Loading...
03090041 CITY OF CUPERTINO BulLDlnc DrvlsloN PERMIT TRACT^ OWIP, BUILDING ADDRESS: YUTRONIC VICENTA PERMIT NO 03090041 "ir? Asir ER'SNAME: FERMITISSUEDATE N ONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH '06 LICENSED CONTRACTOR'S DECLARATION lob Desc, O 0 0 O F 1 hereby afrnm that I am limned under provisions of Chapter 9(commencing - i� with Secuon]IXX))of Division 3 ofthc Business and Poressiom Code.and my license is in full fora and effect. License Class Contractor id NEW DOOR JUL J Dale Gamacror 2014 ARCHITECTS DECLARATION 1 unOcrsmnJ my plans shall W used os Public mcnNs An. BUILDING e p: Licensed Professional 5 OWNER-BUILDER DECLARATION C<0 Wrchy.(firm on 11. exempt s an @ Contactors :Any Lew for IW C20 following moron. panni it]Ions a Business and n.de um Code:Any city nr county m�+ which requires issuance,resell m maroon,aper,impmw,demolish,ore4 sig any mruaurc _zy that heor i¢ ...dmsontto the lW applicant for uchpctors fierise Law(Chapter ExF Q (commencingwJPSect.nlvnh)ofDivision iviomnfthaComapersanccnulsw(Chopwr9 Sq.Ft. Floor Area Valuation `C$ that he sem with Section7")and al Divisi ani of the BusinessanJon.An inmlattionde)ar 3 Natio is esempt Nemfmm ant IAe baso for be alleged c pliant to Any it penalty of 36932050 . 00 notSec thanfiyanyreddenars(Sfor a permitsubjectstheeppl¢anuoacivilpenaltyof APN Number Occupancy Type not more man Bw hanama dollars(55007. - p y .. D 1,u owner oftlicproperty,or my employees with wages As Nair sole campenution, will do the work,and the spt is not intended of offered for sale 7014,Business 101 — OUNDA d InSpeCtl005 And Professions Code:The Co naeloYa License -`Vy Law does nal apply 10 an owner of property who builds or improves thereon,and who does such work himselfor through his 102 - PIERS Own employees,provided that such improvements are not intended oroffered for sale.If, 103 — UFER however,the building or improvement is said within one year of completion,the owner- builder .will have the burden of proving mu he did not Wild or improve for purpose of 104 - REBAR D has owner of the props ny,am exclusively contracting with licensed convectors to 105 — ANCHOR BOLTS Conxwct the pmjcct(Sec.7044,Business and Professions code:)The Contractus Lt. 106 — SEWER & WATER Craft,Law does not apply rain owner of protan who Wilda or impmvea thereon.and, 202 — UNDERFLOOR PLUMBING who contracts for such projects with a contapursuant aor(s)licensed pursuano the Contactors L ease Law. 203 - UNDERFLOOR MECHANICAL Iamc pl under Dec B&PCfnr thiarcvon — 9-� 204 - UNDERFLOOR FRAME WOR ERS OMPENSATIOND LARAratgeN -n 205 - UNDERFLOOR INSULATION ser thereby alT s�nu der Pena yof pcjury aroafthe foltng aeci.r.tiona: 301 — ROUGH PLUMBING ❑Ihaw.ndwmm.imainaCe ¢amafConsenuoulf-insumfarWorkcrsCumpcn- 302 — TUB & OR SHOWER sation,As provided for by Section 3700 of the Labor Code,for the performance of the 303 - ROUGH MECHANICAL wok haor ve and ills permit is issued. 304 - ROUGH ELECTRICAL ❑ 1 have and will maintain Worker's ...corthe w rk for hi h required by Sermon My Of Wtuthehbofpenaionthe performancoaf ad Policy munthich thisamtil is issued. 305 — P'RAIV]Li' - MyWorkcr'sComPemail.nlnsuaux artieraniyNo.: umber am: 306 — HOLDOWNS Cartier, Policy No.: CERTIFICATE OF EXEMPfiON FROM WORKERS' 307 — INSULATION COMPENSATION INSURANCE 308 - SHEETROCK it,Ices)(Teis Mellon need wt he completed lithe Permit is for one hundred dollars IS IW) 309 - EXTERIOR LATH 1 certify mat in the parfnrmaucc of the work for which this Permit Is issued,I so.]]not 310 — INTERIOR LATH employ any person in any mannerso u to become subject o the Workers'Compensation 311 SCRATCH COAT laws of calif rmia.0am Applicant 313 - ROOF NAIL NOTICE TO APPLICANT If.Art"making this Certificate of Exemption,you should 501 - FINAL ELECTRICAL ENERGY become subject to roc Worker's Compensation provisions of the Labor Codc,you must �0 forthwith Comply with such pownim.or this Pcrmim uhall he decad revoked, 502 — FINAL PLUMBING ENERGY ti jjy CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY 1 hereby.lfirm that mea is a Construction lending agency lot the performance of x> mcwork rot which this Permit isissued(Sec.AAT,Cry.C.) 504 - FINAL BUILDING ENERGY p Lender's Name 505 - FINAL ELECTRICAL DZ l<ode,',Add=, 506 - GAS TEST J Q 1 certify that I have read this application and sum that the above information relatiing is .y buildingIagree mcomply with hereby cityanecountynNinmasandaroselawsrup..tl0 507 - FINAL PLUMBING 'U buildingaotioned ogand for oins emhonp representatives of this city to corer upon the FIN MECHAN CAL shave (We) goproperry forimteaion Purposes. /// ti y (We)agme to cove,indemnify and keep humlw the City of Cupertino id Ci 09 FIN rz/1 inecooduccuudgmemhe ,.4uia,Add orthoses which may In any way accac against acid City 5 NG / ^ A co IL C9ANTt,of UNDERS'r1i NOSor rhis AND WILL COMPLY WITH ALL NON-POINT Issued by:5WORKS Date SOU 6RE^UL ON Sig col ApplWrAtC true am e(n PAZ RDD MATERIALS DIS LOSURE Type of Roof Will lb lied.l. fulurc ilding oecup.nt store or candle he'raNaus material as defined by the Cupertino Munici At Code.Chapter 9,12,and the Hearth and Safety Code,Section 25532(a)?� Dyes All roofs shall be inspected prior to any roofing material being installed. Will the applicant r ralare building occppant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove :mil harafdnua air cup(. inanB as defined by the Bay Arca Air Quality Management all new materials for inspection. District? yon Dyes k9- I have read do h xuabousnourrials mquircmen s under Chapwrii.95 of the Califor- nia Health&Safety Cade,Secvum 15505.25533 and 25534.1 torcamnd on if the Wilding d t t'.9= an a IC nl,but it Ire tax re5panxthility in notfy be IKcuPNI nr thC mq mm sew ¢ muss- Iprou. iss cc ora Ce ' cmc f parry. � � Signature ofApplicant . Date owner ar apmarhada rtt Data roof coverings to be Class "B" or better CITY OF CUPERTINO i 1 of 1 PERMIT RECEIPT OPERATOR: suem COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36932050.00 DATE ISSUED. . . . . . . : 09/04/2003 RECEIPT #. . . . . . . . . : 23032 REFERENCE ID # . . . : 03090041 SITE ADDRESS . . . . . : 20162 RODRIGUES AV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : YUTRONIC VICENTA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-3100 RECEIVED FROM . . . . : VICKY YUTRONIC CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : YUTRONIC VICENTA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-3100 TELEPHONE . . . . . . . . : • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL _____ ----------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 77.00 23.10 0.00 23.10 0.00 BPERMFEE VALUATION 700.00 77.00 0.00 77.00 0.00 BSEISMICRE VALUATION 700.00 0.50 0.00 0.50 0.00 BPLANCHK PERMIT FEE 77.00 65.45 0.00 65.45 0.00 __________ __________ __________ ---------- TOTAL PERMIT 166.05 0.00 166.05 0.00 METHOD OF PAYMENT AMOUNT NUMBER _________________ ------------ ________-_-_------ OTHER 166.05 MASTERCARD TOTAL RECEIPT- : 1G6.05 t • OV;W-BUILDER VERIFICATIOTO 1. (Check one) I or my immediate family (parent,spouse or child) will perform: • A. All the work authorized by this permit B. _ A portion of the work C. None of the work If B or C is checked, complete 2 or 3below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. A portion of the work (complete section below) Contractor Address/City Phone # State License # Type of work to be performed • 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer(see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City Phone Number Type of work to be performed ..................................................................................................................................................................................... I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information (reverse side) Property Owner's Signature� (r9M D-51W `f - 0 -71 Job Address: k-(O16 2 d Permit# ( k Any chanees to the information provided on this form shall be submitted to the City of Cupertino Build • Department. City'of Cupertino Building Departmeo CITY�F 10300 Torre Avenu C U P E kT I N O Phone: (408)777-3228 i Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner-builder you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself,you may protect,yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work,with the exception of various trades that you plan to subcontract,you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is$200 or more for the entire project,and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer,you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes,workers' compensation insurance,disability insurance costs,and unemployment compensatiol contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers compensation insurance. For more specific information about your obligations under federal law,contact the Internal Revenue Service (and,if you wish,the U.S.Small Business Administration). For more specific information about your obligations under state law,contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale,property owners who are not licensed contractors are allowed to perform their work personally or through their own employees,without a licensed contractor or subcontractor,only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors'State License Board in your community or at 1020 N Street,Sacramento,California 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, Building Department, • City of Cupertino Printed an Recycled Paper C*Y OF CUPERTINO al, CUPERTINO PERMIT APPLICATION FORM PN # Z f Date: Building Address: A : 2016 Z. Owner's Name: Phone#: t G.K 5 5 0 4- Contracto . A / License#: Y i Gtr i Contact: Cupertino Business License#: Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job escription: Residential Q uJ' Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: r Cost of Project: Occupancy Gr p: r 2 Type of Construction: / AML Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V<= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 C*Y OF CUPERTINO .4ir CUPEf�TINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTDAE Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING' BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREM 3USWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace MECHANICAL BREMFURNOV Relo Furnace > 10K btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2of3 Q CITY OF CUPERTIlA Cm o CUPEI�TINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Ternp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL i EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3 1 3° fig �9CF , D >g>? ems c� c -T ����� SEP 0 4 20(3 t�- sx Lnrt c,t PT yY �/ APPROVED �G IN ACCORDANCE WlT HE CITY©A A CUP.ERTIN D DINA= B, , nrr'r. DATE OFFICE COPY De keU This set of pl sand specifications MUST De kopt on a job at all times and it is un lawful to make any changes or alterations on some without written permission iron: the building Dept., City of Cupertino. • ;; The stamping of this plan and specifications' SHALL NOT be held to permit or to ba ac approval of the violation of any provisions .if any City Ordinance or State Law. CITY OF CUPEWrINO BUILDING DIVISION PERMIT GONTRAGTORINI'ORMATION =�.<. Ate "s�na4Y=. 1 " ve.,64 *`3x BUI LDING ADDRESS: YUTRONIC VICENTA PERMITNO03090041 ()16-) R0nRjrjjr,2 AIT ERS NAME: PERMIT ISSUE DATE NE: SANITARY NO. CONTROL NO. i ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 to LICENSED CONTRACTOR'SunderpOECLARATION- as F C l ionbrichyaffirm that 1 am nacnrcd under pmviaons of Chapter 1(commencing Job'•0 YFI,.QtlOn b with Sation)11M))afDMain.Sof Ne Businessand Profaminm Code.and my license is u in full force and affect. License Class Lk.a NEW DOOR a`a Date Contractor FF'J` ARCHITECT'S DECLARATION f W U I undersand my plana shall be used as public records rywAp� .off Licensed Porromim al S OWNER-BUILDER m Ce Contractors DN ®' 0 0 1 hereby.(Erre that I ore exempt from the Canlns Ccn License Law for the �' y O O following moon. paned ,IDnstr Business and Professions Cmlc:Any city or county 5 m veto which nquissuance.a Parent on cnnewce plica impmw, Permfi,ter repair any saucture -Zee prionoiu ensedpursantto tenhovisiosofcant farsuch the Contrarmiuoiensle a e Law(Cammem ff (commthat he encing WithSection7 the pmvivision3ortheBuiness ndProflaw(Chap¢r9 Sq. Ft.Floor Area Valuation RR D Immmcne xemptherre from and rol ho basis of theBusiness Professions vi Corte)or ��$ Net he is exempt therefrom and tbe buts for the alleged eacmpdon.Any violation of 36932050 . 00 Section 703 1.5 by any applicem for a permit objects the applicant los civil penally of APN Number . Occupancy Type not mon than Era hundred dollars S500). - -- ---" - P Y --- ❑ 1,as owner of the progeny,Or my employees with wages as their sole campeneadon, will do the work.end the swam,is not intended or offend for eala(Sac,7044,Business 101 — UNDAmoreH ;Ggd Inspections and Professions Code:The Contractor's License Law does not apply to an owner of 102 — PIERS --^f property who builds or opposes literati whodoesoch work himselfor though his awn employers,provided that such improvements art not intended or offend for sale.If, 103 — UFER however,the building or improvement Is sold within one you of completion,the owner. builder will have Ne burden of pmving that he did not Wild or improve for purpose of 104 — REBAR 1e')' 105 - ANCHOR BOLTS wn the I,as owner of properly,am elusively confessions with licensed contractors in comc projectct ao (Sec.70M.Businessendnd Professions Code:)The Convutw's Li. 106 — SEWER & WATER cense Law does not apply to an owner of pmpeny who Wilds at improves themon.and, 202 — UNDERFLOOR PLUMBING who contracts for such projects with a contractorB)licensed pursuant to Ne Contractor's L'an.Law. 203 - UNDERFLOOR MECHANICAL 1 am e p oder Sec B h P C to,his mason 9 204 - UNDERFLOOR FRAME III S OMPENSATIOND CLARAr�Nn205 - UNDERFLOOR INSULATION thereby aderrcn rorperjaryoncartherolrowmgdcolanon.. 301 — ROUGH PLUMBING I haveand will maintain a C reek Consent of Conseno self-insun for worker's Compen. 302 — TUB tip OR SHOWER sa'on,n provided for by Section 37W of the Labor Code.for the nanm pcffonof the 3 03 - ROUGH MECHANICAL work for which Nis permit is issued. El have and will maintain Workcra Compensation Insurance,as required by Scotian 3 04 - ROUGH ELECTRICAL 37M of the la ur Cade.for the performance of the wore for which this parmit is woad. 305 — FRAME My Worker's Compensation lnsuremu carrier and Policy number am: - 306 — HOLDOWNS Cartier: Pal icy No.: _ CERTIFICATE OF EXEM PITON FROM WORK ERS' 307 — INSULATION COMPENSATION INSURANCE 308 - SHEETROCK (Otis section need nos be completed if the permit is for one hundred dollars(S 100) 309 - EXTERIOR LATH ter Ina) I Comfy Net in the performance of the work for which this permit is Wood,I shall not 310 — INTERIOR LATH employ any person in any manneran as to become subject no the Workerienmpamallan 311 SCRATCH COAT laws of C&lifomia.Date Applicant 313 - ROOF NAIL NOTICE TO APPLICANT.If,after making this Cenilicem of Exemption,you should 501 - FINAL ELECTRICAL ENERGY became object to the Winter's Compensation previsions of It.IaMr Coda you must � O forthwith comply with such provisions or this Permit shun W deemed revoked. 502 — FINAL PLUMBING ENERGY 1 ZN CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY I hereby affirmNrmat Nen u s comnxim.lendinsagcney Im No perfufmume of 504 - FINAL BUILDING ENERGY the work for which this peit is issued(Sec.3(197,Civ.C.) i q Lender'sAama 505 - FINAL ELECTRICAL Lenders Address Z 506 - GAS TEST 1 certify Net 1 have reed this application and sou that Na above ioninformation Maliiun is 507 - FINAL PLUMBING .y an .1 agree to comply with all city and county ordinances end sok leve rcleting to building Construction,and hereby authorise mpresenutives of mit city to enter upon Nc IV =V whom.menticumdpropertyforinspect, Purposes. FIN MECHAN CAL ?' 4//2 d (We)egos m ave,indemnify end keep harmless the City o(Cupcupm ageirul O 9 FIN rN liabilities judgmeau,coats and expenses which may in any way&come against mid City OZ in consequence of Nag )seg of this permic 5 NG ^^ A IC T UNDERS NDS AND WILL COMPLY WITH ALL NON-POINT Issued bY:5 WORKS Date 1 SOU RE ION ^��tl 9 Re-roofs Signal afAp HAZ RDir D AtATli LOSURE `k Type of Roof Will the linnto Rfaturc ilding occupant ata.or handle hazardous materiel u defined by the peninoel Cade,Chapter 9.13,and the Health and Safety c. Section 2s53z(a). All roofs shall be inspected prior to any roofing material being installed. ❑Ye Will the applicant ruilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove CMR hanolous air contaminants as defined by the Bay Area Air Quality Management District? all new materials for inspection. ❑Ycs pkY I have meal Ne IwaNrmsmakriala requirements under Chapter 6.95 of the Califon ri Haalthg[Safat,Cmk.S ..25505,25533and M334.1undcr ditif Nc Wildins t d (C. ewau m,Nat it ism rcsWnsihilitymnndly theoce"amnfum rcq rum I.. mustW tNiormins _see ora ca teak ane'. Signature of Applicant Date All roof coverings to be Class"B"or better Owner or anhoweal o est Dam g