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03080151 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT gCON RACTQR^INFrORMAT70N BUILDING ADDRESS: ABLE ROOFING INC. PERMIT NO 03080151 OWNER'S NAME; 6908-A SIERRA CT PERMIT LSSUE DATE 'NEE (925) 689-8558 SANITARY NO. CONTROL.NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT' PLUMB MECH ±Op LICENSED CONTRACfOR'SDECLARATION D D O I Ux P 1 hereby affirm that 1 am licsnaedaunder provisions Of Chapter 9(commencing Job Description o<� with Section o(Division 3 of th ness r csaipn Cp .e dmylicenssis .<�„ Lmnr /<77 REROOF/2 NEW SKYLIGHT 1 0 Licen�Llc'N F❑ Dap C``��Yd44[[e,,��r Eq A CHCC,$EECLARA 1 N 22 I understand my plans shall he used as public records 5-u Sod Licensed P...host...I " 5 OWNER-BUILDER DECLARATION <F 1 hereby affirm that 1 am exempt from the Contractors License Law for Nc 0O following nation.tSection 71131.5,Business and Profesainna Code:Any city ar county 2 which requires a permit to consumer,all,improve,demolish,or repair any structure priormiB natures,also requires the applicant forsuch permiuo rile a signed statement that he is licensed punuonun the provisima of the Contractors License Law(Chapter 9 Sq.Ft. Floor Area Valuation 2�'N (commencing with Section 7")of Division 3 of the Business and ProfessionsCode)or Q that he is exempt therefrom and Ne basis for the alleged exemption.Any violation of 37542021 . 0 _ Section 703ls by airy applicant for a permit subjects the applicant to a civil penalty or APN Number. ---- - . Occupancy Type._ not mom Nan Ova handled dollars($500). - "--' ""-' -—-- ❑1,u owner of the property,or my employees with wages as their sole compensation, will do the work.and to structure is not intended or offered for sale(Sm.IDaa.Business 305 - FRAME and Profession.Code:The Contractors License law does not apply to an owner of Required Inspections own enywho yees,rodded that vsuch improvements re mandwho doessuchwned imselfor fferedthrough his 301 - INSULATION ho empisyeesilding or i that such rat is sem within not ear oftlmplinied for owner. 6O1 — ROOF TEAR OFF however,the building or improvement i.sold within one year of completion,the owner. builder will have the burden of proving that he did not build or improve for puryose of 602 - ROOF PLYWOOD NAIL - [D1, 603 - ROOF BATTENS I,u owner of the property,,B exclusively contracting with licensed contractors to - winstrictNepmject(Sec..an Businessendrty,whionsdsoriprove.lacoomsLi 604 — ROOF IN-PROGRESS j cerise law coos not apply je an owner of property who builds or and to the Ncmrac and who nse Laca for such proleca with a contractors)licensed puravem m the Conuactoh License Law. ❑lam exempt under Sec. ,B&PCfor this..on - L� ., Owner Dam - �• i- WORKER'S COMPENSATION DECLARATION -- I hereby affirm under penalty of perjury one of Ne following declaratiora: I hi ve and will mainain a Ccnifiemi of C...enuo self-sorefor Wirkcr's Compem action,az provided for by Section 37Mif the Labor Code,for Ne performan¢of the work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 37M of the Labor Code,for Nc performance of the work for which this permit is issued. My orker's Com�rensasion lsuancec icr and Policy nu ram : 'er. Policy @o' G-L CERTIFICATED KEMPTION FROM RK s' COMPENSATION INSURANCE (fhisseclion need not M compineJ If the Permit is firoae hundred dollars(SI00) or less.) I certify that in the performance Of the work for which this permit is issued,l shall not employ any portion in any manner an as to became Subject la the Workers'Compensation Laws of California.Dam Applicant NOTICE TO APPLICAT:If,after making this Certificate of Exemption,you should become subject in the Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall M decreed mvnked. Z� CONSTRUCTION LENDING AGENCY I hereby affirm that there is a conswction lending agency for the performance of yi ,1 to work for which this permit is issued(Sec.3(191,Civ.C.) YQ Lender's Name Z Lender's Address J p 1 cenify that I have read this application and aam that Ne above information is Fcored.I agree to comply with all city and county ordinances and sale laws relating to 'U building construction,and hereby authorim representatives of this city to enter upon the a above-mentioned property for inspection porpoms. y (We)agree Ii,save,indemnify and keep harmless the City of Cupertino against N liabildies.judgments,costs and expenses which may in any way income aga;nnsiid City J Z in conaeyuenee of the granting of this permit. r-. APPLICANT RSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 5 UR IONS. � 46) Re-roofs 3r icanUContnclar b Dap HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will fie applicant tar(more building Occupant slam it handle havarduus material as&&held by the Cupenimo Muniuip ods,Chapter 9.12,and the Health and Safety Code,StictYeion 25532(x)? s All roofs shall be inspected prior to any roofing material being installed. ❑ Will the applicant or entire bio ing a spoor i egmpmem or devices which If a roof is installed without first obtaining an inspection,I agree to remove it hazardous air eonaminanu as msd by Ile Bay Arca Air Quality Management all new materials for inspection. trio? Yc. 62 1 have read the hazardous materials requirements under Chap erfi.95 of the Calirm, nia Health&Safety Code,SCedau 25505,25533 and 3553x.1 understand Nat if the building does not eureall cram that it is my mop bro bility to nobly the Occupant of the ' m uimn =itpdorwissuuremor.CeniNayif cc Policy u replicant Date 0 ..d agent Date All roof coverings to be Class"B"or better. Community Development Department Building Division City of Cupertino .+ ' 10300 Torre Avenue CITY OF Telephone: (408) 777-3228 IFU P E IST I N 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. 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 compI it the a ove stated policy re-roofin . Homeowner's Name: � Job Site Address: I L° Roofing Company Name: ObLe Applicant's Signature: Date: 62 • Greg teel Building Official Revised 1/30/03 Printed an Recycled Paper 1 CITY OF CUPERTINO 3 REROOF b CUPERTINO PERMIT APPLICATION FORM APN# r / Date: Building Address: L �` Owner's Name:r Phone#: w Contractor: Phone#: License#: S -- S/v a^/j Contact: k Phone#: Cupertino Business License#: Type of Roof Covering: Existin Proposed: Mt-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles F ❑ Other(Specify) C Other(Specify) 11J"t Number of existing coverings L3-Provide I.C.B.O.Report# F12 -y 3f, 13 To be Removed ❑ Provide Mfgr. Installation Specs. . I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: 070 Job Description: g t OW Sh � 1 0 C- S �'Ot k, ' S F6 Residential Commercial ❑ G Fire Zone: Yes ❑ No Confirmed with Planning Det. if there are anrestrictions: LI Cost of Projec Type of Cons t' Occupancy group: /SGoG S Qty. i A li a e Fee ID Fee Description Fee Grou 141) BPERMFEI- Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISIOIICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING