' '
'SOURCANTUNUER.$TkNI+3y.�VD WILL COM�Py�' WITH'ALL NON I
SOURCANT UNATfONC�1 "1 _"!f ��
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Issued by: Date
Signature of ApplimnU�ComraTJ BS
Dto
Re -roofs
HAZARD US MATERIALS DISCLOSURE'
Will the applii'ant afficarm building occupmt it= a hardl hamNous material
r --t
�p e of Roof • - - -- -- - - - - _. _
- as calmed by the Cup. o Municipal Code, Chapter 9.12, and me Health and Safety
Cod Section 25532(sl+
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❑Yes' o' :•
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All roofs shall be. inspected.prior to any roofing material being. installed.-
Will The applicant or future building occupant use equipment or devices which
If a roof is installed without first obtaining an inspection; I'agree te'remove
.mit hoxardous air commitments n defined by the'Bay Arca Air Quality Management
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all new materials for inspection._ Applicant understands and will comply with
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all non -point source regulations,
1 have mad she requirements ander 6.95 me
e,, Col Sections 34. I Ter
if due mil Health b. Salary Code. Sections 25505, ad
if
and 2553x.1 undersand thatQL
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the building dao not currently heveamnan6 that is my msponsibiliry to notify the
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acupam of th rc ane whr h mus a me, Prior W iuvance of e�enifcam of
°ccaptive
Signature of ApOicant Date
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ll roof coverings to be Class "B" or better
Gwne raatnodme rot "' t Data
OFFICE
171
CITY&O
UPEI�TINO
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Fax: (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 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 1/a" 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:
Address:
11
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Reroofing Company Name: -J. A�Jl if - 4= din —
Applicants Signature: d Date:�� /5 O
Joe Antonucci
(Chief Building Official)
6/25/01