The URL can be used to link to this page

05110127 (2) CITY OF CUPERTINO - ' �� ' '`�'"' BUILDING DIVISION PERMIT rL`C11Y2A.C`I �Y� , I:.�" BUILDING ADDRESS: BECKS ROOFING PERMIT NO.05110127 0165 Mr T.ARRN PT, OWNER'S NAME: PERMIT ISSUE DATE MARTIN ZIMMERMAN 6191 NE: SANRABY N0. CONTROL NO. (408) 365-8979 ARCHITECf7ENGINEER: BUILDING PERMIT INFO BLDG EIER PLUMB MECH jOz p LICENSED CONTRACTORS DECLARATION Job Description ltau I hereby Mm dm I am licensed under provisions of Chapter 9(cammencing P zz NthSmtim 70kR ofDiNAan]af the BuAncm+aM leaders my lleonsuis v= in tali forte mrui Off ! �q= I.ieana-�ue.� REROOF--T/O SHAK"a4 {�.5�, TALL COMP. Dale Gomr+eer i� TIECI-S DECLAcr undcrsuml my pWu,IWlhusetl apubllc mtorM eat. Licensed Profesdanal ' V�/V �N Oat I Am aUILDEN DECLARATION 2 Z Q I 1 hereby anirm that I exempt from the Cama,Co :A n c taw,far the ?00 p O which impatient moon.(Section 70313,Business aM ew.do Profession,Cade:Any oily or musty S 5$� which requirca•permit a construct.Wer.hnmaw,demWlN,m repair any suumumifft 0 print An its issuance.Also requires the applicant fer,uch permit a ilk a signed uaemcm G thathis licensed pursuant m the pmvislomaf the Conuectora Lin.taw Chapter Sq.Ft.Floor Area ` q Valuation �$ (commencingwith Section 7ODO)af Division Sof the Business and Professions Cade)or l+ly — Net h u exempt thmtrom and the buts for the alleged esempdo.My violWon of Section 7031.5 by any applicant for a pemlt mbjecu the applicant to civil pen+lty a( -AW MR-LTFM Occupancy Type not mom than Rte hundred dollars r$SOy. 0 1,an owner of Use property,or my employees with Amami As their Ole compensation. will do the whaL sed the swuntme is net im.&d or offered rat sain and Professions Cade:The Contemner,License Law deem an[•(pp y An AM'Business Required Inspections property who build,or improves tierean,and who does sash work himad f m through his ownemployees,provided that suck,imprownums Am natlmeMed oroRemd formle.If. hemsm,the building orimpmvement Is sold within am year afcompleuon,the owner- bulldar .will have One burden of proving that h did an,build or Improve for purpose W sale.). ❑1,an owner of the property,am exclusively contenting with limned comments to construct the project(Sec.7044.Business and Profecdons Code*The Cootracmra Li- cense Law does nm apply An an owner or property who build,or Improves thereon,ad who connects for such projecu with amnoamR,)licensed pursuant An the Charmers License taw. ❑I Am mempt under Be, .B&PC for this moron 11CIllyc ner Data WORKER'S COMPENSATION DECLARATION lley 1 hereby ARrm under penalty of perjury oro of the following declensions: 1 have and will Maintain a CaNRcam of Consent An self-insure for WorkeesCmnpcn- on,a provided for by Section 37M of dm labor Code.for the patient of Wm k far which this permit is issued. 1 have and will munsain Wober,Compensation bue rance,As required by Section 0 of Ne Labor Code,for the performanmof the work for which thn,PAA.(,,Is Armed er. m an insXEMPIION FRO n R EAS' COMPENSATION INSURANCE (This semlan need rot becampkmd If tie perch is farm hundred War,(3100) or Ica) I certify dont in the performance of On were far which this permit is Issued 1"I am employ any person in my manmrm As to became subject to the Workers'Compemtion Laws of California.Data Applicant NOTICE TO APPLICANT:If.Auer making Nis CCAHWAe of Eampdon,yon Waum became wbjm An the Wmkrs Compensation provisions of We labor Cade,you mm .J O faMw(th comply with such provisions or this permit AM deemed mwko. EC CONsmucnam LENDING AGENCY [+ Iherby affirm NU Nem is construction lending Agee for the performance of G' Newark for which thin permit is issued(Ste.3097.CN.C.) LQp Landers Name , 7 z Lnder,Mdma U O i modify that I haw mW this application W sum that the above Information Is LL,^ corms.l asam m comply MN AI city and county mdimrces and Nm rows reading e SV' Wilding construction.and hemby sumorim mpmsenudws of this city An mer upon de Gabow-mentioned property for inspection purposes a sa (Wc)agree w,indemnify and keep harmless the City of Cupenfna+gaunt tiIn IiabiliteLjudgmem,.coats and expenses which may In my way Accrue Against aid City V Z in corleegmnce of the granting of this Permit. APPLICANT UNDERSTANDS AND LL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REG 0 ' Re-roofsfodic.0 Signuam of A Dem HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building mcupantaom"handle Anomalous material u dcRmd by tiro Cupenia.Manic pal Code.Chapter 9.17,and the Health and Safety otic,section 2ss3u+)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yate Nu Will the applicant or future building Occupant um equipment at devlam which If a roof is installed without first obtaining an inspection,I agree to remove all Weardons air conuminsasa a dc0ucd by the Bay Arca Air Quality Management all new materials for inspection. Dimict7 ❑Yca u I have real thehaardausmaedal+requirements under Cham06.95 of the Califon nia Health&Safuy Code.Samios255D5.25533 wW25534.I undcrsmul thaifthe building does not currently have a sen Nat it u m Poa(bility a fy tie occupant of the requiremenawhich h pri e' ora Cc ' eo(Oc p Signature of Applicant Date Owner armma' to 4 All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue . Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �UPEI�TINO - Building Department JOB ADDRESS: / PERMIT#�// OWNER'S NAME: l PHONEC/# GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting • Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing c,-eN e.)S J' Septic Tank Sheet Metal Sheet Rock Tile z Owner/Contractor Signature Date Community Development Department Building Division JJ City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 U��I�O Fax: (408)777-3333 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) 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 a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. 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: Job Site Address: Roofing Company Name: Applicants Signature: Date: • Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper CITY OF CUPERTINO art-As REROOF 6 I1 ° / Z CUPEkTINO PERMIT APPLICATION FORM APN #3( / Z( e)j—zD Date:ZI Building Address: 6 (J Owner's Name: Phone#: w. C Phone#: � License#: Contact: , Phone#: D Cupertino Business License#: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles I Asphalt Shingles t(� Wood Shakes ❑ Wood Shakes Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ]� To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: 6 `' *o 5O Residential I Commer iall F-1 Fire Zone: /Yes ❑ No Confirmed with Planning Det. if there are any restrictions: LJ Cost of Project: , Type of Construct' Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING -2- s /�,? - 76 s /�,? - 76