03080068 CITY,OF s DIViSiONNOPERMIT CONTRACTOR INTORMATION:
BUILDING ADDRESS: PERMIT NO.
20071 SUISUN DR R A CONSTRUCTION 0208000T68
GR1851 MUEZ NOEMI AND ENRIQUE 559 CAMPBELL TECH PARKWAY APPLICA08/13Aj2002
PHONE: (408) 369-9921 SANITARY NO. CONTROL NO.
Poo' ARCHITEC iENGINEER: A BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Z LICENSED CONTRACT'OR'S DECLARATION
5„ Job Description
I.
Iherebyah that un Efe sBurMergmvisionsofCh lat nicoc9(co cine REROOF go—no
FhCW7 with Sectio ] )of Drvi' fthe Busi andu`mmoons dean license OY
mm is in full for d eR 7
C < Li ease Cla Lic,g e� e®
Can ARCIfITECT'I D r ATION JAN 0
mI
E0 1 understand my plans shall be used as public records 9 2003
u so
6 C o Licensed Professional
OWNER attempt
frDECLARATION B ILL)IN
Y 1 greasy a61rm on 1 1. exempt from the Canons,Cr License Law(or the LiV
Z�Q following reason.(Section]Ionstr Business and Professions demolish.oe:Any city stcounty
't2 O wh rt req sea a pcmut t ss do, alma improve, ermittor repair slmcwm
prior to i l issuance,al requires thoAsio ant for such Cont permit Licen signedw(Chtemem - .- - — O O
that wis pSectio tglhe ofDiiumnl die the Business
36SA21N.,T.t�C Iya 1' "r' Valuation
(commencing, wnon,utrn]OooidshebsisoaftheEusumvAndPi.AnyvCOJe) a^_6_h . t UW�J�II ''CC11,lliVV : +Q +{�+p_., ��?jy:
or Nei he is aeuipt thertrrom and the have ford¢alleged exemption.Any i Penalty--of Section]than by anyapplicantollfora500). svhjwts she applicant to acivil penah
ornotmnrtmanE.ennnertaemlaa(s5an. Y 305APPrII49lp¢E Occupancy Type
°1,as owner of the property,or my employees with wages as their sole compensation, '307 INSULATION
--wilt do the works and the'suucture Is htarintended or offered for sak(Sec:]Oaf 6 O 1 - ROOF TEFtR Gih��'InS eC[i00S'
'Business arid'Prafessiotu Cade:The Contractor's License law cases not apply to an q p
owner of property Who Wilds or improves therton,and who does such work himself 602 - ROOF PLYWOOD NAIL
or Naught his own employees.provided that such improvements are not intended or
,ccofferedr sale.If,h ld the l have t mprobbmeov n sold wdhm ane y
ear nr '-"'-603 = ROOF-'BATTENS --
cdmpleti n,Ne owner-builder will have the harden of moving that he did not build or '
improve for pnrpou of sale.). 604 - ROOF IN-PROGRESSn
----- --'-- ex
°1:m owner of the pmprnY•am exclusively contracting with licensed wnuactorsm �'----�� - �, -.--�-_t'-�
construct the project(Sec.71)4a,Business and Professions CWe:)The Contractor's _ _ t
License Law does not apply to an ownerof property who W ilda or impmmi thereon,
_.and.whocomracts.for.such.pro3ecrs.with+,contmetudsllicemed-prrmsarm.the.
O f ar amair's License law,
❑l
_ caempt udder 5ec. � `I .�B&PCfor this rtasnn oOb �;i't Ut'Jb
owner .. °Dam
., "WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty oL perjury one of the following declarations:
Ji
. ° 1 have and will'maimixin o''Certificuie of Consent to self-insure for Worker's
Compensation. as provided for by Section 3700 of the Labor Cade, for the
'perfarmanco of the work fog which thispemtit is issued .
°I have and will maintain Workers 661tornsutipn1Insurance,as required by Section
3700 of the tabor Care,for the p`erfnrm a of the work f h ch this Perron is
ism d MyW k 's Co. a n Hsu gcp ranJP ,amass rare:
s,� t vp 19 ....., .,._
t7 iCE IFlCAT NOF ION FROM,WORKER f til i,Nk'f .�'k .s'V„i'�yC-'411\i.ai:i s• •I i a
COMPENSATION INSURANCE r s.•,e n
.. - .,., r ...
(Thii sectirin need ani be'ivmplemd if the permit is for rine hundred dollars
(51001 or less.) '
" 1 certify that in the perform e,of fWaimals for wh¢hih's penin is Issued.I _vf- .._ ._•14 . . T,1' .s �. Jl n` i .. ,.,�. _
shall nut employ any person in any manner so a to become subject tolhe Workers
Compemetion laws of California.Dam'
.APplicant , - .. . .....x. _......_... _ ... ___..
... . ._ l Em ,
afmr
tNcome subject
OAPo the W6T:If,Compensation
this Genion of of Labor Code.you
� 'T' -,
Wchwith comply with
the such
Compensation provisions of the Labor Cole,you muv
z 0 f---- - ---y with such provisions or this permit shell be deemed revoked.
___. ._-__ _ging_ ._.___._ ..__.____._... ..
"CONSTRUCTION LENDING AGENCY. '--' - --r-°tom- -"' -- ----_'
r t'
` I hereby Ti Out Nem is.emsecouscums leading agency far the Performs.. Mz r
�'> ofth k'f hichrhn,rmtud(S 309] Ci C) '
0..m Lende Name". _� . , , , ..:: I——: "' ---- ........ . ...._._.__. ._. ..... _.. r�e o,zLea cAddress nify that 1 have read Nis applicnmdand seam that the uWve infuriation is
� correct.I.,.a to comply with all city and county ordinanes and state laws relining
to Wilding ronnlmniaCand hereby authorize mpreun...ws mosis city to enter upon
the bo c m ironed l pony f inspectin PUHmses(Wel aB ee ms d nify and keep narml sine Ciy fCpcenosga Hsi
Z liabilite. judgments .t d xpenses h ch y in any sty gains andrJ.Z City nco seq ence of theg i th pc t PPLICANT UNDERST+ W ILL COMPLY WITH ALL' OM1 POINT oURCE REGu � Issued by' D
Signature of Pllc o as as .' - Dore _ Re-roofs
UR DO MATER IAT S DISCLOSURE'
°�.� c applicant or future b ilding occupant store or handle Hazardous materia Type of Roof
as deftidbythe Cupenoro Mmucipal Code Chapter 912 end the Health and Safety c r t ._ ... -.r.1 .,,,,....
Code Section 25532mr, i s ;_,l jr a i '' t i1�Y flsh i'I)11.5 �. t: tl;
❑Yea " , 1;'^.x?'i' Al] roofs shall.be.mspected pnor_to.any roofing.matenal.being.installed.
Will the applicant or nnebuilding occupant use equipment or deviceswhich If a roof is insiailed without first obtaining an inspection; I'agreeto remove
emu awr t t
District' ,ti n a defined by the Bay Area Air Quality Management
California Hearth - ,all new materials for inspection. Applicant understands and will comply with
-
13 Yes �' � -" all non=pointsourc' Pagans i; ,❑ ,,. • y
I'eventual th hazardou renals requirements a der Chapter fi 95 of the \^/
&Safety Code Sect ons 25505 25533 and 25534 1 understand that _Y �
o, tenant,ethato mY po.'blrymnou(ythe - -i� " .
cr, building o(iheeC t t.twhi h mu't b' _ t i rm is an of Certurram of k `
B
cao ant p
Is
re of Applicant
er Poutsg
gent Data All roof coverings to be Class"B"of better `
.. ... _. _.---OFFICE- -- - .. __._ -. . . ... _._._.. .. . .. ___ .... . .... . ..
Building Division
10300 Torn Avenue.
1 . Cupertino,CA 95014-3255
Telephone: (408)777-3228
Fax: (408)777-3333
CUPERTINO
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 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 poli`
Homeowners Name:
Address: fJ
Reroofing Company Name:
Applicants Signature: .Date: � 3�
Joe Antonucci .
(Chief Building Official)
6/25/01