03030051 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT �cdNTRA.GTax 1VkjU.,iVtjt�'I'IO._ ;<
BUILOPIG ADDRESS: WINTER ROOFING INC PERMIT No.
1996S PRENnA 17T
OWNER'S NAME: 151 WYANDOTTE DR PeRnI,IT� A
BRENDA CT. HOA
E. 4083638052 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDO ELECTPLUMB MECH
0 0 E!
30o
LICENSED CONTRACTORS DECLARATION Job Description
1 hareby.fflrm that 1 sum Ikerued under provisions;of Chapecr 9(commencing _ .
with Section 70(0)mfDivtslon 3 of the Bualness and Professimn Code..ndmy license 4
n in full to=and eRecQ REROOF
License Clues —34_ue.0
Dam�cxnecr°soF%cuR ;tIRUIISI REMOVE WOOD SHAKES, �N'T� LI a1 �SB & 30 YR. . CO
1 unde .nd my plan shall be used public records u, !1"7-as
mu
Licensed PnrRullon.
It
b LicensedOWNER-BUILDRRDECLARATION - MAY O S 2003
.�r E 1 hereby affirm that 1 em exempt from the Contractor's License law for the
02 following reason.(Section 7(131.3,Business and Professium Cale:Any city or county
a which requires a permit to conshmcl,alter,improve,demolish.a repair any "cuss
Sri prim in its Issuance,also requires the applicant fonueh permit to file a signed statement
g < uwhciauansedparaaanttodoeprovtsionnfuhecontncmrtLmaseLaw(Chmta9 Sq.Ft.Floor Area ' Valuation
�y O (commencing with Section 7000)of Division 3 of the Business and Profession Code)or '
3 Nat he is exempt dominant and the buts for the alleged exemption.Any violation of
Section 7031.5 by airy applicant for a permit subjects the apptcaut to a civil penalty of APN Number Occu ane
not mon In.0w hundred dollars(5500).
01,uownerofthe properly,ormyemployca with wage utheb sok compennlion, 36943004 . 00
wllldothaworkandbesuuetumismilnundedao@redfw$Wc(See.704/,Bwimal Required Inspections
and Probssian Code:The Cmmxcm License Law does out apply b an owner M 9 P
propenywho builds or improves theman,and whoduesauch wart hlmelre,trough h0 305 - FRAME
own employee,provided thatsuch improvements are,not Intended mattered fm Na If, 307 - INSULATION
however,the building or improvement Is within one year ofcompledon,the owner
builder will have the burden or proving tut he did not build a improve for purpose of 601 - ROOF TEAR OFF -
01. 602 - ROOF PLYWOOD NAIL
co a e owner ej ct properly,atm s and contesting with limnedonnv.cmn lo
wmtmct Ne projem(sec.Tae.Business.na ltaressian Code:)The Contractor's U. 603 - ROOF BATTENS
ceme law does not pply to an owner of Property who builds or improve thereon.and, 604 — ROOF IN-PROGRESS
who contracts for such project,with aeontnctm0)licensed ponwnt b the Comnctorl '
License Law.
❑I am exempt under Sea ,B k P C for this prison
Dwam Data
7�370WORKER'S COMPENSATION DECLARATION
1 hereby all under penalty of perjury aro of the following declarations:
Is w and will maintain•Ccrdnmw ofComent to wlf-lnsum for Warkees Compere
11
n,m provided for by Section 3700 of the Mbar Code,for the performnhca of the
rahich this permit is issued.
hawand will mainWn Worker's Compensation Ins.,u required by Section
of the Labor Cat,for the performance of the work fm which this Permit is isstwd.
WarkW, Policy Na: DL
OMPE ATION INSURANCE WORKERS'
COMPENSATION INSURANCfl
(thlseetlon need not W completed lithe permit is brone hundred dailsn(SIM) _
Or lea) e
I certify that in the performance of the work for which this Permit is Wood,I shall not
employ any person in any manner sat as W become subject to the Workers Compensation
Laws of California.Date _
Applicant
Nonce TO APPLICANT:IL anor making thin Certificate of Exemption,you should
become subject to de, rker'
c Worker's Compensation provisions Of the Iahm Code.you am
0 Q forthwith comply with such pmvislnm or this permit Mall M deemed revoked.
r~yiCONSTRUCTION LENDING AGENCY
E+ I hereby afntm that Nen is a cmtsuuNnn tending agency for the Pon(.anm of
Ne work for which this permit is issued(See.3097,Co.C.)
I[1 Q Landers Name
ax Lender'snddw ..
U 0 I comfy that I have read this application and stsm N.t the ebow mfomMon Is - -
{fn Cartttl.I.jne b Comply with all city and county on it m m,and able Iowa relating b
0 buEdingconwuction,rad hereby totharin npreumWJWA Of Nis city to enter upon the
Lia aMw-mentimmd Imports for WimmUon purposes.
rWc)agree to ave,indemnify and hep ham less the City of Cupertino against
o-„[Al omoona,judgmenWca..and expenses which may in any my acme asaiml said City
r,7 in corequeme of the grunting of this IL -
F7 APPLI Nr UNDERSTAN A WILL COMPLY WITH ALL NON-POINT .Issued by: jate �ty�
Fi -,%
LA
"'fl Re-roofs
fAppl ✓C0 Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
ill to applicant or future building eccupanubre or handle harndons material
by the Cupertino Municipal Cade,Chapter 9.13.and the Health and Safety
cede.Section 25533(.)7 J ,, All roofs shall be inspected prior to any roofing material being installed.
Oyu
will um applicam or future bulliling Occupant tuc equipment at deWm which If a roof is installed without first obtaimp an inspection,I agree to remove
It hazardous air contaminant u recd by the Bay Ams Air Quality Management all new materials!or inspection.
Istricti
�Ye u
I hav pradtheharuNmsmaurialsnqui emu underChapmr6,95 ofthe Califon.
nla H.t myCode.Satiom255052553 25534.1 undesand ten lfOU Wilding
dma rue mently have a tenant. m ponalMllly in anify the acul ant of One
mqu tswhlo mhmbeen I to space,orIceruncamarOccupancy. Signal e f pplicant Date
ow r auN zW ager Dam I roof coverings to be Class"B"or better
! Community Development Department
c
Building Division
City of Cupertino
Aur.
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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) h1-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: ren' -5rc" -
Job Site Address:
Roofing Company Name: 1QZ1RA8 "
A plicant'sSignatu Date:4=14Z..U3
6
Greg eel
Building Official
Revised 1/30/03
Pdnted on Recycled Paper