01050164 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADURISSS: FERMI F NO,
CRAFTSMEN ROOFING .CO 010501.64
OW NIiR'S NAME: APPLICATION SUI]FEWTH
=' DENTWOOD DR 05/22/2001
'HONE: SANITARY NO. CONTROL N0.d5•-s
n ce Z ARCHITIiCI'/FNGINGIdL — —— BUILDING PERMIT INFO
O O BLDG r:LECr PLUMB MECII
u� IJ IBJ �I 1.I
?N
accostucDN'runcrausDra.nRnTlo� Job Description
z�& 1 "'chy a1&at dmf m,.Bcunad under nrovidaas orCh,avr 9 a1roar name
wnn swv.,ion rata. ortne euainesn.an rr wa.awn
is in roll force an cl eym �j
x a Liacnne Gla,.. ( x _ ,SHAKE TO 'SHRKE•-_
ice
Date ne•Y_ Con yr.t
1 understand my plans>hall he uud as s n ofd.
S
OO LiccnmJ Pndcs.ianal
OWRE n c,ca d fear,
UIiCe C raON
I ode( u(See thin 1 1 enema.from the,trown,Code:
A. d Law for the
se ZLx C whichlow ng rennin, anent l 9onstr. t.almd, and Pe,d n ioli Calc:Any city ur mmoe
w,F 2 poor
h q parent l construct. tlm pr d alis) cP' any structurducarent
a 3 p r . e.alsoto a applicant f b penniu iv Lav, swmment
- .huh Ic JlSc t. th p con' Ithe C Fd,ar L Lav, Sy. Ft. Floor Area Valuation
or that be is a with Sccua:t om and
he basis 3 of the B alleged
ex and Proion.An va CoJal
or he is 31.5 b.therefrom and or basis 1'ar the bj ct%the exception.Anyil penalty _ u : ,$11. 150..
of Section](Uan v anyupalicall roc$Penni.sunjens the applicant.00civil penalty
areanone lh:,nBvunamlreddouar,fss(en. APN Number Occupancy Type
01.as ownernf.he fardl .or nryanployceswltb wagesas theirsolc annacnmtion, O^ e 7 .
will do the work,and.he structure is not intended or offered for sale(Sec.v(w, Required Inspections
Ba,oress and 11 Id..tiatta Calc:The Coawemr'a Li cdoc law doss nut apply to as y P
of property Who huild.or ilnprovev bercon.and who docs such work ona,clf
or through his own employee..provided that such impmremems arc not intended or 2,05 — FRAME
offered for sale.If,however.the budding or improvement in wild within one year of
nnplelion.me owner-builder will roe nunlen or proving that he did not bndd or - 307 — T1,1131-11
improve far purpose of a:de.).
cooEl as owner did of the
e,property.am eu,nor,ety ttmtrecting with lice:)ed Tire
iCoarracontractors as
601 —ROOF TEAR OFF
maruetma pojeel(scot apply toa.toher o and Pmfmhonvilds oOTheors tra.u:N 602-'- ,.ROQF—PLYWOOD NAIL. ;'..
-.
andwhcotacaforsucmanownwthaclenywhanaddaarimpnwewtntothe ROOF RATT.ENS
and who amtneu for such pmjces with a amtracasrts)licensed purauam us.he 6Q13 >—
Conorlox.vicenael.aw. B rchtrmkareason 604 — ROOF IN—PROGRF_SSv.-
❑Imte til wcr Sec. .
Owner Data
U ad
WORKi!R'S CQMPENSACION UECIARA(ION '
I berehy affirm under pcnal.y of perjury one of the I ollox,ng deslam.....
0 1 have un I will maintain n C,aodi,ac of Cunscn, to self-insure Ibr Wader's
Congwnsation, as pruvlJb fur by Section 3700 of the Labor Calc, lin the
performance of the work for which this pemtit is issued.
Cl 1 hnvc:mo will nmimnin Worker',C...nodwfwn Inwraace,as req limd by Section FIM AL-E�
3700 of the labor Code.for the pedarmance of the work ha which this potion is -
issued.M1iv e%�C-�p¢cmation Insurance carrier and Policy rolidw
Clerier: C141NiCAl'O GEEXoIfi,y `ONI WGRKERS' MAY 2 9 2001 .
COMPIiNSAT10N INSURANCE
(This.vection need nut he etmsplmed if the pcnnit is lin Inc hundred dollars S v 1'1L•p'NG
(SIW)or leo.)
1 cedlly Dat in the pertnnweac of the work for which this pcnnit is isowd,1
shall not empty any poson in tiny manner au as ,,Isse, a object m the Wader,
Comper,omn taws of Califomio.Date
Applicant
N(1 fICE 1'()APPLICANT:11,11nr ankh,do,Cor.iBcate of lixcntolon,you should
hecomc sunjucW
t.o e Worker'..Cuntpensatlnn provixion.of the Labor Cora yaA
o wa.
hwi.h
Q O foncomply with such Provisions or this pennd shad be deemed revoked.
F zICONSTRUCT ION I.ENDING AGENCY
Z > '1 thereby atfimt low here is a conaaunion lending.gamy bridle peofannanee
n[the work for which.his permit is issued(Sec.30TT.Civ.C.)
1 L Le let,N
LD Z Lender's Address
U 0 I cerily that l have read this application and state that the above information is
W F., a rmnt.I ngme o congtly with Idl city and county onfinxmvs and state laws mining
sr0C.1 mh Id ret
gc t JI reby truth e I t rc'' fth'. t,1 m,upun
w� , .h 1he . ed p apes]f inspection a rpt,v
96 (WO'go,con dod.indsord, adoapl I .;-th C.y 1 Ctilditiorripitilt
h I`.1 It j ri .: t. 1 ' h .y troy Y tete age ms:iJ
U Z C ty c cyuc nc f th gm Bing oft v C C✓/ iY
APPLI URD RSTA\USAN COM ,Y WITH ALf/$NPOI Issued by: Date
RLGU .TIONS,
s. phcen nate Re-roofs
'ARra S MAIIRIAIS DISCLOSURE
uwudmapplicam or boon Eallndng tncaaam more ar nanme nu,traaaa tna.ethw Type of Roof
an defined by the
Culwnina Monidpal Cade.Chaps¢9.12,and the Heullh inn Safety
Ctale. a Ven 25532(ul' 0 Na
All roofs shall be inspected prior to any roofing material being installed.
win the applicant orrwareasldmgoccupant use equipneatordes ices which If a roof is installed without first obtaining an inspection, I agree to remove
or,bomrdous air etma
.m0mm
ins dehA.nad by the tiny AAir Quality Management
all new materials for inspection. A cant understands and will comply with
ElYea ❑No all non-pq ret source regulations.
OF 1 have mind the broarduux matariuls mairm rrcma under Chapter 6.95 of the
Califnmiu Iledth iv snfaty Cuda Seatlon.25505.25531 and YSSA. undvstunJ.hut
it the bullJing Jnca all enrrcndy huvc a lona bol 11 ie toy rcxPonsibility¢t nosily me
occupant tl K
t wni mu c.prior i...uaprwnl'a enllica of "Occup vA. nat o Ap Icant D to
D a Cartelo All roof coverings to be Class `B" or better
OFFICE